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PubMed1989

[The autonomic nervous system in sudden infant death syndrome. Analysis of heart rate and sinusal variability on Holter monitoring of infants who died].

To evidence abnormality of cardiac control by the autonomic nervous system in the sudden infant death syndrome (SIDS) we retrospectively analysed the Holter recordings and cardiopneumograms of 19 infants (11 boys, 8 girls) of mean +/- SD age 2.3 +/- 1.5 months who had subsequently died of SIDS. Two infants were regarded as normal and the reference diagnoses in the remaining 17 infants were: apparent life threatening event (8), SIDS siblings (8) and prematurity (1). At the time of death the age was 4.2 +/- 2 months. Each of these infants was matched with three control infants in term of postnatal age, gestational age and reference diagnosis, but without SIDS at follow-up of at least one year. Nine hours of Holter recordings (9 p.m. to 6 a.m.) were analysed in term of mean heart rate and sinus oscillations waves. To differentiate between short oscillations of 4 to 6 RR, which are induced by respiration and reflect vagal activity, and long oscillations of 20 to 32 RR, which reflect both neurogenic sympathetic and vagal activity, we used a new method which measures the number and the amplitude in milliseconds of each type of oscillations. The results are expressed as the logarithm of the product of these two variables. Heart rate, correlated to age in both groups, is higher in the deceased infants group (141 +/- 14 mn and 135 +/- 15; p less than 0.05: analysis of covariance with age as an independent variable). Short oscillations, also correlated to age, are lower in the deceased infants group (3.35 +/- 0.59 and 3.65 +/- 0.61; p less than 0.05: analysis of covariance with age).(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmia, Sinus↗
PubMed1979

[Early detection and observation of the evolution of congenital malformations of the aorta in newborn infants, infants and young children].

UNLABELLED: 57 infants and small children (42 boys and 15 girls) with congenital aortic malformations were investigated. Clinical, ecg and X-ray follow-up was carried out. Following 4 groups of patients were separated: 1) neonates and infants with supraductal (preductal) aortic hypoplasia or atresia, with hypoplastic left ventricle of the heart (5 boys and 2 girls), 2) infants with supraductal coarctation of the aorta, without underdevelopment of the left heart cavities (2 boys and 2 girls), 3) infants and children with postductal coarctation of the aorta (17 boys and 3 girls) and 4) infants and children with valvular or/and subvalvular, or supravalvular aortic stenosis (18 boys and 8 girls). CONCLUSIONS: Congenital malformations of the aorta and of the left side of the heart should be suspected in all neonates and infants displaying early symptoms of cardiorespiratory failure, resembling frequently the symptoms of severe "pneumonia". Proper measurement and thorough analysis of arterial pulses and pressures in upper and lower extremities is of great importance in detection and differential diagnosis of congenital aortic malformations in infants, even when features of other cardiovascular lesions (e.g. ventricular septal defect, endocardial cushion defect, transposition of the great arteries) dominated in the clinical picture of complex malformations. Small amplitudes of peripheral arterial pulses, with considerably--prolonged upstroke time, small amplitude of arterial pressure measured in upper and lower extremities, co-existing with electrocardiographic patterns of the right ventricular hypertrophy--suggested an aortic malformation complicated by hypoplasia of the left ventricle. Distinctly lower systolic and mean arterial pressure in legs, than in arms was typical for coarctation of the aorta. Significant differences in diastolic pressure values in arms and legs with coexisting ecg patterns of dominating right ventricular hypertrophy should rise a suspicion of abnormal, separate communication of the ascending aorta, and the descending aorta, separately from the left and from the right ventricles of the heart. The electrocardiogram seems to be of great help in differentiation between aortic lesions with or without hypoplastic left ventricle, those with or without systemic right and left ventricle, and those with systemic left ventricle only. Early detection, diagnosis, prompt and proper medical and surgical treatment may be lifesaving for the majority of infants with congenital malformations of the aorta not complicated by left ventricular hypoplasia.

Age Factors↗
PubMed1988

Polysomnographic studies of infants who subsequently died of sudden infant death syndrome.

The polygraphic findings from 11 future victims of sudden infant death syndrome (SIDS) are reported and compared with those of matched pairs of control infants. The recordings had been done to alleviate parental anxiety about sleep apnea. Four infants had siblings who were victims of SIDS. Two infants were studied 3.5 to 9.5 weeks before their deaths because of an unexplained apparent life-threatening event that had occurred during sleep. For each victim of SIDS, two control infants were selected from the 2,000 infants who had been tested in the same hospitals. They were matched for sex, gestational age, postnatal age, and weight at birth with the SIDS victims. Their polygraphic recordings had been performed within similar conditions. Each record was allocated a random code number and was analyzed without knowledge of the patient's identity by two independent scorers. Most sleep and cardiorespiratory variables studied did not differentiate SIDS victims from control infants. Only four variables significantly characterized the future SIDS victims: the maximal duration of central apneas, the number of sighs followed by a central apnea, the presence of obstructive apneas, and the presence of mixed apneas. Central apneas were longer during all sleep states in the SIDS victims compared with their matched controls, but none exceeded 14 seconds. Sighs immediately followed by an apnea were significantly less frequent in the future SIDS group. Obstructive and mixed sleep apneas were seen in eight of 11 SIDS victims and in only three of 22 control infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1979

The effects of the Rice infant sensorimotor stimulation treatment on the development of high-risk infants.

The Rice Infant Sensorimotor Stimulation (RISS) treatment was given to 15 premature infants to determine effects on neurophysiological development. The mothers of the infants were trained to administer the treatment for 15 minutes, 4 times a day, for 1 month, beginning the day the infant arrived home from the hospital. When each infant in the study (15 experimental and 14 control) was 4 months postnatal age, he/she was examined by a pediatrician, a psychologist, and a pediatric nurse who had no knowledge of which infant was experimental or control. The results indicated the experimental infants made significant gains in neurological development (p less than .001), weight gain (p less than .04), and mental development (p less than .05). The findings of this research indicate that early and systematic stimulation of the nerve pathways of the skin and of the vestibular nerve cells can accelerate growth and development of premature infants.

Child Development↗
PubMed1983

Infants weighing 1,000 grams or less at birth: developmental outcome for ventilated and nonventilated infants.

The neurodevelopmental outcome at a mean age of 40 months was investigated in 23/25 surviving infants of birth weights less than or equal to 1,000 gm. Eight infants required intubation and assisted ventilation and 17 were not ventilated. One ventilated infant was lost to follow-up and one nonventilated infant was a victim of sudden infant death syndrome at age 6 months. Fifteen (65%) had a good outcome but the differences between ventilated and nonventilated infants were striking. Thirteen (81%) of the nonventilated group were normal, but only two ventilated survivors (28%) were normal (P less than 0.05). Cicatricial retrolental fibroplasia occurred in three (43%) of the ventilated survivors and in none of the nonventilated infants (P less than .02). The requirement for assisted ventilation in these very low-birth-weight infants is associated with significant morbidity. Improvement in outcome may depend as much upon better understanding and management of prenatal events as upon improvements in neonatal care.

Developmental Disabilities↗
PubMed1983

Oculocardiac reflex in near miss for sudden infant death syndrome infants.

To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles greater than 2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal-Wallis procedure: P less than .01, and P less than .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary.

Female↗
PubMed1982

Quantitative evaluation of the development of tracheal submucosal glands in infants with cystic fibrosis and control infants.

The development of the tracheal submucosal glands has been determined quantitatively in 22 infants with cystic fibrosis and in 25 control infants, all under 4 months of age. In cross-sections of normal trachea significant relationships were found between postconceptional age (PCA) and gland area (P less than 0.001), submucosal area (P less than 0.02), tracheal airway diameter (P less than 0.05), and acinar diameter (P less than 0.001). In infants with cystic fibrosis the pattern of development was similar to that of the control infants. No statistically significant differences were found between three subgroups of infants with cystic fibrosis, which included those with meconium ileus with no lung infection, those with meconium ileus with lung infection, and those with lung infection and no history of meconium ileus. The normal pattern of development of tracheal submucosal glands in infants with cystic fibrosis was in contrast to the deficiency of normal maturation seen in the exocrine pancreas of these infants. The lumen fraction, an index of dilatation of acinar lumina, showed no significant relationship with PCA in either the control group or the group with cystic fibrosis. However, statistically significant dilatation of acini was observed in the tracheal submucosal glands of infants with cystic fibrosis (0.14, P less than 0.005).

Age Factors↗
PubMed1981

Fetal heart rates in siblings of infants with sudden infant death syndrome.

This study examined fetal heart rate (FHR) variables during maternal sleep in subsequent siblings of infants who died of sudden infant death syndrome (SIDS) and who are thus at increased statistical risk for SIDS, and controls. Four findings differentiated the tracings of subsequent siblings of SIDS infants and controls: 1) FHR variability in subsequent siblings of SIDS infants ranged between 11 and 25 beats/min, compared with 6 to 10 beats/min in controls (P less than .001). 2) Bradycardia was more frequent in subsequent siblings of SIDS infants. 3) FHR accelerations (more than 150 beats/min) followed by heart rates below 120 beats/min were elevated in subsequent siblings of SIDS infants (P less than .01). 4) Strong respiratory arrhythmia was more frequent in subsequent siblings of SIDS infants. These siblings exhibited more reactive FHR patterns. Although these data cannot be interpreted as clinical markers to identify the infant who will die of SIDS, they are compatible with the hypothesis that mild chronic hypoxia is associated with risk for SIDS.

Bradycardia↗
PubMed1993

Maternal and infant serum phenylalanine levels and pregnancy outcome in infants of nonphenylketonuric mothers.

Maternal consumption of casein is associated with excess low birthweight and infant mortality. Genetically normal infants of hyperphenylalaninemic mothers also show excess low birthweight and mortality. To determine whether the phenylalanine in casein could produce a secondary phenylketonuria effect, maternal serum phenylalanine levels were measured in 77 specimens of maternal blood serum drawn during the 15th through 21st weeks of pregnancy and in 55 specimens of cord [correction of cold] blood collected from the same mothers' infants. Maternal serum phenylalanine levels correlated negatively with infant birthweight in the 41 infants for whom appropriate confounders were known. Infant serum phenylalanine levels did not correlate with birthweight. Neither maternal nor infant serum phenylalanine levels correlated with 1-minute Apgar scores. A negative association was seen between both maternal and infant serum phenylalanine levels and 5-minute Apgar scores when appropriate confounders were controlled.

Apgar Score↗
PubMed1996

Astrocytes in the hypoglossal nuclei of sudden infant death syndrome (SIDS) infants: a quantitative study.

It has been suggested that brain stem hypoxia or ischaemia underlies the sudden infant death syndrome (SIDS), but previous reports of astrocytosis in the brain stems of SIDS infants have been contradictory. A volumetric quantitative technique was, therefore, developed to compare astrocyte numbers and sizes in the hypoglossal nuclei of SIDS and control infants. In 12 SIDS and eight control infants, serial sagittal sections were taken through the hypoglossal nucleus and every tenth section was stained for glial fibrillary acidic protein. Astrocytes were counted in the central 4% of a grid stepped throughout the hypoglossal nucleus, and the heights of 100 astrocyte nuclei were measured with a microcator. Astrocyte number, corrected for section thickness and nuclear height, was divided by the volume of the hypoglossal nucleus to calculate astrocyte density. Numbers of astrocytes did not differ significantly between SIDS (mean number 44729, SD 12096) and control (mean number 46562, SD 11060) infants. Astrocyte nuclear height did not differ significantly between groups (SIDS: mean height 3.98 microns, SD 0.22; control: mean height 3.84 microns, SD 0.31). Astrocyte density was similar in SIDS (mean density 24378 astrocytes/mm3, SD 6155) and control (mean density 23978 astrocytes/mm3, SD 4031) infants. No quantitative evidence of astrocytosis was found in the hypoglossal nuclei of SIDS infants. This implies that SIDS infants die without previous episodes of hypoxia/ischaemia severe enough to damage the brain stem.

Astrocytes↗
PubMed1996

An analysis of sudden infant death syndrome in aboriginal infants.

The purpose of this case-control study was to identify antenatal and perinatal risk factors for sudden infant death syndrome (SIDS) in Aboriginal infants in Western Australia (WA). Cases were all Aboriginal infants born in WA from 1980 to 1990 inclusive and classified as dying from SIDS in WA. Controls consisted of a matched group and a random group both selected from liveborn Aboriginal infants born from 1980 to 1990. Multivariate modelling showed that SIDS in Aboriginal infants was strongly related to young maternal age (< 20 years, odds ratio (OR) = 2.89), high parity (parity > 3, OR = 4.40) and being small-for-gestational age (OR = 3.36) but was not associated with single marital status (OR = 0.95) or male sex (OR = 0.97). Although the study was based on routinely collected data, results do highlight some important groups for SIDS prevention. To gain further knowledge in terms of SIDS in Aboriginal infants, there is an urgent need to collect information concerning infant care practices in the Aboriginal community.

Adult↗
PubMed2004

Feeding infants and toddlers study: What foods are infants and toddlers eating?

OBJECTIVE: To describe the food consumption patterns of US infants and toddlers, 4 to 24 months of age. DESIGN: Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers study based on telephone interviews and 24-hour dietary recalls. SUBJECTS: A national random sample of 3,022 infants and toddlers age 4 to 24 months. STATISTICAL ANALYSES PERFORMED: The percentage of infants and toddlers consuming foods from specific food groups was estimated for six age groups, using a single 24-hour recall. RESULTS: Infants as young as 7 months of age showed food patterns that have been observed in older children and adults. From 18% to 33% of infants and toddlers between ages 7 and 24 months consumed no discrete servings of vegetables, and 23% to 33% consumed no fruits. French fries were one of the three most common vegetables consumed by infants 9 to 11 months of age. By 15 to 18 months, french fries were the most common vegetable. Almost half (46%) of 7- to 8-month-olds consumed some type of dessert, sweet, or sweetened beverage, and this percentage increased as age increased. By 19 to 24 months, 62% of toddlers consumed a baked dessert, 20% consumed candy, and 44% consumed a sweetened beverage. APPLICATIONS: Parents and caregivers should be encouraged to offer a wide variety of vegetables and fruits daily, with emphasis on dark green, leafy, and deep yellow vegetables and colorful fruits. They should offer desserts, sweets, sweetened beverages, and salty snacks only occasionally, offering nutrient-dense, age-appropriate foods as alternatives (eg, fruit, cheese, yogurt, and cereals). Water, milk, and 100% fruit juices should be offered as alternative beverages. Because family food choices influence what foods are offered to children, family-based approaches to developing healthy eating habits may be helpful.

Animals↗
PubMed2005

Infant feeding practices and early flavor experiences in Mexican infants: an intra-cultural study.

OBJECTIVES: The study explored the maternal beliefs and practices related to pregnancy, breastfeeding, and infant feeding among women living in several regions in Mexico. We hypothesized that, despite the culinary diversity within Mexico, there would be similar patterns in the types of flavors and foods eaten by mothers and fed to infants. DESIGN: A structured interview was conducted through personal interviews with mothers during routine visits to their local family medical units. The units were located in four regions in Mexico that represent the diversity of culinary practices characteristic of the country. SUBJECTS: A random sample of 101 women whose infants ranged in age from 6 days to 9 months. RESULTS: Although the vast majority of mothers knew of its benefits and nursed their infants, breastfeeding during the first week of life was not exclusive; approximately one third of the infants were also fed teas, water, and/or formula. The feeding of teas continued throughout infancy in three of the regions, but the flavor of the tea differed. There were also regional similarities in the foods chosen and avoided during pregnancy and lactation and the type of first foods offered to the infants. CONCLUSIONS: The similarities in the types of foods fed to infants and eaten more of by mothers during pregnancy suggest that these cultural and regional practices contribute to the development of strong preferences for regional cuisines. The foods eaten by the mother during pregnancy and lactation form the basis of the child's weaning patterns.

Adult↗
PubMed1988

Impact of delayed development in premature infants on mother-infant interaction: a prospective investigation.

We examined events that precede a diagnosis of developmental delay by comparing 16 very low birth weight premature infants whose condition was diagnosed as developmental delay at 18 months corrected age with 16 matched developmentally normal infants. All infants were observed with their mothers during maternal visits to the nursery and during home visits 1, 3, 6, and 9 months after discharge. The mothers' reactions to their infants were rated at these times. All the children were followed up at a neonatal clinic, and detailed clinic records were used to document the time when a physician first suspected a delay and when this delay was first mentioned to the mother. The results indicate that parents had usually been told of their child's handicap by the time the child was 6 to 9 months old; yet mothers of the delayed children changed the interaction with their children as early as 1 month after discharge from hospital. These mothers initially touched, smiled at, and talked to their developmentally delayed infants significantly more often, but by 9 months they did so much less often than mothers of nondelayed children. The degree of change in mothers' behavior was related to their psychosocial background, with better-adjusted mothers showing the most change. We conclude that mothers' statements about their infants are usually valid and that physicians may share their potential concerns about infants more freely.

Adult↗
PubMed1993

Outcome of infants born preterm, with special emphasis on extremely low birthweight infants.

The outcome of extremely low birthweight (ELBW) infants has been reviewed from published articles and up-to-date data from Japan. The mortality rate of these infants declined significantly from over 90% to below 50% after the introduction of intensive care in the 1970s, but the incidence of major neurological sequelae remained steady at around 20%. Similarly, the incidence of major neurological sequelae did not increase along with the decrement of birthweight, although the mortality rate increased significantly. Long-term follow-up of ELBW children until school age has revealed poor school performance in spite of the absence of major neurological sequelae and the attainment of average intelligence quotient scores. Physical growth is retarded initially but generally catches up by the age of 8-9 years. In Japan, the neonatal mortality rate of ELBW infants declined from 56% in 1981 to 25% in 1989 with an increased birth rate of ELBW infants. In ELBW infants cared for at Tokyo Women's Medical College during 1984-90, the survival rate was 112 out of 134 (84%) and the incidence of major neurological sequelae was 15 out of 87 (17%) at 1-8 years old. The viability limit of ELBW infants has been discussed based on recent data. As a result of the rapid progress of medical care of ELBW infants, their viability limit as defined in the Eugenic Protection Law in Japan was amended from 24 completed weeks of gestation to 22 completed weeks in 1991.

Birth Weight↗
PubMedDate not supplied

Use of the Bayley Infant Neurodevelopmental Screener with low birth weight infants.

OBJECTIVE: To examine the utility of the Bayley Infant Neurodevelopmental Screener (BINS) as a screening technique for premature, low birth weight infants. METHODS: One hundred thirty-three preterm infants <1,500 grams received a BINS assessment at mean adjusted age 6.8 months and a Bayley Scales of Infant Development, Second Edition (BSID-II) assessment at mean adjusted age 12.9 months. Infants' BINS scores were compared to their BSID-II Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores. RESULTS: The BINS score showed significant association with the MDI (r =.40, p = <.001) and with the PDI (r =.35, p = <.001). The BINS showed moderate predictive validity (67%-76%) for identifying lower functioning infants. CONCLUSIONS: The BINS is a satisfactory screening tool for low birth weight infants when used in conjunction with other known biologic and social risk factors.

Developmental Disabilities↗
PubMed2001

Long-chain polyunsaturated fatty acids in infant nutrition: effects on infant development.

In the past year, two groups of investigators reported the effects of feeding n-3 and n-6 long chain polyunsaturated fatty acids on term-infant development. In general, these small randomised studies, along with two recent large randomised clinical trials, one with preterm and one with term infants, confirm and extend data on efficacy from smaller clinical studies reported in the past ten years. In addition, two independent systematic reviews published this year evaluated all but the most recent studies. Both systematic reviews concluded that there were benefits of feeding long chain polyunsaturated fatty acids to preterm infants in the short-term and acknowledged the absence of studies to address their effects on long-term visual development in infants. The continuing controversy as to the need for long chain polyunsaturated fatty acids by term infants is highlighted by the different conclusions reached in the systematic reviews. A middle view can also be supported by the data; that is, that fewer term infants than preterm infants can benefit from these fatty acids because of greater long chain polyunsaturated fatty acid accumulation in utero. Differences in intrauterine accumulation of these fatty acids may also play a role in inconsistent results among term studies.

Child Development↗
PubMed1993

Sudden infant death syndrome: links with infant care practices.

OBJECTIVES: To investigate infant care practices in a small ethnic minority population within Britain that might suggest possible factors contributing to the low incidence of the sudden infant death syndrome in Asian populations. DESIGN: Ethnographic interviewing, a qualitative comparative method drawn from social anthropology. SETTING: Central Cardiff. SUBJECTS: Non-random sample of 60 mothers of Bangladeshi or Welsh ethnic origin and working or middle class occupational status, who had infants under one year old. None of the families interviewed had experienced a sudden infant death. RESULTS: Broad cultural contrasts emerged as a series of themes from the interview data: living patterns, family networks, sleeping patterns, and concepts of time and dependence. CONCLUSION: Bangladeshi infants were cared for in a consistently rich sensory environment; Welsh infants, in contrast, were more likely to experience alternating periods of high and low sensory input. Long periods of lone quiet sleep may be one factor that contributes to a higher rate of sudden deaths in white than in Asian infants.

Bangladesh↗