• Clinical and Experimental Pediatrics
• /
• 제63권4호
• /
• pp.135-140
• /
• 2020

Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

• Neonatal Medicine
• /
• 제17권2호
• /
• pp.232-238
• /
• 2010

목적: 모유수유율이 증가하면서 재수유에 관한 수요가 증가하고 있다. 이에 성공적인 재수유에 기여하는 인자를 조사하기 위해서 약물, 모유수유 보충기, 상담, 가족의 지지 등의 기여도를 조사하였다. 방법: 후향적인 의무기록 조사와 2004년 1월부터 2007년 4월까지 본원 재수유 클리닉을 방문한 아기 엄마들에게 전화설문을 실시하였다. 결과: 총 84명의 자료를 분석하여 재수유의 성공에 도움이 되는 인자를 조사하였다. 75%에서 완전 모유수유로 성공적으로 이행할 수 있었다. 재수유 클리닉을 다니면서 재수유에 성공한 경우 의료진에 의해서 재수유 클리닉으로 의뢰된 경우, 약물을 사용한 경우와 가족의 지지가 있는 경우가 통계적으로 유의하게 높았다. 결론: 재수유에 성공하기 위해서는 산모들에게 재수유에 관한 정보를 미리 제공하고, 필요 시 유즙분비를 촉진하는 약물을 처방하고 상담 기간 동안 가족과 함께 상담을 받게 해서 정신적인 지지를 제공하는 것이 중요하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제17권2호
• /
• pp.61-73
• /
• 2014

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

• Journal of Preventive Medicine and Public Health
• /
• 제41권4호
• /
• pp.232-240
• /
• 2008

Objectives: This study was conducted to assess the nutritional status and characteristics related to malnutrition in children less than five years of age in Nghean, Vietnam. Methods: In this study, which was conducted in November 2007, 650 child-mother pairs were selected using a two-stage cluster sampling methodology. A structured questionnaire was then administered to the mothers in their home settings. Anthropometric measurement was then used to determine if children were underweight (weight-for-age), wasting (weight-for-height) and stunting (height-for-age) based on reference data from the National Center for Health Statistics (NCHS)/World Health Organization (WHO). Logistic regression analysis was then used to describe the hierarchical relationships between potential risk factors and malnutrition. Results: The mean Z-scores for weight-for-age, height-for-age and weight-for-height were -1.46 (95% CI=-1.57, -1.35), -1.44 (95% CI=-1.56, -1.32) and -0.71 (95% CI=-0.82, -0.60), respectively. Of the children included in this study, 193 (31.8%) were underweight, 269 (44.3%) were stunting and 72 (11.9%) were wasting. Region of residence, the mother's level of education and occupation, household size, number of children in the family, weight at birth and duration of exclusive breastfeeding were found to be significantly related to malnutrition. Conclusions: The findings of this study indicate that malnutrition is still an important problem among children less than five years of age in Nghean, Vietnam. In addition, maternal, socio-economic and environment factors were found to be significant factors for malnutrition among children under five.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제26권2호
• /
• pp.99-115
• /
• 2023

Purpose: Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes. Formula supplementation is common within our low-income, ethnic-minority community. We studied exclusively breastfed (EBF) neonates' early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality. Methods: Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0-24 hours), discharge (30-48 hours), and at first appointment (days 3-5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out. Results: Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples' metabolome (p=0.450). Conclusion: Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

• Clinical and Experimental Pediatrics
• /
• 제58권9호
• /
• pp.330-335
• /
• 2015

Purpose: The clinical interpretation of children sensitized to allergens is challenging, particularly in children with food allergies. We aimed to examine clinical differences between children with monosensitization and those with polysensitization to common food allergens and to determine risk factors for polysensitization in young children <10 years of age with immediate-type food allergies. Methods: The study included children <10 years of age with signs and symptoms indicative of immediate-type food allergies. Serum total IgE level was measured, and ImmunoCAP analysis for food allergens was performed. Results: The mean age of the study subjects was $1.6{\pm}1.6$ years (75 boys and 51 girls). Thirty-eight children (30.2%) were monosensitized and 88 children (69.8%) were polysensitized. Multivariate logistic regression analysis showed that the development of polysensitization to common food allergens was positively associated with a parental history of allergic rhinitis (adjusted odds ratio [aOR], 6.28; 95% confidence interval [CI], 1.78-22.13; P=0.004), season of birth (summer/fall) (aOR, 3.10; 95% CI, 1.10-8.79; P=0.033), and exclusive breastfeeding in the first 6 months of age (aOR, 3.51; 95% CI, 1.20-10.25; P=0.022). Conclusion: We found significant clinical differences between children with monosensitization and those with polysensitization to common food allergens and identified risk factors for the development of polysensitization in young children with immediate-type food allergies. Clinicians should consider these clinical risk factors when evaluating, counseling, treating, and monitoring young children with food allergies.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제9권1호
• /
• pp.31-38
• /
• 2006

목 적: 2세 이하의 변비를 주소로 소아과 외래에 방문한 환아들을 대상으로 임상 증상과 식이 방식을 조사하고, 변비의 치료 기간, 방법, 효과를 조사하며, 예후를 알아보고자 본 연구를 시행하였다. 방 법: 2002년 5월부터 2005년 2월까지 인제대학교 일산 백병원 소아과 외래를 방문한 2세 이하 소아 중 외래 처방프로그램 상 변비를 진단코드로 사용한 소아를 대상으로 후향적으로 차트 조사와 전화 상담을 통해 조사 분석하였다. 결 과: 총 96명(남아 40명, 여아 56명)의 환아가 연구에 참여하였으며, 이들의 평균 연령은 9개월이었고 수유 별로 모유수유 23명, 분유수유 20명, 혼합수유 53명이었다. 배변 통증(95.8%)과 배변을 참는 경우(94.8%)가 가장 많았고, 혈변, 단단한 변 순이었다. 신체적 계측상 복부 팽만, 직장 내 굳은 변, 치열, 항문 피부 용종 등의 증상이 관찰되었다. 이들 중 치열과 혈변, 직장 내에 변이 만져지는 경우는 조제분유의 섭취와 관련성이 있었다. 하루에 액상식이를 500 mL 이상 섭취하는 환아는 54.2% (32/59)였고, 이중 12개월 이상에서는 57.1% (8/14)였다. 액상식이의 양에 따른 임상 증상은 항문 피부 용종을 제외하고는 통계적으로 유의한 결과가 없었다. 변비를 치료하기 위해서 71명이 락툴로즈를 투약 받았으며, 투약 기간은 1달 이내가 가장 많은 79%를 차지하였다. 부모들은 약에 대한 효과가 36명(50.7%)에서 있었다고 대답하였고, 전화 상담 시기까지 변비가 있었던 환아는 5명(5.2%)이었다. 결 론: 2세 이하 영유아 변비의 증상은 매우 다양하였으며, 조제 분유의 수유가 변비의 주요한 증상과 연관이 있었다. 다수의 환자들에서 이유기에 고형식으로의 이행이 부적절한 것으로 나타났다. 치료는 비교적 잘 되었고 좋은 예후를 보였다.