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PubMed2006

[Home enteral nutrition in Spain. Results of the register of the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition in 2003].

INTRODUCTION: The number of children receiving prolonged home enteral nutrition (HEN) is increasing. However, precise information on the incidence and prevalence of HEN in Spain is lacking. Consequently, the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition created a patients' register (NEPAD). The aim of the present study was to analyze the results of the first year of the NEPAD register (2003). MATERIAL AND METHODS: The NEPAD is an on-line register that gathers information on the indications for HEN, route of access, type of diet and duration of nutritional support. Quantitative data are expressed as mean and standard deviation, and qualitative data as percentages. RESULTS: In 2003, 124 children from 6 hospitals were registered. The mean age at the beginning of HEN was 3.6 years. The underlying disease was gastrointestinal in 20%, neurological or mental retardation in 20%, cystic fibrosis in 14.5%, tumor in 11%, innate error of metabolism in 10%, congenital cardiac disease in 6%, severe primary malnutrition in 6%, and other causes in 13%. A nasogastric tube was used as the first route of access in 56%, and gastrostomy was used in 42%. Sixty percent of the children received continuous nocturnal enteral nutrition and 90% used an infusion pump. The type of feeding consisted of blenderized natural food in 14%, polymeric pediatric formula in 50%, and infant formulae in 18%. On December 31st, 84 children continued to receive enteral nutrition (68%). CONCLUSIONS: Despite the efforts made to maintain the on-line national register, it has been underused in its first year of existence (2003). Patients with gastrointestinal or neurological diseases constitute the main group of patients in the register. There is a slight preference for the use of nasogastric tube over gastrostomy.

Adolescent↗
PubMed1997

Meeting lipid needs of infants with allergy and gastrointestinal diseases.

Infant formulas containing medium chain triglycerides (MTC) have been used for the nutritional management of infants with fat malabsorption. The optimal proportion of MTC in the formula remains to be determined. Three infant formulas with varying proportion of MTC in the fat blend were studied in children with cystic fibrosis, cholestasis or persistent diarrhea. The formula containing 48% of the total energy from fat and 55% of the fat component as MTC was found to be the most suitable for the needs of those infants. It leads to an adequate essential fatty acid status and to improved recovery in those conditions.

Dietary Fats↗
PubMed2001

The association of allergic sensitization in mother and child in breast-fed and formula-fed infants.

Human milk contains immunologically active substances potentially capable of altering infant immune response. As part of the prospective Children's Respiratory Study, we assessed whether the association between maternal allergic status and allergic status of the child was altered by breast-feeding. Skin-prick tests for 7 common allergens were administered to 702 6-year-old children and their mothers. The percentage of children sensitized to specific allergens, maternal skin test response to that allergen, and whether or not the child was ever breast-fed was determined. Findings indicated that specific sensitization in the mother was associated with specific sensitization in the child only if the child was breast-fed. This indirectly supports the hypothesis that contents of milk differ with maternal allergic status, and appear to affect allergic status in the child. These results suggest that milk from allergic mothers either promotes a Th2 type immune response or suppresses Th1 immune response in the child.

Allergens↗
PubMed2002

Neonatal thyrotoxicosis and maternal infertility in thyroid hormone resistance due to a mutation in the TRbeta gene (M313T).

We report two unusual cases of resistance to thyroid hormone (RTH) in one family. The first case, a male infant, had clinical features of thyrotoxicosis in the neonatal period. In the fourth week of life weight gain was poor despite a daily intake of standard infant formula almost double the infant's estimated requirements. At this time serum free T4 (fT4) was 60.7 pmol/l (Normal range [NR] 11-25 pmol/l) and TSH was inappropriately normal at 1.8 mU/l (NR 0.3-4.0 mU/l). The infant responded clinically and biochemically to propylthiouracil (PTU) at a dose of 10 mg/kg/day. Following 27 days of treatment serum fT4 was 22.6 pmol/l and TSH had risen to 24.9 mU/l. As the infant was thriving treatment was discontinued. The infant, now aged 6 months old, remains clinically euthyroid and developmentally normal off treatment. The infant's mother, from whom he had inherited a mutation of the thyroid receptor beta (TRbeta) gene (M313T), presented earlier with secondary infertility and clinical features of thyrotoxicosis. Treatment with PTU restored her fertility and she spontaneously conceived. In the subsequent pregnancy, clinical and biochemical features of RTH improved, and she gave birth to a small but healthy female infant. In the next pregnancy, resulting in the birth of the affected male infant, clinical and biochemical features of RTH worsened, and high doses of PTU were required to maintain a clinically euthyroid state. To our knowledge, these are the first case reports of RTH associated with added features of a hypermetabolic state in infancy and secondary infertility.

Adult↗
PubMed1975

Concurrent and subsequent serum cholesterol of breast- and formula-fed infants.

Animal studies have suggested that feeding a high-cholesterol diet early in life will reduce serum cholesterol of later life. We tested this hypothesis by comparing the serum cholesterol of breast-fed children and bottle-fed children. The former type of feeding has a cholesterol content 26-52 mg of cholesterol/8 ounces, and the latter type of feeding has 4 mg/2 ounces. Serum cholesterols were determined by the Wybenga technique. At the end of 4-6 months, both groups were switched from their original feeding to skim milk. The parents were counseled to avoid high-cholesterol content foods such as eggs and to limit the intake of the more moderate cholesterol dietary forms. Our objective was to achieve a cholesterol intake of 200 mg/day for both groups. The serum cholesterol was evaluated at the following ages: 2-4 months, 12 months, 18-24 months, and 15-19 years. The same child was not necessaryily followed longitudinally. Our results indicate that breast-fed children had significantly higher serum cholesterols than bottle-fed children at ages 2-4 months and 12 months. After 1 year, no significant difference in serum cholesterol was found when the two groups were compared. We concluded that no protection against high serum cholesterol in later life occurred as the result of initial feedings high in cholesterol.

Adolescent↗
PubMed1979

Medical evaluation of the special supplemental food program for women, infants, and children.

The special supplemental food program for women, infants, and children administered by the United States Department of Agriculture, was evaluated nationally. Participating infants, children under 4 years old, and pregnant and nursing women were investigated initially, and after receiving food supplements. The supplements were iron-fortified infant formula, iron-fortified infant cereals, and fruit juices for the infants, and milk, cheese, iron-fortified cereals, eggs, and fruit juices for the children and women. Initially, the average birth weight was lower and the infant mortality rate was higher than expected in a well nourished population. There was also evidence of slight growth retardation, a high anemia rate, and a high percentage of participants having saturation of transferrin values less 15%. The program had no effect on the prevalence of unsatisfactory values for saturation of transferrin. There was an increase in weight gain during pregnancy, and increase in birth weight, an acceleration of growth, and a reduction in the anemia rate in all participant categories except women in the first and second trimesters of pregnancy.

Agriculture↗
PubMed2001

Is there a relation between docosahexaenoic acid concentration in mothers' milk and visual development in term infants?

BACKGROUND: Docosahexaenoic acid (DHA), present in high concentrations in the brain and retina, has a role in visual development. DHA is present in human milk, but not in most infant formulas. It is, however, under discussion whether DHA should be added to formulas intended for term infants. The concentration of DHA in human milk, which is influenced by maternal diet, varies considerably, but it is unknown whether this variation affects visual development in term infants. METHODS: The authors investigated 39 4-month-old fully breast-fed term infants in a cross-sectional study. Visual acuity was measured by swept visual evoked potentials, milk DHA was determined by gas chromatography, and maternal fish intake was assessed by a frequency questionnaire. RESULTS: Frequency of fish intake correlated positively to the DHA level in breast-milk (P = 0.001). Mothers who ate fish the day before sampling had a milk DHA level higher than expected from habitual fish intake (P = 0.002). If this was taken into account, 57% of the variation in milk DHA could be explained by fish intake. Multiple linear regression analysis revealed a significant association between visual acuity and milk DHA (P = 0.02, R2 = 0.09). CONCLUSION: This finding suggests a cause-and-effect relationship between infant milk DHA intake and visual acuity. If these data are confirmed, there is a need to consider the optimal intake of DHA for the lactating mother.

Animals↗