• Clinical and Experimental Pediatrics
• /
• 제57권12호
• /
• pp.505-513
• /
• 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.

• Nutrition Research and Practice
• /
• 제9권3호
• /
• pp.242-248
• /
• 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.

• 한국보건간호학회지
• /
• 제17권2호
• /
• pp.192-202
• /
• 2003

This descriptive study aimed to determine the effects of community based health education program for pregnant women on their confidence in labor and breastfeeding. Data were obtained using several questionnaires and administered to 174 pregnant women who have participated (n=49) and have not participated(n=125) in health education program, and 244 mothers of infants who lived in one city in Kyunggi province. Summaries of finding were as follows; First, pregnant women who have participated in health education program showed significantly higher score in confidence in labor than those who have not. Also, confidence in labor was different according to the level of education. Second, pregnant women participated in health education program showed higher score in knowledge and attitude on breastfeeding, but the differences were not significant. Knowledge on breastfeeding was higher in multipara. More positive attitude on breastfeeding was found in working mothers and highly educated mothers. Third, $54.1\%$ of mothers continued breastfeeding over six months. Main reasons for discontinuing breastfeeding were lack of breast milk amount, and health problems in infants and mothers. In this study, we could identify the positive effects of health education program for pregnant women provided by public health center, and find the related factors of confidence in labor and breastfeeding. Community based health education program for pregnant women, especially for vulnerable group should be expanded.

• 한국간호교육학회지
• /
• 제7권1호
• /
• pp.38-53
• /
• 2001

The main purpose of this study was to present the basic materials that help the nursing of the infants and consultation of childcare by examinating the knowledge and practice of the mothers about the weaning diet. The data for this study was collected from 205 mothers with infants(6-36 months) who visited two hospitals or one university hospital in Seoul, who were living in one apartment Suwon area between July. 7. and September 10, 2000. The 57 questionnaires were used for collecting the data and SAS program was used to analyse the data. The results are as follows. 1. The items of low score in the result of the knowledge data were as follows. [Initial weaning time, the important nutritional problem in infant, considering factor during feeding, the relation of proper weaning food & age, the time of used by cup, to apply of proper spicies in weaning food, the time of completing weaning, the time of stopping weaning at abnormal sign, and the inappopriate reason of dry mixed powdered food (Sunsik) as a weaning food.] 2. Higher educated mothers presented more high score than lower educated mothers in the knowledge about the weaning. (p<0.05) 3. Before the weaning, more mothers were using the commercial milk (51.2%) than the breast milk (13.2%). 4. Mothers get the knowledge about the weaning from the infants care book of cook books(26.4%). 68% of mothers had not received any consulting service with regard to the weaning, 10.2% of them consulted Pediatrician about the weaning and 0.5% of them with nurse. 5. Most mothers began supplymentary food, from four to six months (65.4%). the ratio was about the same as the ratio of mothers who knEw the appropriate time for the introduction of supplymentary food(83.2%) 6. The main solid food was commercial food, not home-prepared food. 7. Higher educated mothers used home-prepared weaning food more often than lower educated mothers(P<0.05). 8. The used rate by spoon was 57.4%, but the rate of mother's knowledge data was 95.0%. 9. The time of completing the weaning was in 12-18 months(53.8%). It is similar to the mother's knowledge data(52.7%) Conclusion ; According to knowledge data, it turns out that most mothers know moderatly about the weaning (everage 60/100). However their knowledge and practice on the methods & procedures on the weaning were inadquate. Especially, most mothers did not consult with those qualification about the weaning. Therefore, the role of the nurse as a provider of information on the weaning should be emphasized with varied educational programs in many health care center.

• Neonatal Medicine
• /
• 제18권1호
• /
• pp.104-110
• /
• 2011

목적: 미숙아에게 필요한 영양성분을 알기 위해서는 그들의 모유 성분을 분석하는 것이 도움이 된다. 저자들은 미숙아 모유의 장기적인 철분함량의 변화를 관찰하고 만삭아 모유와 비교하였으며, 이를 토대로 모유수유만 하는 미숙아에서 철분 보충의 필요성과 지침에 대해 알아보고자 하였다. 방법: 재태연령 34주 미만이거나 출생체중 1,800 g 미만의 미숙아를 출산한 산모 103명으로부터 생후 1, 2, 4, 6, 8, 12주의 모유를 수집하였고, 만삭아의 모유는 24명의 산모로부터 생후 1주째에 수집하여 철분함량을 분석하였다. 결과: 생후 2주에서 8주 사이의 미숙아 모유내의 철분함량은 유의한 차이가 없었으며(36.3${\pm}$23.1~45.8${\pm}$26.0 $\mu$g/dL), 이는 생후 1주째의 미숙아모유 (23.1${\pm}$14.6 $\mu$g/dL)나 만삭아 모유(25.2${\pm}$7.55 $\mu$g/dL)의 철분함량보다는 유의하게 높았다. 교정나이로 만삭이 된 미숙아의 모유(42.2${\pm}$19.4 $\mu$g/dL)는 만삭아의 모유보다 유의하게 높은 철분함량을 나타내었다. 결론: 미숙아 모유의 철분함량은 생후 3개월까지 큰 차이가 없었으며, 이는 필요량보다 적어 모유수유만 할 경우 AAPCON(2004)에서 권유하는 대로 2 mg/kg/day의 철분을 보충하는 것이 좋겠다.

• Nutrition Research and Practice
• /
• 제15권3호
• /
• pp.367-381
• /
• 2021

BACKGROUND/OBJECTIVES: This study aimed to establish a mother and child cohort in the Chinese population, and investigate human breastmilk (HBM) composition and its relationship with maternal body mass index (BMI) and infant growth during the first 3 mon of life. SUBJECTS/METHODS: A total of 101 Chinese mother and infant pairs were included in this prospective cohort. Alterations in the milk macronutrients of Chinese mothers at 1 mon (T1), 2 mon (T2), and 3 mon (T3) lactation were analyzed. HBM fatty acid (FA) profiles were measured by gas chromatography (GC), and HBM proteomic profiling was achieved by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). RESULTS: During the first 3 mon of lactation (P < 0.05), significant decreases were determined in the levels of total energy, fat, protein, and osteopontin (OPN), as well as ratios of long-chain saturated FA (including C16:0, C22:0 and C24:0), monounsaturated FA (including C16:1), and n-6 poly unsaturated FA (PUFA) (including C20:3n-6 and C20:4n-6, and n-6/n-3). Conversely, butyrate, C6:0 and n-3 PUFA C18:3n-3 (α-linolenic acid, ALA) were significantly increased during the first 3 mon (P < 0.05). HBM proteomic analyses distinguished compositional protein differences over time (P = 0.001). Personalized motherinfant analyses demonstrated that HBM from high BMI mothers presented increased total energy, fat, protein and OPN, and increased content of n-6 PUFA (including C18:3n-6, C20:3n-6 and n-6/n-3 ratio) as compared with low BMI mothers (P < 0.05). Furthermore, BMI of the mothers positively correlated with the head circumference (HC) of infants as well as the specific n-6 PUFA C20:3n-6 over the 3 time points examined. Infant HC was negatively associated with C18:0. CONCLUSION: This study provides additional evidence to the Chinese HBM database, and further knowledge of FA function. It also helps to establish future maternal strategies that support the healthy growth and development of Chinese infants.