• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.29-37
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• 2012

Purpose: To examine the prevalence of $Clostridium$ $difficile$ ($C.$ $difficile$) colonization (CDC) and potential neonatal determinants of CDC in hospitalized preterm infants. Methods: Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of $C.$ $difficile$ and the toxin A and toxin B genes. The correlation between the results of $C.$ $difficile$ PCR assays and the clinical characteristics of the infants was analyzed. Results: The prevalence rates of CDC were 34.7, 37.2, 41.3, and 53.1% within 72 h after birth and at 1, 2, and 4.6 weeks of age, respectively. The toxin positivity rate was significantly higher in the infants with persistent CDC than in those with transient CDC (8/12 [66.7%] vs. 6/25 [24.5%] ($p$=0.001). Among the various neonatal factors, only the feeding method during the first week after birth was significantly associated with persistent CDC. Exclusive breast-milk feeding (EBMF) significantly decreased the risk of persistent CDC compared to formula or mixed feeding (adjusted odds ratio: 0.133, 95% confidence interval: 0.02-0.898, $p$=0.038). Conclusion: The prevalence of CDC increased with the duration of hospitalization in preterm infants in the NICU. EBMF during the first week after birth in hospitalized preterm infants may protect against persistent CDC.

• Child Health Nursing Research
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• 제26권3호
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• pp.376-384
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• 2020

Purpose: This study aimed to determine the influence of a breastfeeding coaching program (BCP) for mothers of late preterm infants (LPIs) on the breastfeeding rate and neonatal morbidity within 1 month after discharge. Methods: This was a non-randomized quasi-experimental study with a time series design. The participants were 40 LPIs and their mothers who were hospitalized in a neonatal intensive care unit at a university hospital. Nineteen LPIs were assigned to the control group, and 21 to the experimental group. The mothers of the LPIs in the experimental group received the BCP once on the discharge day and then once a week for 1 month. Neonatal morbidity was defined as an outpatient department or emergency room visit due to an LPI's health problem. Results: The breastfeeding rate in the experimental group was significantly higher than in the control group at the fourth week after discharge (χ²=7.17, p=.028). Five and two LPIs in the control group and the experimental group, respectively, visited a hospital due to neonatal jaundice. Neonatal morbidity was not significantly different between the two groups (χ²=1.95, p=.164). Conclusion: The BCP was useful for improving the breastfeeding rates of LPIs and may have potential to reduce neonatal morbidity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권2호
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• pp.154-162
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• 2020

Purpose: The Cow's Milk-related Symptom Score (CoMiSS^TM), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. This study aimed to determine the age-related CoMiSS^TM values in presumed healthy infants in Poland. Methods: This was a cross-sectional study conducted in well-child clinics in two locations. Parents of the presumed healthy infants aged ≤6 months were approached during a routine checkup/vaccination visit. The exclusion criteria were as follows: presence of acute or chronic diseases, preterm delivery, treatment with therapeutic formula, and use of any food supplements (except vitamins) or medications. Results: Data from 226 infants were obtained (median age [Q1-Q3], 4 months [3-4]). The overall median (Q1-Q3) and mean (standard deviation) CoMiSS^TM values were 4 (2-7) and 4.7 (3.5), respectively. The 95th percentile was 11. Scores on some, albeit not all, components of the CoMiSS^TM significantly differed between age groups (crying, stools) or feeding type groups (stools and skin symptoms). Eleven children (4.9%) scored ≥12. Conclusion: This study adds to earlier age-related CoMiSS^TM data by providing CoMiSS^TM values in presumed healthy infants in Poland.

• Neonatal Medicine
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• 제18권2호
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• pp.204-210
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• 2011

목적: 극소 저체중 출생아에서 식이 불내성은 매우 흔하나, 괴사성 장염 외에는 원인에 대한 연구가 미흡하다. 본 연구기관에서는 식이 불내성이 지속되는 극소 저체중 출생아 중 알레르기성 장염을 의심하여 치료한 경험이 있어 이의 임상상을 분석하고자 하였다. 방법: 2009년 1월부터 2010년 7월까지 삼성서울병원 신생아 중환자실에 입원하였던 출생 체중 1,500 g 미만의 미숙아들 중에 식이 불내성을 보이고, 말초혈액 검사상 중등도 이상의 호산구증(${\geq}$1,000 cells/$mm^3$)이 동반되는 경우에 신생아 괴사성 장염이 배제된 상태에서 식이 제한 모유 혹은 가수 분해 분유에 반응하였던 경우들을 조사하였다. 결과: 연구대상 181명 중에서 식이 불내성을 나타낸 환자는 총 161명(88.9%), 호산구 증가증을 나타낸 환자는 119명(65.7%), 중등도 이상의 호산구 증가증을 나타낸 환자는 85명으로 47%의 유병률을 보였다. 알레르기성 장염으로 진단받은 환자는 17명으로 9.4%의 유병률을 보였다. 식이 불내성 환자 중 알레르기성 장염군(n=17)과 비알레르기성 장염군(n=144)과의 비교에서 평균 재태 주수, 출생 체중, 입원 기간, 항생제 사용 기간, 증상 발생일, 정맥 영양 기간은 차이가 없었으나, 최대 호산구 %의 평균값은 두 질환군에서 통계학적으로 유의하게 차이가 있었다. 알레르기성 장염으로 진단 받은 환자들 중 식이 제한모유로 2명인 12%에서 증상의 호전을 보였고, Extensively hydrolyzed formula로 10명(59%)에서 증상의 호전을 보였다. Free amino acid-based formula로 5명(29%)에서 증상의 호전을 보였다. 결론: 극소 저체중 출생아에서 식이 불내성이 있는 경우 알레르기성 장염의 가능성을 고려할 수 있고 이 경우 식이 변경을 통해 적극적인 식이 진행이 가능하였다.