Biomedical subjects
J D Baum
Publications and source records attributed to J D Baum.
Effects of incubator noise on the cochlea of the newborn.
Explore the source record for details and available documents.
Paediatric preparation for multiple premature births.
We describe the managment of 2 sets of pre-term quadruplets born to 2 women pregnant concurrently following the induction of ovulation with gonadotrophin. Careful antenatal planning was necessary to provide for each of the 8 pre-term infants a standard of neonatal medical and nursing care comparable to that normally available for singleton pre-term infants.
Drip breast milk: it's composition, collection and pasteurization.
"Drip breast milk" is that milk which spontaneously drips from the contralateral breask during the suckling of an infant. Biochemically and immunologically, pooled drip milk resembled pooled mature expressed breast milk, although it has a lower fat concentration. About 15% of lactating women are capable of producing drip milk; volumes produced are up to 188 ml/donor/day. A milk bank is described which processes 1400 liters of drip milk/yr. Heat treatment of this milk with a semi-automated holder pasteurizer caused a 21% reduction in IgA concentration and a 36% reduction in lysozyme activity, as well as a decrease in the ability of the milk to inhibit the growth of E. coli. In comparison with boiling, pasteurization was as effective in reducing total bacterial content provided the milk initially contained fewer than 10(6) bacteria/ml.
Increasing breast feeding in a community.
A second survey of infant feeding practice was carried out by questionnaire among patients discharged from one maternity ward at the John Radcliffe Hospital, Oxford, in the winter 1974/75. In comparison with the first survey in the winter of 1972/73, significantly more mothers went home breast feeding (52% compared with 37%); these mothers breast fed their babies for a significantly longer period (43% at 5 months compared with 23%), and introduced mixed feeds significantly later (17% at 2 months compared with 64%). Information was also collected on the difficulties the mothers had experienced with breast feeding. The changing patterns in infant feeding practice in Oxford may relate to changes in advice given by health visitors and community health personnel.
'The continuum of caretaking casualty'.
Explore the source record for details and available documents.
Increased insensible water loss in newborn infants nursed under radiant heaters.
Urine osmolality was studied in 38 babies nursed in conventional incubators or cots and 18 nursed under an overhead radiant heat shield. Among 50 babies receiving a similar fluid intake in the first 48 hours of life mean urinary osmolality was significantly higher in the radiant heater group. In babies weighing less than 1500 g a trend towards higher urinary osmolalities was recorded in those nursed under radiant heaters even though they had received amost double the fluid intake of the incubator group. Severe hypernatraemia occurred in four of the five babies weighing less than 1000 g who were nursed under radiant heaters but in none of the seven babies of similar birth weight nursed in incubators. These findings are consistent with previous observations of an increase in insensible water loss in babies nursed under radiant heaters and emphasise the importance of providing enough extra water for these infants and the need for close monitoring of their fluid balance. The latter may be done at the bedside by measuring urinary specific gravity with a hand refractometer.
Contribution of preterm delivery to perinatal mortality.
A detailed retrospective analysis was made of the records of 486 preterm infants, who accounted for 5-1% of all births during 1973 and 1974. Whereas preterm delivery did not contribute to perinatal mortality in terms of stillbirth, it outweighed all other causes in terms of early neonatal deaths. Preterm birth was responsible for 85% of the early neonatal deaths not due to lethal congenital deformities. Early neonatal mortality rates were closely linked both to gestational age and birth weight and to the reason for preterm birth. Early neonatal mortality was high (97 per 1000) when preterm labour was spontaneous, whether or not associated with material or fetal disease or with multiple pregnancy, but low (27 per 1000) when preterm delivery was elective. Preventing spontaneous preterm labour would considerably reduce neonatal mortality in our community.
Pharyngeal lecithin/sphingomyelin ratios in newborn infants.
Lecithin/sphingomyelin ratios were measured on hypopharyngeal secretions from newborn infants within 6 h of birth. L/S ratios of 1.8 or less correlated with the development of the idiopathic respiratory-distress syndrome. Low L/S ratios were more common in the shorter gestation infants, and there was a predominance of L/S ratios of more than 1.8 above 32 weeks' gestation. In multiple births, the first-born of triplets and quadruplets had higher L/S ratios than those subsequently born. This may indicate a link between fetal lung maturation and the onset of labour.
Successful pregnancy in acute monocytic leukaemia.
Explore the source record for details and available documents.
Neonatal brain growth during prolonged intravenous feeding.
Little is known about the affects of long-term intravenous nutrition on brain growth and development in low birthweight infants. We report the post-mortem analysis of the brain of an infant born at 32 weeks of gestation who died 10 weeks of continuous intravenous feeding. During this time there was evidence of brain growth while somatic growth was severely restricted. Compared with normal data for brain biochemistry for 42 weeks of gestational age, measurements showed that the brain was small and biochemically immature with the cerebellum and brain stem being particularly affected.
Letter: Weight gain in infancy and subsequent development of diabetes mellitus in childhood.
Explore the source record for details and available documents.
Lymphocyte reactivity in pregnant women and newborn infants.
The mitotic response to phytohaemagglutinin (PHA) was determined in lymphocytes of mothers and their newborn infants obtained at delivery and seven days later by measuring the rate of 125 I-idoxuridine uptake into DNA in lymphocytes cultured in their own plasma and after washing and resuspension in fetal bovine serum. There was no difference in the unstimulated counts of maternal lymphocytes taken at delivery, whether unwashed or washed, compared with those from nonpregnant controls. With PHA stimulation the mitotic response of the maternal lymphocytes cultured in their own plasma was reduced compared with that of the control lymphocytes but washed maternal cells showed a similar response to the controls. These findings suggest that the reduced lymphocyte mitotic response to PHA in pregnancy is due to a plasma inhibitory factor This inhibition was not evident in maternal blood taken seven days after delivery. DNA synthesis in unstimulated cultures from newborn infants at birth and seven days after birth was greater than that in adult control cultures. With PHA stimulation the mitotic response of cord-blood lymphocytes cultured in their own plasma paralleled that of control lymphocytes but washed newborn cells showed a greater response. Thus plasma suppression similar to that observed in the mother seems also to affect infants at birth. This inhibition was not demonstrable in blood taken from infants of 7 days.
Immediate effects of alkaline infusion in infants with respiratory distress syndrome.
Nineteen infants with acidosis associated with RDS were studied following the infusion of: (1) 0.58M (7%) THAM over 30 seconds; (2) molar bicarbonate over 30 seconds; (3) molar bicarbonate over 2 minutes; and (4) molar bicarbonate over 5 minutes. PaC02 fell after THAM; PaC02 rose sharply after bicarbonate and remained elevated 10 minutes after infusion. The pH rose abruptly in all infants and remained significantly elevated 10 minutes after infusion. Pa02 changes were variable; no infant had immediate improvement in Pa02. The changes in osmolality, hematocrit, and colloid osmotic pressure describe the immediate osmotic hemodilution following the infusion of hypertonic base.
Lecithin/sphingomyelin ratio in hypopharyngeal aspirate of newborn infants.
The lecithin/sphingomyelin (L/S) ratio was measured in the hypopharyngeal aspirate of 41 newborn infants. In 20 without respiratory distress the ratio within 24 hours from birth ranged from 1.5 to 5.8 with a mean value of 3.3. In 6 with 'transient tachypnoea of the newborn' the ratio ranged from 2.0 to 6.7 with a mean value of 3.2. In 15 infants with idiopathic respiratory distress syndrome (RDS) the ratio ranged from 0.9 to 2.1 with a mean value of 1.4. In 14 of these infants the ratio within 24 hours from birth was 1.7 or less. One infant with a higher ratio and severe RDS is described in detail. Serial hypopharyngeal aspirate L/S ratios were determined in the infants with RDS. There was a possible trend toward the earlier attainment of a ratio of 2.0 in infants who received continuous distending airway pressure compared with infants who did not.
Factors influencing breast feeding.
A survey is reported of infant feeding practice at the time of discharge from a single maternity ward. It is shown that a change in the attitude of nursing staff increased the number of mothers breast feeding their infants and eliminated the practice of giving the infants formula feed complements. This change in attitude, however, did nothing to prevent the rapid decline in lactation after leaving hospital, such that 50% of mothers discharged breast feeding were no longer doing so by 2 months. The early introduction of solid feeds was common practice, 50% of mothers discharged breast feeding having introduced mixed feeds within 2 months. Successful lactation was found to be commoner in those mothers who had themselves been breast fed in infancy and in mothers from socioeconomic classes I and II. Successful lactation was not related to parity. The survey also shows the influential role of the health visitor, district nurse, and midwife upon mothers' decisions about infant feeding.
Proceedings: Depressed lymphocyte response to phytohaemagglutinin in pregnant women and newborn infants.
Explore the source record for details and available documents.