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Biomedical subjects

R G Whitehead

Publications and source records attributed to R G Whitehead.

At least 91 records · Page 5Linked to original sources
PubMed1982

How much breast milk do babies need?

A reassessment of the breast milk requirements of young babies at different ages has been made from a statistical analysis of energy intake data collected prospectively in Cambridge, U.K. and from data derived from a literature survey of cross-sectional food energy intakes of infants from Canada, Sweden, the U.K. and USA. In contrast to the slow progressive linear decline in energy requirements per kg body-weight that has previously been assumed, measured intakes have been shown to fall more rapidly in the first six months of life. Thereafter they then rise again as the baby becomes more active. These findings are of fundamental importance to a realistic assessment of the adequacy of breast milk as the sole source of food in the first six months of life. The data show that typical breast milk intakes found in the industrialized countries can satisfy infant energy needs for healthy growth for much longer than would be indicated by current international dietary recommendations. A discussion of the physiological interpretation of the results is included as is an appraisal of their practical significance both to breast and bottle feeding practices.

Body Weight↗
PubMed1981

Breast-milk fat concentrations of rural African women. 1. Short-term variations within individuals.

1. Detailed studies of variations in breast-milk fat concentrations were performed over 12 or 24 h periods on sixty rural Gambian women feeding on demand. The creamatocrit method (Lucas et al. 1978) was used. 2. The complex pattern of within-feed and between-feed changes in fat concentration was largely explained by differences in volume per feed and time interval between feeds. 3. No consistent difference in fat production between the breasts of each individual was found despite the local custom of starting all feeds on the right breast. 4. A marked diurnal variation in the mean fat concentration per feed was noted. On average the highest values occurred in the early morning, the lowest values in the late afternoon. 5. There was significantly greater between-individual than within-individual variation in the mean fat concentration per feed over 12 h (P less than 0.001). 6. A simple, rational and non-intrusive sampling procedure was devised for the estimation of whole-day mean fat levels based on the finding that the mean fat concentration of small samples of milk (0.25 ml) taken from both breasts before and after one specific feed of the day was closely correlated with 12 h and 24 h mean fat concentrations.

Breast Feeding↗
PubMed1981

Breast-milk fat concentrations of rural African women. 2. Long-term variations within a community.

1. Long-term variations in breast-milk fat concentration of mothers feeding on demand were studied in 120 rural West African women over a 12-month period. 2. The over-all mean 12 h breast-milk fat concentration was 39.3 g/l. 3. Mean breast-milk fat concentrations were affected by season in a manner which was correlated with seasonal changes in maternal subcutaneous fat stores (P less than 0.05) but which was unrelated to seasonal variations in maternal energy intake and breast-milk output. 4. Breast-milk fat concentrations were highest in early lactation, decreasing to a constant level during the first year. 5. There was significantly greater between-mother than within-mother variation in breast-milk fat concentrations measured in successive months, after correcting for season and stage of lactation (P less than 0.001). 6. Breast-milk fat concentrations were highest for primiparous mothers, decreasing to a constant level at parity 4 and higher. 7. A mother's relative breast-milk fat concentration was not correlated with her levels of dietary energy intake and breast-milk output but was positively correlated with her relative subcutaneous fat deposits (P less than 0.01).

Energy Intake↗
PubMed1981

Long-term energy balance in child-bearing Gambian women.

The energy intake of 143 pregnant and lactating Gambian women was measured prospectively each week for a year. Anthropometric, birth weight, and breast milk output measurements were also obtained. The average energy intakes (+/- SE) during the dry and wet seasons respectively were: pregnancy, 1483 +/- 22 and 1417 +/- 41 kcal/day; lactation (1st trimester), 1773 +/- 31 and 1474 +/- 42 kcal/day; lactation (subsequent trimesters), 1662 +/- 16 and 1413 +/- 37 kcal/day. Pregnant women gained 1.4 kg body weight per month in the dry season, but only 0.4 kg in the wet season. Lactating women gained weight in the dry season and lost weight in the wet season. Maternal nutritional status did not deteriorate with increasing parity. Mean birth weights (+/- SE) were: 2.94 +/- 0.07 and 2.78 +/- 0.11 kg in dry and wet seasons, respectively. Breast milk output and quality and early infant growth were close to values from well-nourished communities during the dry season, but deteriorated markedly during the wet season. Wet season energy intakes were clearly inadequate, but these results indicate that, despite being low by international standards, the dry season intake was compatible with a good lactational performance. Except for a somewhat low birth weight, which is partly explained by small maternal stature, progress during pregnancy was also remarkably normal during the dry season.

Birth Weight↗
PubMed1981

Riboflavin status in Gambian pregnant and lactating women and its implications for Recommended Dietary Allowances.

Riboflavin status by the erythrocyte glutathione reductase (NAD(P)H2:glutathione oxidoreductase EC1.6.4.2) test, and dietary riboflavin intake, were measured in 156 pregnant and lactating women in Keneba, a rural Gambian village, and in 59 pregnant and lactating women in Cambridge, England. The Keneba women were studied longitudinally, for up to 19 months. In Keneba, where the mean daily riboflavin intake was 0.5 mg, the mean erythrocyte glutathione reductase activation coefficient was 1.78 and there was a marked deterioration of biochemical status near parturition. In Cambridge, where the mean intake was 2.3 mg/day, the mean activation coefficient was 1.19. A vitamin fortified diet supplement, given to lactating women in Keneba for 8 months, raised their mean riboflavin intake for 0.5 to 1.5 mg/day and reduced the mean activation coefficient to 1.42. It is therefore likely that an intake even greater than the current United Kingdom or United States recommended daily amounts would be needed to achieve biochemical 'normality' in these women.

Adolescent↗
PubMed1981

A critical analysis of measured food energy intakes during infancy and early childhood in comparison with current international recommendations.

An examination of published reports of measured energy intakes of infants and young children reveals that during the first year of life the pattern of change in food energy intake differs fundamentally from the WHO/FAO (1973) Recommendations. In contrast to the progressive linear decline in intake per kg body weight that has previously been assumed, measured intakes are not only substantially lower, but fall much more rapidly up to six months. In even greater contrast, they then rise again, to coincide with the recommendations, reaching a peak at around two years. These findings enable a more realistic assessment to be made of the adequacy of breast milk as the sole source of food in the early months of life.

Age Factors↗
PubMed1980

Dietary supplementation of Gambian nursing mothers and lactational performance.

A dietary supplement, resulting in a mean net increase in energy intake of over 700 kcal/day, was supplied to all nursing mothers in a West African village for 12 months. The supplement produced a slight initial improvement in maternal body weight and subcutaneous fat stores but did not increase breast-milk output or fat content.

Body Weight↗
PubMed1980

The better use of food resources for infants and mothers.

The nutritional and food safety characteristics of the foods customarily eaten by infants and mothers in The Gambia are discussed. Special emphasis is placed on their low energy and nutrient density and the consequent difficulty of meeting internationally recommended levels of intake. The consequences of an inadequate diet during pregnancy and lactation are considered in terms of their effect on the size of the baby at birth, the mother's lactational performance, and the growth and development of the baby. The microbiological contamination of locally introduced weaning foods is also highlighted. Suggestions are made concerning the desirable characteristics of new foods that need to be introduced to overcome these problems. Attention is paid to a more rational distribution and use for aid foods.

Agriculture↗
PubMed1980

Influence of maternal diet on plasma-prolactin levels during lactation.

An improvement in maternal diet produced significant reductions in plasma-prolactin concentration at all stages of lactation. The prolonged high prolactin concentrations found in undernourished mothers may ensure milk synthesis when food intake is limited, by preferentially channelling nutrients towards the breast. The lower hormonal levels associated with improved maternal nutrition may shorten the period of post-partum infertility despite prolonged breast-feeding.

Amenorrhea↗
PubMed1979

New method for measuring milk intakes in breast-fed babies.

A method for the measurement of milk intake in young breast-fed babies is described in which heavy water (2H2O) enrichment in saliva is measured on only two occasions after a single oral dose of 2H2O. Values obtained by this method are compared with those obtained by test-weighing. This new method is ideal for routine surveys since it does not interfere with feeding habits and maternal life style, and no technical expertise is required of the mother.

Breast Feeding↗