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PubMed1985

The growth of breast fed and artificially fed infants from birth to twelve months.

Growth data collected from 394 healthy infants were analysed in relation to feeding practices. Infants were grouped on the basis of sex, if breast fed or artificially fed, and duration of breast feeding. From birth to 3 months, weight gains were similar for boys (2.5 kg) and also for girls (2.3 kg) irrespective of feeding method. From 3 to 6 months weight gains were greater in infants who were artificially fed from birth (2.0 kg both sexes) or breast fed for only a short time (1.9 kg) than for those exclusively breast fed for 6 months (1.6 kg) or longer (1.7 kg). Weight gains continued to be greater in artificially fed infants after 6 months. Over 12 months, artificially fed boys gained 410 g and girls 750 g more than those who were breast fed from birth. These differences occurred even though the artificial feedings that prevailed to 6 months and longer were low-solute ('humanized') formulas.

Body Weight↗

PubMed1995

Health professionals and breastfeeding counseling: client and provider views.

Health care providers are the most influential and trusted source of information about breastfeeding, yet many are neither prepared nor able to provide good breastfeeding counseling to their clients. This paper reports findings on low-income mothers' and on providers' perceptions of professional breastfeeding counseling. Data collection included focus group discussions with mothers recruited from public health department clinics in the Southeast USA and who were stratified by age, parity, rural/urban residence and feeding method, and focus groups and individual interviews were conducted with health care providers from the same geographic area. The results of the study indicate a gap between the promotion and support processes for breastfeeding, and point to areas where breastfeeding counseling can be strengthened.

Attitude of Health Personnel↗

PubMed2006

The timing of complementary feeding of infants in Switzerland: compliance with the Swiss and the WHO guidelines.

BACKGROUND: The importance of adequate complementary feeding of infants is increasingly acknowledged. Little is known of the actual complementary feeding practices in Switzerland. AIM: To report the prevalence of adequate timing of complementary feeding, comparing the compliance to Swiss and World Health Organization (WHO) guidelines, and to investigate factors influencing infant complementary feeding. METHODS: In 2003 a cross-sectional study was conducted of mother-and-infant pairs in Switzerland. The mothers, randomly chosen by local community mother-and-child health services, completed a 24-h dietary recall questionnaire and reported the infant's age at the first introduction of various foods. Descriptive analysis, group testing and regression analysis of data collected were conducted. RESULTS: Introduction of solids mainly occurred between the 5th and 6th months. Five per cent of the mothers introduced complementary food before the age of 4 mo. The main influencing factors for infant feeding were maternal age, language regions, mother's BMI and smoking status, the presence of siblings, and an allergic predisposition of the infant. CONCLUSION: The timing of the introduction of complementary foods meets with Swiss guidelines. WHO recommendations, however, are not met. This may be due to a misunderstanding of the Swiss Paediatric Association's age-range recommendations or insufficient promotion of the WHO recommendations.

Adult↗

PubMedDate not supplied

Effect of feeding-tube properties on residual volume measurements in tube-fed patients.

BACKGROUND: The effect of feeding tube size and port configuration on the ability to measure gastric residual volume (GRV) is poorly understood. In addition, there is confusion about the need to measure GRVs during feedings into the small bowel. This study sought to (1) compare the volume of gastric contents obtained from small-diameter feeding tubes and large-diameter sump tubes concurrently positioned in the stomach and (2) describe the distribution of GRVs during small-bowel feedings. METHODS: For the first objective, GRV measurements were made from 10-Fr tubes (n = 645) and 14-Fr or 18-Fr sump tubes (n = 645) concurrently present in 62 critically ill patients. Sixty-milliliter syringes were used to measure GRVs from the 10-Fr tubes; the fluid was returned to the stomach and measurements were repeated from the large-diameter sump tubes. To address the second research objective, 890 GRV measurements were made from 14-Fr or 18-Fr gastric sump tubes (not connected to suction) in 75 critically ill patients who were receiving small-bowel feedings. RESULTS: When GRVs were >50 mL, a linear regression equation indicated that volumes obtained from the large-diameter sump tubes were about 1.5 times greater than those obtained from the small-diameter tubes concurrently present in the stomach, p < .001. Gastric volumes > or =100 mL were found in 11.6% of the 890 measurements made in patients receiving small-bowel feedings; volumes > or =150 mL were found in 5.4% of the measurements. CONCLUSIONS: The findings suggest that GRVs obtained from large-diameter sump tubes are about 1.5 times greater than those obtained from 10-Fr tubes. Large GRVs occur in at least 5% of patients receiving postpyloric feedings.

Adolescent↗

PubMedDate not supplied

A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique.

BACKGROUND: Benefits of enteral feeding are diminished by aspiration pneumonia and mechanical complications of misplaced feeding tubes. To avoid complications, clinicians determine the location of the tip before feeding. This study compares diagnostic test characteristics of 4 techniques for tip localization. METHODS: A prospective, blinded trial was conducted on the wards and critical care units of four acute-care hospitals. Patients requiring at least 3 days of enteral feeding were studied. Four observers at each institution used a randomly assigned technique to determine a tube's tip location. Methods included auscultation, aspiration with inspection or pH determination of aspirated material, and a recently developed electromagnetic technique. Results were compared with radiographic determination. Success rates were compared using sensitivity, specificity, and likelihood ratios. RESULTS: The 4 methods agreed with the radiograph in (mean, 95% confidence interval): 84 (80 to 88)%, 50 (45 to 55)%, 56 (51 to 61)%, and 76 (72 to 81)% of observations, respectively. Only the electromagnetic method and aspiration identified all tubes located above the diaphragm (negative likelihood ratio 0 and sensitivity 100%). Aspiration was unsuccessful in making a determination in 53% of the observations, whereas the electromagnetic method was successful 90% of the time.

Adolescent↗

PubMed2000

Endothelins, their receptors, and retinal vascular dysfunction in galactose-fed rats.

PURPOSE: Endothelins are potent vasoactive factors that have been implicated in the pathogenesis of several vascular disorders. This study was conducted to determine the role that endothelins play in the development of retinal microangiopathy under hyperhexosemic conditions induced by galactose feeding. METHODS: Retinal blood flow was determined using Doppler sonography in galactose fed rats with or without an endothelin receptor antagonist (Bosentan) treatment and were compared to control rats after 1 and 6 months of follow-up. Levels of endothelin-1, endothelin-3, (ET-1, ET3) and receptors endothelin A, endothelin B, (ET(A), ET(B)) mRNA expression were determined by semiquantitative RT-PCR. Immunohistochemical distribution of ET-1 and ET-3, ligand binding, and autoradiography to determine ET receptor distribution were carried out. RESULTS: Retinal vasoconstriction measured by an increase in resistivity index (RI) was present in 1 month galactose feeding compared to controls, which was prevented by Bosentan treatment. After 6 months of follow up all animal groups exhibited higher RI compared to their 1 month counterpart, although they were not different from each other. Compared to the controls, after 1 month levels of mRNA for ET-1, ET-3, and ET(A) were increased in galactose-fed rats, whereas ET(B) mRNA production remained similar to controls. After 6 months, all four genes exhibited increased levels compared to the controls, and no effect of Bosentan treatment on gene expression was evident. Increased immunoreactivity of ET-1 and ET-3 was determined, as well as increased ET receptor concentration was further present in the retina of galactose-fed animals. CONCLUSION: The data suggests that endothelin production is increased under hyperhexosemic conditions and that the endothelins play an important role in regulating the hemodynamics of retinal blood flow.

Animals↗

PubMed2003

Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland.

Northern Ireland has one of the lowest breastfeeding initiation rates in the world. Given that attitudes toward infant feeding are formed at an early age and a high rate of teenage pregnancy, it has become necessary to survey attitudes to infant feeding and breastfeeding promotion preferences in teenagers in Northern Ireland. Questionnaires were distributed to teenagers aged 14 to 18 years (n = 419) based in 7 schools selected by type and location throughout Northern Ireland. Attitudes to breastfeeding in public reflected preferred infant-feeding method and were positively influenced by prior exposure to breastfeeding (P = .024). Females were more positive than males both in relation to breastfeeding in public (P = .002) and breastfeeding promotion (P = .003). Recommendations for breastfeeding promotion include specific targeting of young people (both male and female) and enabling contact between teenagers and nursing mothers as much as possible.

Adolescent↗

PubMed2001

Battering and breastfeeding in a WIC population.

The study reported in this paper was based on the hypothesis that women who are victims of domestic violence may be less likely to select breastfeeding than women who are not abused. Informed consent was obtained from 212 women at 2 Women, Infants and Children (WIC) Nutritional Supplemental Program clinics in the Midwestern United States. The Abuse Assessment Screen was administered by interview and women were also questioned about intended feeding choice and whether they had breastfed any previous children. No association was found between present or previous abuse and infant-feeding choice. Nevertheless, the findings of this study can be considered important, for two reasons: (1) this was an initial inquiry examining the relationship between having been abused and ability to choose the feeding method of a newborn; and (2) women in the sample who reported present or current abuse were able to breastfeed their infants in the same proportion as those who did not report abuse, which suggests that a woman's concern for her child overcomes her possible fears of control by the batterer.

Adult↗

PubMedDate not supplied

Breastfeeding: how could it be enhanced? The perceptions of Vietnamese women in Sydney, Australia.

In Australia, the prevalence and duration of breastfeeding is on the decline. The low incidence of breastfeeding includes the immigrant Vietnamese. The purpose of this study was to examine Vietnamese women's perceptions of factors that might influence their choice of infant feeding and how breastfeeding could be promoted and maintained by nurses, midwives, other health professionals, and the health care system as a whole. A convenience sample of 124 postnatal Vietnamese women from community agencies in western and southwestern suburbs of Sydney was interviewed. Content analysis showed that factors that affect their choice of infant feeding method were language difficulties in communicating with health professionals concerning breastfeeding, lack of social support and follow-up care, and attitudes of health professionals toward breastfeeding. To promote and maintain breastfeeding within the Vietnamese community in Sydney, Australia, appropriate health care planning and implementation based on their social, cultural, and language backgrounds and practices need to be considered.

Adolescent↗

PubMed2003

Evaluation of an occupational injury intervention among Wisconsin dairy farmers.

OBJECTIVES: Dairy farming injury rates are high. Previous agricultural research has shown that better information flow can speed adoption of more profitable practices. We conducted and evaluated an intervention to increase voluntary adoption of three production practices that were safer and more profitable than typical practices: barn lights, bag silos, and a mixing site for calf feed. METHODS: Print mass media, public events, university Extension, and dairy farmers already using the practices were all enlisted to disseminate information to 4,300 northeast district Wisconsin dairy farmers. Evaluation questionnaires were mailed to independent samples of farm managers before (n = 582) and after (n = 572) the 12 month long intervention. RESULTS: After the intervention, more managers reported getting information about barn lights from public events (12% vs. 23%) and private consultants (8% vs. 17%) and about silo bags from print media (79% vs. 87%) and private consultants (9% vs. 14%). More managers were aware of barn lights (48% vs. 72%) and the calf feed mixing site (44% vs. 56%). There was a nonsignificant tendency for more managers to report adopting barn lights (12% vs. 23%). CONCLUSIONS: Improving information flow to operation managers about safer, more profitable production practices may be a relatively easy way to supplement conventional injury control efforts in high-hazard industries.

Accidents, Occupational↗

PubMed2002

Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening.

BACKGROUND & AIMS: We evaluated the effect of a novel rehabilitative exercise on restoration of deglutition in a group of patients with deglutitive failure caused by abnormal upper esophageal sphincter (UES) opening manifested by postswallow residue and aspiration necessitating percutaneous tube feeding. METHODS: We studied a total of 27 patients by videofluoroscopy and functional assessment of swallowing scores before and after 6 weeks of a head-raising exercise program. Seven of 27 patients, assigned randomly, participated in a sham exercise before entering the tested exercise program. Eleven of 27 were randomized to the real exercise program. RESULTS: Although there was no change in swallow function and biomechanics after the sham exercise, following 6 weeks of real exercise, all 11 patients exhibited a significant improvement in their UES opening, anterior laryngeal excursion (P < 0.01), as well as resolution of postdeglutitive aspiration and were able to resume oral feeding. Similar results were found when the 7 patients in the sham group were crossed over to the real exercise group. Comparison of before and after exercise values for anteroposterior UES opening (P < 0.01) and laryngeal anterior excursion (P < 0.05), as well as functional outcome assessment of swallowing (P < 0.05) in the entire group of 27 patients also showed significant improvement. Etiology and duration of dysphagia did not affect the outcome. CONCLUSIONS: The proposed suprahyoid muscle strengthening exercise program is effective in restoring oral feeding in some patients with deglutitive failure because of abnormal UES opening.

Aged↗

PubMed1983

Effect of feeding regimens on the functional recovery of pancreatic enzymes in postnatally malnourished weanling rats.

Malnutrition was induced in the immediate postnatal period by expanding newborn litters to 20 rat pups/dam. The reversibility of the effects of malnutrition on the pancreas was evaluated by comparing two different feeding methods. At 21 days of age, pups from the expanded litters exhibited significantly decreased body (P less than 0.0005) and pancreatic (P less than 0.0025) weights as compared to those from control litters (12 pups/dam). Malnourished pups also had less contents of amylase (P less than 0.01), lipase (P less than 0.0005) and trypsinogen (P less than 0.0025) in their pancreases. The concentrations (specific activities) of amylase (P less than 0.05) and lipase (P less than 0.0125) were significantly decreased but trypsinogen (P less than 0.35) was not affected. Subsequent nutritional rehabilitation by an ad libitum (food available 24 h/day) or restricted (food available 2 h/day) feeding regimen failed to allow for "catch-up" in body (P less than 0.025) and pancreatic weight (P less than 0.05) by 56 days of life. With ad libitum feedings, enzyme contents and concentrations of amylase and lipase in malnourished animals attained control values by 7 and 14 days, respectively. Restricted feedings, however, delayed the recovery in amylase by an additional 7 days but lipase remained depressed in both content, (P less than 0.005) and specific activity (P less than 0.0025) for the duration of the experiment (56 days). Changes in pancreatic enzymes in response to malnutrition are readily reversible with ad libitum feedings but changes in somatic and pancreatic weights were not reversed.(ABSTRACT TRUNCATED AT 250 WORDS)

Amylases↗

PubMed1996

The 'new' risk factors for SIDS: is there an association with the ethnic and place of birth differences in incidence in Victoria, Australia?

Home interviews and assessments of infant development were carried out in a project examining the family environments of four groups of women and their infants with different risks of sudden infant death syndrome (SIDS): a reference group of 200 Australian-born (Anglo-Celtic) women (SIDS incidence, 2.04/1000), 101 women born in Asia (0.97/1000) and 56 women born in Southern Europe (0.58/1000) whose infants have a very low risk of SIDS and 102 women who chose to give birth at home whose infants have a high risk of SIDS (8.9/1000). As these differences are not explained by the classic social and perinatal risk factors, it was possible that they might be attributable to the 'new' risk factors: prone sleeping position, not fully breast feeding, exposure to cigarette smoke and bed sharing. Analysis of the data did not show this expected association: there were no significant differences between the groups in the use of the prone position; although only two Asian-born women smoked, infant exposure to cigarette smoke was similar in the other three groups; choice of infant feeding method did not fit the expected pattern--homebirth infants were fully breast fed almost exclusively while this was so for only about 50% of infants in both low risk groups; more than 50% of homebirth families slept with their infants, but bed sharing was also significantly more common in the Asian-born group than in the reference group.

Asia↗

PubMed1996

Low density lipoproteins (LDL) heterogeneity and intravenous fat in neonates.

BACKGROUND: The properties of iv-fat emulsions are similar to those of triglyceride-rich plasma lipoproteins and rapidly hydrolyzed by lipoprotein lipase. Neonates frequently do not tolerate iv-fat because of low levels of the key enzymes for fat metabolism. PURPOSE OF THE STUDY: We examined the effect of iv-fat therapy on LDL subclass distribution of 20 neonates unable to tolerate enteral feeding. METHODS: Particle size was determined by non-denaturing gradient gel electrophoresis. RESULTS: The LDL size distribution profiles at baseline showed unexpected diversity in the position of the major lipoprotein peak with three different profiles identified by peak position; profile I with a major peak of large-sized LDL (26.3-28.2 nm), profile II with a major peak at 25.2-26.7 nm and profile III with a major peak of small-sized particles (24.9-25.6 nm). None of the profiles fit the classical LDL pattern A or B found in adult plasma since the skewness associated with the adult pattern was not present. With iv fat feeding and enteral nutrition, no major shift in peak position was observed, even though plasma triglyceride and apo B concentrations increased suggesting that there was an increased number of LDL particles rather than an increase in the size of particles. CONCLUSION: The constancy of the LDL peak position in the face of increases in plasma triglyceride and apo B concentrations during iv fat and the onset of enteral nutrition in neonates suggests that other metabolic events, such as hormone status and lipid and transfer protein activities need to be considered.

Adult↗

PubMed1999

Identification of risk factors for delayed onset of lactation.

OBJECTIVE: To identify infant feeding, socioeconomic, demographic, and delivery-related factors that affect women's self-reported timing of the onset of lactation. DESIGN: Longitudinal survey of women from day 1 postpartum until self-reported onset of lactation. Subjects were interviewed in person on day 1 postpartum, then surveyed daily by telephone regarding infant feeding method, breast symptoms, and perception of whether the onset of lactation had occurred. Medical records were reviewed. SUBJECTS/SETTING: Data were collected from 192 women after they gave birth to a healthy, term singleton. STATISTICAL ANALYSES PERFORMED: chi 2 Analyses were used to identify variables associated with delayed onset of lactation (onset of lactation > or = 72 hours postpartum). Multivariate logistic regression was used to identify the independent association of each significant variable with delayed onset of lactation. RESULTS: Risk factors for delayed onset of lactation included white/Hispanic ethnicity, heavy/obese body build, delivery of offspring by unscheduled cesarean delivery, vaginal delivery with prolonged stage 2 labor, infant birth weight less than 8 lb, and exclusive formula-feeding before the onset of lactation. APPLICATIONS/CONCLUSIONS: Women who are at risk for delayed onset of lactation need additional breast-feeding support during the first week postpartum. During their hospitalization, these women should be instructed about the normal lactation process and the possibility that onset of lactation may occur later than 72 hours postpartum. Frequent nursing should be recommended, as delayed onset of lactation was associated with the lack of infant suckling.

Adult↗

PubMed1980

Reversible stabilization of liver lysosomes by zinc ions.

The effect of zinc ions on the stability of rat liver lysosomes was studied. Zinc was added by several methods: feeding the animals a high-zinc diet; infusion of zinc into the liver through the portal vein, or by adding zinc to the lysosomal fraction either before or after isolation of this fraction from rat liver homogenates. By all techniques, addition of zinc reduced the release of beta-glucuronidase from liver lysosomes. Lysosomes and lysosomal membranes from rats fed a high-zinc diet were found to be relatively high in zinc. These lysosomes were less fragile than lysosomes from the liver of control animals. The stabilizing effect of zinc ions could be reversed by treatment of lysosomes with phosphate buffer. We concluded that increasing the zinc content in the liver by any of these methods results in stabilization of liver lysosomes.

Animals↗

PubMed1998

Intestinal flora in breast- and bottle-fed infants.

We verified whether an adapted formula, which presents poly-oligosaccharides containing maltose, promotes intestinal implantation of bacterial microflora to the extent that breast milk does, as an epidemiological link exists between newborn feeding methods and infant health. Stool specimens were taken and cultured at the fourth day of life from vaginally born neonates. Twenty-two were breast-fed and 20 were fed with formula. In breast-fed infants, the Bifidobacterium was significantly prevalent expressed in percentage (47.6% vs 15%) and in mean bacterial fecal counts/g (7.1 +/- 0.8 vs 5.3 +/- 0.6). Enterococci prevailed in formula-fed infants (mean counts 6.7 +/- 0.9 vs 7.4 +/- 0.5). Of interest is the significant and simultaneous presence of Bifidobacteria and Bacteroides in breast-fed infants. Our study indicates that flora with a diet-dependent pattern is present from the fourth day of life. These results support a preference for breast feeding over formula feeding, even though renewed.

Bacteriological Techniques↗

PubMed1999

Use of backrest elevation in critical care: a pilot study.

BACKGROUND: Use of lower backrest positions occurs frequently and is a factor in the development of ventilator-associated pneumonia. OBJECTIVES: To determine the usual bed elevation and backrest position in a medical intensive care unit and their relationship to hemodynamic status and enteral feeding. METHODS: Data were collected in a 12-bed medical respiratory intensive care unit for 2 months. A protractor was used to measure the elevation of the head of the bed. Hemodynamic status was defined by systolic, diastolic, and mean arterial blood pressure measurements retrieved from each patient's flow sheet. RESULTS: The sample included 347 measurements of 52 patients. Mean backrest elevation was 22.9 degrees, and 86% of patients were supine. Backrest position differed significantly (P = .005) among nursing shifts (days, evenings, nights) but not for systolic (r = -0.04, P = .49), diastolic (r = 0.01, P = .83), or mean arterial blood pressure (r = -0.01, P = .84). Backrest elevation did not differ significantly between patients who were receiving enteral feedings and patients who were not (P = .23) or between patients receiving intermittent versus continuous nutrition (P = .22). CONCLUSIONS: Use of higher levels of backrest elevation (> or = 30 degrees) is minimal and is not related to use of enteral feeding or to hemodynamic status. The rationale for using lower backrest positions for critically ill patients may be based on convenience, the patient's comfort, or usual patterns in the unit. However, the dangers of supine positioning and its relationship to aspiration and ventilator-associated pneumonia should not be minimized.

Critical Care↗