Breast milk zinc and copper concentrations in Bangladesh

Breast-fed infants in Bangladeshi villages were weighed at 1, 2, 6, 9 and 12 months. The concentrations of zinc and copper in the breast milk were measured and the daily intake of these elements calculated. Breast milk Zn concentration decreased over the year but was comparable with that found in developed countries. The calculated daily intake decreased from 17.7 to 8.0 mumol (10-30% of recommended dietary allowances (RDA); National Academy of Sciences, 1980). Breast milk Cu concentration also fell over the year and was lower than that reported from developed countries. Calculated daily Cu intake was 1.95-2.63 mumol (RDA 7.81-15.63 mumol). Deficiencies of trace elements may therefore be a problem in poorly nourished communities where breast feeding is continued for several years with only small amounts of additional food. Breast milk may not be adequate as the only source of infant nutrition after the first few months of life in Bangladesh.

Oral rehydration therapy for low birth weight neonates suffering from diarrhea in the intensive care unit

A total of 62 low birth weight (LBW) neonates (29 boys and 33 girls) suffering from diarrhea in our neonatal intensive care unit were included in this period of intense observation. The mean age was 13.89 +/- 13.22 days and average body weight was 1,500.49 +/- 281.45 g. Severity of dehydration was assessed by the Fortin-Parent score. When the score was less than 8 (mild to moderate hypovolemia), oral rehydration therapy (ORT) was administered by feeding bottle or nasogastric tube hourly. Severely hypovolemic neonates needed intravenous rehydration; 52 neonates received ORT only using the World Health Organisation (WHO) formula; 58 neonates received either cow's milk-based or soy-based formula within 12 h after ORT began, and the rest within 24 h. Diarrhea lasted less than 1 day in 92% of cases. The regimen corrected hyponatremia and hypernatremia. Only two neonates developed mild asymptomatic hypernatremia. No child became edematous. Using the WHO solution, ORT was safely given to LBW neonates, sparing painful and potentially hazardous invasive techniques, and resulted in excellent outcomes.

Use of powdered formula and incidence of underweight among infants of educated and uneducated mothers in Ile-Ife, Nigeria

The duration of usage of a tin of powdered formula and the incidence of underweight among 250 infants 14 days to 12 months old, whose parents were educated and uneducated, are reported. Twenty-two percent of the educated mothers and 42% of the uneducated mothers started their infants on formula from the 14th day of life. Only 6% of all the mothers exclusively breastfed for 1 month, and a meager 2% of the uneducated mothers exclusively breastfed for 3 months. There was a significant (p less than 0.001) increase in the duration of usage of a tin of powdered formula among the uneducated mothers as compared to the educated ones. Of the 250 infants, 93 (37.2%) greater than or equal to 1 month old were assessed as underweight for age. Most of the underweight infants had uneducated mothers. Practical ways of improving feeding practices and curbing early introduction of supplementary feeds are suggested.

Factors affecting the duration of breast feeding: 2. Early feeding practices and social class

Breast milk intake by babies on the third and the sixth postpartum day was measured by a test-weigh procedure in a group of 47 mothers and babies. Women who gave the largest amount of breast milk to their babies on the third postpartum day continued to breast feed for longer than women who gave smaller amounts. These mothers also suckled most frequently, gave least additional fluid to their babies, and their infants regained their birth weight most rapidly. However, an increased early milk intake and duration of breast feeding were both associated with higher social class. These results suggest that, although practices in the initiation of breast feeding are relevant, factors in the background and environment of the mother are also of fundamental importance. Thus recent emphasis on the importance of breast-feeding practices in the immediate puerperium should not divert attention from the equally important task of establishing the optimum conditions for breast feeding in the home environment of mothers.

Factors affecting the duration of breast feeding: 1. Measurement of breast milk intake in the first week of life

Test-weigh measurements of 24 h milk intake by babies in the immediate puerperium (days 1-9) were carried out in a group of 18 mothers and babies using an accurate electronic balance. Estimated milk intakes were then calculated on the basis of one, and of two consecutive, breast feeds. These estimates were then compared with the actual total intake to give a measurement of reliability. Significant positive correlations were found between both the one-feed and the two-feed estimated intake, and the measured 24 h intake. Accuracy increased from day 3 onwards. These results show that using an electronic balance an accurate estimate of 24 h milk intake during the first week of life can be obtained by using one or two test-weigh measurements. While this gives a minimally invasive and reliable method for estimating daily milk intake, it is not advocated as a routine procedure in postnatal wards.

A clinical trial of norethisterone oenanthate (Norigest) injected every two months

A clinical trial was carried out in which Norigest (200 mg norethisterone oenanthate) was administered by intramuscular injection every 56 days into 383 women studied for 5,521 woman-months of use. No pregnancies occurred. Continuation rates at the end of one, two and three years were 76.6%, 63.7% and 33.8%. Only minor side-effects were recorded. After one year of use, 20.1% women had gained more than 2 kg in weight and 14.8% had lost more than 2 kg. There was marked disruption of the menstrual pattern and irregular bleeding was the major cause of discontinuation. In 38% of the injection intervals analysed, women were amenorrhoeic. Norigest proved an effective and acceptable method of fertility control.

An incremental-dose combined oestrogen-progestogen oral contraceptive: effects on body weight, blood pressure, and biochemical parameters

An evaluation is presented of the effects of an incremental-dose combined oestrogen-progestogen contraceptive (0.05 mg ethinyl oestradiol throughout the cycle plus d-norgestrel 0.05 mg for the first 11 days and 0.125 mg for the subsequent 10 days). The majority of women showed weight changes less than 1.0 kg; a weight gain in excess of 2 kg was observed in 11.4% and a similar loss in 14.3%. The net change in blood pressure after 12 months was a slight reduction; no excessive elevation of pressure was recorded. Although no significant change in glucose tolerance was noted, triglyceride levels became progressively elevated; the increase in cholesterol levels were observed mainly in the second half of the cycle. Changes occurred in some but not all haematologic parameters: a significant increase in plasminogen level and decrease in activated prothrombin time; factors 7, 9 and 10 were progressively increased, whereas factors 5, 8, fibrinogen and antithrombin activity remained unaltered. This new preparation provides effective contraception with satisfactory cycle control and body weight changes. It is particularly useful in women who require additional oestrogen.

Association between estrogen receptors and weight in women with breast cancer

A significant association between body weight and estrogen receptor protein (ERP) was noted in 83 women with primary and metastatic breast cancer. Thirteen of 34 (54%) women with weight greater than 150 lb had low or absent receptor protein (less than 10 femtomoles/mg of cytoplasmic protein) compared to 15 of 59 (25%) women with weight less than 150 lb (P less than 0.025). The observed association was stronger in the group of 62 postmenopausal women (P less than 0.01). The findings suggest that the endocrine and metabolic milieu in women with increased weight favors autonomous growth of breast cancer, and adjuvant treatment in this group should be planned accordingly.