Biomedical subjects
Y Hofvander
Publications and source records attributed to Y Hofvander.
Problems associated with breast-milk substitutes.
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Breast-feeding and its promotion.
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[Health status of adopted children from abroad and their adaptation to Swedish conditions].
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The amount of milk consumed by 1-3 months old breast- or bottle-fed infants.
The consumption of breastmilk was studied by the weighing method in 75 infants aged 1, 2 and 3 months (+/- 1 week), 25 infants in each group. Similarly the same number of infants in the same age groups, bottle-red ad libitum, was studied and the consumption and consumption pattern were compared between the two groups. The mean and range of consumed amounts of both types of milk were similar to that found in other studies. The means for breastmilk were 656-773-776 g and for breastmilk substitutes 713-811-853 g in the 1, 2 and 3 months infants, respectively, but with wide variations. When expressed as kcal/kg it appeared to be practically no difference between the two feeding groups. The bottle-fed infants had fewer meals and had a more even consumption from meal to meal. It is concluded that infants largely regulate themselves the intake they require.
Appropriate timing for complementary feeding of the breast-fed infant. A review.
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International comparisons of postnatal growth of low birthweight infants with special reference to differences between developing and affluent countries.
A large majority of low birthweight infants are born in developing countries where however, only few follow-up studies have been made. However, there are clear indications that in general the AGA infants catch-up better than the SGA of the same weight. A particularly poor catch-up growth is shown by full-term SGA indicating that if a fetal growth retardations is diagnosed, delivery should be induced prematurely. Social and environmental factors are important for the optimal growth postnatally and particularly so if the environmental conditions are adverse.
Studies on human milk III. Secretory IgA quantity and antibody levels against Escherichia coli in colostrum and milk from underprivileged and privileged mothers.
We studied the milk content of secretory IgA (SIgA) and of specific IgA antibodies to E. coli in relation to volume, in 24 h samples from mothers belonging to different socio-economic groups and living under different ecologic conditions in Ethiopia, Guatemala and Sweden. There were no statistically significant differences in the daily output of milk SIgA among the population groups investigated at different times after onset of lactation. There was, however, a certain trend towards lower SIgA levels among the Guatemalan poor women, compared to the corresponding privileged one (Tables 2 and 3). Three days after delivery the underprivileged Ethiopian mothers showed significantly lower antibody levels than the privileged Ethiopian. These differences were no longer seen when the values were corrected for differences in volume (Table 5). One month after delivery, the levels of SIgA antibodies in milk from Swedish women and Guatemalan privileged women, against a pool of eight E. coli somatic antigens were comparable; these two groups of mothers had significantly higher antibody levels than the Guatemalan rural and urban ones (Table 4). The same pattern was observed after correction for differences in 24 h volumes (Table 5). At 3 months after delivery, the Guatemalan urban privileged women, again showed higher levels and daily output of antibodies against the E. coli antigens than the urban poor and rural mothers (Tables 4 and 5). The milk samples taken from a population where malnutrition is evident, i.e., mothers from Santa María Cauqué, did not show any changes in the levels of SIgA and the anti-E. coli antibodies 3, 6, 9 months after initiation of lactation. The data presented here provide evidence that chronically malnourished mothers are able to produce SIgA and transfer it to their offspring via breast milk. Furthermore, they do so in quantities that are comparable to those observed in well-nourished populations. There was a wide range of concentrations and daily output of SIgA and of specific antibodies in all groups, suggesting that some of the infants get less than others. The observed differences in levels of antibodies against E. coli may be explained by differences in exposure to E. coli strains of the eight serogroups studied here. The possibility of a deficiency in the SIgA antibody response in the undernourished mothers still remains unanswered.
[Health for all by the year 2000 - is that true for all the children of the world, too?].
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WHO collaborative breast feeding study. I. Organochlorine contaminants in individual samples of Swedish human milk, 1978--1979.
Individual samples of human milk collected in Uppsala at 3 months post-partum (18 samples) or 6 months post-partum (23 samples) were analysed for chlorinated insecticides and polychlorinated biphenyls (PCBs) by gas chromatography. The mean levels of the organochlorine compounds in the 3- and 6-month groups were similar. The mean content of DDE, the major metabolite of DDT, in all the samples was 54 micrograms/kg fresh weight (1.3 mg/kg on a fat basis) with a range of 8.4--220 micrograms/kg (0.49--3.0 mg/kg fat). The results confirm that the decline since 1967 in the levels of DDT and its metabolites in Swedish human milk reported by other authors is continuing. The levels of dieldrin and beta-hexachlorocyclohexane found are lower than those reported earlier in Sweden, whereas the levels of hexachlorobenzene are about the same. On the other hand, the levels of PCBs (mean 64 micrograms/kg, range 15--150 micrograms/kg, fresh weight, equivalent to 1.6 mg/kg, range 0.84--2.9 mg/kg, on a fat basis) are higher than those reported earlier in Swedish human milk. Although the calculated intake of the DDT complex (DDT + DDE + DDD) by some of the suckling infants exceeds the acceptable daily intake proposed by a FAO/WHO expert group, it does not constitute a reason for recommending any restrictions on breast feeding--for nutritional, immunological and other reasons it should be encouraged.
WHO collaborative breast feeding study. II. Levels of lead and cadmium in Swedish human milk, 1978-1979.
Individual samples of human milk collected in Uppsala at 3 months post partum (18 samples) and 6 months post partum (23 samples) from 21-35-year-old healthy mothers were analysed for lead and cadmium by flameless atomic absorption spectrometry. The median lead content in the 41 samples was 2 microgram/kg fresh weight (range 0.5-9.0 microgram/kg), and the median cadmium level was 0.1 microgram/kg. There were no appreciable differences between the 3-month and 6-month samples as regards lead or cadmium levels. The calculated median weekly intakes of lead and cadmium by the 3-month-old infants (who received nothing else except breast milk) were approx. 2 microgram and 0.1 microgram/kg body-weight, respectively. There is no reason to believe that these low intakes of lead and cadmium constitute any risk to the health of the child. The intake of these metals by the breast-fed infant is likely to be the same as or somewhat lower than that of infants fed human milk substitutes and certainly less than that of children fed cereal-based infant foods.
[Breast feeding or bottle feeding in developing countries: important WHO/UNICEF conference on infant nutrition in developing countries].
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[The health status of immigrant children upon arrival in Sweden].
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A prospective study of individual courses of breast feeding.
A prospective study of the course of breast feeding was carried out in 75 randomly selected women. Weekly interviews were performed from the day after delivery until the termination of breast feeding, but in no case for longer than 6 months. In each case a detailed analysis was made of the factors leading to transient lactation crises or to complete cessation of breast feeding. A second group of 71 mothers, also randomly selected, was interviewed in retrospect only, 6 months after delivery, and served as controls. Twenty-four weeks after delivery 47% of the mothers in the weekly interview group were still breast feeding. The corresponding figure in the control group was 38%. In both groups only few mothers terminated lactation for medical reasons, while about one fourth stopped for some other reason and about one half because of a combination of factors. Brief case reports are presented to illustrate how varying the factors were that threatened breast feeding.
Breast feeding trends and recent information activities in Sweden.
The breast feeding rate has been declining steadily in Sweden since the 1930's up to the early 1970's. It is suggested that this was linked to the changing role of women, the development towards the nuclear family, the changing way of living, the influence of strict routines at the maternities and many other factors. A Committee was appointed in 1973 by the National Board of Health and Welfare, which initiated a number of breast feeding promoting activities: the editing of a Manual for health personnel, and booklets for mothers, the systematic arranging of workshops for key personnel in each county, stimulation to more flexible and breast feeding favouring maternity routines, backing of working groups of La Leche League-type, etc. Coinciding with these activities and probably a result of changed breast feeding attitudes among mothers, the breast feeding rate has increased considerably--at 2 months from an all time low of 31% in 1972 to 62% in 1976/77, and at 6 months from 6% to 20%.
[Clinical findings in health examinations of adopted children from developing countries].
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WHO collaborative study on breast feeding.
WHO, concerned with the declining breast feeding rate in developing countries, has organized investigations in nine different countries of different aspects of breast feeding and breast milk with the ultimate aim of formulating programmes of intervention. The basic epidemiological study on 24000 mother/child pairs is just completed and some preliminary data are reported on the pattern of breast feeding in the three studied socio-economic groups--urban elite, urban poor and traditional rural--which differ significantly in their breast feeding rate as well as in the pattern of return of menstruation in breast-feeding and non-breast-feeding mothers.