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Biomedical subjects

J Golding

Publications and source records attributed to J Golding.

At least 73 records · Page 4Linked to original sources
PubMed1998

Does the supine sleeping position have any adverse effects on the child? II. Development in the first 18 months. ALSPAC Study Team.

OBJECTIVE: To assess whether the recommendations that infants sleep supine could have adverse consequences on their motor and mental development. DESIGN: A prospective study of infants, delivered before, during, and after the Back to Sleep Campaign in the United Kingdom, followed to 18 months of age. SUBJECTS: The children were participants of the Avon Longitudinal Study of Pregnancy and Childhood born to mothers resident in the three former Bristol-based health districts of Avon, with expected date of delivery from April 1, 1991 to December 31, 1992. Questionnaires were completed on sleeping position at 4 to 6 weeks of age and sets of standardized questions on development at 6 and 18 months. MAIN OUTCOME MEASURES: Social, communication, fine and gross motor, and total developmental scales based on the Denver Developmental Screening Test at 6 and 18 months. RESULTS: After adjustment for 27 factors using multiple regression, 3 of the 10 scales and subscales significantly distinguished between front and back sleeping position. At 6 months of age, infants put to sleep on their front had a mean score 0.38 SD (95% confidence interval [CI]: 0.28, 0.49) higher on the gross motor scale, 0.11 SD (95% CI: 0.00, 0.23) higher in the social skills scale, and a total development score 0.20 SD (95% CI: 0.10, 0.30) higher than those on their backs. These differences were no longer apparent at 18 months. CONCLUSIONS: There is some evidence that putting infants to sleep in the supine position results in a reduced developmental score at 6 months of age, but this disadvantage appears to be transient. Weighing this against the adverse health effects demonstrated with the prone sleeping position, these results should not change the message of the Back to Sleep Campaign.

Child Development↗
PubMed1998

Children's adjustment and prosocial behaviour in step-, single-parent, and non-stepfamily settings: findings from a community study. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

The adjustment and prosocial behaviour of 4-year-old children and their older siblings growing up in step-parent or single-parent families, or with two biological parents, was investigated within a longitudinal community study, the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Mean differences in mothers' perception of adjustment were found for children in different family settings, with higher levels of problems and lower prosocial scores reported for those in single- and step-parent families than those in non-stepfamilies. Individual differences within each family setting were marked. With the exception of single parenthood, which remained a risk indicator for the 4-year-olds, the contribution of family type to differences in adjustment and prosocial behaviour largely disappeared when account was also taken of negativity in family relationships, maternal age, education level, depressive symptomatology, and history of previous live-in relationships, mothers' support networks, and the family's current financial and housing circumstances. Boys remained more at risk for adjustment difficulties than girls when this range of factors was taken into account. The limitations and implications of these findings on a community sample, a first step in a programme of research into family processes in children's adjustment, are discussed.

Adolescent↗
PubMed1997

Unnatural constituents of breast milk--medication, lifestyle, pollutants, viruses.

It is well recognised that although nutritionally breast milk is the optimal food for babies, there are a number of caveats to this, based on the consequences of the modern lifestyle. Here we have considered ways in which the young breast fed child may be exposed to various environmental and medical contaminants which might cause adverse reactions and to which he/she may not otherwise be exposed. These substances are divided into four different areas: (i) medication taken by the mother; (ii) exposure to possibly addictive drugs taken by the mother; (iii) exposure to pollutants mainly from the maternal diet or as the result of her occupation; (iv) viruses. The infant who consumes breast milk may be exposed to a variety of chemicals which may have untoward effects on his/her immediate health and temperament and future development. Potentially hazardous substances ingested by the breast fed infant include medicaments (or their metabolites) that may have been ingested by the mother, potentially addictive common neurotoxicants such as nicotine, caffeine and alcohol, illicit drugs such as heroin and cocaine, and pollutants such as polychlorinated biphenyls and dichlorodiphenyltrichloroethane (DDT). There is a paucity of good information on which to base reliable estimates of the harm that this may cause the child. Although breast feeding is known to protect against bacterial infection, a number of viruses are excreted in the breast milk which may infect the child asymptomatically (e.g. cytomegalovirus, Epstein-Barr virus) and which are not known to be harmful, as well as human immunodeficiency virus (HIV) excretion which, in contrast, does appear to increase the risk of the child becoming infected. Balancing the risk of infection to the child born to an HIV infected mother, results in the proposition that known HIV positive women in developing countries (where the risk of gastrointestinal infection is high) should continue to breast feed but those in the developed world (where the risk of gastrointestinal infection is lower) are better advised to bottle feed.

Environmental Pollutants↗
PubMed1997

The incidence and duration of breast feeding.

Information obtained from a variety of sources shows different rates of initiation and duration of breast feeding and different supplementation strategies. Among populations of developing countries, in general, the mothers resident in rural-areas are more likely to breast feed than those in urban areas; in addition the better off or more highly educated are less likely to breast feed. In contrast in the developed countries, the better educated and the higher social class mothers are more likely to breast feed. There is some evidence that delay in initiation of breast feeding, lack of professional support, conflicting advice from health professionals and the presence of free samples of artificial milk (whether or not given to the mother) can result in a mother failing to establish breast feeding. Additionally, mothers who smoke cigarettes are less likely to breast feed successfully. Whilst breast feeding is almost universal in a number of developing countries, many also commonly use complementary feeds. In some countries, particularly in Asia, it is still commonplace for a child not to be given the mother's colostrum, and therefore for the first breast feed to occur well after the first 24 h.

Attitude↗
PubMed1997

Gastroenteritis, diarrhoea and breast feeding.

In this paper we review the literature in regard to possible relationships between breast feeding and diarrhoea or gastroenteritis. We show that in the developed as well as the developing world, there is consistent evidence of a protective effect of exclusive breast feeding in the first 4-6 months of life. The odds ratios were generally in excess of 3.0 for non-breast milk feeds. The relationship was not consistent for rotavirus infections but was consistently strong for non-viral pathogens. There are a number of indicators that suggest biological plausibility, in both the developing and developed world. The triple indicators of consistency and strength of the epidemiological associations, together with biological plausibility are major arguments for believing that there is a causal sequence involved.

Breast Feeding↗
PubMed1997

Does breast feeding protect against non-gastric infections?

There is convincing evidence that breast-feeding is protective against gastro-enteritis and diarrhoea, but for other infections the situation is less clear cut. There is evidence that breast-fed infants are at increased risk of one infection (infant botulism). They are probably not significantly protected from upper respiratory tract infections (other than otitis media.), but they may be at a decreased risk of lower respiratory tract infections, particularly those associated with respiratory syncytial virus. There is strong evidence that Haemophilus influenzae B infection is more likely in the bottle-fed infant, and consistent evidence of protection of young children from chronic otitis media with prolonged breast-feeding.

Breast Feeding↗
PubMed1997

Eczema, asthma and allergy.

The literature in relation to the development of atopic and allergic disorders has been reviewed, in order to assess the claim that prolonged and exclusive breast feeding protects against the development of such disorders. The data in the literature show little consistent evidence to identify any protective association between breast feeding and either eczema, wheezing/asthma or other types of atopy or allergic response.

Asthma↗
PubMed1997

Does breast feeding have any impact on non-infectious, non-allergic disorders?

Feeding of breast milk in the first weeks of life appears to have a strong protective effect against necrotising enterocolitis. Nevertheless breast milk also seems to be positively linked to the development of jaundice and to late haemorrhagic disease in infants who have not received vitamin K supplements. There is no consistent evidence that other childhood conditions such as insulin dependent diabetes or cancer are less prevalent among children who have been breast fed. Among adult conditions suggested to be less prevalent in the breast fed, only single reports of significant findings for multiple sclerosis and breast cancer exist and convincing corroboration is not available. There are a number of studies that indicate a relationship between breast feeding and later cholesterol levels--and one that has considered the mortality of ischaemic heart disease among adult males. There is some suggestion that breast feeding (during the first year of life) is the optimal protection against future raised lipid levels and mortality from coronary heart disease, but the evidence is far from conclusive. The major health advantage of breast feeding that has been clearly demonstrated remains in the protection of the infant from certain infections in early life. If there are other long-term health advantages they have yet to be fully elucidated and confirmed.

Adult↗
PubMed1997

Breast feeding and infant mortality.

The evidence linking bottle feeding to infant and early childhood mortality has been reviewed. Ecological studies of national time trends in infant mortality do not parallel breast feeding trends in those countries, and indicate that falling death rates are more likely to be related to better health care facilities and social conditions. Direct studies of deaths provide some contradictory findings; meta-analyses are not informative because of the many differences in statistical and sample methodology. The methodology exhibited in most studies is more likely to have over- rather than under-estimated a relationship between bottle feeding and infant mortality. Retrospective analyses must take account of changes in feeding pattern due to early signs of illness. Prospective population studies able to account for large numbers of potential confounders provide the best estimates, especially if proportional hazards models are used. Two such studies have been carried out--both showed protective effects of breast feeding.

Breast Feeding↗
PubMed1997

The growth and nutritional status of the breast-fed infant.

The literature on the relationship between early infant feeding and growth shows that after the first 3 or 4 months, breast-fed infants in the developed world are lighter than formula-fed infants with markedly lower adiposity. There is some evidence of a slightly lower rate of linear growth over the first year or so. These differences in weight and length do not apparently persist beyond the first few years of life. In the developing world the situation is very different. The growth curves of breast-fed infants of malnourished mothers may falter between the third and sixth month of life. However, the generally poor quality of the supplementary foods offered in the developing world and the increased risk of diarrhoeal infections mean that supplementary feeding before the age of 6 months is unlikely to lead to a growth advantage and may well lead to growth faltering.

Breast Feeding↗
PubMed1997

Association between breast feeding, child development and behaviour.

Consistent data are available to suggest that children who have been breast fed are, on average, intellectually more able than their formula-fed contemporaries. This has been shown in eight of 10 population studies and all three studies of low birthweight infants. In general, the longer the child has been breast fed the more pronounced the effect. There is evidence that breast milk that has been pasteurised before feeding does not have this effect, but that fresh breast milk is effective whether the milk is delivered by tube or by the breast. However no studies have been able to have both sufficient statistical power and the ability to allow for other confounders such as parental ability, parental IQ and other factors that might explain these findings. Additional data from studies of visual acuity show an association between breast feeding and enhanced vision which is hypothesised to be due to the unique fatty acid composition of breast milk. The differences in intellectual development might also be related to these fatty acids. Alternative explanations for the effect on intellectual development concern the possible consequences of early infections, particularly gastroenteritis, which are more common in bottle-fed babies. In contrast with the many publications on cognitive function and breast feeding, there was only one on neurological dysfunction (showing a protective effect of breast feeding) and one on childhood behaviour (using the teacher's assessment no relationship with breast feeding was found). Further research is needed in both areas.

Breast Feeding↗
PubMed1997

The effects of lactation on the mother.

Undernourished mothers are likely to have limited fat reserves to draw on during lactation. In order to supply nutrition to her child the mother may therefore become more malnourished and suffer from bone resorption. Repeated or overlapping pregnancies with lactation are likely to compound the issue. Little research has been carried out into the health of mothers while breast feeding, or subsequently. There are theoretical reasons to think that the malnourished mother in the developing world may be particularly vulnerable, but no studies appear to have been undertaken. Investigations in the developed world have concentrated on cancers of the reproductive organs and shown consistent evidence in large case-control studies for a reduced risk of pre-menopausal breast cancer in mothers with a history of prolonged breast feeding. In contrast there have been a number of studies in the developed world concerned with emotional well-being with some indications that mothers who breast feed are more likely to be depressed and are less likely to be positive about their baby.

Female↗
PubMed1997

Maturation of the mammalian dorsal root entry zone--from entry to no entry.

Interfaces between glial cell precursors of the PNS and CNS are established early in development and form the sites where sensory axons enter and motor axons exit the developing CNS. The molecular and cellular interactions that lead to the formation of these glial interfaces are only now becoming apparent. New in-vitro techniques are providing clues as to how the maturation of PNS-CNS glial interfaces generates barriers to regenerating axons.

Aging↗
PubMed1997

Sudden infant death syndrome and parental smoking--a literature review.

There are a variety of methodological problems with published studies of parental smoking and sudden infant death syndrome (SIDS), with over-control the most consistent and problematic. Nevertheless, even though this is likely to minimise the true magnitude of relationships, the results are consistent. There are five cohort studies with prospectively collected information on maternal smoking in pregnancy: all show strong and statistically significant relationships that were dose dependent-the more cigarettes the mother had smoked, the more at risk was the baby of SIDS. Similar results have been shown from the case-control studies in which information has been collected retrospectively from parents or birth certificates. There are data from several studies indicating that environmental tobacco smoke (ETS) is also important. Since it has not yet been possible to determine conclusively whether associations are with smoking (or ETS) during pregnancy or postnatally, it is concluded that both should be discouraged.

Case-Control Studies↗
PubMed1997

Magnetic fields from domestic appliances in the UK.

In a survey of 50 UK homes the 50 Hz fundamental and harmonic magnetic fields generated by 806 domestic appliances found in the homes, and used regularly by mothers, were measured. Measurements were made in the direction of most likely access, and from the surface of the appliances. Mothers completed a questionnaire on the use of appliances and were monitored for 24 h so that acquired exposure could be compared with the measured ambient fields in the home. Appliances were measured at standard distances and an algorithm was used to calculate fields at 100 and 50 cm to remove room background contributions. A few appliances generated fields in excess of 0.2 microT at 1 m: microwave cookers 0.37 +/- 0.14 microT; washing machines 0.27 +/- 0.14 microT; dishwashers 0.23 +/- 0.13 microT; some electric showers 0.11 +/- 0.25 microT and can openers 0.20 +/- 0.21 microT. Of continuously operating devices, only central heating pumps (0.51 +/- 0.47 microT), central heating boilers (0.27 +/- 0.26 microT) and fish-tank air pumps (0.32 +/- 0.09 microT) produced significant fields at 0.5 m. There were no obvious ways to group different types of appliances as high- or low-strength sources. Mothers spent on average about 4.5 h per day in the kitchen, where the strongest sources of magnetic field were located.

Algorithms↗
PubMed1997

Are sociodemographic factors predictive of preterm birth? A reappraisal of the 1958 British Perinatal Mortality Survey.

OBJECTIVE: Reassessment of the predictive value of sociodemographic factors on preterm birth. DESIGN: Population-based case-control study. SETTING: England, Wales and Scotland. SAMPLE: The study sample consisted of 5630 primiparous and 9538 multiparous women who were delivered during the first week of March 1958 in Britain. Multiple births were excluded. METHOD: Factors potentially predictive of preterm birth were assessed for primiparous and multiparous women separately, using the split-sample cross-validation technique. MAIN OUTCOME MEASURE: Preterm birth, defined as birth occurring before 259 days of gestation. RESULTS: Preterm birth rates for primiparous and multiparous women were 54 and 53 per 1000 births, respectively. In primiparous women low maternal age (under 20 years) was the only sociodemographic variable that was predictive of preterm birth (P = 0.01). However, only 10.7% of preterm birth among primiparous women was associated with low maternal age. In multiparous women, using univariable analysis, employment status was statistically significantly associated with preterm birth. This association disappeared when employment status was adjusted for by other variables in the model. Social class was not predictive of preterm birth in either primiparous or multiparous women. CONCLUSION: From the results of this study it is concluded that sociodemographic factors do not have a substantial impact on the risk of preterm birth. It seems unlikely that preventative measures aimed at social-demographic adversity will reduce preterm birth rates.

Case-Control Studies↗