Search

Growth patterns among breastfed infants appear to vary from infants fed formula or solids. Seven studies have plotted weights and lengths for a total of 453 North American or European breastfed infants. Overall, 226 were breastfed for 12 months or more and of those, 141 were not given other milks or formula during that period. Forty-two percent were started on solids at four to five months, 38% at six to seven months, and 17% at eight to nine months. Infant growth rates followed the same pattern in all seven studies. Compared with standard growth charts, breastfed babies grew more rapidly for the first two months and then more slowly for months three through twelve. In particular, weight gain was slower after month eight, but gain in length was not. Babies weaned at six to eight months did not show the same drop in weight gain. Standard growth curve charts do not appear to be appropriate for breastfed infants., Objective. To compare growth patterns of a large sample of breast-fed infants with the current World Health Organization (WHO)/Centers for Disease Control and Prevention (CDC) reference data. Methods. Data from seven longitudinal studies of infant growth in North America and northern Europe were pooled (n = 453 breast-fed infants). Weight, length and head circumference were compared with the WHO/CDC reference, and repeated-measures analysis of variance was used to examine associations between growth patterns and breast-feeding duration, age of introduction of solid foods, and use of other milks. Results. In comparison with WHO/CDC reference data, infants breast-fed for at least 12 months (n = 226) grew more rapidly in the first 2 months and less rapidly (particularly in weight) from 3 to 12 months; the mean z score at 12 months was -0.53 for weight for age, -0.29 for length for age, and -0.32 for weight for length. In contrast, mean head circumference was well above the WHO/CDC median throughout the first year of life. These patterns were generally consistent across studies. In the full sample (n = 453), a longer duration of breast-feeding was associated with a greater decline in weight for age and weight for length but not length for age. Conclusion. These results suggest that if growth charts are to reflect patterns consistent with those of infants following WHO feeding recommendations, new reference data based on breast-fed infants are needed. Pediatrics 1995;96:495-503; breast-feeding, growth monitoring, growth references, anthropometry, weight, recumbent length, infant feeding practices., The World Health Organization/Centers for Disease Control and Prevention (WHO/CDC) growth charts' currently used throughout the world for monitoring growth of children are based on the US National Center for [...]

Oral rehydration of children with acute diarrhea and mild-to-moderate dehydration may be slightly more effective using rice flour (RF) oral rehydration solution (ORS), but conventional ORS may still be adequate. A total of 134 male infants between 3 and 36 months of age with diarrhea were randomly assigned to one of three ORS treatment groups. Forty-three children were treated with glucose ORS, 46 with rice dextrin ORS and 45 with RF-ORS. Time until rehydration was similar between the three groups. During the first six hours of treatment, stool output decreased by 24% to 27% among infants receiving RF-ORS. By 12 hours there were no significant differences in stool output between the groups. ORS with rice components may reduce stool output better than other carbohydrates because of its low osmolality and additional organic substances. RF-ORS may be more difficult to prepare and may have a higher risk of microbial contamination compared to the other ORSs., Objective. To assess the effects of glucose (G)-oral rehydration solution (ORS), rice dextrin (RD)-ORS, and rice flour (RF)-ORS on fluid intake, rapidity of rehydration, and stool output of children with acute diarrhea and mild or moderate dehydration. Methods. The study was a randomized, double-asked clinical trial. One hundred forty-six male infants, ages 3 to 36 months, were randomly assigned to one of three treatment groups. Clinical evaluations and fluid balances were conducted every 2 to 4 hours for 48 hours. Principal outcome variables were ORS consumption, recovery of hydration status, and fecal output. Results. The groups were similar at admission with regard to age, nutritional status, history of the current episode, and clinical status. There were no differences in ORS consumption by treatment group during any period of study. During the first 6-hour period, patients in group RF had less stool output (16 [+ or -] 14 g/kg/body weight) than those in group G (22 [+ or -] 20 g/kg) or RD (21 [+ or -] 19 g/kg; P < .05). After 12 hours of hospitalization, there were no differences by treatment group. Recovery of hydration status, changes in serum sodium and potassium, and duration of diarrhea in the hospital were similar in all three groups. Conclusion. There was a 24% to 27% reduction in stool output during the first 6 hours of treatment among children who received RF-ORS compared with those who received G-ORS or RD-ORS, but this effect did not persist after the first 12 hours of therapy. Because this difference was of small magnitude and limited duration, it has minor clinical importance. Thus, we conclude that the three solutions had similar efficacy for children with acute, watery diarrhea and mild or moderate dehydration. Pediatrics 1995;95:191-197; diarrhea, rehydration therapy, electrolytes, oral rehydration solution, clinical trial., ABBREVIATIONS. ORS, oral rehydration solution; G-ORS, glucose-ORS; RD-ORS, rice dextrin-ORS; RF-ORS, rice flour-ORS; SD, standard deviation. Therapy for diarrheal dehydration consists of providing fluid and electrolytes either orally or intravenously, [...]

Young children with severe diarrhea may be able to safely tolerate a diet of undiluted, nonhuman milk. In a meta-analysis of 14 clinical studies, researchers studied the treatment, outcome and diet of children up to 59 months old. In six of 13 studies which discussed treatment outcomes, treatment failure rates were much greater among children who received diets containing lactose. Overall, 22% percent of the children with lactose-containing diets were therapeutic failures versus 12% of those without lactose in their diets. The bowel movements of those with lactose-containing diets were not much more frequent than in the lactose-free diet group. Treatment failure rates for those receiving diluted versus undiluted milk were not statistically different. The number of bowel movements were greater in the undiluted milk group. The overall results from these trials indicate that a majority of children with acute diarrhea may be able to safely continue a diet of undiluted, nonhuman milk if severe dehydration and malnutrition are not complicating factors., ABSSTRACT. Objective. To assess the effects of continued feeding of nonhuman milks or formulas to young children during acute diarrhea on their treatment failure rates, stool frequency and amount, diarrheal duration, and change in body weight. Methods. A total of 29 randomized clinical trials of 2215 patients were identified by computerized bibliographic search and review of published articles. Data were abstracted and analyzed using standard metal-anlytic procedures. Results. Among studies that compared lactose-containing milk of formula diets with lactose-free regimens, those children who received the lactose-containing diets during acute diahhrea were twice as likely to have a treatment failure as those who received a lactose-free diet (22% vs 12%, respectively; P

Dietary fiber can reduce the duration of severe diarrhea in children. Of 34 Peruvian male infants between 2 and 24 months of age hospitalized with severe watery diarrhea, 19 were fed a soy-protein isolate, lactose-free formula with soy polysaccharide as a source of fiber and 15 were fed the same diet without added fiber. Although the added fiber did not affect stool output, macronutrient absorption or nutritional status during acute watery childhood diarrhea, soy polysaccharide reduced the duration of diarrhea significantly. Diarrhea lasted an average of 43 hours in the children on the fiber diet, compared to 163 hours in those on the fiber-free diet.

Antthropometric data were collected monthly from birth to 18 months as part of the Davis Area Research on Lactation, Infant Nutrition and Growth study, which followed infants who were either breast-fed or formula-fed during the first 12 months. The two cohorts were matched for parental socioeconomic status, education, ethnic group, and anthropometric characteristics and for infant sex and birth weight, and neither group was given solid foods before 4 months. While mean weight of formula-fed infants remained at or above the National Center for Health Statistics median throughout the first 18 months, mean weight of breast-fed infants dropped below the median beginning at 6 to 8 months and was significantly lower than that of the formula-fed group between 6 and 18 months. In contrast, length and head circumference values were similar between groups. Weight-for-length z scores were significantly different between 4 and 18 months, suggesting that breast-fed infants were leaner. The groups had similar weight gain during the first 3 months, but breast-fed infants gained less rapidly during the remainder of the first year: cumulative weight gain in the first 12 months was 0.65 kg less in the breast-fed group. Length gain was similar between groups. These results indicate that weight patterns of breast-fed infants, even in a population of high socioeconomic status, differ from current reference data and from those of formula-fed infants. Thus, new growth charts based on breast-fed infants are needed.