• Title/Summary/Keyword: Infant feeding

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Prevalence and Risk Factors of Functional Gastrointestinal Disorders in Infants in Indonesia

  • Lily Arsanti Lestari;Adhyatma Noor Rizal;Wahyu Damayanti;Yulianti Wibowo;Chang Ming;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.1
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    • pp.59-86
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    • 2023
  • Purpose: Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia. Methods: This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs. Results: The prevalence of regurgitation was 26.3%; 16.8% of the infants presented cryingrelated symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; p=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; p=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; p=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; p=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; p<0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; p=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; p=0.007). Conclusion: Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.

An Analysis of Nursing Research related to the Mother-Child Interaction in Korea (모아상호작용 관련 간호연구 분석)

  • Oh Jina;Lee Ja-Hyung
    • Child Health Nursing Research
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    • v.9 no.2
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    • pp.149-161
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    • 2003
  • Purpose: The purpose of this study is to identified patterns and trend of studies and to analyzed the nursing research related to the mother-child interaction in Korea and to improve direction of nursing research in mother-child interaction in Korea. Method: The research studies related to the mother-child interaction were selected from the Korean Nurses Academic Society Journal, and from dissertation, which were conducted between 1961 and 2002 with the consideration of the condition and the cultural specialty of Korea. The total numbers of the studies were 34. These studies were classified according to 1)time of publication or presentation, 2)research design, 3)type of interaction objects, 4)measurement tool, and 5)chief content of studies. Ressult: 1) Until 1984, there was no research studies related to mother-child interaction. The number of studies on the mother-child interaction on the mother-child interaction has been increased rapidly after 1985. The mother-child interaction studies were 13(38.2%) from the doctoral dissertation, 4(11.8%) from the Master's theses and 17(50%) other papers were published in academic journals. 2) Experimental studies of research design was used in these research studies was 13(38.2%). Descriptive studies was 8(23.6%), correlational studies was 4(11.8%) and comparative studies was 4(11.8%). Qualitative study was just one(2.9%) and literature review was 4(11.8%). Especially experimental studies has been increased. 3) Participants of these studies were mother and infant 29(85.5%), father and infant 2(5.9%), mother and fetus 2(5.9%) and nurse and infant 1(2.9%) 4) Utilization of instruments as follows: 13 studies used Walker et al(1986)'s MIPIS (Mother-Infant Play Interaction Scale), 6 studies used Barnard(1978)'s NCAFS (Nursing Child Assessment Feeding Scale), 4 studies used NCATS(Nursing child Assessment Teaching Scale) for assessing mother-infant interaction. 3 studies used Stainton(1981)'s Parent-Infant Interaction Scale. Choi(1987), Kim(1999) and Kim and Son(1997) used measurement tool researcher made which was modified from NCATS (Nursing child Assessment Teaching Scale) and AMIS(Assessment of Mother-Infant Sensitivity Scale). Other tools used to survey influencing factors of interaction. 5) Content of the research studies were classified 3 different types, such as ① studies about the mother-child interactions' pattern, ② studies about influencing factors of the mother-child interaction, ③ studies about effect of nursing intervention program to improve the mother-child interaction. Conclusion: Therefore we make following suggestions which are made based on the above research analysis : 1) In the future research studies need to compare with other area of discipline in mother-child interaction. 2) More attention and in depth research is needed to validate in terms of research design and statistical data analysis. 3) It is important to develop the instruments which is culturally acceptable in Korea society. 4) The results of correlational studies and experimental studies needs to the integrated by meta analysis.

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A Study on Child-Care in Rural Korea : Feeding, Weaning and Toilet-Training (농어촌지역의 양육방법에 관한 연구 - 수유·이유·배변훈련을 중심으로 -)

  • Lim, Hee Kyou
    • Korean Journal of Child Studies
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    • v.5
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    • pp.65-80
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    • 1984
  • The purpose of this study was the description of general trends in feeding, weaning and toilet training in agricultural and fishing communities in Korea, where the traditions are better preserved; thereby to present useful material for improving child rearing practices. The results of this study showed that: 1) Breast-feeding is the dominant form of nursing. The mother nurses freely whenever the baby wants to be fed. The mother caresses the baby while she nurses him. The nursing period is relatively long, up to 1 and a half years. 2) Generally, the time of weaning starts late - between 9 months and 18 months. Many mothers apply a bitter tasting solution to their nipples to aid weaning. The many things give a baby foods, the recipe for which the acquire knowledge from his family and acquaintances. 3) Toilet training generally starts after 1 full year. Potties are commonly used. The infant is reminded of its error whenever it makes a mistake and cleanliness is stressed. Urination and defecation are taught to be dirty things. In summary, discipline is not strict enforced but given naturally as the infants grow: This was interpreted in terms of the traditional way of life and geographical characteristics.

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A Study on the Maternal Perception of Her Newborn Baby (신생아에 대한 산모의 감지도에 관한 연구)

  • 박영숙;변희재
    • Journal of Korean Academy of Nursing
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    • v.14 no.1
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    • pp.50-59
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    • 1984
  • The purpose of this study was to evaluate the maternal perception of her newborn and identify the risk of mother-infant relationship. Broussard's Neonatal Perception Inventories were completed by 113 mothers on the first or second postpartum day (Time I ) while they were still in the University Hospital. These inventories were again administered when the infants were approximately one month of age (Time Ⅱ). The data was analyzed by S.P.S.S. program and the results were as follows: 1) There were differences between the mothers' exportations of the average baby and perceptions of their babies at Time I and Time Ⅱ (p<0.01). 2) The maternal perception of her newborn at Time I was not related with the education, the parity, the experience of abortion, the type of delivery and the sex of baby but related with the method of feeding (p<0.05). 3) The maternal perception of her newborn at Time Ⅱ was not related with the education, the parity, the experience of abortion, the type of delivery and the method of feeding but related with the sex of baby (p<0.05). 4) The changes of maternal perception between Time I and Time Ⅱ were not related with the education, the parity, the experience of abortion, the method of delivery and the sex of baby but related with the method of feeding (p<0.1). 5) The maternal perception of the newborn was not correlated with the age and the duration of labor.

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An update on necrotizing enterocolitis: pathogenesis and preventive strategies

  • Lee, Jang-Hoon
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.368-372
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    • 2011
  • Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

The Effects of Breast Milk Olfactory Stimulation on Physiological Responses, Oral Feeding Progression and Body Weight in Preterm Infants (모유후각자극이 미숙아의 생리적 반응, 구강수유 진행 및 체중에 미치는 영향)

  • Lee, Eun Jee
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.126-136
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    • 2019
  • Purpose: This study was conducted to evaluate the effect of breast milk olfactory stimulation on physiological responses, oral feeding progression, and body weight in preterm infants. Methods: A repeated measures design with nonequivalent control group was used. The participants were healthy, preterm infants born at a gestational age of 28~32 weeks; 12 in the experimental group and 16 in the control group. Data were collected prospectively in the experimental group, and retrospectively in the control group, by the same methods. Breast milk olfactory stimulation was provided 12 times over 15 days. The data were analyzed using the chi-square test, Mann-Whitney U test, Wilcoxon signed rank test and linear mixed models using SPSS 19. Results: The gastric residual volume (GRV) of the experimental group was significantly less than that of the control group. The heart rate, oxygen saturation, respiration rate, transition time to oral feeding, and body weight were not significantly different between the two groups. Conclusion: These findings indicate that breast milk olfactory stimulation reduces GRV and improves digestive function in preterm infants without inducing distress.

Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.153-173
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    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

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Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)

  • Han, Kyung-Ja
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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Regurgitation and Gastroesophageal Reflux Disease in Six to Nine Months Old Indonesian Infants

  • Hegar, Badriul;Satari, Debora Hindra I.;Sjarif, Damayanti R.;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.240-247
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    • 2013
  • Purpose: Regurgitation is known to peak at the age of 3-4 months, with a sharp decrease around the age of 6 months. Little is known about the natural evolution of infants who still regurgitate after the age of 6 months. Methods: Hundred thirty-one infants older than 6 months regurgitating more than once a day were followed for a period of 3 months. Results: According to our data, gastroesophageal reflux disease (GERD) is seldom at this age. Most of the infants regurgitated 3 or more times/day and spit up an estimated volume of more than 15 mL. Eighty-five parents were educated regarding frequency of feeding. There were only 6 infants that still had frequent regurgitation (>3 times/day) despite an appropriate feeding schedule. The Infant GER Questionnaire score reached a score of 0 in 50% of the infants after one month of follow-up and in 81.9% at the third month of follow-up. There was an increase of the "weight for age z-score" trends in infants that still regurgitated at the end of follow-up and a declining z-score in infants that no longer regurgitated. An explanation may be that infants that regurgitate drink larger volumes than infants who do not regurgitate. Conservative treatment (reassurance, dietary treatment, behavioral advice) resulted in a significant better outcome than natural evolution. Conclusion: Regurgitation that persisted after the age of 6 months, strongly decreased during a 3-month follow-up with conservative treatment. GERD is rare in this age group; therefore, anti-reflux medication is only seldom needed.

Vitamin D deficiency in infants aged 1 to 6 months

  • Choi, You Jin;Kim, Moon Kyu;Jeong, Su Jin
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.205-210
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    • 2013
  • Purpose: The aim of this study was to recognize the state of vitamin D among healthy infants aged 1 to 6 months in South Korea, and also to identify the risk factors affecting the level of vitamin D. Methods: A total of 117 infants were enrolled in this study for 12 months, from March 1, 2011 to February 29, 2012. Serum levels of 25-hydroxyvitamin D (25[OH]D), calcium, phosphorus, and alkaline phosphatase were measured and data including birth weight, body weight, sex, feeding pattern, delivery mode, siblings and maternal age and occupation were collected. Data was mainly analyzed with independent t-test model. Results: We determined that the prevalence of vitamin D deficiency (serum 25[OH]D<20 ng/mL [50 mmol/L]) was 48.7% in the population investigated. Particularly in breastfed infants, the prevalence of vitamin D deficiency was strikingly high (90.4%). The mean serum level of 25(OH)D in breastfed infants was lower than that of formula fed infants (9.35 ng/mL vs. 28.79 ng/mL). Also female infants showed lower mean serum level of 25(OH)D than male. Mean serum values of calcium and phosphorus had positive correlation with vitamin D state (P<0.001). Conclusion: Vitamin D deficiency was found to be very common in infants aged 1 to 6 months in South Korea, and breast feeding was the most critical risk factor of vitamin D deficiency. Therefore we suggest to start vitamin D supplementation in South Korea, as soon as possible, to all infants, including breastfed and female infants.