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Author(s): Jie Shao [sup.1] [sup.2] , Blair Richards [sup.3] , Niko Kaciroti [sup.3] , Bingquan Zhu [sup.1] , Katy M. Clark [sup.3] , Betsy Lozoff [sup.3] [sup.4] Author Affiliations: (1) [...], Background/Objectives The contribution of iron status at birth to iron status in infancy is not known. We used a physiologic framework to evaluate how iron status at birth related to iron status at 9 months, taking iron needs and sources into account. Subjects/Methods In a longitudinal birth cohort in China, iron status measures in cord blood and venous blood in infancy (9 months) and clinical data were prospectively collected in 545 healthy term maternal-infant dyads. We used structural equation modeling (SEM) to create a 9-month iron composite and to assess direct and indirect contributions of multiple influences on 9-month iron status. Logistic regression was used to calculate odds ratios for iron deficiency (ID), iron deficiency anemia (IDA), and anemia. Results Approximately 15% (78/523) of infants were born with cord SF Conclusions Indicators of iron status at birth, postnatal iron needs, and iron sources independently related to iron status at 9 months. Sex was an additional factor. Public health policies to identify and protect infants at increased risk of ID should be prioritized.

INTRODUCTION Excess adiposity is a major risk factor for adverse health outcomes and chronic diseases. (1) Body fat assessment in infants is important not only as an indicator of nutritional [...], BACKGROUND/OBJECTIVES: Prediction equations are commonly used to estimate body fat from anthropometric measurements, but are population specific. We aimed to establish and validate a body composition prediction formula for Asian newborns, and compared the performance of this formula with that of a published equation. SUBJECTS/METHODS: Among 262 neonates (174 from day 0, 88 from days 1-3 post delivery) from a prospective cohort study, body composition was measured using air-displacement plethysmography (PEA POD), with standard anthropometric measurements, including triceps and subscapular skinfolds. Using fat mass measurement by PEA POD as a reference, stepwise linear regression was utilized to develop a prediction equation in a randomly selected subgroup of 62 infants measured on days 1-3, which was then validated in another subgroup of 200 infants measured on days 0-3. RESULTS: Regression analyses revealed subscapular skinfolds, weight, gender and gestational age were significant predictors of neonatal fat mass, explaining 81.1% of the variance, but not triceps skinfold or ethnicity. By Bland-Altman analyses, our prediction equation revealed a non-significant bias with limits of agreement (LOA) similar to those of a published equation for infants measured on days 1-3 (95% LOA: (- 0.25, 0.26) kg vs (- 0.23, 0.21) kg) and on day 0 (95% LOA: (- 0.19, 0.17) kg vs (- 0.17, 0.18) kg). The published equation, however, exhibited a systematic bias in our sample. CONCLUSIONS: Our equation requires only one skinfold site measurement, which can significantly reduce time and effort. It does not require the input of ethnicity and, thus, aid its application to other Asian neonatal populations. European Journal of Clinical Nutrition (2013) 67, 922-927;doi: 10.1038/ejcn.2013.69;published online 3 April 2013 Keywords: body composition; neonatal fat mass; prediction equation; skinfolds

The assessment of fluid balance and body composition is critical to many aspects of neonatology. FLUID BALANCE During the first days of life, the distribution of fluid within the body [...], BACKGROUND/OBJECTIVES: There is a critical need for improved technologies to monitor fluid balance and body composition in neonates, particularly those receiving intensive care. Bioelectrical impedance analysis meets many of the criteria required in this environment and appears to be effective for monitoring physiological trends. SUBJECT/METHODS: The literature regarding the use of bioelectrical impedance in neonates was reviewed. RESULTS: It was found that prediction equations for total body water, extracellular water and fat-free mass have been developed, but many require further testing and validation in larger cohorts. Alternative approaches based on Hanai mixture theory or vector analysis are in the early stages of investigation in neonates. CONCLUSIONS: Further research is required into electrode positioning, bioimpedance spectroscopy and Cole analysis in order to realise the full potential of this technology. European Journal of Clinical Nutrition (2013) 67, S28-S33; doi: 10.1038/ejcn.2012.162 Keywords: bioelectrical impedance; neonate; fluid balance; body composition

The optimal growth of newborn infants depends on securing an adequate and sufficient supply of energy and indispensable nutrients (Dogan et al, 2005). When a newborn must remain in hospital, [...], Background/Objectives: To quantify the rate of progressive failure of very-low-birth-weight (VLBW) infants over time in the neonatal intensive care unit to meet growth milestones. Subjects/Methods: In a prospective longitudinal study, 114 VLBW preterm infants (≤ 1500g) of both sexes, with normal and/or low weight for gestational age were included. At the start, weight, length, mid-upper arm (MUAC), thigh and cephalic circumferences were measured. Weight/age (W/A), length/age and weight/length (±2 z-score) indices were calculated. All measurements were taken at inclusion, at 7, 15 and 30 days of hospitalization. Chi-square test, analysis of variance and repeated-measures tests were estimated. Results: Thirteen cases (14%) died and were excluded soon after the first determinations. In all, 9 (8.9%) died during the study, 12 (11.9%) were discharged before 30 days of life and 80 (79.2%) completed the study. At 7 days, the percentage of preterm infants with an index of W/A < -2 z-scores increased from 44 to 67% (44-68 subjects; P < 0.01), with no changes afterwards; the indicator MUAC < -2 z-scores increased at 7 days from 23 to 49% (23 to 49 subjects); at 15 from 23 to 65% (23-61 subjects) and at 30 days from 23 to 79% (23-63 subjects; P < 0.001). Conclusions: Clinicians could use these indicators for earlier detection of growth failure in VLBW infants in order to target more aggressive nutrition early. European Journal of Clinical Nutrition (2012) 66, 474-480; doi: 10.1038/ejcn.2011.191; published online 16 November 2011 Keywords: preterm infants; nutritional status; intensive care Introduction

Introduction According to World Health Organization, low birth weight (LBW) is defined as weight at birth less than 2500 g (UNICEF and WHO, 2004). The two major causes of LBW [...], Background/Objectives: Low birth weight (LBW), defined as the body weight at birth of less than 2500g, is a major public health problem in Bangladesh, where 37% of the babies are born with LBW. The objective of this study is to see the impact of nutrition education on growth of LBW babies with early initiation and exclusive breastfeeding compared to control group. Subjects/Methods: A total of 184 LBW babies and their mothers who attended the Maternal Care and Health Training Institute and Dhaka Medical College Hospital were randomly allocated to either intervention or control group. Enrollment of the study population started in May 2008 and was completed in October 2008. Nutrition education was given to mothers twice weekly for 2 months, on initiation of breastfeeding within 1 h, exclusive breastfeeding and increasing their dietary intake. Nutritional status of LBW babies was assessed for length and weight every 2 weeks. Data were analyzed using SPSS/Window's version 12. Comparison of mean of data was done using standard Student's t-test. Results: Mean initial body weight and length of LBW babies were similar in both groups (2261 [+ or-] 198g vs 2241 ± 244g, P = 0.535 and 43.0 [+ or-] 1.3 cm vs 43.0 [+ or-] 1.7 cm, P = 0.77). Body weight and length of the LBW babies after 2 months increased significantly (3620 [+ or-] 229 g vs 3315 [+ or-] 301 g, Po 0.001 and 50.2 [+ or-] 1.3 cm vs 48.7 [+ or-] 1.6cm, Po 0.001). It was found that the intervention group suffered less from respiratory illness compared with the control group (39% vs 66%, Po 0.001). The rate of early initiation of breastfeeding was also significantly higher with nutrition intervention (59.8% vs 37.2%, P < 0.001). Exclusive breastfeeding rate was significantly higher in intervention group (59.8% vs 37%, P = 0.003). Conclusions: The present study showed that weight and length gain of LBW babies significantly increased by breastfeeding and nutrition education. Therefore, nutrition education on breastfeeding proves to be a strong tool to reduce the high risk of malnutrition and mortality of the LBW babies. European Journal of Clinical Nutrition (2012) 66, 376-381; doi: 10.1038/ejcn.2011.182; published online 16 November 2011 Keywords: nutrition education; LBW; weight and length gain; exclusive breastfeeding