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PubMed2004

Infant Affect during Parent-Infant Interaction at 3 and 6 Months: Differences Between Mothers and Fathers and Influence of Parent History of Depression.

Fifty families participated in mother- and father-infant still-face interaction at infant ages 3 and 6 months as part of a study of affect in early parent-infant relationships. Infants' positive and negative affect and parents' positive affect and physical play were coded from videotapes. Consistent with previous research, during the normal condition, mothers displayed more positive affect than did fathers, and fathers were more likely than mothers to display physical play. Infants were more positive with mothers than with fathers. Parents' positive affect but not parent gender predicted infants' positive affect at 6 months. During the still-face condition, infants of parents with a lifetime history of depression were more likely to display negative affect and less likely to display positive affect than infants with no such parent history. Infants' affect was unrelated to parents' current level of depressive symptoms, which indicates the value of considering family history of psychopathology when examining individual differences in infants' affect.

Journal Article↗
PubMed2001

Developmental outcomes of infants with bronchopulmonary dysplasia: comparison with other medically fragile infants.

The purpose of this study was to compare the developmental outcomes and mother-infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD.

Bronchopulmonary Dysplasia↗
PubMed2000

Breast-fed infants achieve a higher rate of brain and whole body docosahexaenoate accumulation than formula-fed infants not consuming dietary docosahexaenoate.

Docosahexaenoate (DHA) has been increasingly recognized as an important fatty acid for neural and visual development during the first 6 mon of life. One important point of controversy that remains is the degree to which adequate levels of DHA can be acquired from endogenous synthesis in infants vs. what should be provided as dietary DHA. We have approached this problem by a retrospective analysis of published body composition data to estimate the actual accumulation of DHA in the human infant brain, liver, adipose tissue, remaining lean tissue, and whole body. Estimating whether infants can synthesize sufficient DHA required comparison to and extrapolation from animal data. Over the first 6 mon of life, DHA accumulates at about 10 mg/d in the whole body of breast-fed infants, with 48% of that amount appearing in the brain. To achieve that rate of accumulation, breast-fed infants need to consume a minimum of 20 mg DHA/d. Virtually all breast milk provides a DHA intake of at least 60 mg/d. Despite a store of about 1,050 mg of DHA in body fat at term birth and an intake of about 390 mg/d alpha-linolenate (alpha-LnA), the brain of formula-fed infants not consuming DHA accumulates half the DHA of the brain of breast-fed infants while the rest of the body actually loses DHA over the first 6 mon of life. No experimental data indicate that formula-fed infants not consuming DHA are able to convert the necessary 5.2% of alpha-LnA intake to DHA to match the DHA accumulation of breast-fed infants. We conclude that dietary DHA should likely be provided during at least the first 6 mon of life.

Brain↗
PubMed2006

Feeding Infants and Toddlers Study: do vitamin and mineral supplements contribute to nutrient adequacy or excess among US infants and toddlers?

OBJECTIVE: To report the prevalence of dietary supplement use in a random sample of US infants 4 to 24 months of age, and to compare demographic characteristics, usual nutrient intakes, and food patterns of supplement users and nonusers. DESIGN: Data from 24-hour recalls collected for the 2002 Feeding Infants and Toddlers Study were analyzed. Recalls included nutrient contributions from dietary supplements as well as all foods and beverages. We estimated usual energy and nutrient intakes of supplement users and nonusers, as well as the prevalence of nutrient adequacy and excess in the two groups. We also compared demographic characteristics and food patterns of supplement users and nonusers and, for supplement users, estimated the proportion of total intake provided by foods and the proportion provided by supplements. SUBJECTS: A national random sample of 3,022 infants and toddlers age 4 to 24 months, including 430 vitamin and/or mineral supplement users and 2,592 nonusers. STATISTICAL ANALYSIS: We compared means, percentile distributions, and proportions by age and supplement subgroup, and applied the Dietary Reference Intakes to assess usual nutrient intakes. We conducted regression analysis to determine which population characteristics predict the use of dietary supplements in this population. RESULTS: Overall, 8% of infants age 4 to 5 months received some type of dietary supplement. The prevalence of supplement use increased with age, to 19% among infants 6 to 11 months and 31% among toddlers 12 to 24 months. The vast majority of supplement users (97%) received only one type of supplement, most commonly a multivitamin and/or mineral supplement. Vitamin/mineral supplement use among infants and toddlers was associated with being a first-born child and being reported by the primary caretaker as being a picky eater. Characteristics that were independent predictors of supplement use were living in the Northeast, being male, and living in a household with fewer children. We found no significant differences between supplement users and nonusers in mean daily intakes of nutrients or nutrient density from foods alone, and few differences in food consumption. Overall, the prevalence of inadequate intakes was low (<1% to 2%). However, 65% of supplement nonusers and 9% of supplement users had vitamin E intakes less than the Estimated Average Requirement. Excessive intakes (ie, intakes above the Tolerable Upper Intake Level) were noted for both supplement users and nonusers for vitamin A (97% and 15% of toddlers) and zinc (60% and 59% of older infants and 68% and 38% of toddlers) as well as for folate among supplement users (18% of toddlers). CONCLUSIONS: Generally, healthy infants and toddlers can achieve recommended levels of intake from food alone. Dietetics professionals should encourage caregivers to use foods rather than supplements as the primary source of nutrients in children's diets. Vitamin and mineral supplements can help infants and toddlers with special nutrient needs or marginal intakes achieve adequate intakes, but care must be taken to ensure that supplements do not lead to excessive intakes. This is especially important for nutrients that are widely used as food fortificants, including vitamin A, zinc, and folate.

Child Day Care Centers↗
PubMed1995

Deficient hypoxia awakening response in infants of smoking mothers: possible relationship to sudden infant death syndrome.

OBJECTIVE: To determine whether fetal exposure to cigarette smoke impairs postnatal chemoreceptor control of ventilation and hypercapnic and hypoxic awakening responses. STUDY DESIGN: Smoking (n = 13) and nonsmoking (n = 34) women were recruited during pregnancy. Serum cotinine levels were measured to assess level of nicotine exposure. The infants were studied at 2 to 3 months of age for ventilatory and awakening responses to hypoxia (17%, 15% and 13% inspired O2) and hypercapnia 4%, 6%, and 8% inspired CO2). Continuous measures were analyzed with unpaired t tests and analysis of variance for repeated measures. Proportions of awakening and periodic breathing were analyzed by means of a comparison of proportions. RESULTS: The infants of smokers had lower birth weights (3022 +/- 566 vs 3518 +/- 491 gm; p < or = 0.005) and were older at the time of study (10.4 +/- 2.8 vs 8.7 +/- 1.3 weeks; p < 0.01) than the control infants. Maternal cotinine levels were higher in smokers (97.8 +/- 107 ng/ml vs no cotinine; p < 0.0001). More infants of smokers failed to awaken with hypoxia than did control infants (54% vs 15%; p = 0.006). The ventilatory responses to hypoxia and hypercapnia were similar in the two groups. All infants awakened with hypercapnia, and there was no difference in the awakening threshold for carbon dioxide (50.3 +/- 4.5 vs 48.3 +/- 5.4 mm Hg; p = 0.28). CONCLUSION: Infants of mothers who smoked during pregnancy have deficient hypoxic awakening responses, which may contribute to the increased risk of sudden infant death syndrome in infants of smoking mothers.

Adult↗
PubMed2003

Efficacy of an infant formula containing anti-Escherichia coli colostral antibodies from hyperimmunized cows in preventing diarrhea in infants and children: a field trial.

OBJECTIVE: To examine the efficacy of using oral bovine hyperimmune immunoglobulin concentrate with high-titer antibodies against Escherichia coli in preventing diarrhea caused by enteropathogenic E. coli. DESIGN AND SETTING: This was a randomized, double-blind, controlled field trial conducted at the Al-Sheikh Omer Maternal and Child Health Center in Baghdad, Iraq from May to September 1998. PARTICIPANTS: One hundred and twenty-five infants who satisfied the study criteria were included. One hundred and seven infants had adequate outcome data for the assessment of efficacy. INTERVENTION: Infants were randomly assigned to receive either immunoglobulin concentrate-supplemented infant formula or non-supplemented control formula for 7 days. Groups were matched for physical characteristics at enrollment in the study. Another group, which was breastfed, was included to allow the collection of diarrhea morbidity data. Anthropometrics and diarrheal morbidity data were collected by weekly monitoring during the 6-month follow-up period. RESULTS: The infants receiving supplemented formula had a lower incidence of diarrhea than the infants receiving control formula (P <0.05). Episodes of diarrhea were shorter in infants receiving supplemented formula (P <0.01). Moreover, infants receiving supplemented formula gained significantly more weight than control infants after 8 months of follow-up. The preparation was safe and well tolerated. CONCLUSION: The results indicate that the reduction in morbidity associated with formula supplementation is of sufficient magnitude to be of public health significance. The use of these preparations provides an effective method for the prevention of diarrheal diseases.

Adult↗
PubMed2002

Mothers' insightfulness regarding their infants' internal experience: relations with maternal sensitivity and infant attachment.

This study examined the associations among mothers' insightfulness into their infants' internal experience, mothers' sensitivity to their infants' signals, and infants' security of attachment to their mothers. The insightfulness of 129 mothers of 12-month-old infants was assessed by showing mothers 3 videotaped segments of observations of their infants and themselves and interviewing them regarding their infants' and their own thoughts and feelings. Interviews were classified into 1 insightful and 3 noninsightful categories. Mothers' sensitivity was assessed during play sessions at home and at the laboratory, and infant-mother attachment was assessed with the Strange Situation. Mothers classified as positively insightful were rated as more sensitive and were more likely to have securely attached children than were mothers not classified as positively insightful. Insightfulness also accounted for variance in attachment beyond the variance explained by maternal sensitivity. These findings add an important dimension to research on caregiving, suggesting that mothers' seeking of explanations for the motives underlying their infants' behavior is related to both maternal sensitivity and infant attachment.

Attitude↗
PubMed2002

Parents' emotional availability and infant emotional competence: predictors of parent-infant attachment and emerging self-regulation.

One-year-old infants (N = 62) and their mothers and fathers were observed in free play and teaching sessions in order to examine parents' emotional availability and the infant's emotional competence. Mothers were more emotionally available than fathers, and infants exhibited more effortful attention with mothers than with fathers. Similar relations between parental emotional availability and infant emotional competence were found for mother-infant and father-infant dyads. Change in parental emotional availability covaried with change in infant emotional competence. Individual differences in parental emotional availability and infant emotional competence were more consistent across contexts than across parents. Infant effortful attention at 12 months was a mediator between maternal emotional availability at 12 months and toddler situational compliance at 16 months.

Adult↗
PubMed2002

Treatment of infants with lymphoblastic leukaemia: results of the UK Infant Protocols 1987-1999.

One hundred and twenty-six infants with acute lymphoblastic leukaemia (ALL) were treated on two consecutive protocols, Infant 87 (n = 40) and Infant 92 (n = 86), in an attempt to improve the poor prognosis of this disease. Both included intensive induction and consolidation with intrathecal and high-dose systemic therapy for central nervous system (CNS) protection. Intensification therapy was modified and high-dose chemotherapy with bone marrow transplantation in first remission was permitted in Infant 92. Four-year event-free survival was superior in Infant 92 (33%; 95% CI 23-44%) compared with Infant 87 (22.5%; 95% CI 12-37%) (P = 0.04) and survival at 4 years was also superior, 46% (95% CI 35-57%) c.f. 32.5% (95% CI 20-48%) (P = 0.01), largely as a result of a significant reduction in remission deaths. Twelve patients in Infant 92 underwent bone marrow transplantation (BMT) in first remission, but their survival was no better than that of patients receiving chemotherapy. Multivariate analysis of prognostic factors showed the adverse influence of younger age, CNS involvement at diagnosis and a high initial leucocyte count, but not of CD10 expression. Cytogenetic analysis, available in 93% of patients in Infant 92, showed that 67% had chromosomal rearrangements involving 11q23 of which 39% had the translocation t(4;11) (q21;q23). There was no significant difference in event-free survival between cytogenetic subgroups, although no children under 6 months of age with 11q23 abnormalities, other than the t(4;11), survived. In conclusion, infants with lymphoblastic leukaemia remain a high-risk group, but it is unclear whether their adverse prognosis can be attributed to unfavourable cytogenetics alone. The role of high-dose therapy and BMT in first remission remains uncertain.

Age Factors↗
PubMed2000

Sudden infant death syndrome in South Australia 1968-97. Part 3: is bed sharing safe for infants?

OBJECTIVE: To examine the risk of death for bed-sharing infants. METHODOLOGY: All unexpected infant deaths occurring in South Australia between 1970 and 1997, occurring after the infant was put to rest and diagnosed by after death scene investigation and autopsy as sudden death infant syndrome, accidental death, or 'undetermined' were studied. RESULTS: Accidents were the most likely cause of death for 5% of infants who died in designated infant containers (cots, cradles, etc), 24% of those who were sharing a bed or couch, and 72% of those who were placed alone on a bed or couch. CONCLUSIONS: While bed sharing showed an increased risk of dying accidentally, when compared with infants sleeping in designated infant containers, the risk of accidental death in this study was even greater for infants left alone on adult beds or couches.

Bedding and Linens↗
PubMed1998

Differences in respiratory metabolism during treatment of hypoglycemia in infants of diabetic mothers and small-for-gestational-age infants.

We investigated oxygen consumption and carbon dioxide production during treatment of hypoglycemia in infants of diabetic mothers (IDM) (n=11) and small-for-gestational-age (SGA) infants (n=6). Healthy newborn infants served as controls (n=16). The infants in both groups received normal enteral feedings and they were treated with intravenous glucose at a rate adjusted to increase plasma glucose concentration above 45 mg/dL. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured using indirect calorimetry and respiratory quotient (RQ) was calculated. Measurements were performed immediately after the correction of hypoglycemia (6-10 hr), and 24, 72, and 120 hr later. After initiation of treatment, and 24 hr later mean VCO2 and RQ were significantly higher in the IDM and the SGA infants than in healthy infants. 72 and 120 hr after the first measurement, the IDM did not differ from the healthy controls, whereas in the SGA infants mean VCO2 and VO2 were still significantly increased. In the SGA infants, the hypermetabolism was sustained during whole study period. Our results indicate that the metabolic defect resulting in hypoglycemia is different between the SGA and IDM infants. However, the treatment with supplemental glucose is necessary to both groups.

Calorimetry, Indirect↗
PubMed1997

Viral load and disease progression in infants infected with human immunodeficiency virus type 1. Women and Infants Transmission Study Group.

BACKGROUND: There are only limited data on human immunodeficiency virus type 1 (HIV-1) RNA in perinatally infected infants. Understanding the dynamics of HIV-1 infection and its relation to disease progression may help identify opportunities for effective antiviral treatment in infected infants. METHODS: We obtained plasma samples from 106 HIV-infected infants at birth; at 1, 2, 4, 6, 9, 12, 15, and 18 months of age; and subsequently every 6 months. HIV-1 RNA was assayed by means of a reverse-transcription polymerase chain reaction. The infants were born between 1990 and 1993, and only 21 percent of the infants' mothers received any treatment with zidovudine during pregnancy. RESULTS: Plasma HIV-1 RNA levels increased rapidly after birth, peaked at 1 to 2 months of age (median values at 1 and 2 months, 318,000 and 256,000 copies per milliliter, respectively), and then slowly declined to a median of 34,000 copies per milliliter at 24 months. Newborns with a first positive HIV-1 culture within 48 hours after birth had significantly higher HIV-1 RNA levels, although only during the first two months of life, than those with a first positive culture seven or more days after birth. Infants with a rapid progression of disease had higher peak HIV-1 RNA levels in the first two months of life than those without rapid progression (median value, 724,000 vs. 219,000 copies per milliliter; P=0.006), as well as a higher geometric mean value during the first year of life (median value, 330,000 vs. 158,000 copies per milliliter, P=0.001). CONCLUSIONS: In perinatally infected infants, HIV-1 RNA levels are high and decline only slowly during the first two years of life. Infants with very high viral loads in the first months of life are at increased risk for a rapid progression of disease, which suggests that early treatment with antiretroviral agents may be indicated for these infants.

Child, Preschool↗
PubMed2001

Sleep position and the use of soft bedding during bed sharing among African American infants at increased risk for sudden infant death syndrome.

UNLABELLED: Soft bedding increases the risk for death among prone infants. We compared the softness of beds and bedding and infant sleep position for infants sleeping alone and for those bed sharing. STUDY DESIGN: Questionnaires were used to record the bedding and sleep practices of 218 consecutive African American infants. Enrollment was prospective. Mechanical models were used in the homes of a subgroup to measure the softness of bedding and its propensity to cause rebreathing. Results were compared by using the Student t test, Mann-Whitney U test, and chi(2) analysis. RESULTS: In a cross-sectional sample of infants, at 8.2 +/- 3.3 weeks of age, 61% (133 of 218) had bed shared > or =1 of the previous 14 nights and 48.6% (106 of 218) had bed shared the night before. Breast-feeding rates were not different for bed sharers and those sleeping alone. The rates of maternal smoking for both groups were low (13.6% vs 11.8%). Comforters, pillows, and waterbeds were more commonly used beneath bed-sharing infants. Bed sharers were twice as likely to habitually be placed prone for sleep (18% vs 9%). In the subgroup studied in their homes (13 bed sharing, 19 alone), the shared beds were softer (P <.0001) and could cause more rebreathing (P =.007). CONCLUSIONS: Infants at increased risk for sudden infant death syndrome, by sociodemographic criteria, who also bed share are more likely to sleep prone and to use softer beds. These findings may explain part of the risk associated with bed sharing among US infants, a risk that appears to be independent of the effects of maternal smoking.

Black or African American↗
PubMed1987

Paternal care of infants during maternal separations: associations with father-infant interaction at one year.

Observations of father-infant interaction in the home environment at age one year were compared for two groups of infants that in the months preceding the observations differed in the amount of experience they had with their fathers when the mother was outside the home. The sample consisted of 46 middle-class families, each with a first-born infant (23 males, 23 females). Estimates of the amount of experience the father had with the infant when the mother was outside the home were obtained from detailed maternal interviews that addressed all mother-infant separations. At one year, fathers who provided more extensive care in the absence of the mother showed a higher degree of breadth or variety in their patterns of engaging the infant and higher rates of behavior directed to the infant. These infants showed higher rates of responding to their fathers and more frequent instances of exploratory behavior. Distinctive patterns of differences were evident in the behavior of fathers and infants who had contrasting amounts of experience with each other in social contexts without the mother.

Child Development↗
PubMed2002

Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children.

UNLABELLED: This study investigated faecal calprotectin concentration, a measure of intestinal inflammation, in infants and children with abdominal pain. Faecal calprotectin was measured by an enzyme-linked immunosorbent assay kit in spot stool samples in 76 infants with typical infantile colic, 7 infants with transient lactose intolerance and 27 healthy infants. All infants were 2-10 wk of age. In addition, 19 children with recurrent abdominal pain (RAP; mean age 11.5 y), 17 with inflammatory bowel disease (IBD; mean age 11.1 y; 10 had Crohn's disease and 7 ulcerative colitis) and 24 healthy children (mean age 5.3 y) were studied. In infants with infantile colic the mean faecal calprotectin concentration was not different from that in healthy infants (278 +/- 105 vs 277 +/- 109 mg kg(-1), p = 0.97) or in infants with transient lactose intolerance (300.3 +/- 124 mg kg(-1), p = 0.60). The calprotectin level was similar in boys and girls and fell significantly with age (p = 0.04). Children with IBD had faecal calprotectin levels (293 +/- 218 mg kg(-1)) much higher than healthy children (40 +/- 28 mg kg(-1), p < 0.0001) and children with RAP without identified organic disease (18 +/- 24 mg kg(-1), p < 0.0001). CONCLUSION: Faecal calprotectin may differentiate between functional abdominal pain and IBD in school-aged children. In young infants high faecal calprotectin levels are normal.

Abdominal Pain↗
PubMed2001

Relationship between infant sleep position and motor development in preterm infants.

To determine whether motor development in premature infants varies according to sleep position, we evaluated 213 infants <1750 g birth weight enrolled in the Collaborative Home Infant Monitoring Evaluation (CHIME). At 56 weeks postconceptional age (PCA), sleep position was determined by maternal report, and the Bayley Scales of Infant Development 2nd Edition (BSID-II) were performed. Infants who slept supine were less likely than infants who slept prone to receive credit for maintaining the head elevated to 45 degrees (p = .021), and infants who slept nonprone were less likely than prone sleepers to receive credit for maintaining the head elevated to 90 degrees and lowering with control (p = .001). The Psychomotor and Mental Development Indices at 56 and 92 weeks PCA were not altered by usual sleep position at 56 weeks PCA. In summary, infants sleeping supine are less able to lift the head and lower with control at 56 weeks PCA, but global developmental status was unaffected. Supine sleeping has been associated with decreased risk for sudden infant death syndrome, but compensatory strategies while awake may be needed to avoid delayed acquisition of head control.

Child Development↗
PubMed1992

Plasma vitamin E concentrations of older infants fed cow's milk or infant formula.

Nutrition of older infants, though important for optimal brain development, is inadequately studied. The beverage choice markedly influences nutrient intake, but little is known regarding nutrition status of older infants, particularly for vitamin E. This study assessed vitamin E intakes and plasma tocopherol concentrations in two groups of healthy infants, 8 to 13 months of age, who had consumed either cow's milk (n = 45) or milk-based formula (n = 55) for a minimum of the 3 preceding months. Mean (+/- SEM) vitamin E intake was significantly lower (p < or = 0.001) by the infants who had consumed cow's milk (CMF) than by infants who had consumed formula (FF); 4.1 +/- 0.25 mg/day and 10.9 +/- 0.57 mg/day, respectively. Mean (+/- SEM) intake of linoleic plus linolenic acids was significantly lower (p < or = 0.005) by CMF infants (3.4 +/- 0.2 g) than by FF infants (9.9 +/- 1.0 g), although mean (+/- SEM) dietary vitamin E to polyunsaturated fat ratio (E/PUFA ratio) was the same in both FF and CMF infants (1.3 +/- 0.1). Plasma alpha-tocopherol concentration (mean +/- SD) was significantly lower (p < or = 0.005) in CMF than in FF infants (0.86 +/- 0.28 mg/dl vs. 1.14 +/- 0.42 mg/dl, respectively). Dietary vitamin E intakes were positively correlated (p < or = 0.05) with plasma alpha-tocopherol concentrations. No correlations were found between plasma alpha-tocopherol concentrations and total fat intake, dietary E/PUFA ratios, erythrocyte polyunsaturated fatty acids > or = C18:2, or number of hours postprandial that blood was drawn.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1980

Transepidermal water loss in newborn infants. IV. Small for gestational age infants.

Using a method described earlier, the evaporation rate (ER) from the skin was studied at different ambient humidities in 14 full-term and 10 pre-term small for gestational age (SGA) infants. Transepidermal water loss (TEWL) was estimated in 25 SGA infants born after 30-40 weeks of gestation. Comparisons were made with infants appropriate for gestational age (AGA). A linear relationship was found between ER and ambient humidity in full-term SGA infants, but with lower ER values than in AGA infants. Lower ER values were also found in moderately pre-term SGA infants at different ambient humidities. ER was higher at lower ambient humidities in both SGA and AGA infants. In full-term and moderately pre-term SGA infants TEWL was lower than in corresponding AGA infants.

Female↗