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Anemia and Iron Deficiency according to Feeding Practices in Infants Aged 6 to 24 Months

  • 김순기
    • Journal of Nutrition and Health
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    • v.31 no.1
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    • pp.96-101
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    • 1998
  • The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

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The effect of oral breast milk on pain response of the neonates during heel lancing (모유경구투여가 발뒤꿈치 천자 시 신생아의 통증반응에 미치는 효과)

  • Kim, Kyunghwa;Park, Youngim;Kim, Taeim
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.1
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    • pp.203-215
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    • 2016
  • This study was performed in order to investigate the effect of breast milk on pain relief in newborn during heel lancing. Nonequivalent control group pretest-posttest design by double blinded experiment was used. 50 neonates were randomized to receive breast milk (experimental group, n=25) or no treatment (control group, n=25) before undergoing heel lancing. Informed consent was obtained from parents of 50 neonates. Neonatal infant pain scale (NIPS), respiration rate, heart rate, oxygen saturation, and crying duration were used to assess subjects' pain reaction. Data were analyzed using SPSS 18.0. The experimental and control group showed a statistically significant differences in NIPS score (F=28.89, p<.001), heart rate (F=14.03, p<.001), respiration rate (F=4.79, p=.001), oxygen saturation (F=2.69, p=.027), and crying duration (t=-8.78, p <.001) at each time points (during heel lancing, right after heel lancing, 1, 2, 3 minutes after heel lancing). The result suggest that oral administration of expressed breast milk is safe and natural agents for reducing procedural pain of neonates. Another clinical trial study with more samples is recommended.

Comparison of Plasma Taurine Levels in Some of Breast-fed Infants and Formula-fed Infants (일부 모유 영양아와 인공 영양아의 혈중 타우린 함량 비교)

  • Cho Kum-Ho;Kim Eul-Sang
    • Journal of the East Asian Society of Dietary Life
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    • v.15 no.4
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    • pp.397-404
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    • 2005
  • The propose of this study was to investigate taurine intake in formula-fed and breast-fed infants and to estimate the level of taurine of blood and urine in order to determine the requirement of taurine intake in infants. These results will be useful to suggest the guideline of requirement of taurine intake and may contribute toward the proper use of breast milk substitutes. Experimental groups were breast-fed infants (n=10) and formula-fed infants (n=10) of 20 normal delivery infants in general hospital. This study was longitudinal study from birth up to 16weeks (0 week, 4 weeks, 8 weeks, 12 weeks, 16 weeks). The items of test were anthropometry(weight, height, head circumference, chest circumference), intake of taurine, taurine level of blood and urine in breast-fed and formula-fed infants. There were no significant differences between breast-fed and formula-fed infants in weight, height, head and chest circumference. There is a need for future studies of exclusive infants with larger samples to determine which growth pattern should be considered as the norm. Taurine concentration of plasma and urine did not differ between breast-fed and formula-fed infants. Taurine intake recommendations for infants is about 30mg/day from this study. This data will be useful for production of human-like formula milk and suggestion of an index of selection of a consumer in taurine.

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A Basic Treatise of Korean Mother′s Concern for the Artificial Feeding (인공영양에 대한 한국 어머니들의 반응에 관한 기초조사)

  • 변수자
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.41-51
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    • 1972
  • In this article, the writer attempted to study the followings: (1) mother's knowledge of milk feeding (including method of sterilization, formula and feeding) (2) reasons of artificial feeding (3) how much mothers are concerned about their artificial feeding infants (4) condition of growth and development of artificial feeding infants. As the object of study, 96 mothers with artificial feeding infants, who had consulted dep't of pediatrics of two Hospitals in Seoul (Korea Hospital and Med. College Woo Suk Hospital, Korea Uni.) and well baby clinic of the two Health Centers (Sung Dong and Dongdaemoon), were randomly sampled. The data were treated by the statistic method of chi-square and percentage, and come to the following conclusion. 1. Knowledge of milk feeding Sterilization: 70 percentages of mothers know about the milk sterilization (including bottle, nipple and instrument), but 55 percentages of them do not know the nipple sterilization correctly. Formula: 69 percentages of mothers follow the indicator or in accordance with doctor's directions, but 31 percentages do at their option by reasons that the baby often coughs up the milk, the baby is too small, the baby often has digestive troubles, or the baby grow fleshy heavily etc, except family economic problems. Feeding: only half of mothers know the correct feeding method, especially they do not know how to determine the heat degree of milk and how to bubble up the baby correctly. They just do feeding according to the accepted usages. 2. Reasons of artificial feeding Of the reasons of artificial feeding, 18 percentages were caused by infants and 82 percentages by mothers. Most of the reasons are mainly due to the lack of breast milk and sufficient supply of nourishments rather than mother's deficiency or mother's abnormality. 3. Mother's concern for artificial feeding infants Mothers who are sharply concerned for their artificial feeding baby's growth and development: 63%, mothers who made the baby (artificial feeding infant) routine vaccinated: 81%, mothers who ear anxious about the baby's future personality forming : 68%, mothers who care about the baby's condition of nourishment; 60%, mothers who are anxious about tile selection of baby's food; 54%. 4. The growth and development of artificial feeding infants compared with Korean average infants. The artificial feeding infants are above the Korean average infants in stature by 1.21 centimeters and in weight by 0.3 kilograms. Conclusion: It has been said that there is no better food for infant than the breast milk. However, the artificial feeding has been used for the supplement of nourishments and as substitute food for the breast milk. And this artificial feeding could give the married women the chance to act in society and more opportunity to develop themselves and to work for others at home and other fields. Considering these advantages, artificial feeding should not be exclusive, but preferably should be more improved and inquired positively. And even in artificial feeding, what is most important is that mothers should recognize the requirement and need of artificial feeding clearly and correctly, and they should be accustomed to the correct knowledge and skills of artificial feeding in order to practice it appropriately. In some degree, they should be properly trained in school education process.

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The Study for the Effect of Breast Massage and Manual Expression of the Breast before Engagement after Delivery (산후 유방 마싸지 및 유즙압출이 충유 및 유즙분비에 미치는 영향)

  • 김원옥
    • Journal of Korean Academy of Nursing
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    • v.5 no.2
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    • pp.74-91
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    • 1975
  • A purpose of this study was to compare the breast massage and manual expression of the breast before engagement after delivery with the time of engagement, the throbbing pain in breast, the first amount of breast milk and involution of the uterus. The subjects selected for this study were 138 women (experimental group;69, control group :69) who were admitted to the Dept. of Obtest. and Gyneco. of Kyung Hee University Hospital from Jan. 5 to June 5, 1975. The results of study were as follows; 1 The average age of the women 26.9 years old in the experimental group and 27.6 years old in the control group. As to religion, the number of those who had no religion was 58.0 percent and 62.4 percent respectively. Classified according to occupation, there were 87.0 percent in house wives of the booths group. Educational background; 87.0 percent of high school graduates or above, 78.3 percent respectively. The occupation of husband 53.7 percent of company employees stood highest and 42.0 percent respectively. In according to the grade of wards, 55.1 percent and 52.2 percent of four-men room stood highest. 2. Physical condition: Body weight before this Pregnancy(T=0.4962, N.S.), the size of breast(X²df2 = 0.1728, N.S.), the shape of nipple(X²df3 =1.3804, N.S.), hemoglobin's level of the first day after delivery(T=1.2572, N.S.), the above were showed non significant between the experimental group and control group The investigator found any difference between the two groups of the health condition during the pregnancy, 3. The rate of no experience of breast massage during pregnancy was 85 percent and 75.4 percent (X²df1=2.2562, N.S.). 4. As to the meal during hospitalization after delivery: The booth of the groups in ordinary food took usually of meyer soup and milk(X²df8=2.5957, N.S.). 5. The relation between the first step of breast massage, second step of the manual expression of breast before engagement after delivery and time of engagement : average time of engagement in the experimental group (2.1 days±0.8) was shortened than the control group (3.3 days±1.2). (T=-6.9045, P< 0.005). It toot less time in the experimental group of primipara(2.2days±0.7) than in the control group (3.1day±1.2) and it also took less time in the experimental group of multipara (2.0 days±0.9) than in the control group (3.5days±1.4). (Primipara T=-3.9266, 0< 0.005. Multipara T= 5.2356, P<0.005). 6. The relationship between the first step of the massage and second step of manual expression and the throbbing pain at the time of engagement: The experimental group showed less effect than control group (X²df4= 27.3342 P<0.005). The separate study of primipara and multipara showed remarkable difference in the group of primipara)X²df4=20.7285, p<0.005) and little difference in the multipara group (X²df4=8.8351, p< 0. 10). 7. The relationship between the first step of the breast massage, second stop of the manual expression and first amount of breast milk: The average amount of breast milk increased more conspicuously in the experimental group (33.8㎖±23.4) than in the control(29.8㎖±25.3) (T=0.8262, N.S.). No remarkable difference was found in the respective groups that investigated in the groups of primipara and of multipara. (Primipara T=1.1467, N.S., Multipara T=-0.0354, N.S.). 8. The relationship between the first step of breast massage and second step of manual expression of breast and involution of uterus : Average time needed for uttering involution was sooner in the experimental group of primipasa(-3.3 F.B.±1.1), than the control group of primipara (-2.5F. B.±1.2), and it was sooner in the experimental group of muitipara (-3.0 F. B.±l..3), than the control group of multipara(-2.3 F.B±0.9). Primipara T=-2.9272, p< 0.005, Multipara T=2.5557, p< 0.01).

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Breast Milk-Transmitted Cytomegalovirus Infection in Preterm Infants

  • Gang, Mi Hyeon;Chang, Mea-young
    • Neonatal Medicine
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    • v.25 no.2
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    • pp.58-65
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    • 2018
  • Purpose: The purpose of this study is to describe the rate of cytomegalovirus (CMV) virolactia, and the prevalence of breast milk (BM)-transmitted postnatal CMV infection among premature infants after freeze-thawing (FT) and Holder pasteurization (HP) of breast milk. Methods: This is a single-center, retrospective study of 312 infants born at less than 32 weeks of gestation, or with a birth weight less than 1,500 g from January 2013 to June 2017. All infants were screened for CMV-specific immunoglobulin (Ig) G and IgM at birth. Initial CMV specific polymerase chain reaction (PCR) and CMV culture were performed on mothers' BM and babies' urine within the first 21 days of life. FT and HP of BM was used to prevent the transmission of CMV. For the surveillance of postnatal CMV infection, CMV culture and CMV specific PCR of urine from babies were repeated one to two months after the initial screening. Screening for viremia and viruria was performed if postnatal CMV infection was suspected. Results: Among 178 BM samples obtained from mothers of CMV-IgG-seropositive infants, 80 (44.9%) were CMV PCR positive. CMV deoxyribonucleic acid (DNA) was detected in five of the 22 BM samples (22.7%) obtained from the mothers of CMV-IgG seronegative infants. When CMV DNA load in BM was measured before and after HP, various results were shown. Sixty-three infants out of 232 (27.2%) were evaluated for postnatal CMV infection and four infants out of 63 (6.3%) were infected. Conclusion: Interventions to prevent BM-transmitted CMV infection can reduce the chance of postnatal CMV infection, but not completely eliminate it.

Anaphylactic Shock in a Breast Milk-Fed Infant due to Skin Contact with Egg White (모유 수유아에서 발생한 계란 흰자 피부접촉에 의한 아나필락시스 쇽 1례)

  • Kim, Eo Jin;Yoon, Young Ran;Yeom, Jung Sook;Kim, Jum Su;Seo, Ji Hyun;Lim, Jae Young;Choi, Myoung Bum;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.83-86
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    • 2004
  • Food allergy is not uncommon among small children. Cow milk and eggs are most frequently incriminated as the major cause of food allergy. A 4-month-old female infant who did not have a previous history of contact with the egg developed anaphylactic shock when an emulsion of raw egg white was rubbed on the buttock by her mother to relieve erosive diaper dermatitis. She had been fed on breast milk. She had no past medical history of any other allergy and no family history of atopy, asthma or allergic rhinitis. Her IgE PRIST was 29.46 IU/ml and multiple antigen simultaneous testing chemiluminescent assay for food specific IgE antibody showed a level 4 positive value only to egg white.

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