[Chronic nutrition disorders in infants].
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The validity of using the index weight--height in the assessment of nutritional status was evaluated. The suitability of the index and its relation to growth status and nutritional deficiency signs were assessed through the: 1) comparison of incidence rates of nutrition deficiency signs and growth rates by scales of overall weight--height values less than or above 0.15; 2) comparison of growth rates and incidence of nutrition deficiency signs by classification of children depending on the frequency with which they maintained the index above or below 0.15; and 3) intercorrelations between growth rates, incidence rates of PCM, and absolute values of weight--height index.
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Maternal age and parity, according to the findings of the Inter-American Investigation of Mortality in Childhood, have a direct relationship to the health and survival of the infant. Among the results of this broad undertaking are data suggesting that babies born close in succession, especially within large families and as birth order ascends, are at greater risk of dying. Also, the offspring's future is increasingly threatened as the mother's age tends toward the extremes of the childbearing years. Compromise of the mother's health, in turn, was indicated in the earlier Investigation, a study of deaths in adults, which revealed unexpectedly high maternal mortality in the Latin American cities that it covered. Immaturity, or low birthweight, and malnutrition emerged as the two major underlying or associated causes of death in the Latin American projects of the Inter-American Investigation of Mortality in Childhood. Despite the marked variations in the data available from the different areas, there appeared to be some correlation between these two indicators of deficits in growth and development. Mortality due to immaturity was especially high for babies of young mothers, with increases occurring as the birth order rose. Not only are the risks greater for mothers having low-weight babies when they are young (under 20), but they increase even more with the second, third, and fourth products when the birth intervals become shorter. Maternal age, birth order, and birthweight are factors that must be considered in combination in the programming of protective health measures.
The research that was carried out with comparative groups showed the influence of the work done by a coordinated health group on the prolonged natural lactation. This experience has proved the evident reduction of percentages of malnutrition and diarrhoea in children under 6 months of age.
Measurement of tryptic and chymotryptic activity in the faeces was not disturbed by bacterial proteolytic activity of different bacteria such as proteus, pseudomonas, coli, enterococci, bacteroides. Both activities within a group follow a logarithmic normal distribution. Lower limit of the standard deviation is 51% upper limit 129% for tryptic activity, respectively 60 and 170% for chymotryptic activity. There were no differences in chymotryptic activity between the 10 age groups comprising 157 healthy children, whereas a significant difference could be found for tryptic activity between premature and older children. Daily fluctuations of the enzyme activities are quite high in the same individual, and only reduced in "bottlefed" infants with constant nutrition. In prematures and very young infants chymotryptic activity predominates, later tryptic activity. Influence of increased and decreased bowel movements on deviation of the data was tested. There was, however, no real alteration of enzyme activity due to the bowel dysfunction beyond the standard deviation of the control groups. But passage time and nutrition have to be considered beside other factors in the wide distribution of the enzyme activities and the latter limits the value of this method.
An outline is given of the aims and activities of the Nestlé Foundation, notably the inquiries performed at the Study center at Adiopodoumé (Ivory Coast) about the nutrition situation, and the efforts made there to improve the protein intake by introducing new food-stuffs of high protein content.
Thirty children were measured when they entered nutrition centres. Their younger siblings were later measured at the same age. Over the same period, a matched group of control children and their siblings were measured. The younger siblings of Centre participants showed the same growth patterns as the younger siblings of control children. Centre teaching had evidently not affected the way mothers fed their younger children, and thus it had no effect on their growth.
This review addresses vitamin and mineral supplementation recommendations, practices and rationales, patterns of supplement use, and the relationship between supplementation and nutrient concerns for older infants. According to current recommendations, healthy infants do not need supplements if vitamin D-fortified milk is used, the diet includes adequate vitamin C, and iron-fortified cereals or formula are used. Infants fed human milk exclusively may need vitamin D supplements. Nevertheless, approximately one third to one half of 6- to 12-month-old U.S. infants receive nutrient supplements, as liquid vitamin A, D, and C preparations or multivitamin preparations, with or without iron or fluoride. Recent surveys suggest that most infants have more than adequate vitamin and mineral intakes, with the possible exception of iron. The risk of poor vitamin A status is less likely than the risk of poor water-soluble-vitamin or iron status in the United States. Possibly marginal intakes of zinc and copper (not in currently available infant supplements) suggest the need for further research. Research, infant supplement formulation reevaluation, and education are suggested so that nutrient supplements for prophylaxis can be used most effectively and appropriately.
Serial concentration values of 25-hydroxyvitamin D (25-OHD) were determined in the sera of term, premature, and twin infants. In infants born at term with normal concentrations of 25-OHD in cord blood, serial concentrations of 25-OHD remained normal; in infants born at term with low concentrations of 25-OHD in cord blood, serial concentrations of 25-OHD increased. In premature infants with normal concentrations of 25-OHD in cord blood, serial concentrations of 25-OHD decreased; in premature infants with low values of 25-OHD in cord blood, serial concentrations of 25-OHD did not increase until a postconceptual age of 36 to 38 weeks. The concentrations of 25-OHD in the sera of twin infant pairs followed parallel courses. Oral and intravenous supplementation of vitamin D did not significantly increase the concentrations of 25-OHD in serum of premature infants. These findings suggest that a decreased rate of 25-hydroxylation of vitamin D may be a factor impairing homeostasis of 25-OHD in premature infants.
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