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PubMed1987

Developmental intervention for low birth weight infants: improved early development outcome.

This prospective longitudinal study was designed to evaluate the effects of a multidisciplinary infant development program (IDP) on the mental and physical development of low birth weight infants (less than 1,800 g). Infants in the neonatal intensive care were randomly assigned to the IDP or to traditional care (control group). IDP infants received developmental interventions in the hospital and at home through the first 2 years of life. Counseling and parenting education were provided to their parents during this same period. The control group received all the postnatal care and referrals customarily given in traditional care. Both IDP and control infants were enrolled in an independent follow-up program, which used the Bayley Scales of Infant Development in a blind evaluation design. The IDP group had a significantly lower incidence of developmental delay (P less than .05) and scored significantly higher than the control group (P less than .05) on mean mental and physical indices at 12 and 24 months of adjusted age.

Counseling↗
PubMed1995

Duration of oxygen therapy and exchange transfusion as risk factors associated with retinopathy of prematurity in very low birthweight infants.

One hundred and thirteen consecutive infants with a very low birthweight of less than 1500 g were followed prospectively for 6 months to determine the incidence of retinopathy of prematurity (ROP) and associated risk factors. Of this group, 36 (31.9%) infants developed ROP (13 infants had stage 1 ROP, nine had stage 2, six had stage 3, six had stage 4, and two had cicatricial stage ROP). Stepwise logistic regression analysis of various potential risk factors (birthweight, gestation, duration of oxygen therapy, duration of ventilation, highest documented PaO2 and exchange transfusion) showed that only two risk factors were significantly associated with the development of ROP. These risk factors were: the duration of oxygen therapy (p = 0.0005) and exchange transfusion during the neonatal period (odds ratio 5.754, 95% confidence interval 1.002 to 32.997, p = 0.049). The equation of the regression model is: log (odds of developing ROP) = -0.8395 + 0.1447 (OXY)- 0.8750 (ET), where OXY is the duration of oxygen therapy in days, ET = -1 when there was a history of exchange transfusion, and ET = 1 when there was no history of exchange transfusion.

Exchange Transfusion, Whole Blood↗
PubMed2000

Influence of timing and dose of thyroid hormone replacement on development in infants with congenital hypothyroidism.

OBJECTIVES: To test whether early treatment with a high initial dose of levothyroxine can prevent suboptimal mental development in all neonates with congenital hypothyroidism (CH). STUDY DESIGN: Sixty-one patients, 27 with severe CH and 34 with mild CH, were treated either early (<13 days) or late (> or =13 days) with either a high initial dose of levothyroxine (> or =9.5 microg/kg/d) or a low initial dose (<9.5 microg/kg/d). With these criteria, 4 treatment groups were formed. The results of the Bayley test, performed at the age of 10 to 30 months and expressed as mental developmental index (MDI) and psychomotor developmental index (PDI), were related to socioeconomic status, treatment group, initial free thyroxine (FT(4)) concentration, and mean FT(4) concentration during the first 3 months of treatment (FT(4)-A) and the ensuing 9 months (FT(4)-B). RESULTS: Mean (+/- SD) MDI was 113 +/- 14, and mean PDI was 114 +/- 12. In the severe CH group, only the patients treated early with a high initial dose had normal MDI scores (124 +/- 16), whereas the scores of the other groups ranged from 97 to 103. In contrast, all patients in the mild CH group had normal scores (range, 122-125), except those in the group treated late with a low initial dose, whose score was 110 +/- 10. Forty-three percent of the variance in MDI and PDI scores was explained by treatment factors, such as the treatment group, initial FT(4) concentration, FT(4)-A, and FT(4)-B. CONCLUSIONS: Our data suggest that optimal treatment includes achievement of euthyroidism before the third week of life by initiation of therapy before 13 days with a levothyroxine dose above 9.5 microg/kg/d and maintenance of FT(4) concentrations in the upper normal range during the first year. Thus treated, patients with CH can achieve normal psychomotor development at 10 to 30 months, irrespective of the severity of the disease.

Child Development↗
PubMed2006

Infant motor development is associated with adult cognitive categorisation in a longitudinal birth cohort study.

BACKGROUND: The relationship between the age of reaching infant developmental milestones and later intellectual function within the normal population remains unresolved. We hypothesised that the age of learning to stand in infancy would be associated with adult executive function and that the association would be apparent throughout the range of abilities, rather than confined to extremes. METHODS: The Northern Finland 1966 Birth Cohort is based upon 12,058 live-born children in a geographic and temporally defined population. Information on age at learning to stand without support was obtained at one year. At age 33-35 a random sample of 104 subjects underwent a neuropsychological test battery including tests of executive function (cognitive categorisation), visuo-spatial memory, verbal learning and visual object learning. We investigated associations between developmental data and adult neuropsychological test scores. RESULTS: There was a significant linear relationship between age of learning to stand and adult categorisation: the earlier the attainment of the milestone, the better was the categorisation. No such relationships were observed between infant neurodevelopment and adult cognition in other neuropsychological domains. CONCLUSION: Even within the normal range of development, early development in the gross motor domain is associated with better adult executive function (in tests of categorisation). Investigation of the determinants and sequelae of normal neural development will facilitate research into a variety of neurodevelopmental disorders.

Adult↗
PubMed1996

Effects of altered olfactory experiences on the development of infant rats' responses to odors.

A "natural" olfactory learning paradigm was used to assess the effects of an altered perinatal olfactory environment on the development of odor-elicited behavior in young rats. Infant rats (from 3 to 12 days of age) reared by dams fed a eucalyptol-adulterated diet responded to the odor of eucalyptol with high levels of activity, mouthing, and probing, and also demonstrated a marked preference for that odor in a two-choice situation (Experiment 1). The effects were observed only in pups whose dam was fed eucalyptol-adulterated diet and were not observed in pups exposed to nonmaternal sources of odor. The intensity of behavioral activity elicited by eucalyptol odor varied, to some extent, with the concentration of the eucalyptol in the dam's diet during prenatal exposure (Experiment 2). Cross-fostering revealed that these effects were due almost entirely to the pups' postnatal exposure to the eucalyptol odor (Experiment 3). These findings indicate that novel odors specifically associated with the mother can gain control over orientation and ingestion-related behaviors.

Animals↗
PubMed1997

Bronchiectasis in pediatric AIDS.

OBJECTIVES: There are several reports of the pulmonary findings in children with HIV disease; however, the occurrence of bronchiectasis rarely has been noted. We evaluated occurrence of bronchiectasis in a large group of children referred to us with AIDS pneumopathy. METHODS: From January 1984 to April 1996, 203 children with AIDS and respiratory problems were referred to the pediatric pulmonary division at Children's Medical Center of Brooklyn. Medical records for 164 of these children were available and retrospectively reviewed. RESULTS: Uncomplicated pneumonia was present in 75, 24 had recurrent pneumonia, and 18 had unresolved pneumonia; lymphocytic interstitial pneumonitis (LIP) was diagnosed in 47 patients, worsening with time in all patients. Bronchiectasis was observed in 26 patients (26/164, 15.8%), diagnosed by chest radiograph in 26 (26/26, 100%), confirmed by CT scan of chest in 10 (10/26, 38.4%), and by histology in three (3/26, 11.5%). Median age at time of diagnosis of bronchiectasis was 7.5 years (range, 1 to 16 years). Sixteen children with LIP developed bronchiectasis (16/47, 34.0%). Three patients with recurrent pneumonia (3/24, 12.5%) developed bronchiectasis. Five patients with unresolved pneumonia (5/18, 27.7%) developed bronchiectasis. One infant developed bronchiectasis after Pneumocystis carinii pneumonia; another child developed bronchiectasis after P. carinii and Mycobacterium tuberculosis pneumonia. The CD4+ T-cell counts measured within 6 months of diagnosis of bronchiectasis were available in 23/26 patients and, all were < 100 cells per cubic millimeter. CONCLUSION: We conclude, from our experience, that there is a significant occurrence of bronchiectasis in children with AIDS and pulmonary disease, especially in children developing LIP, recurrent pneumonia and unresolved pneumonia, and CD4+ T-cell counts < 100 cells per cubic millimeter.

AIDS-Related Opportunistic Infections↗
PubMed1997

Learning in the development of infant locomotion.

Infants master crawling and walking in an environment filled with varied and unfamiliar surfaces. At the same time, infants' bodies and skills continually change. The changing demands of everyday locomotion require infants to adapt locomotion to the properties of the terrain and to their own physical abilities. This Monograph examines how infants acquire adaptive locomotion in a novel task--going up and down slopes. Infants were tested longitudinally from their first week of crawling until several weeks after they began walking. Everyday locomotor experience played a central role in adaptive responding. Over weeks of crawling, infants' judgments became increasingly accurate, and exploration became increasingly efficient. There was no transfer over the transition from crawling to walking. Instead, infants learned, all over again, how to cope with slopes from an upright position. Findings indicate that learning generalized from everyday experience traveling over flat surfaces at home but that learning was specific to infants' typical method of locomotion and vantage point. Moreover, learning was not the result of simple associations between a particular locomotor response and a particular slope. Rather, infants learned to gauge their abilities on-line as they encountered each hill at the start of the trial. Change in locomotor responses and exploratory movements revealed a process of differentiation and selection spurred by changes in infants' everyday experience, body dimensions, and locomotor proficiency on flat ground.

Child Development↗
PubMed2004

Identity, narcissism and the emotional core.

This paper describes the course of an analysis which demonstrates how borderline and narcissistic functioning can be understood in terms of a struggle with issues of identity. It shows how such functioning can come to exert a profound hold on the individual and why it seems, at times, a matter of life and death to the patient to avoid states of separation from the analyst. The paper suggests that these complex phenomena can be understood, perhaps surprisingly, in the simple terms of the nature of affect itself. The concept of the emotional core is introduced to embody and highlight that which lies beneath both Jungian and Freudian models (offering a potential bridge between the two models)--namely the psyche's essentially affective nature. It is suggested that the emotional core can serve as an organ of perception giving the individual both their primary relation to reality and an emotional attachment to others. This emotional core is understood to function in a narcissistic manner to preference experiences of sameness and in aversion to experiences of difference--a view consonant with Stern's understanding of infant development where the infant is able to distinguish self from other from the beginning of life (as Fordham also held); taking up Stern's terminology, it gives the individual a 'core' sense of being. There is, however, no stable, on-going sense of 'I' associated with this form of functioning as the individual is immersed in the latest affect to enter consciousness (as in the borderline state of mind) and consequently the individual comes to rely intensely on the other to determine their sense of being (the other becomes a self-regulating other in Stern's terms). The development of ego-functioning gives a more stable and on-going sense of 'I' to the individual, giving contact with the broader personality, allowing the individual to be less reliant on the other and orientating them to reality in a way more fitting to their overall needs. The paper describes how consciousness, which is not seen as identical with the ego, moves between the mode of functioning of the ego and that of the emotional core, i.e., shifting in and out of states where projective identification predominates. It elaborates the range of self-experience encompassing spiritual experience and states of disintegration (which are understood to have a similar structure) on one side, to ego-based experience (which can itself be defensive and rigid at times) on the other. It explores the consequences of such a view for analytic technique and relates it to the Jungian view of the self and the Freudian unconscious.

Affect↗
PubMed1976

Enterocolitis in low-birth-weight infants associated with milk and soy protein intolerance.

Two low-birth-weight infants developed a syndrome of vomitting, distension, septic appearance, and bloody diarrhea. Both infants developed symptoms after ingestion of cow milk-based formula initially, and, later, soy-based formulas. These symptoms resolved with intravenous fluids and alimentation. Vomiting, diarrhea, melena, and polymorphonuclear leukocytosis recurred with reintroduction of either milk- or soy-based formulas. This sensitivity persisted throughout the neonatal period and was still present at seven to eight months of age. It appears from these data that intolerance to whole protein formulas can cause a syndrome similar clinically to neonatal necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed2006

Cyclic exposure to ozone alters distal airway development in infant rhesus monkeys.

Inner city children exposed to high levels of ozone suffer from an increased prevalence of respiratory diseases. Lung development in children is a long-term process, and there is a significant period of time during development when children growing up in urban areas are exposed to oxidant air pollution. This study was designed to test whether repeating cycles of injury and repair caused by episodes of ozone exposure lead to chronic airway disease and decreased lung function by altering normal lung maturation. We evaluated postnatal lung morphogenesis and function of infant monkeys after 5 mo of episodic exposure of 0.5 parts per million ozone beginning at 1 mo of age. Nonhuman primates were chosen because their airway structure and postnatal lung development is similar to those of humans. Airway morphology and structure were evaluated at the end of the 5-mo exposure period. Compared with control infants, ozone-exposed animals had four fewer nonalveolarized airway generations, hyperplastic bronchiolar epithelium, and altered smooth muscle bundle orientation in terminal and respiratory bronchioles. These results suggest that episodic exposure to environmental ozone compromises postnatal morphogenesis of tracheobronchial airways.

Animals↗
PubMed2005

LC-PUFA content in human milk: is it always optimal?

UNLABELLED: The content of long-chain polyunsaturated fatty acids (LC-PUFAs) in human milk has been connected with infant growth and developmental indices. The LC-PUFA content of human milk usually reflects the dietary habits of mothers, so questions have been raised regarding the possibility of enriching maternal diet with LC-PUFAs during lactation (or even before) in order to improve infant outcome. Nevertheless, environmental and genetic factors have independent roles in affecting both maternal milk composition and infant development. CONCLUSION: Diet-related differences in the LC-PUFA composition of human milk are under active investigation for their possible contribution to infant development, but environment- and gene-related differences in both human milk composition and maternal diet should be considered in evaluating the adaptive mechanisms of infants and the effects of specific LC-PUFA dietary supplementations.

Breast Feeding↗
PubMed1983

[Modification of the development of infant kidneys by homotransplantation to adult recipients. Hemodynamic and morphologic study on the minipig].

To study the development or absence of a compensatory hypertrophy and early maturity of suckling kidneys after allotransplantation into adult recipients, MLC histocompatible piglet kidneys of the minipig were transplanted en bloc into the binephrectomized mother. As a result, the significant higher renal perfusion pressure in the circulation of the sow in comparison with the lower arterial pressure in the piglet organism caused a autoregulatoric increase in the blood flow of the infantile kidneys following the transplantation. After 1-2 weeks, the transplants showed an abnormal weight increase attributable to the prematurity associated with glomerular and tubular hypertrophy as well as to rejection-induced or unspecific inflammatory infiltrations. The functional effectiveness of the pediatric grafts were limited especially by the body weight of the recipients and by the rapidly occurring deficit of nephrons in consequence of infection and/or rejection. As a survival period of 45 days was reached in one case, the recipient shows approximately physiological creatinine concentrations in serum.

Animals↗
PubMed1983

Maternal psychological determinants of infant obesity. Development and testing of two new instruments.

We have developed and tested two instruments to measure psychological factors that may affect infant feeding and thus "confound" the relationship between feeding and subsequent obesity. The Maternal Preconceptions of Ideal Infant Body Habitus (IBH) consists of 4 drawings of 9-month-olds exhibiting a range of body habiti from quite lean to very chubby; new mothers are asked to rank the 4 in order of preference for their new baby. The Maternal Feeding Attitudes (MFA) ia a 10-item questionnaire addressing the new mother's food "pushiness". Both the IBH and the MFA produced high test-retest intraclass correlation coefficients (RI's): 0.92 and 0.95, respectively. Significant inverse correlations were found between the IBH and both maternal age (r = -0.38; p = 0.004) and the Green SES index (r = -0.28; p = 0.025), indicating that older, higher-SES mothers prefer leaner infants. Breast-feeding mothers had significantly lower mean IBH scores than did formula-feeding mothers (p = 0.029). The MFA, by contrast, was not associated with any of these variables. We conclude that maternal adiposity preference and feeding attitudes can be reliably measured. Owing to their possible associations with infant obesity and its determinants, we suggest that these factors be included in future studies in this domain.

Adult↗
PubMed1999

Transient periventricular echodensities and developmental outcome in preterm infants.

The outcome of very low-birth-weight infants is reported in relation to neonatal cerebral ultrasound findings. Routine cerebral ultrasound scans were performed in all 147 very low-birth-weight infants admitted to the authors' neonatal intensive care unit from January 1995 to June 1997. Group 1 consisted of 22 infants without ultrasound abnormalities, group 2 consisted of 32 infants with transient periventricular echodensities, and group 3 consisted of 15 infants with intraventricular hemorrhage. Neurologic status was recorded at follow-up visits at the corrected age of 6 and 12 months, and the infants were evaluated further using the Bayley Scales of Infant Development II. More infants in groups 2 and 3 appeared to have significant and mild motor developmental delays than infants in the control group (group 1) at the corrected age of 1 year (P = 0.001). Furthermore, more infants in group 3 appeared to have significant motor developmental delays than did infants in group 2 at the corrected age of 1 year (15% vs 3%). Infants with transient periventricular echodensities and intraventricular hemorrhage have an increased risk of delayed developmental outcome. Infants with transient periventricular echodensities have a more favorable prognosis than do the infants with intraventricular hemorrhage.

Cerebral Ventricles↗