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Lins ACDL, Pedraza DF. [Growth rate of children of a cohort up to the sixth month of life]. CIENCIA & SAUDE COLETIVA 2021; 26:5777-5792. [PMID: 34852108 DOI: 10.1590/1413-812320212611.22212020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 09/18/2020] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to investigate factors that contributed to the growth rate of children from birth through the sixth month of life. It involves a cohort study with 144 children observed at birth and in the first, second and sixth months of life. Child head circumference (cm/month), weight (g/day) and length (cm/month) rates were compared according to birth, pregnancy, maternal and family characteristics and those related to the food, illness and health care of the child. The female sex and difficulty in breastfeeding contributed to the deceleration of all three growth rates, while maternal non-vaccination against tetanus affected the increase of head circumference and of child length. Severe maternal mental disorder, moderate/severe food insecurity, oatmeal consumption and failure to follow-up the development of the child influenced the head circumference and weight rates. The intake of alcohol during pregnancy, cesarean delivery, mixed/predominant breastfeeding, use of infant formula and episodes of diarrhea/vomiting affected the head circumference, while inadequate prenatal care affected weight, and low-stature mothers and pacifier use affected length. Modifiable factors are highlighted, such as the consumption of oatmeal and infant formula, and the use of pacifiers, which are related to breastfeeding in infants.
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Affiliation(s)
- Anahi Cézar de Lima Lins
- Universidade Estadual da Paraíba. R. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Dixis Figueroa Pedraza
- Universidade Estadual da Paraíba. R. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
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Sindhu KN, Ramamurthy P, Ramanujam K, Henry A, Bondu JD, John SM, Babji S, Koshy B, Bose A, Kang G, Mohan VR. Low head circumference during early childhood and its predictors in a semi-urban settlement of Vellore, Southern India. BMC Pediatr 2019; 19:182. [PMID: 31170939 PMCID: PMC6552319 DOI: 10.1186/s12887-019-1553-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 05/22/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Stunting in developing countries continues to be a major public health problem. Measuring head circumference (HC) during clinical anthropometric assessment can help predict stunting. The aim of this study was to assess burden and determine the predictors of low HC (<- 2 SD) at birth and during first 2 years of life in a semi- urban settlement of Vellore. METHODS The study uses baseline data and serial HC measurements from the birth cohort of MAL-ED study, where 228 children from Vellore completed follow-up between March 2010 to February 2014. Analysis of baseline, maternal and paternal characteristics, micro-nutrient status and cognition with HC measurements was performed using STATA version 13.0 software. RESULTS The mean HC (±SD) at 1st, 12th and 24th month were 33.37 (1.29) cm, 42.76 (1.23) cm and 44.9 (1.22) cm respectively. A third of the infants (75/228) had HC less than - 2 SD at first month of life, and on follow-up, 50% of the cohort had HC ≤ -2 SD both at 12th and 24th month. Low HC measurements at all three time-points were observed for 21.6% (46/222) infants. Low HC was significantly associated with stunting in 37.3% (OR = 10.8), 57.3% (OR = 3.1) and 44.4% (OR = 2.6) children at 1st, 12th and 24th month respectively. Bivariate analysis of low HC (<- 2 SD) at 12th month showed a statistically significant association with lower socioeconomic status, low paternal and maternal HC and low maternal IQ. Multivariable logistic regression analysis showed maternal (AOR = 0.759, 95% CI = 0.604 to 0.954) and paternal (AOR = 0.734, 95% CI = 0.581 to 0.930) HC to be significantly associated with HC attained by the infant at the end of 12 months. CONCLUSIONS One-third of the children in our cohort had low head circumference (HC) at birth, with one-fifth recording low HC at all time-points until 2 years of age. Low HC was significantly associated with stunting. Paternal and maternal HC predicted HC in children. HC measurement, often less used, can be a simple tool that can be additionally used by clinicians as well as parents/caregivers to monitor child growth.
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Affiliation(s)
| | - Prashanth Ramamurthy
- Rural Unit for Health and Social Affairs, Christian Medical College, Vellore, Tamil Nadu, 632 209, India.
| | - Karthikeyan Ramanujam
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ankita Henry
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Joseph Dian Bondu
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sushil Mathew John
- Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sudhir Babji
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Developmental Pediatric Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Bose
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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Nagahori C, Tchuani JP, Yamauchi T. Factors associated with nutritional status in children aged 5-24 months in the Republic of Cameroon. Nurs Health Sci 2015; 17:229-35. [PMID: 25818304 DOI: 10.1111/nhs.12176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 08/13/2014] [Accepted: 09/14/2014] [Indexed: 11/29/2022]
Abstract
This study was conducted to clarify nutritional status and associated factors in 5-24 month old children in the district of Batouri, Republic of Cameroon. Mothers were interviewed using a semistructured questionnaire, and the child's weight, length, head circumference, and mid-upper arm circumference was collected. The data were compared with child growth standards proposed by the World Health Organization using Z-scores; χ(2) -test, Fisher's exact test, and Wilcoxon rank sum test were used to determine variables associated with malnutrition. A total of 100 mother-child pairs participated in this study; valid data from 100 pairs were subjected to analysis. The percentages of children with malnutrition indicators were wasting (6%), stunting (31%), underweight (14%), and low mid-upper arm circumference (16%). Five factors were found to be statistically significant in their association with the children's malnutrition: mother's age, child's age, mother's educational level, mothers who had family planning information, and the source of tap water. A high percentage of stunting was positively associated with a high percentage of chronic malnutrition. We speculate that insufficient nutrition was more likely to begin after weaning.
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Affiliation(s)
- Chikako Nagahori
- Department of Nursing, Okinawa Prefectural College of Nursing, Naha, Japan; Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
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Methods to quantify soft tissue-based cranial growth and treatment outcomes in children: a systematic review. PLoS One 2014; 9:e89602. [PMID: 24586904 PMCID: PMC3937373 DOI: 10.1371/journal.pone.0089602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 01/23/2014] [Indexed: 12/20/2022] Open
Abstract
Context Longitudinal assessment of cranial dimensions of growing children provides healthcare professionals with information about normal and deviating growth as well as treatment outcome. Objective To give an overview of soft tissue–based methods for quantitative longitudinal assessment of cranial dimensions in children until age 6 years and to assess the reliability of these methods in studies with good methodological quality. Data source PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, and CINAHL were searched. A manual search was performed to check for additional relevant studies. Study selection Primary publications on facial growth and treatment outcomes in children younger than age 6 years were included. Data extraction Independent data extraction was performed by two observers. A quality assessment instrument was used to determine methodological quality. Methods used in studies with good methodological quality were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements. Results In total, 165 studies were included, forming three groups of methods: head circumference anthropometry, direct anthropometry, and 2D photography and 3D imaging techniques (surface laser scanning and stereophotogrammetry). In general, the measurement error was below 2 mm, and correlation coefficients were very good. Conclusion Various methods for measuring cranial dimensions have shown to be reliable. Stereophotogrammetry is the most versatile method for quantitative longitudinal assessment of cranial dimensions and shapes in children. However, direct anthropometry continues to be the best method for routine clinical assessments of linear cranial dimensions in growing children until age 6 years.
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Natale V, Rajagopalan A. Worldwide variation in human growth and the World Health Organization growth standards: a systematic review. BMJ Open 2014; 4:e003735. [PMID: 24401723 PMCID: PMC3902406 DOI: 10.1136/bmjopen-2013-003735] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 10/31/2013] [Accepted: 11/18/2013] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The World Health Organization (WHO) has established a set of growth curves for use as international standards in children up to age 5. The WHO's position is that all economically advantaged children who were breastfed as infants grow similarly. As a result, a single set of growth charts can be used to judge growth in any child, regardless of race or ethnicity. The goal of this study was to compare mean heights, weights and head circumferences from a variety of studies with the WHO's data. DESIGN We compared data from the WHO's Multicentre Growth Reference Study (MGRS) with data from studies performed in 55 countries or ethnic groups. DATA SOURCES PubMed, WHO Global Database on Child Growth and Malnutrition, SciELO, Google Scholar, Textbooks and Ministries of Statistics and Public Health. ELIGIBILITY CRITERIA Large recent studies (1988-2013) of economically advantaged groups, including comparisons with cohorts of breastfed children wherever possible. RESULTS Height varied somewhat among different national and ethnic groups. Means were generally within 0.5 of an SD of the MGRS means. Weight varied more than height, but the low MGRS means were seen as endorsing slenderness in the midst of an obesity epidemic. The mean head circumference varied widely. In many groups, means were consistently 0.5-1 SD above the MGRS mean. Head size in breastfed children at any age examined was far closer to local norms than to the MGRS means. CONCLUSIONS Height and weight curves may not be optimal fits in all cases. The differences between national or ethnic group head circumference means were large enough that using the WHO charts would put many children at risk for misdiagnosis of macrocephaly or microcephaly. Our findings indicate that the use of a single international standard for head circumference is not justified. SYSTEMATIC REVIEW REGISTRATION PROSPERO (# CRD42013003675).
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Affiliation(s)
- Valerie Natale
- The Forgotten Diseases Research Foundation, Santa Clara, California, USA
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Ferreira HDS, Xavier Júnior AFS, de Assunção ML, Dos Santos EA, Horta BL. Effect of breastfeeding on head circumference of children from impoverished communities. Breastfeed Med 2013; 8:294-301. [PMID: 23414229 PMCID: PMC3663451 DOI: 10.1089/bfm.2012.0105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigated the effect of exclusive breastfeeding on head circumference (HC) among children living in impoverished communities. SUBJECTS AND METHODS A cross-sectional study was conducted among children 12-60 months old from the 39 quilombos located in the State of Alagoas, Brazil. HC deficit was defined by a z-score of less than -2 from the median (based on the 2006 World Health Organization growth standards). Prevalence ratio and 95% confidence interval (95% CI) were estimated using Poisson regression with robust adjustment of the variance, and estimates were adjusted for possible confounders (anthropometric, socioeconomic, demographic, and health-related variables). RESULTS We evaluated 725 children (365 boys and 360 girls). The prevalence of HC deficit was 13.3% among those children who were exclusively breastfed for less than 30 days, 10.6% among those exclusively breastfed for 30-119 days, and 5.8% among those who were exclusively breastfed for 120 days or more. Even after controlling for possible confounding variables, exclusive breastfeeding for ≥4 months decreased the risk of HC deficit (prevalence ratio, 0.48; 95% CI 0.24, 0.99). CONCLUSIONS Exclusive breastfeeding for ≥4 months was associated with a larger HC in children exposed to great social vulnerability in impoverished communities.
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Jaldin MDGM, Pinheiro FS, Santos AMD, Muniz NC. Crescimento infantil comparado com as referências NCHS e o padrão WHO/2006. REV NUTR 2013. [DOI: 10.1590/s1415-52732013000100002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Este trabalho teve como objetivo analisar o crescimento de crianças em regime de aleitamento materno exclusivo até o sexto mês, bem como comparar seu peso e comprimento com a referência do National Center for Health Statistics 1978 e com o padrão da World Health Organization 2006. MÉTODOS: Trata-se de estudo longitudinal realizado em um Banco de Leite Humano, na cidade de São Luís, Maranhão, entre outubro de 2007 e novembro de 2008. Foi feita amostragem não probabilística com 328 crianças nascidas a termo e submetidas a aleitamento materno exclusivo. Finalizaram o estudo 181 crianças. Avaliou-se o crescimento por meio de médias e desvio-padrão, comparando-se os resultados com aqueles dois parâmetros. RESULTADOS: Os meninos mostraram-se mais pesados que as meninas, do primeiro ao sexto mês (p<0,05). A maior velocidade no ganho ponderal ocorreu nos dois primeiros meses de vida, em ambos os sexos. Quanto ao peso, as meninas apresentaram peso médio superior ao padrão da World Health Organization 2006, ao nascer e do terceiro ao sexto mês (p<0,05), enquanto os meninos mostraram peso superior do quarto ao sexto mês (p<0.05). Já em relação à referência do National Center for Health Statistics 1978, ambos os sexos apresentaram peso superior desde o nascimento até o sexto mês (p<0,05), exceto os meninos ao nascer. Quanto ao tamanho, as meninas apresentaram comprimento médio semelhante ao padrão da World Health Organization 2006, porém menor do que a outra referência, ao nascer e no sexto mês (p<0,05). Já os meninos obtiveram comprimento médio inferior, tanto quando comparados ao padrão da World Health Organization 2006, do nascimento ao sexto mês (p<0,05), exceto o quinto; como quando comparados à referência da National Center for Health Statistics 1978, ao nascer e no primeiro, no quarto e no sexto meses de vida (p<0,05). CONCLUSÃO: O crescimento ponderal das crianças em aleitamento materno exclusivo assemelhou-se mais ao padrão World Health Organization 2006 que à referência National Center for Health Statistics 1978, ao passo que o crescimento linear mostrou-se compatível com os dois parâmetros.
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Herba CM, Roza S, Govaert P, Hofman A, Jaddoe V, Verhulst FC, Tiemeier H. Breastfeeding and early brain development: the Generation R study. MATERNAL AND CHILD NUTRITION 2012; 9:332-49. [PMID: 23167730 DOI: 10.1111/mcn.12015] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Breastfeeding during infancy is associated with a range of short- and long-term health benefits. We examine whether breastfeeding in the first 2 months of life is associated with structural markers of brain development in infants from the general population. This study was embedded within the Generation R study. Cranial ultrasounds were obtained at approximately 7 weeks post-natal age. The diameter of the gangliothalamic ovoid, corpus callosum length, ventricular volume and head circumference were measured. Maternal reports of breastfeeding were obtained at 2 months of age. We examined associations in relation to current breastfeeding practices (exclusively breastfed, n = 318, breast- and bottle-fed, n = 119, and bottle-fed, n = 243). Analyses were adjusted for head size and relevant covariates. Secondary analyses were conducted for breastfeeding history (exclusively breastfed, n = 318, breast- and bottle-fed, n = 281, and never breastfed, n = 81). Exclusive breastfeeding was associated with more optimal brain development compared with babies who were bottle-fed or never breastfed. Results were most consistent for gangliothalamic ovoid diameter. Larger gangliothalamic ovoid diameters were evident in babies who were exclusively breastfed compared with bottle-fed babies [difference between means (95% confidence interval) = 0.21(0.02, 0.39), P = 0.02]. Smaller ventricular volume and larger head circumference were also found for exclusively breastfed babies. Breastfeeding was not significantly associated with corpus callosum length. Maternal reports of breastfeeding are associated with more mature brain development within the first 2 months of life. Results are most consistent for gangliothalamic ovoid diameter, a subcortical structure rich in docosahexaenoic acid. Findings also pointed to non-specific neural developmental advantage for exclusively breastfed babies.
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Affiliation(s)
- Catherine M Herba
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Jaldin MDGM, Pinheiro FS, Santos AMD, Muniz NC, Brito LMO. Crescimento do perímetro cefálico nos primeiros seis meses em crianças em aleitamento materno exclusivo. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Analisar o perímetro cefálico de crianças amamentadas exclusivamente do nascimento ao sexto mês com relação à referência National Center for Health Statistics (NCHS/1977) e ao padrão internacional World Health Organization/2006 (WHO/2006). MÉTODOS: Estudo longitudinal realizado no Banco de Leite Humano do Hospital Universitário Materno-Infantil, São Luís (MA), entre outubro de 2007 e novembro de 2008. Amostra não probabilística de 328 crianças nascidas a termo, parto único, peso ao nascer > 2500g e < 4000g, em aleitamento exclusivo do nascimento ao sexto mês. Finalizaram o estudo 181 crianças (95 meninas e 86 meninos). Avaliou-se o perímetro cefálico por meio de média, desvio padrão e percentis 5, 50 e 95. Os resultados em percentis foram comparados aos da referência NCHS/1977 e do padrão WHO/2006. RESULTADOS: Nos primeiros seis meses, houve um aumento do perímetro cefálico, em média, de 1,5cm por mês nos meninos e de 1,4cm nas meninas. O crescimento do perímetro cefálico, em ambos os sexos, acompanhou o percentil 50 do padrão WHO/2006. Nos meninos, exceto ao nascer, o percentil 50 do perímetro cefálico foi equivalente ao da referência NCHS/1977; nas meninas, situou-se próximo desde o nascimento. CONCLUSÕES: As crianças em aleitamento materno exclusivo até o sexto mês de vida apresentaram crescimento satisfatório do perímetro cefálico, em conformidade com o percentil 50 do padrão WHO/2006 e da referência NCHS/1977.
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Abstract
BACKGROUND Macrosomia is associated with childhood obesity. Gestational diabetes mellitus (GDM) is a risk factor for macrosomia. The aim of this large-scale investigation was to determine the incidence, risk factors, characteristic features, and perinatal outcome of macrosomic infants. METHODS This prospective study was carried out on 6385 newborns. Demographic data included maternal age, paternal age, type of delivery, sex, parity and gestational age at delivery. Anthropometric measurements were recorded. ABO/Rh typing was performed and GDM was diagnosed. RESULTS Out of 6385 term deliveries, 477 infants (7.47%) were macrosomic. Incidence of GDM was 0.6% and 4.8% in the control group and in macrosomic births, respectively. Incidence of GDM(+) cases was 4% among macrosomic infants weighing 4000-4500 g. GDM(+) cases were densely populated (11%) in macrosomic infants weighing ≥ 4500 g (P ≤ 0.05). Male/female ratio was significantly higher in macrosomic infants weighing ≥ 4500 g than those weighing 4000-4500 g (P ≤ 0.05). High parental age was the risk factor for GDM. Blood group A was the most frequently observed type among mothers with macrosomic infants, however, blood group O was dominant in cases with GDM. In multivariate logistic regression analysis, the male infant was the most striking infant characteristic and GDM was the most striking maternal characteristic that were significantly associated with increased odds of macrosomic birth. CONCLUSIONS This research reports the association between blood group system and macrosomia as well as parental age and GDM simultaneously. Our study reports a prevalence of GDM in both infants with normal birth weight and macrosomic newborns at the same time.
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Affiliation(s)
- Mustafa Metin Donma
- Department of Neonatology Unit, Pediatrics Clinics, Ministry of Health, Suleymaniye Maternity and Children's Diseases Education and Research Hospital, Istanbul, Turkey.
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Singhal A, Kennedy K, Lanigan J, Clough H, Jenkins W, Elias-Jones A, Stephenson T, Dudek P, Lucas A. Dietary nucleotides and early growth in formula-fed infants: a randomized controlled trial. Pediatrics 2010; 126:e946-53. [PMID: 20837597 DOI: 10.1542/peds.2009-2609] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Dietary nucleotides are nonprotein nitrogenous compounds that are found in high concentrations in breast milk and are thought to be conditionally essential nutrients in infancy. A high nucleotide intake has been suggested to explain some of the benefits of breastfeeding compared with formula feeding and to promote infant growth. However, relatively few large-scale randomized trials have tested this hypothesis in healthy infants. OBJECTIVE We tested the hypothesis that nucleotide supplementation of formula benefits early infant growth. PATIENTS AND METHODS Occipitofrontal head circumference, weight, and length were assessed in infants who were randomly assigned to groups fed nucleotide-supplemented (31 mg/L; n=100) or control formula without nucleotide supplementation (n=100) from birth to the age of 20 weeks, and in infants who were breastfed (reference group; n=101). RESULTS Infants fed with nucleotide-supplemented formula had greater occipitofrontal head circumference at ages 8, 16, and 20 weeks than infants fed control formula (mean difference in z scores at 8 weeks: 0.4 [95% confidence interval: 0.1-0.7]; P=.006) even after adjustment for potential confounding factors (P=.002). Weight at 8 weeks and the increase in both occipitofrontal head circumference and weight from birth to 8 weeks were also greater in infants fed nucleotide-supplemented formula than in those fed control formula. CONCLUSIONS Our data support the hypothesis that nucleotide supplementation leads to increased weight gain and head growth in formula-fed infants. Therefore, nucleotides could be conditionally essential for optimal infant growth in some formula-fed populations. Additional research is needed to test the hypothesis that the benefits of nucleotide supplementation for early head growth, a critical period for brain growth, have advantages for long-term cognitive development.
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Affiliation(s)
- Atul Singhal
- Institute of Child Health, Medical Research Council Childhood Nutrition Research Center, 30 Guilford St, London WC1N 3EH, United Kingdom.
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Lira PIC, Eickmann SH, Lima MC, Amorim RJ, Emond AM, Ashworth A. Early head growth: relation with IQ at 8 years and determinants in term infants of low and appropriate birthweight. Dev Med Child Neurol 2010; 52:40-6. [PMID: 19758366 DOI: 10.1111/j.1469-8749.2009.03353.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relation between head growth at different periods and IQ at 8 years, and to identify factors associated with more rapid head growth. METHOD Two parallel cohorts of term low birthweight (LBW) and appropriate birthweight (ABW) infants were enrolled at birth in northeast Brazil. Anthropometric measurements were made at birth, 2 months, 6 months, 12 months, 24 months, and 8 years. Cognition was assessed at 8 years (n=164) with the Wechsler Intelligence Scale for Children. Multivariable analysis with a two-stage residual model was used to relate head growth between successive time points with IQ. RESULTS Mean birthweight was 2.35kg (SD 0.15) in the LBW group (33 males, 50 females), and 3.21kg (SD 0.15) in the ABW group (28 males, 53 females). Mean gestational age was 38.8 weeks (SD 1.4) and 40.0 weeks (SD 1.3) respectively. In the LBW group, head growth from birth to 2 months and from 2 to 6 months, conditional on previous size, were significant independent predictors of IQ at 8 years. Conditional head growth from 6 months to 8 years and head size at birth were unrelated to IQ. In the ABW group there was no significant relation between conditional head growth and IQ for any period. Determinants of more rapid head growth from birth to 6 months in LBW infants were maternal height and rate of infant weight gain. INTERPRETATION Head growth from birth to 6 months in term LBW infants is more important than prenatal or later postnatal head growth in predicting IQ at 8 years.
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Abstract
Brain abnormality in surviving premature infants is associated with an enormous amount of neurodevelopmental disability, manifested principally by cognitive, behavioral, attentional, and socialization deficits, most commonly with only relatively modest motor deficits. The most recognized contributing neuropathology is cerebral white matter injury. The thesis of this review is that acquired cerebellar abnormality is a relatively less recognized but likely important cause of neurodevelopmental disability in small premature infants. The cerebellar disease may be primarily destructive (eg, hemorrhage, infarction) or primarily underdevelopment. The latter appears to be especially common and relates to a particular vulnerability of the cerebellum of the small premature infant. Central to this vulnerability are the extraordinarily rapid and complex developmental events occurring in the cerebellum. The disturbance of development can be caused either by direct adverse effects on the cerebellum, especially the distinctive transient external granular layer, or by indirect remote trans-synaptic effects. This review describes the fascinating details of cerebellar development, with an emphasis on events in the premature period, the major types of cerebellar abnormality acquired during the premature period, their likely mechanisms of occurrence, and new insights into the relation of cerebellar disease in early life to subsequent cognitive/behavioral/attentional/socialization deficits.
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Affiliation(s)
- Joseph J. Volpe
- From the Department of Neurology, Children’s Hospital and Harvard Medical School, Boston, Massachusetts
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Donma MM, Donma O. Low birth weight: a possible risk factor also for liver diseases in adult life? Med Hypotheses 2004; 61:435-8. [PMID: 13679007 DOI: 10.1016/s0306-9877(03)00190-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Birth weight is a popular topic, because it is precisely recorded, a major determinant of infant survival, associated with infant mortality, and health outcomes later in life. Low birth weight (LBW) is a predisposing factor for metabolic abnormalities such as atherosclerosis, renal disease, non-insulin diabetes mellitus, asthma, low IQ, hypertension, obesity, psychological distress. They have all been reported to be more common among those who were small at birth. Due to lack of studies suggesting a linkage between LBW and diseases of liver; evidences, which support the hypothesis on the creation of a link between LBW, an indicator of unfavourable intrauterine environment, and liver diseases emerging in the adult life, and possible direct associations of LBW with liver diseases, e.g., hepatitis, non-alcoholic fatty liver disease, cirrhosis, hepatoblastoma, or hepatocellular carcinoma were discussed. The associations between LBW and hepatitis vaccination as well as paediatric parental nutrition were also noted.
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Affiliation(s)
- M M Donma
- Ministry of Health, Suleymaniye Education and Research Hospital, Turkey.
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Saxon T, Gollapalli A, Mitchell M, Stanko S. Demand feeding or schedule feeding: Infant growth from birth to 6 months. J Reprod Infant Psychol 2002. [DOI: 10.1080/02646830220134586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
BACKGROUND To evaluate the impact of various feeding patterns on the physical growth and mental development of infants, particularly during the first 6 months of life, and to compare growth patterns of Turkish infants with those of infants living in various countries. METHODS One hundred and seventy-two healthy newborn infants were included in the study and were divided into three feeding groups: (i) 62 infants were exclusively breast-fed (BF); (ii) 58 infants were mixed-fed (MF) with both breast milk and formula; and (iii) 52 infants were formula-fed (FF). Infants were assessed at birth and at 1, 2, 3, 4, 5 and 6 months of age. Anthropometry was repeated on each occasion. The weight and length of the infants was also recorded. Analysis of variance and modified t-test were used for statistical evaluation of the results. RESULTS Values in the BF group were the closest to the tabular norms for weight. Infants in the FF group tended towards a lower weight during the first 3 months (P < 0.05). During the second 3 months, weight gain observed in the FF group was significantly higher than that of BF infants. In comparison with MF infants, a significant progressive weight gain was detected in BF infants (P < 0.05). The values obtained for length increments were consistent with those for weight (P < 0.05 for BF vs FF). No significant difference was found between the length increments detected for BF and MF infants from birth to 6 months. CONCLUSIONS These results suggest that exclusive breast-feeding is the most appropriate feeding pattern for newborn infants in Turkey and is sufficient during the first 6 months, the most important fraction of life.
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Affiliation(s)
- M M Donma
- Republic of Turkey, Bakirköy State Hospital, Clinics of Pediatrics, Turkey.
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