• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.153-161
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• 2016

This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and ${\beta}$-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added ${\beta}$-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.

• Clinical and Experimental Pediatrics
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• 제46권7호
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• pp.635-641
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• 2003

목 적 : 임신 시 모유 수유를 계획한 수유모의 모유 수유 실천과 이에 영향을 주는 요인을 알아보고자 본 조사를 시행하였다. 방 법 : 임신 시 모유 수유를 계획했던 1,128명 중에서 지역과 병원급을 층화하여 무작위 추출한 152명을 연구의 대상으로 하였다. 2001년 11월부터 2002년 3월까지 연구 대상자의 출산 후 4개월에 전화로 설문을 실시하여 결과를 분석하였다. 결 과 : 1) 임신 시 모유 수유를 계획한 수유모 중에서 출산 4개월 후의 모유 수유율은 37.5%였고, 실패 이유는 66.3%가 모유가 나오지 않거나 양이 적어서라고 대답하였고 그 외 수유모의 직장 또는 일 13.7%, 수유모의 질환 7.4%, 변이 묽어서 5.3%, 아기의 질병 4.2% 등이었다. 2) 수유모의 연령, 자녀의 유무, 모유 수유를 결정한 사람, 가족의 형태에 따른 차이는 없었으나, 임신 시 모유 수유를 4개월 이상으로 계획했던 경우 모유 수유율이 2.3(95% 신뢰구간 1.15-4.62)배로 유의하게 높았다(P<0.05). 3) 전문대졸 이상의 수유모의 모유 수유율이 고졸 수유모보다 0.43(95% 신뢰구간 0.21-0.86)배로 유의하게 낮았으며 취업 수유모의 모유 수유율이 0.37(95% 신뢰구간 0.17-0.83)배로 유의하게 낮았다(P<0.05). 4) 모유 수유 장점과 수유의 방법에 대한 인식항목 20개에 대한 점수의 중앙값 12점을 기준으로 할 때 12점 이상인 사람의 모유 수유율은 41.5%였던 반면, 12점 미만인 경우 34.5%의 모유 수유율을 보여 인식이 높은 군이 낮은 군에 비해 1.35(95% 신뢰구간 0.70-2.62)배의 모유 수유율을 보였다(P>0.05). 5) 출산 장소가 산부인과 의원인 경우 종합병원 보다 모유 수유율이 3.97(95% 신뢰구간 11-14.23)배로 유의하게 높았다(P>0.05). 출산아 성별, 병원내 모유 수유, 모자동실 및 분만 형태에 따른 모유 수유율의 유의한 차이는 없었다. 결 론 : 모유 수유율 높이기 위해서 적극적인 산전 교육과 출산 후 병의원에서 모유 수유를 할 수 있도록 모자동실, 모유 수유 상담 및 교육이 적절하게 제공되어야 할 것이다. 또한 취업 수유모의 모유 수유를 위한 공간과 시설 및 휴가 문제 등이 사회 정책이나 국가 정책으로 제도화 되어야 할 것이다.

• Neonatal Medicine
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• 제18권2호
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• pp.387-390
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• 2011

식도천공은 신생아에서 드문 질환이다. 그러나 영양관 삽관으로 인한 의인성 식도천공은 미숙아에서는 특히 드물지 않게 나타난다. 의인성 식도천공은 기흉같은 심한 합병증을 유발하며 사망을 일으킬 수 있다. 일반적으로 식도천공의 결과로 기흉이 발생하는 것으로 알려져있다. 반면에, 저자들은 기흉이 먼저 병발하고 이 후 의인성으로 발생한 식도천공을 경험하였다. 증례의 식도천공은 환아에게 기흉이 발생한 채로 영양관을 삽관하여 야기되었다. 기흉이 있는 상태에서 영양관 삽관을 고려할 때는 더 심사숙고 하여야 할 것이다.

• Clinical and Experimental Pediatrics
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• 제51권2호
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• pp.150-155
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• 2008

목 적 : 모유 황달은 지속성 황달을 일으키는 중요한 원인이다. 모유 황달은 모유의 여러 가지 성분으로 인해 일어난다고 알려져 있지만 아직 그 원인이 명확하게 밝혀지지 않았으나 이전의 연구에서는 모유 황달이 가족력과 관계있다는 결과도 제시되었다. 이에 저자들은 신생아 황달을 가진 모유수유 환아들에서 Gly71Arg와 TATA box 유전자의 다형성을 조사한 후 이것이 한국인 신생아의 지속성 황달과 연관성이 있는지 알아보고자 본 연구를 시행하였다. 방 법 : 혈중 빌리루빈 수치가 10 mg/dL 이상의 건강하고 위험인자가 없는 모유수유를 시행한 만삭아 중 신생아 황달 환자 50명과 대조군 162명으로부터 혈액 0.5 cc를 채취하여 DNA를 분리하였고 TATA box와 Gly71Arg 유전자를 PCR 증폭하였다. 이를 염기서열 분석 방법을 통해 각 유전자의 다형성을 확인하였다. 결 과 : Gly71Arg 다형성은 환자군 50명 중 2명(4.0%)에서 AA로 40명(80.0%)은 GA로 나타났으며, 유전자가 분석된 대조군 129명 중 5명(3.9%)에서 AA로 4명(3.1%)은 GA로 나타났고, 대립유전자 빈도는 대조군에서 44.0% 환자군에서 5.5%로 나타났다(P=0.000001). TATA box는 환자군 50명 중 1명에서 $A(TA)_6TAA/A(TA)_7TAA$로 나타났으며 대조군에서 모두 $A(TA)_6TAA/A(TA)_6TAA$로 나타났다. 결 론 : 모유수유한 한국인 신생아 지속성 고빌리루빈혈증에서 UGT1A1의 Gly71Arg과 TATA box의 다형성을 확인하였으며, Gly71Arg 유전자의 다형성은 고빌리루빈혈증군에서 대조군에 비해 의미 있게 증가되어 모유수유한 한국인 신생아 지속성 고빌리루빈혈증과 연관이 있었고, TATA box의 다형성은 연관이 없었다.

• 대한간호학회지
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• 제22권1호
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• pp.29-41
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• 1992

The purpose of this research was to study the effects of antenatal breast care on decreases in breast discomfort and increases in the breast feeding rate during the postpartum period. A nonequivalent control group posttest research design was used. The experimental group consisted of fifty -one pregnant women(primigravida) who were receiving antenatal care in the OBGYN clinics of four hospitals between March 5 and May 30, 1991. The control group was made up of seventy - five postpartum women who delivered at two hospitals OBGYN clinic and one midwife clinic between May 4 and June 15, and between September 5 and October 15, 1991. Data were collected via telephone interviews on the seventh postpartum day and at the end of the second month. Data analysis methods used frequencies and the x$^2$- test. The results were as follows : 1. The rate of breast feeding practice at two months was higher in the experimental group(70.6%) than in the control group(25.3%) (p＜.01). 2. Nipple soreness in the early breast feeding period was lower in the experimental group(14.6%) than in the control group(25.3)(p＜.01). 3. Severe breast discomfort in the early breast feeding period was lower in the experimental group (12.5%) than in the control group(39.2%)(P＜.01). 4. There was a significant relationship between the breast feeding practice and the planned feeding method(p＜.05), and between breast feeding practice and nipple soreness(p＜.01) in the experimental group, and the presence of a job(p＜.01), the sex of the infant(p＜.05), and the first feeding time(p＜.05) in the control group. 5. The reasons for unsuccessful breast feeding were a deficiency of breast milk (66.7% in the experimental group, 30.4% in the control group), poor sucking on the part of the baby(13.3% in the experimental group, 21.4% in the control group).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권4호
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• pp.261-268
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• 2013

Purpose: To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT). Methods: This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT). Results: Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth. Conclusion: Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.

• Clinical and Experimental Pediatrics
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• 제46권11호
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• pp.1143-1146
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• 2003

저자들은 아토피 피부염 조절을 위해 7개월간 선식만 먹고 발생한 구루병 1례를 경험하여 근래에 대두되고 있는 영양식의 실태와 문제점을 살펴보고자 문헌 고찰과 함께 보고하는 바이다.

• 대한지역사회영양학회지
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• 제1권3호
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• pp.335-345
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• 1996

The solids(supplementary food) consumption of 200 healthy infants aged from 4 to 6 months have been measured. Five groups were assigned to different feeding patterns. Breastfed group(BF, n=38), formula-fed group(FF, n=102) and mixed-fed group(MF, n=14) were fed breast milk, formula and mixed(breast mile+formula) from birth until 6 months of age respectively. Convert 1 group(C1F, n=14) and convert 2 group(C2F, n=32) were fed breast milk and mixed milk at 2 months of age respectively and were switched to formula thereafter. All infants received solids form 4 months of age. The energy intake from solids at 4 and 6 months averaged 59.1 and 110.3㎉/d among BF groups vs 151.9 and 239.3㎉/d among FF groups respectively. Intakes of protein, calcium and iron were 38-46$\%$, 34-44% and 25-37$\%$ higher in the FF than in the Bf group during the first 6 months. However, no significant differences were found in the intakes of energy and nutrient intakes from solids in all 4 groups excluding BF group(39$\%$). Although BF infant's nutrient intakes from solids were lower than other group's intakes, they intaked evenly solids from various food groups. As the age of infant had increased, the energy intake ratio from solids was cereals and dairy products was increased whereas energy intake ratio from meats, eggs, fruits and vegetables was decreased. TSC4, TSC6(the frequency score for the kinds of weaning food taken) showed no significant difference among 5 feeding groups but CIF-and C2F group's scores tended to be high. Consequently, these results suggest that BF group's solid intake pattern is more desirable and that Korean lactating Mother's dependence on commercial weaning food is too high.

• 한국식생활문화학회지
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• 제23권2호
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• pp.268-272
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• 2008

The breast feeding habits of 507 college students were evaluated between March 27 to April 26 (2006). Data were collected from self-administered questionnaires and analyzed using SPSS for Windows V.12.0. The study population consisted of 245 (48.3%) male and 262 (51.7%) female college students that answered ‘yes’ when asked whether they had been breast feed. A total of 52.7% of the study population were fed with breast milk (most frequent answer), as opposed to 11.0% that were fed with infant formula (least frequent answer) during their infancy. When asked whether they ever got educated on breast feeding, 78.1% of the college student subjects answered ‘no’. A total of 95.1% of the female college students replied ‘yes’ when asked if they intended to breast feed their child. Moreover, 62.2% of the college student subjects indicated that their parents had an influence on their decision to breast feed. A comparison between male and female college students indicated that female college students had a superior knowledge level of the general characteristics of breast feeding over the male subjects (p<0.05) . Moreover, a comparison of the different levels of college attained suggest that freshman college students had the highest knowledge level, followed by senior, sophomore and junior college students in terms of advantage, BF Tabu (p<0.05). Also, students provided with education on breast feeding had a higher knowledge level than college students with no formal education. In summary, the results suggest that the knowledge on breast feeding in college students were different by general characteristics such as gender, major and school year, and education on breast feeding in advance was appeared to be an important factor, therefore nutritional education course on breast feeding is recommended for the college students.

• Journal of Nutrition and Health
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• 제31권1호
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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.