Influence of dietary manipulation on incidence of atopic disease in infants at risk.

Of 5,500 newborn infants whose family histories were screened, 900 were found to have anamnestic risk. Cord-blood IgE was evaluable in 4,677 of these newborns, of which 394 had levels > or = 1 IU/mL; 84 infants had both anamnestic risk and elevated cord-blood IgE levels. Parents of infants with anamnestic risk were informed of their child's risk of atopy. Additionally, for 391 infants at two of the three participating hospitals, a preventive diet was prescribed that recommended breastfeeding for the first 6 months of life, with maternal diet restricted to no more than 200 dL of cow milk per day, no more than one egg per week, and no tomato, fish, shellfish, nuts, or foods allergenic to the mother. Only soy formula was recommended, and introduction of solid foods was also carefully prescribed. Furthermore, doctors recommended against exposure to tobacco smoke, animal allergens, and early entrance into daycare. Evaluable infants whose parents complied with the prescribed diet were found to have a lower incidence of atopy during the first year of life (13.3%, n = 158) than infants whose parents had ignored the prescribed diet (54.7%, n = 86) or infants whose parents were offered no dietary recommendations (28.9%, n = 218). Differences between the compliant group and the two groups with unrestricted diets were significant, indicating that this prescribed diet may protect against or delay onset of food allergies during the first year of life.

Protein profiles in breast milk from mothers delivering term and preterm babies.

During the last few years, advances in the care of low-birth-weight and preterm neonates has stimulated research on the best dietetic program to improve survival and to reduce handicap incidence. At present, fortification of human milk with artificial formulas is the most usual dietetic solution. As yet, however, little is known about the composition of milk from mothers giving birth prematurely. The aim of this study was the quantification of different proteins in human milk during the lactation period. By use of an electrophoretic method, lactoferrin (LF), alpha-lactalbumin, beta-casein, and lysozyme concentrations were measured in milk from mothers delivering normally (TM) or prematurely (PM). LF concentration in milk from TM presented higher values in the very first days and a fast decrease to d 10. After d 10, the concentration reached a plateau. In milk from PM, the LF concentration in the first days was lower than for TM. Similar profiles of alpha-lactalbumin, beta-casein, and lysozyme concentrations were found in milk from TM and PM. A general higher variability in PM samples was observed both between different mothers and for the same woman during the lactation period. Lactation profiles for four human milk proteins are described here. No significant difference was observed (apart from LF in the very first days) between preterm and term milk samples, confirming the unsuitability of unfortified breast milk for preterm neonates.

Ambroxol in the treatment of idiopathic respiratory distress syndrome. An interim report on a controlled double-blind multicenter study versus placebo.

In a double-blind multicenter study versus placebo, the therapeutic effects of ambroxol (10 mg/kg, i.v. twice daily for 7 days) were studied in an appropriately selected population with severe respiratory failure. Treatment was given to 28 neonates with birth weight less than or equal to 2,000 g, appropriate for gestational age with idiopathic respiratory distress of such severity as to require assisted ventilation (IMV or IPPV) within 12 h of birth. The preliminary results showed that ambroxol treatment, and not placebo, increased survival, reduced the time during which mechanical ventilation was required and improved the FiO2/PaO2 ratio and the biochemical indices of pulmonary maturity. This latter improvement suggests that the amelioration of the IRDS clinical picture and the reduction of ventilatory requirement might be due to an increase in pulmonary surfactant. No side effects attributable to ambroxol therapy were observed in the treated infants.