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Comparison of risks from percutaneous central venous catheters and peripheral lines in infants of extremely low birth weight: a cohort controlled study of infants < 1000 g.

OBJECTIVE: To evaluate in infants of < 1000 g (extremely low birth weight; ELBW) the success rate of insertion of percutaneous central venous catheters (PCVC) and their duration; and the short- and long-term complications, i.e. mechanical and infectious, when compared to a control group of infants of the same age treated only with peripheral venous access. STUDY DESIGN: A cohort of 44 ELBW infants managed with PCVC (study group) was compared to a cohort of 44 infants managed only with peripheral venous access (control group). The two groups were matched for birth weight, gestational age and gender, and were comparable for severity of illness (CRIB scores). RESULTS: The success rate of PCVC insertion was 74% with the right axillary vein being the most frequently used site. The mean duration of PCVC treatment was 28 +/- 13 days. The reasons for removal of the catheter were: cessation of the total parenteral nutrition administration in 75% of the cases and occlusion in 25%. There were three infectious episodes for a total of 1138 catheter days in the PCVC group vs. 12 episodes for a total of 1114 days (p = 0.03) in the control group. Three infants died in the study group and 11 infants died in the control group (p = 0.05) of infants of ELBW. CONCLUSION: Insertion of PCVC is successful in the vast majority of cases and carries a lower risk of infection than multiple insertions of peripheral lines in infants of ELBW. It prevents repeat and painful introductions of intravenous needles.

Bacteremia↗

Plasma amino acid concentrations, indexes of protein metabolism and growth in healthy, full-term infants fed partially hydrolyzed infant formula.

BACKGROUND: It has been reported that feeding extensively hydrolyzed infant formula influenced the availability of arginine, glycine, histidine, lysine and threonine in full-term infants investigated during the first 2 months of life. In the present study, the nutritional effects of feeding partially hydrolyzed formula (PHF) were investigated. METHODS: Term infants fed conventional formula (F; n = 11) or PHF (n = 11) were investigated at the ages of 5, 30, 60, 90, and 120 days. Anthropometric data were obtained, and plasma amino acid concentrations and biochemical indices of protein metabolism were measured. RESULTS: Plasma concentrations (in micromoles per liter) of lysine on day 90: 117 (21) versus 143 (24); of threonine on day 30: 140 (53) versus 263 (87); of ornithine on day 90: 56 (21) versus 78 (29); and of tyrosine on day 30: 52 (17) versus 77 (20), on day 60: 56 (14) versus 87 (19) and on day 90: 46 (9) versus 81 (17) were significantly lower in infants receiving PHF than in those fed F. Values are median (range from 1st to 3rd quartile), PHF versus F; p < 0.05. At day 120, infants fed PHF showed significantly lower serum albumin concentrations than did infants receiving F (43.3 +/- 3.4 versus 48.9 +/- 3.5, g/l; mean +/- SD; p < 0.05). Serum creatinine, urea nitrogen, uric acid and total protein concentrations and gain in weight, length, and head circumference did not differ throughout the study. CONCLUSIONS: In this study, feeding PHF did not affect the majority of plasma amino acid concentrations, some indices of protein metabolism, and basic parameters of growth in full-term infants. However, plasma concentrations of lysine, threonine, tyrosine, ornithine, and albumin were, on at least one occasion, significantly lower in infants fed PHF than in those receiving F.

Amino Acids↗

Effect of type of early infant feeding on fatty acid composition of plasma lipid classes in full-term infants during the second 6 months of life.

BACKGROUND: Previously, the authors found significantly higher arachidonic and docosahexaenoic acid values in plasma lipids in 2-month-old full-term infants fed human milk than in those receiving formula. This is the report of data obtained in full-term infants during the second half of the first year of life. METHODS: Healthy, full-term infants fed human milk (n = 12) or formula without preformed long-chain polyunsaturated fatty acids (n = 12) were investigated. Fatty acid composition of plasma lipid classes was determined by high-resolution capillary gas-liquid chromatography. RESULTS: Linoleic acid acid values in plasma phospholipids (18.5 [3.94] vs. 20.79 [4.34]) and gamma-linolenic acid values in plasma cholesteryl esters (0.17 [0.09] vs. 0.27 [0.20]) and triacylglycerols (0.27 [0.18] vs. 0.46 [0.27]) were significantly (P < 0.05) lower in breast-fed infants than in those receiving formula. Data are percentage weight by weight shown as median (range from 1st to 3rd quartile) for breast-fed vs. formula fed infants, respectively. In contrast, arachidonic acid values in plasma phospholipids (10.05 [2.90] vs. 7.03 [1.87]; P < 0.01), cholesteryl esters (7.54 [3.58] vs. 4.09 [1.81]; P < 0.05), and triacylglycerols (1.28 [0.84] vs. 0.80 [0.39]; P < 0.05), as well as docosahexaenoic acid values in plasma phospholipids (1.92 [0.36] vs. 1.02 [0.31]; P < 0.001), cholesteryl esters (0.39 [0.13] vs. 0.15 [0.13]; P < 0.001), and triacylglycerols (0.17 [0.17] vs. 0.09 [0.04]; P < 0.01) were significantly higher in infants fed human milk than in those receiving formula. CONCLUSION: Healthy, full-term infants fed formula without preformed dietary long-chain polyunsaturated fatty acids are unable to match the arachidonic and docosahexaenoic acid status of breast-fed infants even during the second half of the first year of life.

Cholesterol Esters↗

Colon microflora in infants fed formula with galacto- and fructo-oligosaccharides: more like breast-fed infants.

OBJECTIVES: The intestinal flora of breast-fed infants is generally dominated by Bifidobacteria. We aimed to investigate whether an infant formula supplemented with galacto-oligosaccharides and fructo-oligosaccharides (GOS/FOS) is able to establish a bifido-dominant microflora, not only in numbers but also with respect to the metabolic activity in the colon. METHODS: Two groups of infants fed infant formula with 0.8 g/100 ml GOS/FOS in a ratio of 9:1 (OSF group), or control formula (SF group) were evaluated in a randomised, double blind, placebo controlled intervention study. A breast-fed group was studied in parallel. At study onset and after 4 and 6 weeks, faecal samples were examined for the number of bifidobacteria, pH, short chain fatty acids and lactate. RESULTS: After 6 weeks, the mean proportion of bifidobacteria was significantly higher in the OSF group (59.6% versus 49.5% in the SF group; P < 0.05). Compared with controls, infants in the OSF group had a lower stool mean pH and an increased proportion of acetate and a decreased proportion of propionate. The mean pH in the OSF and SF groups were 5.7 and 6.3, respectively (P < 0.001). CONCLUSIONS: The addition of the prebiotic GOS/FOS mixture to an infant formula has a stimulating effect on the growth of bifidobacteria and on the metabolic activity of the total intestinal flora. The changes in short chain fatty acids, lactate and pH in the prebiotic group represent a fermentation profile that is closer to that observed in breast-fed infants compared to infants fed control formula.

Bifidobacterium↗

An audit of the impact of a consultation with a paediatric dermatology team on quality of life in infants with atopic eczema and their families: further validation of the Infants' Dermatitis Quality of Life Index and Dermatitis Family Impact score.

BACKGROUND: Atopic dermatitis (AD) accounts for 10-20% of referrals to secondary care dermatology, often requiring multiple visits and occupying much valuable time and resources. OBJECTIVES: We audited the usefulness (ease of use, reliability and sensitivity to change) of two simple and easy to use quality of life (QoL) measures, the Infants' Dermatitis Quality of Life Index (IDQOL) and Dermatitis Family Impact (DFI), for assessing the impact on QoL of AD in infants and their families in a routine clinical setting. We also examined the impact of an initial consultation with a dermatology team on AD severity and QoL impairment from the parent's perspective. METHODS: The parents of 203 infants (mean age 19.8 months) with AD attending paediatric dermatology clinics completed the DFI and IDQOL. The parents of 50 of these infants completed both questionnaires before first and second consultations. RESULTS: In the 203 children the mean of both the IDQOL and DFI scores was 8.47 (median 8 and 7 and SD 5.8 and 6.5, respectively). The IDQOL and DFI correlated well (r(s) = 0.776, P < 0.0001). The parent's assessment of the global severity of AD correlated well with the IDQOL score (r(s) = 0.636, P < 0.0001) but less well with the DFI (r(s) = 0.394, P < 0.001). The highest-scoring IDQOL items were itching and scratching, problems at bathtime and time taken to fall asleep. The highest-scoring DFI items were tiredness/exhaustion, sleep loss and emotional distress. In both measures these domains also correlated most strongly with eczema severity. After dermatology consultation the median global severity score, rated by 50 parents, fell from 2 (SD 0.83) to 1 (SD 0.8; 95% confidence interval, CI 0.5-1), the median IDQOL score fell from 8 (SD 5.92) to 5.5 (SD 5.92; 95% CI 2-5.5) and the median DFI score fell from 9 (SD 6.45) to 3 (SD 6.56; 95% CI 2-5.5). In 50 infants the median IDQOL scores for those infants with global AD severity scores of 1, 2 and 3 were 5 (SD 5.65), 8 (SD 4.27) and 14 (SD 5.67), respectively and improved by 10%, 38% and 64%, respectively while the median DFI scores improved by 54%, 56% and 79%, respectively. The most improved IDQOL items were the time taken to get to sleep and difficulty at mealtimes and the most improved DFI domains were tiredness/exhaustion and emotional distress in the parents. CONCLUSIONS: We have provided further important information on the effects of AD on infants and their families using the IDQOL and DFI QoL measures. We demonstrate the usefulness of these measures in routine clinical management of AD and show the beneficial effect for both infants and parents of the initial consultation by a dermatology team in a secondary care setting.

Child, Preschool↗

Do infants of depressed mothers cry more than other infants?

OBJECTIVE: This study compared the crying behaviour of infants of depressed and non-depressed mothers at 3 and 6 months of age. METHODOLOGY: Twenty-nine depressed and 44 non-depressed mothers, their infants and partners participated in this study. Mothers were asked to complete 24-hour diaries of the amount their infants cried for 1 week. RESULTS: The diurnal variations in crying patterns of infants of depressed and non-depressed mothers were not significantly different. However, infants of depressed mothers were found to cry significantly more in total per day than infants of non-depressed mothers at 3 months of age, but not at 6 months. The results could not be explained by differences in infant temperament. CONCLUSION: Maternal depression may be a contributory factor to infant crying at 3 months of age.

Adult↗

Sudden infant death syndrome and unascertainable deaths: trends and disparities among Aboriginal and non-Aboriginal infants born in Western Australia from 1980 to 2001 inclusive.

AIM: To analyse patterns and trends in mortality from unknown causes (sudden infant death syndrome and unascertainable deaths) for all Aboriginal and non-Aboriginal infants born in Western Australia, 1980-2001. METHODS: Using total population linked data, we reviewed all post-mortem reports, including death scene investigations and final causes of death as ascertained by the coroner. Neonatal, post-neonatal and infant mortality rates attributed to unknown causes were calculated and the latter were analysed according to maternal age, geographical location, gestational age, sex and birthweight. Relative risks (95% confidence interval) for Aboriginal infants (compared with non-Aboriginal) were calculated. RESULTS: The proportion of deaths considered to be of unascertainable cause has significantly increased in recent years. In contrast to the non-Aboriginal population, there has been no significant decrease in deaths in the Aboriginal population and the overall relative risk for Aboriginal infants for the most recent years studied was 7.9 (95% confidence interval 5.1-12.2). The relative risk was significantly increased for most categories analysed. CONCLUSION: Reviewing post-mortem reports enabled identification of changes in the classification of deaths due to unknown causes. This provided a more accurate picture of the patterns and long-term trends of such deaths so that programmes can be developed to specifically target those groups most at risk. Adequately funded and evaluated education campaigns aimed at reducing the risk of sudden infant death syndrome among Aboriginal infants are required, as well as sustaining the current efforts that have been so successful for non-Aboriginal infants.

Cause of Death↗

Serum glucagon-like peptide-2 levels in neonates: comparison between extremely low-birthweight infants and normal-term infants.

BACKGROUND: Glucagon-like peptide-2 (GLP-2) arises from proglucagon within enteroendocrine L cells of the small and large intestines, and its physiological roles have been gradually elucidated. However, the circulating GLP-2 levels in human neonates are still unknown. The aim of the present study was to measure serum GLP-2 levels in extremely low-birthweight (ELBW) infants and normal-term infants, and to compare these values between the two groups. METHODS: Blood samples were collected and serum GLP-2 concentrations measured, from 15 ELBW infants at three stages (stage I, before initial feeding after birth; stage II, point at which milk intake reached 100 mL/kg per day; stage III, corrected 40 weeks of gestation), and from 30 normal-term infants at two stages (stages I and II). RESULTS: No significant difference in basal GLP-2 values at stage I (before initial feeding) was found between ELBW infants and normal-term infants (7.37 +/- 0.95 ng/mL vs 9.47 +/- 0.94 ng/mL). However, in ELBW infants, serum GLP-2 concentrations at stage II were significantly increased, compared with those at stage I (P < 0.0001). In normal-term infants, serum GLP-2 concentrations at stage II were also significantly increased compared with those at stage I (P < 0.001). CONCLUSION: The results suggest that initial feeding stimulates secretion of serum GLP-2 in neonates. In addition, the secretion mechanism of GLP-2 is considered to be established at 24 weeks of gestation at the latest.

Eating↗

Adult perception of emotion intensity in human infant cries: effects of infant age and cry acoustics.

The relation between adult perception of emotion intensity in the cries of 1- and 6-month-old infants and the acoustic characteristics of the cries was examined. In the first study, adults who were inexperienced in child care rated 40 cries on 3 emotion intensity scales: anger, fear, and distress. The cries of 6-month-olds were rated as being significantly more intense. Different acoustic variables accounted for emotion intensity ratings for the 2 infant ages. Peak amplitude and noisiness of the cry predicted adult judgments of intensity ratings of 1-month-olds' cries; a measure of amplitude ratio (in 2 frequency bands) was the best predictor of intensity ratings of 6-month-olds' cries. In the second study, parents of infants rated the same cries on the same scales. They also rated the older infants' cries as being more intense. The 2 adult groups did not differ on their ratings, and a regression equation derived from one adult group predicted the other adult group's rating of the same infant age better than it predicted its own ratings for the other infant age. Infant age, and its associated acoustic features, seems to be a more important determinant of adults' perception of emotion intensity than are such adult characteristics as gender or infant-care experience.

Adolescent↗

Transepidermal water loss in newborn infants. VII. Relation to post-natal age in very pre-term and full-term appropriate for gestational age infants.

During the first weeks after birth the transepidermal water loss was determined repeatedly in 7 infants born after 25-27 weeks of gestation, in 13 infants born after 28-30 weeks and in 14 full-term infants. All infants were appropriate for gestational age. The very pre-term infants had high evaporative water losses from their skin on their first days after birth. A gradual decrease was then observed, but after four weeks the values were still higher than those in full-term infants. The transepidermal water loss in full-term infants was unchanged during the first two weeks of life, but increased during the subsequent two weeks. The relation between evaporation rate from an interscapular skin area and ambient humidity was studied repeatedly during the first week of life in two very pre-term infants. The magnitude of evaporation decreased with increasing post-natal age, but was still dependent on the ambient relative humidity.

Female↗

Transepidermal water loss in newborn infants. VIII. Relation to gestational age and post-natal age in appropriate and small for gestational age infants.

In 68 appropriate for gestational age (AGA) and 33 small for gestational age (SGA) infants, transepidermal water loss was studied during the first four weeks after birth. The method used to measure evaporation rate is based on measurement of the water vapour pressure gradient close to the skin surface. All measurements were made at an ambient humidity of 50% and with the infants calm and quiet. At all the investigated post-natal ages in both AGA and SGA infants, an exponential relationship was found between transepidermal water loss (g/m2 h) and gestational age, this loss being much higher in the pre-term infants than in those born at term. The transepidermal water loss was generally lower in SGA than in AGA infants during the first week of post-natal life, irrespective of gestational age at birth. There was a gradual decrease in transepidermal water loss with increasing post-natal age in both pre-term AGA and pre-term SGA infants. Three weeks after birth this water loss tended to be higher in pre-term SGA infants than in pre-term AGA infants of corresponding gestational age.

Age Factors↗

The infant lung function model: a mechanical analogue to test infant lung function equipment.

To facilitate international multicentre studies and quality control of infant pulmonary function measurements, the European Respiratory Society-American Thoracic Society (ERS-ATS) working group for infant lung function testing aims to develop specifications for standardized infant lung function equipment and software. However, a standardized test device is also needed to test whether existing infant lung function equipment is able to meet these requirements. The authors have built a "mechanical model baby" consisting of a linear pump which can reproduce prerecorded tidal flow waveforms with a precision of 0.5% (full stroke), enabling the simulation of tidal and forced flow patterns. This linear pump can be connected to a series of copper lung volumes (range 50-300 mL) with known time constants, so that lung volumes can be reproduced with a precision of +/-1% at frequencies 10-120bpm. Five airflow resistors were built using sinter material. When assessed using flows 0-300 mL.s(-1) all resistors showed a quasilinear pressure/ flow relationship, with slopes 1.0-5.6 kPa.L(-1).s. These resistances could be reproduced with a precision of +/-2.5%. The infant lung model can also be used to assess frequency responses of infant lung function equipment, since the pump is capable of delivering low amplitude volumes up to 20 Hz in a pseudorandom noise manner. In summary, based on error estimations, this infant lung model is able to test whether or not infant lung function equipment meets the requirements suggested by the European Respiratory Society-American Thoracic Society standardization group, that is: flow measurements within +/-2.5%, volume and resistance measurements within +/-5%, frequency response: magnitude attenuation <+/-10% and phase shift <+/-3 degrees at 10 Hz.

Airway Resistance↗

Abnormal maturation of sleep states in infants with aborted sudden infant death syndrome.

The time spent in REM, quiet, and indeterminate sleep was computed in 13 aborted SIDS infants and compared to that spent in the same sleep states, in 19 normal infants. Aborted sudden infant death syndrome (SIDS) infants were studied within a week of their aborted SIDS episode and subsequently at monthly intervals through the age of 4 months. Normal infants were studied at 1, 2, 3, and 4 months of age. Sleep staging was performed by two independent observers using electroencephalogram, electrooculogram, electromyogram and behavioral criteria. Although there was an increase in the percentage of time spent in quiet sleep with age in both normal and aborted SIDS infants, the significantly greater regression coefficients in normal infants (6.3 versus 2.9; P less than 0.01) indicate that there are differences in the two groups and suggest a maturational abnormality or delay in sleep state distribution in the aborted SIDS infants.

Age Factors↗

Exclusively breast-fed healthy infants grow slower than reference infants.

We have studied the nutritional adequacy of exclusive breast-feeding by following prospectively the growth and protein nutrition of healthy infants during the 1st yr of life. The number of exclusively breast-fed infants was 116 at the age of 6 months and 36 at 9 months. These infants had slower length velocity after age 3 months than a comparison group of 32 infants who were weaned early and given formula plus solids. As a group, the exclusively breast-fed infants lagged slightly, but progressively, behind in relative length. By 9 months, 45% of them versus 18% of the comparison group showed a greater than 1 SD decrease in relative length. No such decrease was found in relative weight. Skinfolds and weight for length index showed that they were heavier for their length than the comparison infants. At 6 and 9 months the calculated protein intake (0.9 g/kg/day) was much less than the recommended amount (2.0 g/kg/day). Serum prealbumin concentration was lower than in the comparison group but this was noted as early as 4 months. No relation was found between the parameters of growth and protein nutrition either individually or in general. Whether the slower growth of the exclusively breast-fed infants represents appropriate physiological growth or whether it indicates nutritional deficiency is not known but we did not find any evidence of protein deficiency. Six infants did, however, show subsequent catch-up growth which could indicate previous malnutrition.

Breast Feeding↗

Postheparin plasma lipoprotein and hepatic lipase activities in hyperinsulinemic infants of diabetic mothers and in large-for-date infants at birth.

To study postheparin plasma lipase activities in nonfed newborn infants immediately after birth and to investigate the possible influence of fetal hyperinsulinemia on lipoprotein lipase activity, we measured lipoprotein and hepatic lipase activities in 55 macrosomic newborn infants: group I consisted of 21 infants born to mothers with insulin-dependent diabetes. The infants were hyperinsulinemic at birth and had hypoglycemia and poor lipolysis at the age of 2 h. Group II consisted of 18 infants born to mothers with gestational diabetes. Group III consisted of 16 large-for-date infants born to nondiabetic mothers. The mean postheparin plasma lipoprotein lipase activities at 2 h of age were similar (mean 36 mumol free fatty acids/ml/h; SEM 15) in groups I-III. Lipoprotein lipase activity correlated negatively with cord-serum triglycerides (range 0.13-1.2 mmol/liter) but did not correlate with serum insulin (range 5.4-524 microU/ml) or C-peptide (range 0.6-21.0 micrograms/liter). Hepatic lipase activity was somewhat higher in group I (mean 68 mumol free fatty acids/ml/h; SEM 23) than in groups II and III (mean 55 mumol free fatty acids/ml/h; SEM 14). Hemoglobin Alc was the only important factor explaining the difference in hepatic lipase activities between groups. Lipoproteins and apolipoproteins A-I, A-II, and B were similar in all three groups. We conclude that in large-for-date infants lipoprotein lipase is active at birth without exogenous fat induction, and that these infants are capable of hydrolyzing fat, their main source of energy, immediately after birth. In addition, we conclude that postheparin plasma lipoprotein lipase activity is not affected by fetal hyperinsulinemia.

Birth Weight↗

The role of maternal cognitions in infant sleep problems as assessed by a new instrument, the maternal cognitions about infant sleep questionnaire.

Sleeping problems in young children are very common, affecting up to 20% of 1-year-olds. Behaviour therapy is the most widely recognised treatment but a significant proportion of parents find it aversive. This suggests that parental cognitions may be important and underevaluated. The aims of this study were therefore fourfold: (1) to describe the development of a new tool to measure maternal cognitions in relation to infant sleeping problems, the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ): (2) to assess the psychometric properties of the MCISQ; (3) to test the hypothesis that maternal cognitions will be associated with, and specific to, infant sleep problems; and (4) to discuss the implications of the findings with respect to aetiological models of infant sleep problems, treatment, and future research. Results showed that maternal cognitions about setting limits, anger at the infant's demands, and doubts about parenting competence were significantly associated with infant sleep problems, whereas cognitions about infant hunger or cot death were not. It is hypothesised that these cognitive responses, if extreme, may disrupt sensitive parent-child interactions, which over time could lead to impairments in the development of infant self-regulation.

Adult↗

Sleep state organization in normal infants and victims of the sudden infant death syndrome.

Infants at increased risk of the sudden infant death syndrome (SIDS) show abnormal patterning of sleep-waking states. It was hypothesized that infants who were to die of SIDS would show abnormalities of sleep state distribution prior to their deaths. Twenty-two 12-hour recordings were obtained from infants who subsequently died of SIDS, and sleep state patterns were compared in these records and 66 records of age-matched control infants. Each 1-minute epoch was classified as quiet sleep, rapid eye movement (REM) sleep, waking, indeterminate state, or artifact-contaminated. Victims of SIDS showed less waking and more sleep than control infants during the early-morning hours. Victims of SIDS younger than 1 month of age showed significantly more epochs classified as REM sleep across the night and significantly fewer epochs contaminated by artifacts relative to control infants. Further analysis indicated that the increased number of REM epochs resulted from fewer artifact-contaminated epochs, suggesting reduced motility during REM sleep in the SIDS victims compared with the control infants. The finding of decreased waking time during the early morning is of particular importance since most SIDS deaths occur during this portion of the day. The findings of altered sleep patterns in SIDS victims suggest that central neural changes are associated with SIDS risk.

Analysis of Variance↗

Status of carotenoids, vitamin A, and vitamin E in the mother-infant dyad and anthropometric status of infants in Malawi.

This prospective study was carried out during February 2000-April 2003 to characterize the relationship between the status of carotenoids, vitamin E, and retinol and anthropometric status in apparently healthy infants and their mothers in Blantyre, Malawi. Anthropometric status of infants and concentrations of carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, and lycopene), retinol, and alpha-tocopherol in plasma were measured in 173 infants at 12 months of age, and concentrations of carotenoids, retinol, and a-tocopherol in plasma were measured in their mothers two weeks postpartum. In multivariate analyses, concentrations of retinol, total carotenoids, non-provitamin A carotenoids, and alpha-tocopherol in infants were associated with under-weight (p = 0.05). Concentrations of a-tocopherol were associated with wasting (p = 0.04). Concentrations in mothers and infants were all correlated (correlation coefficients from 0.230 to 0.502, p < 0.003). The findings suggest that poor status of carotenoids, retinol, and alpha-tocopherol in infants is associated with their poor anthropometric status, and status of carotenoids, retinol, and alpha-tocopherol in mothers and infants has a low-to-moderate association in the mother-infant dyad.

Adult↗