Plasma cholecystokinin concentrations after breast feeding in healthy 4 day old infants

Infant Distress in a Food Delay Task Changes With Development and Predicts Amount Consumed

Objective

Eating behavior regulation emerges during early development and involves general self-regulation (emotional, behavioral), appetite regulation (homeostatic metabolic need) and appetite self-regulation (including both Bottom-Up Food Approach and Bottom-Up Food Avoidance and top-down purposeful self-control of eating). Limited research has investigated developmental trajectories of the regulation of eating behavior before the preschool years. The current study used a novel food delay task to assess infant distress as an early emerging marker of eating behavior regulation constructs across early infancy and examine associations with amount of milk consumed.

Method

Mother-infant dyads (n = 179) completed the Ability to Delay Gratification for Food in Infants Task (ATDG-FIT) at 2 weeks, 8 weeks, and 16 weeks of age. The ATDG-FIT required infants to wait before being fed while their bottle was present, but not accessible (3-min Pre-Feeding Delay). After this, the infant was fed for 1 min, then the feeding was paused for 30 s (Mid-Feeding Delay). Infant distress was coded during each feeding delay period and the amount of milk consumed was measured.

Results

The mean proportion of distress during the Pre-Feeding Delay period decreased from 8 to 16 weeks of age (F(2,230) = 15.02, p < 0.001), whereas the mean proportion of distress during the Mid-Feeding Delay increased from 2 to 8 weeks of age (F(2,230) = 27.04, p < 0.001). There was a positive interaction between distress during Mid-Feeding Delay and infant age predicting the amount consumed in the protocol (ß = 0.30, p = 0.022), suggesting that the association between distress during this part of the task and amount consumed strengthens as infants get older.

Conclusion

The ATDG-FIT may be an effective method to assess emerging eating behavior regulation constructs during early infancy.

Nutritive sucking induces age-specific EEG-changes in 0-24 week-old infants

Little is known how the brain of the newborn infant responds to the postnatal nutrition and care. No systematic studies exist in which the effects of nutritional and non-nutritional sucking on the brain activity of the infant were compared. We recorded the EEG activity of 40 infants at the ages of 0,6,12 and 24 weeks in four successive behavioral stages: while the infants were hungry and waiting for sucking, during non-nutritional and nutritional sucking, and during satiation after completed feeding. Quantitative EEG analysis was performed using occipital, parietal and central EEG channels. In the newborn infants, a significant reduction in the EEG power was found after nutritional sucking in the all EEG frequency bands studied (1-10Hz), which was paralleled by a significant behavioral alertness decline. This response decayed during the subsequent neonatal period and was completely absent at the age of 12 weeks. In 24-week-old infants, nutritional sucking was accompanied with an increase in rhythmic theta activity during which no significant alertness change took place. Non-nutritional sucking was connected with minor and non-significant effects on the EEG. We conclude that in newborn infants nutritional sucking has a direct effect on the EEG, which has a soothing character and is connected with an alertness decline. In 24-week-old infants the response to nutritional sucking is of a different type and consists of an organized, rhythmical theta activity in the EEG not directly linked with alertness change. Our findings suggest a developmental relationship between nursing and infant brain function with plausible affective and cognitive implications.

Weight loss and low age are associated with intensity of rooting behaviours in newborn infants

AIM

Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics.

METHODS

We studied 13 mothers and healthy full-term infants after normal births. At 24-48 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software.

RESULTS

Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p ≤ 0.001) and positively related to neonatal weight loss (p = 0.02) after birth.

CONCLUSION

Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain.

Large molecule protein feeding during the suckling period is required for the development of pancreatic digestive functions in rats

We examined if large molecule protein feeding during the suckling period is prerequisite for the proper development of pancreatic digestive functions. Most amino acids in breast milk exist as the constituent of large proteins and not as oligopeptides or free amino acids. Accumulating evidence indicates the nutritional importance of large protein feeding for suckling infants; however, evidence on the physiological significance remains small. We thus artificially reared rat pups on a standard rat formula with milk protein or a formula with milk protein hydrolysate from 7 to 21 days of age, and thereafter, fed a standard solid diet until 42 days of age. Pancreas weight and the stock of pancreatic digestive enzymes in the hydrolysate-fed rats were significantly lower than those in the protein-fed rats during and also after the suckling period. Plasma insulin, a stimulator of amylase synthesis, was also significantly low in the hydrolysate-fed rats compared with the protein-fed rats. At 28 days of age, we evaluated the pancreatic secretory ability in response to dietary protein and cholecystokinin (CCK) by means of pancreatic duct cannulation. Pancreatic secretion stimulated by dietary protein in the hydrolysate-fed rats was significantly weaker than that in the protein-fed rats. No significant difference was observed in the increasing rate of pancreatic enzyme secretion in response to CCK between the two groups. These results suggest that the presence of large proteins in breast milk is significant for the development of pancreatic digestive functions and the outcomes could remain even later on in life.

Breast milk and glucose for pain relief in preterm infants: a noninferiority randomized controlled trial

OBJECTIVE

The study goal was to compare the efficacy of expressed breast milk (EBM) versus 25% glucose on pain responses of late preterm infants during heel lancing.

METHODS

In a noninferiority randomized controlled trial, a total of 113 newborns were randomized to receive EBM (experimental group [EG]) or 25% glucose (control group [CG]) before undergoing heel lancing. The primary outcome was pain intensity (Premature Infant Pain Profile [PIPP]) and a 10% noninferiority margin was established. Secondary outcomes were incidence of cry and percentage of time spent crying and adverse events. Intention-to-treat (ITT) analysis was used.

RESULTS

Groups were similar regarding demographics and clinical characteristics, except for birth weight and weight at data collection day. There were lower pain scores in the CG over 3 minutes after lancing (P < .001). A higher number of infants in the CG had PIPP scores indicative of minimal pain or absence of pain (P = .002 and P = .003 on ITT analysis) at 30 seconds after lancing, and the mean difference in PIPP scores was 3 (95% confidence interval: 1.507-4.483). Lower incidence of cry (P = .001) and shorter duration of crying (P = .014) were observed for CG. Adverse events were benign and self-limited, and there was no significant difference between groups (P = .736 and P = .637 on ITT analysis).

CONCLUSIONS

Results based on PIPP scores and crying time indicate poorer effects of EBM compared with 25% glucose during heel lancing. Additional studies exploring the vol and administration of EBM and its combination with other strategies such as skin-to-skin contact and sucking are necessary.

A potential gastrointestinal link between enhanced postnatal maternal care and reduced anxiety-like behavior in adolescent rats

Early life experience impacts emotional development in the infant. In rat pups, repeated, brief (i.e., 15 min) maternal separation (MS15) during the first 1-2 postnatal weeks has been shown to increase active maternal care and to reduce later anxiety-like behavior in the offspring. We hypothesized that the anxiolytic effect of MS15 is partly due to increased intestinal release of cholecystokinin (CCK) in rat pups as a result of increased maternal contact. We predicted that rats with a history of MS15 would display less anxiety in the elevated plus maze (EPMZ) and novelty-suppressed feeding (NSF) tests, as compared with nonseparated (NS) controls, and that the anxiolytic effect of MS15 would be attenuated in rats in which daily MS15 was accompanied by systemic administration of a CCK-1 receptor antagonist (i.e., devazepide). Treatment groups included NS control litters, litters exposed to MS15 from postnatal days (P)1-10, inclusive, and litters exposed to MS15 with concurrent subcutaneous injection of devazepide or vehicle. Litters were undisturbed after P10 and were weaned on P21. Subsets of adolescent males from each litter were tested in the EPMZ on P40-41, while others were tested for NSF on P50-52. As predicted, rats with a developmental history of MS15 displayed reduced anxiety-like behavior in the EPMZ and NSF tests. The anxiolytic effect of MS15 was preserved in vehicle-treated rats, but was reversed in devazepide-treated rats. These results support the view that endogenous CCK-1 receptor signaling in infants is a potential pathway through which maternal-pup interactions regulate the development and functional organization of emotional circuits that control anxiety-like behavior in the offspring.

The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling

BACKGROUND

Few investigations have considered evaluating the effects of certain combinations of ward routines like swaddling of the baby and separation of mother and baby on infant variables such as neonatal weight loss.

AIMS

To study the effect of different ward routines in respect to proximity to mother and type of infant apparel, on breastfeeding parameters (amount of ingested milk, volume of supplements, number of breastfeeds, total duration of breastfeeding time) day 4 after birth as well as recovery from neonatal weight loss and infant's weight on day 5.

STUDY DESIGN AND SUBJECTS

In a randomized trial with factorial design four treatment groups including 176 mother-infant dyads were studied 25-120 min after birth. Randomized treatments focused on care routines administered to the infants after delivery and later in the maternity ward as well as to the type of clothing the infants received. Group 1 infants were placed skin-to-skin with their mothers after delivery, and had rooming-in while in the maternity ward. Group 2 infants were dressed and placed in their mothers' arms after delivery, and roomed-in with mothers in the maternity ward. Group 3 infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group 4 infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or clothed in baby attire. Breastfeeding parameters were documented during day 4 after birth. Infant's weight was measured daily.

RESULTS

Babies who were kept in the nursery received significantly more formula and significantly less breast-milk, than did babies who roomed-in with their mothers. Swaddling did not influence the breastfeeding parameters measured. However, swaddled babies who had experienced a 2-h separation period after birth and then were reunited with their mothers tended to have a delayed recovery of weight loss compared to those infants who were exposed to the same treatment but dressed in clothes. Furthermore, swaddled babies who were kept in the nursery and received breast-milk supplements had a significantly delayed recovery of weight loss after birth when compared to those infants ingesting only breast-milk. On day 5, regression analyses of predicted weight gain in the exclusively breastfed infants indicated a significant increase per 100 ml breast-milk (59 g), compared to the predicted weight gain on day 5 per 100 ml supplements in the swaddled babies (14 g) (P=0.001).

CONCLUSION

Supplements given to the infants in the nursery had a negative influence on the amount of milk ingested. In addition, supplement feeding or a short separation after birth when combined with swaddling was shown to have a negative consequence to infant weight gain.

Ghrelin and cholecystokinin in term and preterm human breast milk

AIM

To determine whether ghrelin and cholecystokinin (CCK) are present in significant quantities in term and preterm human breast milk, and to identify their source.

METHODS

Samples were collected from 10 mothers who delivered term infants and 10 mothers who delivered preterm infants. Estimated fat content was measured. Ghrelin and CCK levels were measured in whole and skim breast milk samples using radioimmunoassays (RIA). Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed using RNA from human mammary epithelial cells (hMECs) and mammary gland with primers specific to ghrelin.

RESULTS

The median ghrelin level in whole breast milk was 2125 pg/ml, which is significantly higher than normal plasma levels. There was a direct correlation between whole milk ghrelin levels and estimated milk fat content (r=0.84, p<0.001). Both the mammary gland and hMECs produced ghrelin. While CCK was detected in some samples, levels were insignificant. Infant gestational age, birthweight, maternal age, and maternal pre-pregnancy body mass index did not significantly affect the results.

CONCLUSION

Ghrelin, but not CCK, is present in breast milk. Since the mammary gland produces ghrelin message, and ghrelin levels in breast milk are higher than those found in plasma, we conclude that ghrelin is produced and secreted by the breast.

Mental health, attachment and breastfeeding: implications for adopted children and their mothers

Breastfeeding an adopted child has previously been discussed as something that is nice to do but without potential for significant benefit. This paper reviews the evidence in physiological and behavioural research, that breastfeeding can play a significant role in developing the attachment relationship between child and mother. As illustrated in the case studies presented, in instances of adoption and particularly where the child has experienced abuse or neglect, the impact of breastfeeding can be considerable. Breastfeeding may assist attachment development via the provision of regular intimate interaction between mother and child; the calming, relaxing and analgesic impact of breastfeeding on children; and the stress relieving and maternal sensitivity promoting influence of breastfeeding on mothers. The impact of breastfeeding as observed in cases of adoption has applicability to all breastfeeding situations, but may be especially relevant to other at risk dyads, such as those families with a history of intergenerational relationship trauma; this deserves further investigation.

Biliary atresia due to delayed maturation of the gut hormones' system?--Introducing a new treatment modality

BACKGROUND

Congenital biliary atresia is suspected to originate from prenatal biliary duct inflammation of unknown etiology.

OBJECTIVE

Based on clinical grounds, we aimed to establish a hypothesis on the primary cause of inflammation, and to suggest a causal treatment modality.

CASE REPORT

History. A 28 years old Turkish woman had lost her first child aged two years from congenital biliary atresia (parents second degree cousins). After a miscarriage, in her otherwise uneventful third pregnancy sonography at 34 wks revealed echogenic material in the fetal gallbladder. Nine days later the gallbladder was completely filled with sludge. Chemical inflammation was suspected, and birth was induced at 36+3 weeks in order to allow for surgical flushing of the bile duct. Neonatal clinical chemistry was insuspicious. There was no spontaneous resolution of the sludge within the first 24 hours of life. A trial of medical treatment with intermittent i.v. secretin (0.03 CU/kg/h) and i.v. coeruletid (60 ng/kg/h) was started. Within 24 hours, sludge had resolved.

CONCLUSIONS

We hypothesize that dysmaturation may lead to insufficient induction/production/activity of intrinsic gut hormones resulting in prenatally impaired bile flow, or even inspissated bile. Familial occurrence suggests a genetic defect. Exogenous hormone therapy might be an appropriate treatment modality.

Mother-Infant Interactions in Rats Lacking CCKA Receptors

Mediation of mother-infant interactions by the brain-gut peptide cholecystokinin (CCK) was examined by observing behavior of Otsuka Long-Evans Tokushima Fatty (OLETF) rats, which lack functional CCKA receptors because of a genetic abnormality. OLETF (n = 10) and control (Long-Evans Tokushima Otsuka [LETO] n = 10) dams interacted with 1 pup of each line on Postpartum Days 6-9. OLETF pups received more body and anogenital licking and emitted substantially more ultrasonic vocalizations than LETO pups. OLETF dams carried pups less frequently and showed a nursing position more frequently than LETO dams. No significant Pup X Dam Line interactions or line differences in dams' activity were detected. The results provide convergent validity to previous pharmacological studies implicating CCK mediation of both infant and maternal behavior.

Low plasma cholecystokinin levels in colicky infants

OBJECTIVES

Cholecystokinin (CCK) plays an important role in postprandial gallbladder contraction and may also have pacifying behavioral effects, such as inducing satiety and calming in infants. The authors hypothesized that colicky infants have impaired CCK secretion, which contributes to their gallbladder hypocontractility (reported earlier) and excessive crying.

METHODS

Cholecystokinin levels of 40 colicky and 37 control infants were evaluated at a mean of age 5 weeks. Plasma CCK levels were drawn before, immediately after, and 1 hour after a regular milk feeding and analyzed using radioimmunoassay (RIA). The contraction of the gallbladder was calculated using ultrasound measurements before and 1 hour after the feeding. The two-tail t test for independent samples was used to test continuous data.

RESULTS

The preprandial and 1-hour postprandial plasma levels of CCK were lower in the colicky infants than in the control subjects (P < 0.05). The immediate postprandial CCK levels were also lower in the colicky infants, although this difference did not reach a statistical significance. The proportion of gallbladder contractions did not differ between the study groups.

CONCLUSIONS

The authors conclude that low CCK levels in colicky infants may predispose them to excessive crying in the absence of the calming effect of CCK.

Emotion regulation and touch in infants: the role of cholecystokinin and opioids

Behavioral-pharmacological research in infant rats supports the role of cholecystokinin (CCK) and opioid peptides in mediating early learning of new associations with aspects of the nest and dam, such as maternal odor, milk, and contact. The current paper reviews research that examines the hypothesis that these neuropeptide systems are further involved in mediating emotion regulation in infants, thus playing a role in the emergence of stress-reactivity and other motivational systems. The beneficial effects of maternal proximity, handling, and touch on the development of emotion regulation have been demonstrated in both human and animal models. Interventions that promote tactile stimulation of the infant ("touch therapy") and infant-mother contact ("skin-to-skin contact" or "kangaroo care") have been shown to improve the infant's ability to self-regulate, and to moderate the effects of some risk factors. Theoretical perspectives and empirical findings regarding emotion regulation in infants are first discussed. This is followed by a review of work providing evidence in animal models (and suggestive evidence in humans) for the importance of CCK and opioid neuropeptides in affecting infant emotion regulation and the impact of touch-based interventions, in particular in the context of infant-mother attraction, contact, separation, and attachment.

Feeding behavior in neonates whose diet contained medium-chain triacylglycerols: short-term effects on thermoregulation and sleep

BACKGROUND

Feeding formulas for premature infants often contain medium-chain triacylglycerols (MCTs). However, previous studies in animals and adults showed that MCTs may decrease food intake.

OBJECTIVES

The objectives were to determine in hospitalized premature infants whether food intake is modified by dietary MCT supply and to assess the effects on thermoregulation and sleep, which are involved in the regulation of energy metabolism and in the optimal physiologic development of the neonates.

DESIGN

Food intake, body mass, and nutritional efficiency during 3 consecutive days were compared in 2 groups of neonates according to the fat composition of their feeding formula [MCT group: 37% MCT, 63% long-chain triacylglycerols (LCTs); LCT group: 100% LCT]. On the third day, sleep and metabolic rate were recorded in the morning during an interval between meals.

RESULTS

Regardless of day, energy intake was greater in the MCT group than in the LCT group (x difference: 67.3 kJ x kg(-1) x d(-1); P = 0.007). Metabolic rate (1.8 mL x min(-1) x kg(-1); P < 0.001), cheek skin temperature (0.31 degrees C; P = 0.04), and total sleep time (52 min; P = 0.01) were also higher in the MCT group.

CONCLUSION

The ratio of MCTs to LCTs in neonates' feeding formulas can modify physiologic functions involved in energy-balance regulation.

Cholecystokinin receptor antagonists increase the rat pup's preference toward maternal-odor and rug texture

The role of the cholecystokinin (CCK) system in mediating the infant's natural preferences toward maternal-related stimuli was examined by peripheral administration of selective CCK(A) and CCK(B) receptor antagonists (Devazepide and L-365,260, respectively) to 11-12-day-old rats and presenting them with a 3-minute preference test. In Experiment 1, the choice was between two floor textures, rug and plywood; the time spent on the relatively preferred side (rug) was measured. In Experiment 2, the odor of maternal faces emanated from one end of the test arena; time spent near that end was measured. These sensory stimuli were chosen as they represent olfactory and tactile aspects of the dam and nest. Compared to controls, both CCK receptor antagonists selectively increased the time spent on the preferred side, in both experiments, without affecting axillary temperature or locomotor activity. The results suggest that CCK may mediate and attenuate the infant's attraction toward naturally preferred stimuli.

Plasma somatostatin and cholecystokinin levels in response to feeding in preterm infants

BACKGROUND

The functions of the gut are modulated by the autonomic nervous system and gut peptides, such as somatostatin and cholecystokinin, which have opposite functions. This study reports plasma somatostatin and cholecystokinin levels in response to feeding in preterm infants.

METHODS

In 76 infants--gestational age 23 to 36 weeks, birth weight 460 to 2867 g--blood samples were taken on day 1 before the first meal in life, and 30 minutes after the end of the meal. Samples were again taken on days 3 and 4. The infants were fed human milk by nasogastric tube, by breast, or by bottle. In 10 additional infants, (gestational age 27-36 weeks) who were studied at a median postnatal age of 15 days, the response of the peptides to breast-feeding was compared with that of tube-feeding. Plasma somatostatin and cholecystokinin were analyzed by specific radioimmunoassays.

RESULTS

On day 1, the median plasma somatostatin level increased after feeding in small-for-gestational-age infants but not in appropriate-for-gestational-age infants. On days 3 and 4, the somatostatin level decreased in infants with a gestational age of 32 weeks or more. On day 1, plasma cholecystokinin levels increased in infants with a gestational age of 32 weeks or more: The response was more pronounced in small-for-gestational-age infants. On days 3 and 4, plasma cholecystokinin levels increased only in breast-feeding infants. In the 10 infants fed by breast and by tube, plasma cholecystokinin levels increased after breast-feeding and tended to increase after tube-feeding. The plasma somatostatin levels were unaffected after feeding.

CONCLUSIONS

Plasma somatostatin and cholecystokinin increased after feeding in small-for-gestational-age infants on day 1. On days 3 and 4, the responses to feeding seemed to be dependent on the infant's gestational age. Breast-feeding enhanced the release of cholecystokinin but not that of somatostatin.

The effect of nursing on the brain activity of the newborn

OBJECTIVE

To determine whether nursing influences brain activity in the newborn and whether there are differences in this respect between breast- or bottle-feeding and pacifier sucking.

STUDY DESIGN

Fifty unselected volunteer mothers and their healthy full-term infants, under care in the maternity ward after delivery, served as subjects. Thirty mother-infant pairs were studied in relation to breast-feeding and 20 to bottle-feeding and pacifier sucking. Breast-fed infants were studied between the 1st and 7th day after delivery (mean +/- 2.7 days) and the infants in the bottle-fed group between the 1st and 8th day after delivery (mean +/- 3.3 days).

METHODS

Qualitative and quantitative electroencephalogram (EEG), electrooculogram, submental electromyogram, and electrocardiogram were recorded before, during and after breast- and bottle-feeding and pacifier sucking.

RESULTS

The amplitude of the EEG increased significantly during breast-feeding in the posterior cortical areas in both hemispheres with a slight predominance on the right. Bottle-feeding caused a similar, but somewhat less marked change. When the breast- and bottle-fed infants were compared, a significant difference was found in only one parameter of the 84 studied. Pacifier sucking had no significant effects on EEG activity.

CONCLUSION

Nursing effects a change in the brain activity of the newborn. The cortical response to nursing is most probably a result of activation of the neurohumoral mechanisms related to hunger and satisfaction, including the hypothalamic, limbic, and other brain stem structures, which also regulate the sleep-wake cycle and modulate the level of cortical activity with respect to attention and vigilance.

Development of a preferential relationship with the mother by the newborn lamb: importance of the sucking activity

Lambs develop a preferential relationship with their mothers within 24 h after birth. In a first experiment, we attempted to determine whether neonatal sucking was a potent reinforcer in the establishment of this preference by temporarily covering the udders of ewes after parturition. Lambs were assigned to one of three treatments: they had free access to the udder (group 1) or were prevented from sucking either between birth and 6 h afterward (group 2) or between 12 and 18 h after birth (group 3). Measurements of cholecystokinin plasma levels at birth and at 6 and 18 h showed that all lambs ingested some colostrum when the udder was made accessible. When tested in a two-choice test situation at 24 h of age, lambs from group 1 spent significantly more time near their mothers than near the alien ewes, those from group 2 did not show any discrimination, and lambs from group 3 clearly preferred the alien ewes. At 2 days of age, lambs from groups 1 and 3 showed a strong preference for their mothers, whereas those from group 2 still displayed no preference. In a second experiment, we attempted to determine whether sucking also had a reinforcing value in the maintenance of this preference. Lambs were assigned to one of three treatments: they had free access to the udder (group 1) or were prevented from sucking for 6 h either at birth (group 2) or at the age of 3 days (group 3). Lambs from group 2 did not discriminate between their own and alien dams when tested at 24 h of age, unlike those of groups 1 and 3. When a second test was performed at 4 days of age, all the lambs showed a strong preference for their dams. We concluded that sucking has strong rewarding properties in the establishment of a preferential relationship with the mother by the lamb. On the other hand, the maintenance of this preference does not rely on sucking as strongly.

Physiological and endocrine effects of social contact

Nonnoxious sensory stimulation associated with friendly social interaction induces a psychophysiological response pattern involving sedation, relaxation, decreased sympathoadrenal activity, and increased vagal nerve tone and thereby an endocrine and metabolic pattern favoring the storage of nutrients and growth. It is suggested that oxytocin released from parvocellular neurons in the paraventricular nucleus (PVN) in response to nonnoxious stimulation integrates this response pattern at the hypothalamic level. The response pattern just described characterized by calm, relaxation, and anabolic metabolism could be regarded as an antithesis to the well known fight-flight response in which mental activation, locomotor activity, and catabolic metabolism are expressed. Furthermore, the health-promoting aspect of friendly and supportive relationships might be a consequence of repetitive exposure to nonnoxious sensory stimulation causing the physiological endocrine and behavioral changes just described.

Age-related decrease in plasma levels of gastrin, cholecystokinin and somatostatin

Newborn babies have higher concentrations of gastrointestinal hormones than adults. The aim of the present study was to investigate the relationship between age and plasma levels of the three peptides gastrin, cholecystokinin and somatostatin in healthy children aged 1-15 years. Gastrin, cholecystokinin and somatostatin concentrations were twice as high at 1-2 years of age compared with children older than 10 years. Significant negative correlations between age and hormone concentrations were established. It is suggested that these age-dependent differences are related to the growth rate and relative energy consumption during the early years of life.

Swimming upstream: breastfeeding care in a nonbreastfeeding culture

Women once gave birth and began breastfeeding within the cultural context of a traditional system of care; now they begin breastfeeding in a hospital. Historically, hospital care was arranged to fit artificial feeding. Little was known about the science of breastfeeding until recently. Basing our breastfeeding care on the cultural norm of bottle feeding has led to the development of many unfavorable attitudes and practices. Given an opportunity to learn how breastfeeding works and to improve our breastfeeding care skills, hospital nurses can play an important part in current efforts to make breastfeeding the community norm.