• Clinical and Experimental Pediatrics
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• v.57 no.12
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• pp.505-513
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• 2014

While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.

• The Journal of Pediatrics of Korean Medicine
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• v.13 no.2
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• pp.171-186
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• 1999

Atopic dermatitis is a chronic or chronically relapsing, pruritic dermatitis. It commonly occurs in patients with a personal or family history of atopy. We studied 67 children suffering from atopic dermatitis Oriental Medicine Hospital in Kyunghee University, and analyzed sex, age, feeding, clinical manifestation, risk factor. The results were as follows : 1.Most age distribution of children was from 2 to 6, male to female ratio was 1:1.03 2.Breast-feeding to milk-feeding ratio was 2.93:1 3.Frequency of aggravating symptom by specific food was 31.3%, among this, meat(especially chicken) was revealed high risk factor 4.Frequency of family history suffering from other allergic disease was 61.2%, among this father to mother ratio was 1.27:1 5.Sites of atopic dermatitis were as follows : The inner space of elbow and knee joint was 77.65, back, face, neck was 56.7%, back of ear was 52.2%, wrist was 46.3%, abdomen was 38.8%, ankle was 34.3%,head was 29.9%.

• Women's Health Nursing
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• v.26 no.4
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• pp.326-335
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• 2020

Purpose: This study was conducted to evaluate the construct validity, reliability, measurement invariance, and latent mean differences in the Breastfeeding Adaptation Scale-Short Form (BFAS-SF) for use with mothers at 2 weeks postpartum. Methods: This methodological study was designed to evaluate the validity, reliability, and measurement invariance of the BFAS-SF at 2 weeks postpartum, with data collected from 431 breastfeeding mothers. Confirmatory factor analysis and multi-group confirmatory factor analysis were conducted to assess the factor structure and the measurement invariance across employment status, delivery mode, parity, and previous breastfeeding experience, and the latent mean differences were then examined. Results: The goodness of fit of the six-factor model at 2 weeks postpartum was acceptable. Multi-group confirmatory factor analysis supported strict invariance of the BFAS-SF across employment status and delivery mode. Full configural invariance, full metric invariance, and partial scalar invariance across parity and full configural invariance and full metric invariance across previous breastfeeding experience were supported, respectively. The results for latent mean differences suggested that mothers who were employed showed significantly higher scores for breastfeeding confidence. Mothers who had a vaginal delivery showed significantly higher scores for sufficient breast milk and baby's feeding capability. Multiparous mothers showed significantly higher scores for baby's feeding capability and baby's satisfaction with breastfeeding. Conclusion: The validity and reliability of the BFAS-SF at 2 weeks postpartum are acceptable. It can be used to compare mean scores of breastfeeding adaptation according to employment status, delivery mode, and parity.

• Korean Journal of Community Nutrition
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• v.2 no.4
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• pp.477-485
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• 1997

This study was conducted to determine the effect of large amounts of whole cow's milk intake on serum levels of minerals and lipids. Subjects were normal infants who were brought to the pediatric hospital for vaccination at the age of 7-26 months after birth, living in Eumsung-Choongbuk area. The serum concentrations of the imnerals(calcium, phosphorus, magnesium, iron, zinc and copper), lipids and fatty acids composition were analyzed in 38 infants which consumed large amount of whole cow's milk(over 700ml/day). The results obtained are summarized as follows : 1) The mean levels of calcium, phosphorus and magnesium in the serum of the total subjects were 7.56$\pm$0.51mg/dl, 11.12$\pm$0.72mg/dl and 1.62$\pm$0.13mg/dl respectively. The serum concentrations of iron, zinc and copper in total subjects averaged 72.42$\pm$1.62$\mu\textrm{g}$/dl, 76.29$\pm$3. 62$\mu\textrm{g}$/dl and 86.44$\pm$2.98$\mu\textrm{g}$/dl respectively. 2) The mean serum concentrations of triglyceride, total cholesterol, HDL and LDL in the total number of subjects were 96.84$\pm$9.22mg/dl, 133.45$\pm$6.30mg/dl, 32.79$\pm$1.77mg/dl and 81.29$\pm$4.81mg/dl respectively. 3) The average percentages of SFA, MUFA and PUFA inth total serum fatty acids were 38.98$\pm$2.42$\%$, 25.82$\pm$0.98$\%$ and 37.30$\pm$1.09$\%$ respectively and the mean$w6/w3$fatty acids ratio was 13.48. In general, the levels of serum minerals and $\omega$3 fatty acid composition in the subjects of this study, who were whole cow's milk fed infants were lower than those reported in breast milk or formula fed infants. Therefore, the intake of large amount of whole cow's milk in the weani ng period should be controlled and adequate for the infant's nutritional status. (Korean J Community 2(4) : 477-485, 1997)

• Women's Health Nursing
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• v.6 no.4
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• pp.632-642
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• 2000

This study was carried out to investigate effect of education for breastfeeding on practice of breastfeeding 171 primiparae (experimental group with education 83 and control group without education 88) who gave birth in hospitals located in Taegu City from October 25, 1999 to December 25, 1999 and planned to breastfeed their children after childbirth. The results of this study were as follows. 1) The experimental group's practice rate of breast-feeding was statistically higher than the control group's at the points of two weeks, four weeks, eight weeks and twelve weeks after childbirth(p<0.05). However, the rate at the points of sixteen weeks and twenty weeks after childbirth was higher in the experimental group than in the control group but there was no significant difference between both groups. 2) The experimental group's discontinuance rate of breast-feeding was lower than the control group's at all the points of two weeks, four weeks, eight weeks, twelve weeks, sixteen weeks and twenty weeks after childbirth, and it was statistically significant(p<0.05). The discontinuance rate of breast-feeding at the point of four weeks after childbirth was the highest in both groups. It accounted for 25.5% in the experimental group and 36.8% in the control group. 3) The reason of which the rate appeared to be the highest among those for discontinuance of breast-feeding was the lack of breast milk. The rate accounted for 65.5% in the experimental group and 50.7% in the control group. In conclusion, the study suggested that the education for encouraging breast-feeding provided to the primiparae after childbirth has an positive effect on the practice of breast-feeding.

• Women's Health Nursing
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• v.3 no.1
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• pp.5-27
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• 1997

This study was carried out to identify the difference between nursing needs and levels of satisfaction of primiparae during the early postpartum period. The goal of the study was to obtain data needed to develope maternal education programs and to improve the nursing quality for primipara. The subjects were 111 primiparae who had normal delivery at 2 general hospitals in the Seoul area. The data was gathered using an 81 items questionnaire which was developed by the researcher from Nov. 30, 1995 to Feb. 5, 1996. Results found are as follows : 1. The characteristics of subjects : The majority of subjects were aged 26-30yrs(60.4%), high school graduated(49.5%), jobless(52.3%), had no religion(49.5%), no antenatal(74.5%), and postnatal education on self and infant care(55.9%). A large proportion of primiparae intended to feed breast milk(49.5%) but in fact only 7.2% fed breast milk while in the hospital. Many subjects perceived that they had reasonable self confidence about self care(46.8%), and infant care(36%). 2. The level of nursing needs of overall nursing care was relatively high(Mn 3.98) but the level of satisfaction was of average level(Mn 3.09). Therefore, difference between the level of nursing needs and satisfaction was significant(p=0.0001). 3. The nursing needs by category of nursing care the highest need was on the education of infant care(4.29), the lowest was on physical care(3.80). The level of satisfaction was higher on environmental care(3.40) and physical care(3.32). But the category that showed the lowest satisfaction was education of infant care(2.67). Hence, difference of categories between the level of nursing needs and satisfaction was significant(p=0.0001). 4. Among items of physical care, observation of primiparas' conditions(4.21), accurate medication and treatment(4.18), care of breast engorgement(4.07) and control of postpartal hemorrage(4.01) showed high nursing needs. On the other hand, only the level of satisfaction was higher on accurate medication and treatment(3.82). The rest of items revealed only average level of satisfactions. Difference of items between the level of nursing needs and satisfaction was significant(p=0.0001) except items of dietary care. 5. Among items of psychological care, 8 items of nursing needs were high(3.72-4.29), expecially detailed explanation on which mothers want to know(4.29), treatment and nursing care they receive(4.23), kind and faithful care(4.22), early contacts with their baby(4.20), and adequate draping during the care and treatment(4.18). Among items of psychological care higher satisfactions were shown on items of kind and faithful care(3.80), personal treatment(3.70), and detailed explanation to mothers, but the least satisfied items was early contact with baby(2.13). Difference between the level of nursing needs and satisfaction was significant(p=0.0001). 6. Among items of environmental care, the highest level of need and satisfaction was on the items of neat bedding and pajamas(3.54). The difference was significant (p=0.0001). 7. Among the items of educational needs on self care, all of 22 items revealed higher educational needs(3.50-4.33) but the levels of satisfaction varied with a range of 2.63-3.42. Among the items the satisfactions were high on items of breast care including massages(3.42), perineal care(3.36) and expression of breast milk(3.32). Less satisfied items were drugs not be taken by breast milk feeder(2.63), maintenance of breast figure(2.76) and postpartum exercise(2.80) and so on. The difference was significant(p=0.0001). maintain 8. Among the items of educational needs on infant care, 19 items revealed higher educational needs(3.28-4.54). And the highest need were on the 3 items of normal growth and development of infant, safety and emergency care, symptoms of sick(4.45) and the meaning of crying of the baby(4.52). The level of satisfaction among items of education of infant care ranged from 2.47 to 3.16. Most satisfied items were buriping(3.16), bathing(3.11) and diapering(3.09). The items of which the mother's needs were high revealed the lowest satisfaction level. The difference was significant (p=0.0001). 9. Relationship between nursing needs and levels of satisfaction among primiparae of different characteristics were as follows : 1) Nursing needs of physical and psychological areas were significantly different among different age levels but no relationship was found on other categories regardless of the level of satisfaction. 2) With regard to different levels of education, some relationship was found in nursing needs of psychological area(p=0.007), educational needs on infant care(p=0.04) and environmental care(p=0.01). Also, the difference of satisfaction level was significant. 3) Working mothers had higher nursing needs and were more satisfied on items of physical care(p=0.05), education on self care and infant care. Difference were significant between nursing needs and level of satisfaction. 4) With regards to different religion a moderate relation was found between nursing needs of environmental care infant care education but no relationship was found on levels of satisfaction. 5) With regards to antenatal education, the mothers who have had no antenatal education revealed higher nursing needs on physical care but those who had antenatal education were more satisfied with education on self care and infant care. The difference was significant. (p=0.0001). 6) With regards to postpartum education, the mothers who have had some sort of postpartum education revealed higher nursing needs on physical and self care. And they were more satisfied with nursing of every category except infant care than mothers who had not any postpartum education. Differences was significant between the nursing needs and levels of satisfaction.(p=0.0001). 7) With regards to breast feeding experience during the hospitalization, those who had no experience of breast feeding revealed higher nursing needs on physical care in contrast to breast feeders, who had higher educational needs on infant care. And breast feeder were more satisfied with all categories. Differences was significant(p=0.0001). 8) With regards to perception of self confidence on self care and infant care, no relationship was found on nursing needs and level of satisfaction in every category of nursing.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.41-46
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• 2001

Purpose: We studied to know the effect of early feeding on the course and the recovery of acute diarrheal disease. Methods: The study was conducted on 76 patients who admitted to the Soonchunhyang university hospital for acute diarrhea. We divided 76 patients into 3 dietary groups (whole milk group (WMG): 35, diluted milk group (DMG): 29, breast milk group (BMG): 12). We compared three groups by numbers of diarrhea, numbers of vomiting, calory intake, weight increments, and duration of diarrhea. Results: 1) The mean age was $16.45{\pm}18.20$, $11.53{\pm}9.80$, $5.38{\pm}5.01$ months for WMG, DMG, and BMG, respectively. The mean weight was 9 kg and the mean duration of diarrhea was 2.29 days. 2) The numbers of diarrhea during admission was not significantly different in the three groups. 3) The calory intake during admission was significantly low in DMG. 4) The weight increments during admission was significantly low in DMG. 5) The duration of diarrhea during admission was not significantly different in the three gourps. Conclusion: Early refeeding with whole milk or breast milk did not prolong or worsen the course or symptoms of diarrhea compared with gradual reintroduction with diluted milk. But there were advantages of improved nutrition and weight increments. Futher study is necessary to demonstrate the effect of diet according to the causative organisms.

• Women's Health Nursing
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• v.5 no.3
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• pp.379-388
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• 1999

Breastfeeding is an excellent way of feeding infants and continues to be an important source of nutrition and antibodies for infants. Although breast-feeding is believed to be important, the rate of breastfeeding among Korean women is very low. One reason for the low breastfeeding rate is that the health professionals in the past have given little practical help couples to overcome difficulties encountered during breastfeeding. The promotion of breastfeeding has recently become a high priority among health professionals because of the undisputed physiological, psychological, social, economic, and nutritional benefits. Fathers have been found to influence the course of breastfeeding, but no one has conducted a systematic investigation into in and included fathers perspectives of breastfeeding in Korea. It is important to find strategies to solve the problems by assessing the knowledge, attitude and practice of breastfeeding with fathers as well as mothers. The purpose of this research is to find ways to promote primiparous(first child) couples's breastfeeding by assessing their general knowledge, attitude and practice of it. More specifically its purposes is to identify the relationship between knowledge, attitude, practice and the background factors of breastfeeding of primiparous couples in order to promote and support breastfeeding. The data will help health professionals to guide first-pregnancy couples to prepare and overcome any difficulties encountered during breastfeeding. Data were collected through a questionnaire which included both structured and open-ended questions. The questionnaire was composed referencing earlier literature, studies and surveys. This survey was made postpartum 2-3days after childbirth on 96 couples. The numbers of subjects for data analysis were selected 51 couples through pilot screening test. Data were coded and analyzed using the Statistical Package for Social Sciences : Cronbach's alpha coefficient, T-test, ANOVA, Stepwise pearson's correlation coefficient. The relations between the variables of breastfeeding were examined using a Pearson's correlation coefficient. This study showed that, the internal validity of the instrument was tested by Cronbach's alpha. The result was : mother knowledge 0.72, mother attitude 0.88, and father knowledge 0.70, father attitude 0.92, practice 0.76 and planning of breast feeding 0.95. The average age of mothers in the sample was 28.9 years old, and the average age of fathers in the sample was 31.3 years old. The other descriptive informations available included. the study also found that fathers were more important than doctors or nurses. However results of the study indicate that there were no differences between father and mother knowledge of breastfeeding(t=-0.39, p=0.698), and father attitude was statistically significant higher than mother attitude of breastfeeding (t=2.24, p=0.030). In analysis, the variable 'practice' with breastfeeding was the relationship with mother knowledge (p=0.031) and mother attitude(p=0.015). In this study, the correlation between one couple' knowledge and attitude was not significant. Primiparous couples surveyed in the postpartum period regarding knowledge, attitude and practice about breastfeeding might be affected by recall bias, the effects of the euphoria of the first 24-48 hours postpartum, but these variables were not examined. This study results add to the body of knowledge about nursing care for breastfeeding mothers and fathers. This indicates that a need for education about breastfeeding and, that fathers be included in it as well as mothers.

• Nutrition Research and Practice
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• v.9 no.3
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• pp.242-248
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• 2015

BACKGROUND/OBJECTIVES: Feeding in infancy is the most significant determinant of the intestinal microbiota in early life. The aim of this study was to determine the gut microbiota of Korean infants and compare the microbiota obtained between breast-fed and formula-fed Korean infants. SUBJECTS/METHODS: We analyzed the microbial communities in fecal samples collected from twenty 4-week old Korean (ten samples in each breast-fed or formula-fed) infants using pyrosequencing. RESULTS: The fecal microbiota of the 4-week-old Korean infants consisted of the three phyla Actinobacteria, Firmicutes, and Proteobacteria. In addition, five species, including Bifidocbacterium longum, Streptococcus salivarius, Strepotococcus lactarius, Streptococcus pseudopneumoniae, and Lactobacillus gasseri were common commensal intestinal microbiota in all infants. The predominant intestinal microbiota in the breast-fed infants (BFI) included the phylum Actinobacteria (average 70.55%), family Bifidobacteriacea (70.12%), genus Bifidobacterium (70.03%) and species Bifidobacterium longum (69.96%). In the microbiota from the formula-fed infants (FFI), the proportion of the phylum Actinobacteria (40.68%) was less, whereas the proportions of Firmicutes (45.38%) and Proteobacteria (13.85%) as well as the diversity of each taxonomic level were greater, compared to those of the BFI. The probiotic species found in the 4-week-old Korean infants were Bifidobacterium longum, Streptococcus salivarius, and Lactobacillus gasseri. These probiotic species accounted for 93.81% of the microbiota from the BFI, while only 63.80% of the microbiota from the FFI. In particular, B. longum was more abundant in BFI (69.96%) than in FFI (34.17%). CONCLUSIONS: Breast milk supports the growth of B. longum and inhibits others. To the best of our knowledge, this study was the first attempt to analyze the gut microbiota of healthy Korean infants according to the feeding type using pyrosequencing. Our data can be used as a basis for further studies to investigate the development of intestinal microbiota with aging and disease status.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.189-195
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• 2018

Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.