Prospective surveillance for intussusception in Indian children aged under two years at nineteen tertiary care hospitals.

BACKGROUND: India introduced rotavirus vaccines (RVV, monovalent, Rotavac™ and pentavalent, Rotasiil™) in April 2016 with 6, 10 and 14 weeks schedule and expanded countrywide in phases. We describe the epidemiology of intussusception among children aged 2-23 months in India. METHODS: The prospective surveillance at 19 nationally representative sentinel hospitals from four regions recruited children with intussusception from April 2016 to September 2017. Data on sociodemography, immunization, clinical, treatment and outcome were collected. Along with descriptive analysis, key parameters between four regions were compared using Chi-Square/Fisher's exact/Mann-Whitney U/Kruskal-Wallis tests. The pre- and post-RVV periods were compared to estimate the risk ratios. RESULTS: Six hundred twenty-one children with intussusception from South (n = 262), East (n = 190), North (n = 136) and West (n = 33) regions were recruited. Majority (n = 465, 74.8%) were infants (40.0% aged 4-7 months) with median age 8 months (IQR 5, 13 months), predominantly males (n = 408, 65.7%) and half (n = 311, 50.0%) occurred during March-June months. A shorter interval between weaning and intussusception was observed for ragi based food (median 1 month, IQR 0-4.2 months) compared to rice (median 4 months, IQR 1-9 months) and wheat (median 3 months, IQR 1-7 months) based food (p < 0.01). Abdominal pain or excessive crying (82.8%), vomiting (72.6%), and bloody stool (58.1%) were the leading symptoms. Classical triad (abdominal pain, vomiting and bloody stool) was observed in 34.8% cases (24.4 to 45.8% across regions). 95.3% of the cases were diagnosed by ultrasound. 49.3% (10.5 to 82.4% across regions) cases were managed by reduction, 39.5% (11.5 to 71.1% across regions) cases underwent surgery and 11.1% spontaneously resolved. Eleven (1.8%) cases died. 89.1% cases met Brighton criteria level 1 and 7.6% met Level 2. RVV was received by 12 cases within 1-21 days prior to intussusception. No increase in case load (RR = 0.44; 95% CI 0.22-1.18) or case ratio (RR = 0.5; 95% CI 0.3-1.2) was observed after RVV introduction in select sites. CONCLUSIONS: Intussusception cases were observed across all sites, although there were variations in cases, presentation and mode of management. The high case load age coincided with age of the RVV third dose. The association with ragi based weaning food in intussusception needs further evaluation.

Dietary intake of pearl millet based weaning food supplemented with iron and vitamin A enhances bioavailability of vitamin A in anemic rats.

The study was aimed to assess vitamin A bioavailability and allergenicity of pearl millet (Pennisetum glaucum) based weaning food (PMWF) fortified with iron and retinyl acetate in male Wistar albino rats. Animals (n = 64) were divided into Normal (NG) and Anemic (AG) groups; further sub-divided into 4 sub-groups having 8 animals each receiving synthetic diet, commercial diet, iron fortified PMWF diet and iron (150.00 ± 0.73 ppm) plus retinyl acetate (393.00 ± 3.07 µg/100 g) fortified PMWF diet (Final diet). Results revealed that anemic sub-groups showed apparent digestibility coefficient (ADC) in the range of 69.5 ± 0.40-93.2 ± 0.79%, which was significantly (P < 0.01) higher than normal sub-groups (65.5 ± 0.62-84.6 ± 0.33%). In both groups, rats fed final diet presented significantly (P < 0.01) higher ADC (84.6 ± 0.33-93.2 ± 0.79%) than that of animals received iron fortified diet (69.0 ± 0.59-76.1 ± 1.02%), indicating higher bioavailability of vitamin A in final diet. Moreover, hepatic vitamin A replenished rapidly in anemic groups (1.79-27.8) when compared to normal rats (1.11-19.4 µg/g liver). Immunoglobulins IgG, IgE in blood serum and IgA in intestinal fluid ranged from 574 ± 6.48 to 603 ± 9.76 µg/ml, 287 ± 4.46 to 309 ± 5.70 ng/ml and 204 ± 10.33 to 255 ± 13.22 µg/ml, respectively. However, no significant (P > 0.05) difference was observed between the groups and/or subgroups, suggesting no allergic response of final diet. Stimulation index triggered by lipopolysaccharide (LPS) ranged from 1.22 ± 0.06 to 1.45 ± 0.09 µg ml-1 in normal sub-groups and 1.16 ± 0.02 to 1.33 ± 0.03 µg ml-1 in anemic sub-groups with no significant (P > 0.05) difference among them. Overall, it can be concluded that retinyl acetate could be an effective fortificant to improve the status of vitamin A in anemic models.

In vivo assessment of iron bioavailability from fortified pearl millet based weaning food.

BACKGROUND: Iron is an essential micronutrient required for normal growth and development of the body. Infants are more vulnerable to develop iron-deficiency anaemia due to inadequate iron supply in early stages. The objective of the study was in vivo assessment of iron bioavailability from pearl millet based weaning food fortified with iron and vitamin A, and to investigate the role of vitamin A in iron absorption in animal models. RESULTS: Results revealed that anaemic group showed significantly (P < 0.05) higher bioavailability than that of normal rat models. Animals fed vitamin A supplemented pearl-millet diet exhibited comparable results with a sub-group provided commercially available weaning diet in both normal and anaemic groups, but significantly (P < 0.05) higher values for studied biological indices than that of a sub-group provided iron fortified pearl-millet or synthetic diet. When the anaemic rats were provided iron + vitamin A fortified diet, iron bioavailability increased and liver iron stores returned to the normal levels after 30 days, indicating a promoter role of vitamin A in intestinal iron absorption. CONCLUSIONS: Overall, bioavailability of electrolytic iron could be improved by supplementation of vitamin A, and this mixture can be considered as a useful fortificant for pearl millet based complementary foods fortification designed to prevent iron deficiency. © 2016 Society of Chemical Industry.

Formulation of fortified instant weaning food from Musa paradisiaca (banana) and Eleusine coracana.

Weaning food is a soft, easily digestible type of food other than breast milk for infants aged 6 to 24 months. The present study was conducted to develop cereal-fruit-based complementary foods for infants and evaluate the nutritional quality of such types of foods. Few researchers have focused on formulating weaning foods from locally available, nutritious, and rich ingredients without nutrient loss to reduce malnutrition and infant morbidity rates. In this study, the formulated infant food was prepared from Musa paradisiaca (Nendran banana) and Eleusine coracana (ragi). Formulated weaning food was analyzed using various standard methods, demonstrating that it could provide adequate nutrients to growing infants for their proper growth and development. The shelf life of the weaning food was also studied for a period of 3 months at ambient conditions in two different packaging materials: aluminum and plastic (low-density polyethylene or LDPE), with the aluminum foil pouch exhibiting the best shelf life. This ready-to-serve food, which is formulated and fortified with natural ingredients containing essential macronutrients and micronutrients, could be regarded as highly effective supplementary food for infants. Furthermore, this development has the potential to introduce an affordable weaning product specifically targeted at low socioeconomic groups.

Study of pattern of foods given to the infants during weaning period in an urban field practice area in Vijayapura.

Background: The first 2 years of life are a critical period for a child's growth and development. Exclusive breastfeeding for 6 months and continued breastfeeding with safe, appropriate, and adequate feeding are recommended as a global health policy in both developing and developed countries. Objective: The objective was to study the pattern of foods given to the infants during the weaning period in an urban field practice area in Vijayapura. Materials and methods: The mothers of infants (aged 6-12 months) were interviewed by using predesigned and pretested questionnaires regarding different types of foods given to their infants and also about their immunization status, incidence of diarrhea and acute respiratory infection (ARI). Results: A total of 95 mothers with infants aged between 6 and 12 months were enrolled in the study during the period of 1 month. Majority of the infants were fed with milk (animal) as a type of complementary food. Conclusion: Poor complementary feeding practices were observed in urban areas, and urgent health education and demonstration of weaning foods in the community play a major role in preventing diseases.

Comparative study of innovative blends prepared by fortification of date powder to alleviate child malnutrition.

Child malnutrition is one of the biggest problems in developing countries with higher level of food insecurity. Pakistan is 5th largest producer of date fruit; therefore, its processing and products should be explored in various dimensions. Being rich source of minerals and sugars, it can contribute in weaning foods in a good manner. In current study, three blends were prepared with specific proportions of spray-dried date powder and rich in specific proportions. They were compared with each other and control (free of date powder). The nutritional profile of the formulations revealed that 100 g of each formulation included all macronutrients in compliance with the requirements of Food and Agriculture Organization for weaning formulations; moreover, they are enriched with minerals due to presence of date powder. The iron contents reached up to 12.74 ± 0.16 mg/100 g. The phosphorus, zinc, and potassium contents also increased with the increase in date powder subsequently. Physicochemical properties exhibited in compliance with the requirement of the weaning foods. The protein quality was assessed both in vivo and in vitro. Amino acid profiling indicated that the limiting amino acid in F1 and control were lysine but in F2 and F3 were threonine. This is suggested that date powder might contain good quality protein that was further explained in biological studies, the formulations that contained higher amount of date powder reveled better PDCAAS score 86.76 ± 4.5, true digestibility 84 ± 4.36, biological value 69.45 ± 0.69, net protein utilization 73.82 ± 1.46, and protein efficiency score 1.18 ± 0.07. The sensory evaluation revealed that F2 showed better result in overall acceptability. Thus, date powder is suggested to be used as good constituent that can fortify mineral contents and sugar contents of the weaning foods.

Selenium and cadmium in bioaccessible fraction of organic weaning food: Risk assessment and influence of dietary components.

BACKGROUND: The tendency of some sectors of the population to consume organic food has also come to include baby food. Nevertheless, it is necessary to develop studies to support the true nutritional and toxicological value of these products, making special emphasis in several trace elements. To our knowledge, no studies have been conducted on this type of organic food. METHODS: Weaning foods with different formulations categorized as organic were analyzed to determine Se and Cd contents as well as its bioaccesibility. The analyses were conducted by electro thermal atomic absorption spectroscopy (ET - AAS) after the treatment of the samples with acid mineralization. Besides, macronutrient analyses (protein, fat and dietary fiber) were also developed. Finally, a novelty statistic approach such as @Risk was used to evaluate contributions to DRI or PTWI of Se and Cd derived for consumption of these weaning foods. RESULTS: Se content ranged between 2.44-15.4 µg Kg 1. Samples with meat ingredients showed the highest Se contents, while weaning foods consisting of fruits or vegetables presented the lowest concentrations. Se bioccessible concentration ranged between 1.90-4.35 µg Kg-1 with a greater uniformity amongst analyzed samples. Regarding Cd, concentrations of this heavy metal ranged between 1.23 and 3.64 µg Kg-1. Furthermore, Cd bioaccessibility of organic weaning foods ranged between 0.17 and 1.38 µg Kg-1. The solubility of all samples studied was around 20% from the initial Cd concentration. A negative statistical correlation between fat content - Cd bioaccesible (p < 0.05; r = - 0.756) and Cd content - Se bioaccesible (p < 0.05; r = - 0.777) were also found. CONCLUSIONS: Cd concentrations are considerably lower than those reported in weaning formulas which were not categorized as organic. On the other hand, the analysed organic jars did not represent a significant source of Se. The probabilistic assessment developed, showed that contributions to DRI of Se for infants 1-3 years old by consumption of these weaning foods, are excessively low (15% at best).

Physicochemical and sensory qualities of complemenatry meal made from sprouted and unsprouted sorghum, Irish potato and groundnut.

Weaning food was produced from the blends of sprouted and unsprouted sorghum-Irish potato, and groundnut flour. In the developed weaning foods, moisture content ranged from 8.44% to 12.70%, crude protein (7.40%-14.53%) crude ash (1.53%-1.77%), crude fiber (6.65%-6.88%), crude fat (3.31%-3.73%) and carbohydrate content (65.10%-69.15%). Sprouting and protein supplementation with groundnut improved the protein content of the formulated meals with values comparable to commercial sample (cereals). Mineral content reduced with sprouting, whereas the addition of Irish potato and groundnut increased the mineral content. Calcium ranged from 91.00% to 121.33% and potassium (487.33%-956.67%). Sample NSIG2 had the highest potassium. Tannin ranged from 0.11 to 0.64 mg/100 g; phytate (4.98-7.42 mg/100 g); and oxalate (0.36-0.98 mg/100 g). Peak viscosity ranged from 43.08 to 23.57 RVU, trough (41.08-22.50 RVU), breakdown viscosity (61-14), final viscosity (84.33-52.53 RVU), setback viscosity (41.33-89.00 RVU), and peak time (5.07-7.00) in both the sprouted and unsprouted sorghum-irish potato-groundnut flour, respectively. The pasting temperature of the weaning food blends ranged between 87.25 and 89.60°C with SIG0 and NSIG2 having the lowest and highest values, respectively. The study showed that complementary food products formulated from this locally available food commodities is a promising food and has good nutritive value.

Promoting hygienic weaning food handling practices through a community-based programme: intervention implementation and baseline characteristics for a cluster randomised controlled trial in rural Gambia.

OBJECTIVE: Contamination of weaning food leads to diarrhoea in children under 5 years. Public health interventions to improve practices in low-income and middle-income countries are rare and often not evaluated using a randomised method. We describe an intervention implementation and provide baseline data for such a trial. DESIGN: Clustered randomised controlled trial. SETTING: Rural Gambia. PARTICIPANTS: 15 villages/clusters each with 20 randomly selected mothers with children aged 6-24 months per arm. INTERVENTION: To develop the public health intervention, we used: (A) formative research findings to determine theoretically based critical control point corrective measures and motivational drives for behaviour change of mothers; (B) lessons from a community-based weaning food hygiene programme in Nepal and a handwashing intervention programme in India; and (C) culturally based performing arts, competitions and environmental clues. Four intensive intervention days per village involved the existing health systems and village/cultural structures that enabled per-protocol implementation and engagement of whole villager communities. RESULTS: Baseline village and mother's characteristics were balanced between the arms after randomisation. Most villages were farming villages accessing health centres within 10 miles, with no schools but numerous village committees and representing all Gambia's three main ethnic groups. Mothers were mainly illiterate (60%) and farmers (92%); 24% and 10% of children under 5 years were reported to have diarrhoea and respiratory symptoms, respectively, in the last 7 days (dry season). Intervention process engaged whole village members and provided lessons for future implementation; culturally adapted performing arts were an important element. CONCLUSION: This research has potential as a new low-cost and broadly available public health programme to reduce infection through weaning food. The theory-based intervention was widely consulted in the Gambia and with experts and was well accepted by the communities. Baseline analysis provides socioeconomic data and confirmation of Unicefs Multiple Indicator Cluster Survey (MICS) data on the prevalence of diarrhoea and respiratory symptoms in the dry season in the poorest region of Gambia. TRIAL REGISTRATION NUMBER: PACTR201410000859336; Pre-results.

Simultaneous Measurement of Zinc, Copper, Lead and Cadmium in Baby Weaning Food and Powder Milk by DPASV.

Apart from the breast milk, infant formula and baby weaning food have a special role in infant diet. Infants and young children are very susceptible to amount of trace elements. Copper and zinc are two elements that add in infant food. Lead and cadmium are heavy metals that enter to food chain unavoidably. DPASV is a benefit and applicable method for measurement of trace elements in food products. In this study, concentration of zinc, copper, lead and cadmium in four brands of baby food (rice and wheat based) and powder milk was analyzed with DPASV and polarograph set. Total Mean ± SE of zinc, copper, lead and cadmium in baby foods (n = 240) were 11.86 ± 1.474 mg/100g, 508.197 ± 83.154 µg/100g, 0.445 ± 0.006, 0.050 ± 0.005 mg/Kg respectively. Also these amount in powder milk (n = 240) were 3.621± 0.529 mg/100g, 403.822 ± 133.953 µg/100g, 0.007 ± 0.003, 0.060 ± 0.040 mg/Kg respectively. Zinc level in baby food type I was higher than lablled value (P = 0.030), but in other brands was not difference. Concentration of copper in all of samples was in labeled range (P > 0.05). In each four products, level of lead and cadmium were lower than the standard limit (P < 0.05). Amount of zinc and lead in baby food I, had difference versus other products. Concentration of zinc, camium in baby food type I, was higher than type II (P = 0.043, 0.001 respectively). Concentration of lead and cadmium in baby food type II, was higher than infant formulas, but are in standard limit.

Formulation and nutritional evaluation of weaning food processed from cooking banana, supplemented with cowpea and peanut.

The possibility of processing a ready-to-eat nutrient-rich weaning food (WF) for infants within the age group of 0.5-0.9 years from cooking banana fortified with popular and affordable legumes (cowpea and peanut) was investigated with the aid of computer software and available technology in Nigeria. A composite of 47% cowpea, 40% ripe banana, and 13% peanut was processed, analyzed to compare the actual nutrient composition to that predicted by the software and that of two popular commercial WFs produced by Gerber Products Company: rice with banana (RB) and oats with banana (OB). Proximate composition was determined by Association of Official Analytical Chemists (AOAC) methods, in vitro digestibility by the pH drop method, and amino acid was determined using high performance liquid chromatography. Essential amino acid values were comparable to the predicted values. Protein and oil contents had values of 16.89% and 8.38%, 6.9% and 1.10%, and 12.03% and 3.16% for WF, RB, and OB, respectively. Octadecenoic (oleic) acid had the highest value of 3.65% followed by octadecadienoic (linoleic) acid with a value of 2.64% amounting to 76.69% of the total fatty acid. Total sugar content of WF was recorded as 15.96 g/100 g, with fructose having the highest value of 8.07 g/100 g, followed by dextrose with a value of 7.66 g/100 g. In vitro-digestibility was in the order OB>WF>RB. The results show that it is feasible to produce precooked WF which has the potential to meet the nutritional needs of an infant, from local staples using computer-assisted technique and inexpensive technology available in Nigeria.

[Knowledge and practices of the mothers of children from 6 to 18 months relative to the conduct of weaning: cases from the general hospital of Marcory]. / Connaissances et pratiques des meres d'enfants de 6 a 18 mois relatives à la conduite du sevrage: cas de l' hôpital général de Marcory.

Weaning is a high-risk phase in the life of infants around the world, because poorly managed, it raises protein-energy malnutrition to levels causing crucial problems to the health of infants. AIMS: The purpose is to estimate the knowledge and the practices of the mothers regarding the conduct of food weaning of their children aged 6 to 18 months. MATERIALS AND METHODS: We conducted a descriptive cross-sectional survey at the general hospital of Marcory in Abidjan-CI on a sample of 100 mother-child pairs who came to consult. RESULTS: It emerges from this survey that.The mothers are young, with 94% younger than 35 years old. 88% of the mothers were of a low socioeconomic level. Dietary restrictions still remained a real obstacle to a better practice of weaning.The vast majority of the mothers (74%) ignore the notion of weaning and 40% of them had no information regarding this process. Food weaning was not conventional with an early weaning at 1 to 6 months in 38% of the cases and a late weaning (30%) after 13 months. CONCLUSION: It is necessary to set up a program focusing on the adequate conduct of weaning in infants to improve mothers' knowledge and the practices.

Le sevrage constitue une phase à haut risque dans la vie des nourrissons dans le monde , car mal conduit, le sevrage hisse la malnutrition protéino énergétique au rang des problèmes cruciaux de santé chez les nourrissons. OBJECTIF: Le but est d'évaluer les connaissances et les pratiques des mères concernant la conduite du sevrage alimentaire de leurs enfants âgés de 6 à 18 mois. MATERIEL: Nous avons réalisé une enquête transversale descriptive à l'hôpital général de Marcory à Abidjan-CI sur un échantillon de 100 couples mères enfants venus consulter. RESULTATS: Il ressort de cette enquête que.Les mères sont jeunes puisque 94% des mères avaient moins de 35 ans.88% des mères étaient d'un niveau socio économique bas. Les interdits alimentaires restaient encore un réel obstacle à une meilleure pratique du sevrage.La grande majorité des mamans (74%) méconnaissent la notion de sevrage et 40 % d'entre elles ne disposaient d'aucune information. Le sevrage alimentaire n'était pas conventionnel avec un sevrage précoce d'1 à 6 mois dans 38% des cas et un sevrage tardif (30%) au delà de 13 mois. CONCLUSION: Il faut mettre en place un programme axé sur la conduite adéquate du sevrage des nourrissons pour améliorer les connaissances et pratiques des mères.

Development and Evaluation of Weaning Foods Using Locally Available Nutritious Fruits in Bangladesh

Bangladesh has one of the highest rates of malnutrition in the world although the country is endowed with agricultural produce that could be properly utilised to prepare adequate food for children. Considering this, three weaning foods were formulated using locally available cereals and nutritious fruits such as wheat, soya flour, jackfruit and mango. Methods: Standard procedures of Association of Official Analytical Chemists (AOAC) and American Public Health Association (APHA) were used to determine the chemical composition and microbiological analysis. Organoleptic qualities were analysed by twenty adult panelists of the Institute of Food Science and Technology, Bangladesh, using a 9-hedonic scale against a cereal based commercial brand as standard for proximate and sensory properties. Results: The moisture content of the developed weaning foods ranged from 2.78-3.59%, crude protein content 14.74-16.55%, fat 11.04-12.70%, ash 1.38-1.68%, crude fibre 1.04-1.52%, carbohydrate 65.83-71.09% and energy content from 445.80-465.48 kcal/100g of the foods. The formulated weaning foods A, B and C were significantly different (p<0.05) in moisture, protein, fat, carbohydrate and energy contents from the commercial brand, D. According to rat bioassay method, the prepared weaning foods C and B had the highest Protein Efficiency Ratio and Feed Efficiency Ratio than the commercial brand, D. Total bacterial counts were nil for all weaning foods. Sensory analysis revealed acceptability of all the weaning foods and preference for weaning food C that compared favorably with the standard in all the quality attributes. Conclusion: The formulated weaning foods are inexpensive and nutritious, and its ingredients are locally available. These foods have the potential for improving malnutrition problems facing children in Bangladesh.

A Case of Barley Anaphylaxis due to Infant's Weaning Food / 소아알레르기및호흡기학회지

Barley is not a rare dietary content in Asian food but very few cases of anaphylactic reactions to barley have been reported. Furthermore, most reports are in adult patients with allergic reactions to beer containing barley components or occupational asthmatics known as 'baker's asthma'. We present a case of 11-month old boy who experienced an episode of anaphylaxis with generalized urticaria, periorbital swelling, wheeze and dyspnea after eating baby food containing barley, chestnut, glutinous rice, nonglutinous rice, within 30 minutes. Laboratory tests demonstrated high total serum IgE (531 kU/L) and revealed high level of IgE sensitizations to wheat (64.3 kU/L), barley (35.2 kU/L), rice (1.39 kU/L). Using the IgE-immunoblot assay, 7, 14, 25, and 26 kDa of IgE binding bands were identified and high degree of IgE cross-reactivity between barley and wheat extracts were revealed using IgE-immunoblot inhibition and ELISA-inhibition tests in this case.

Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants / 대한소아소화기영양학회지

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional problems, despite a recent improvement of nutritional status of infants and children. We assessed the risk factors for IDA in infants and vitamin D deficiency and IDA by nutrition analysis. METHODS: We analyzed blood tests and evaluated 103 children with IDA and 123 children without IDA, 6-36 months of age, who were cared for in our hospital between March 2006 and July 2010. Nutritional analysis using Canpro was performed among breastfed infants 6~12 months of age who had been diagnosed with IDA and had detailed diet histories. RESULTS: Breastfed infants accounted for 87.4% and 40.7% of the IDA and comparison groups, respectively. The IDA and comparison groups began weaning food at 6.4+/-1.8 and 5.9+/-1.3 months, respectively. In the IDA and comparison groups, 46.4% and 53.5% began to adapt to weaning food within 4 weeks, respectively. The most common reason for hospital care of the IDA group was respiratory symptoms constituting 36.2%. Only 18.6% visited the hospital for palloror anemia. The Canpro analysis, performed on 11 infants with IDA, showed that iron and vitamin D were <40% and 30% of recommended intakes, respectively. CONCLUSION: Weaning food should be started 4~6 months of age in breastfed infants. In infants at high risk for IDA and vitamin D deficiency, screening tests should be recommended. The high-risk infants may require iron, vitamin D fortified formula, or oral supplements.

Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants / 대한소아소화기영양학회지

PURPOSE: Iron deficiency anemia (IDA) is one of the most common nutritional problems, despite a recent improvement of nutritional status of infants and children. We assessed the risk factors for IDA in infants and vitamin D deficiency and IDA by nutrition analysis. METHODS: We analyzed blood tests and evaluated 103 children with IDA and 123 children without IDA, 6-36 months of age, who were cared for in our hospital between March 2006 and July 2010. Nutritional analysis using Canpro was performed among breastfed infants 6~12 months of age who had been diagnosed with IDA and had detailed diet histories. RESULTS: Breastfed infants accounted for 87.4% and 40.7% of the IDA and comparison groups, respectively. The IDA and comparison groups began weaning food at 6.4+/-1.8 and 5.9+/-1.3 months, respectively. In the IDA and comparison groups, 46.4% and 53.5% began to adapt to weaning food within 4 weeks, respectively. The most common reason for hospital care of the IDA group was respiratory symptoms constituting 36.2%. Only 18.6% visited the hospital for palloror anemia. The Canpro analysis, performed on 11 infants with IDA, showed that iron and vitamin D were <40% and 30% of recommended intakes, respectively. CONCLUSION: Weaning food should be started 4~6 months of age in breastfed infants. In infants at high risk for IDA and vitamin D deficiency, screening tests should be recommended. The high-risk infants may require iron, vitamin D fortified formula, or oral supplements.

Survey on the Awareness of Guardians of Young Infants on the Weaning of Food in Pohang and Gyeongju Area / 대한소아소화기영양학회지

PURPOSE: This study was carried out to investigate the awareness of the weaning of food using questionnaires, and the relationship with the weight gain in young infants. METHODS: From September 2005 to December 2005, we performed a survey on 141 guardians of young infants aged from 6 to 18 months, who visited the pediatric out-patient department at Dongguk University Medical Center. We calculated the total score for each responder from ten questions on the weaning of food and assessed the body weight percentile of each of the young infants. RESULTS: The most commonly reported information source for weaning food was 'the friends around' by 62 respondents (44.0%); 54 (38.3%) responded that the definition of weaning food was the preparatory step before starting a solid diet. Most used a spoon (90.8%) to feed when weaning food with a thin gruel of rice (78.7%). The time for weaning of food was before breast or infant formula feeding (55.3%). Addition of cow's milk was around 12 months (77.3%). The mean score was 6.21; however this did not show a statistically significant correlation with weight gain in young infants. CONCLUSION: The overall awareness of weaning of food has improved; however, information from doctors has decreased. Although the relationship between the awareness of weaning of food and the growth of young infants was not statistically significant, further studies on weaning of food, with larger and controlled sample sizes may provide important information.

NUTRITIONAL EVALUATION OF SEVERAL WEANING FOODS / 营养学报

In this study the nutritive value of 4 kinds of weaning foods containing soyflour were measured by chemical and animals experiments. The 4 experimental weaning foods were:1.This formula was developed by the Institute of Health collaborating the First Food Factory of Beijing. It was produced by the Factory and the trade name is "Baobao Le" The soybean was processed by the infra-red light.2.This formula was recommended by UNICEF (Formula No. 5). Soybean flour was treatded with the extruded method.3.This formula was the same as No. 2 (UNICEF Formula No. 5). In which the soybean was wet-heat treated. No. 2 and 3 samples were produced by Wu Xi Light Industry College.4.This formula was developed by the Institute of Shanghai Food Industry as formula D. Puffed soybean flour was used.The 2 control foods were:5.This formula was based on formula "5410". The sample was made by the First Food Factory of Beijing (trade name, "Nutritive Baby Powder").6.Infant Milk Powder, produced by the Child Milk Factory of Shuang Cheng Xian, Hei Long Jiang Province, cow's milk powder was used as the main source of protein. The protein content of the products were:No. 1 and 4, 19.0%, equal to the protein requirement for weaning foods; No.2 and 3, 15.8%, lower than No.1 and 4; Infant Milk Powder, 15.1%; Nutritive Baby Powder, 17.0%.From the results of the animal experiment on weaning rats with respect to growth, after 9 weeks of feeding, the average body weight of control group 5 and 6 increased by 185.8 and 180.5g respectively, which were significantly higher than 146.7 and 150.4g of the experimental groups No. 1 and 4. While the increased body weight of No. 1 and 4 were higher than group 2 and 3 (79.8g and 113.1g respectively). The increase of body lengths were of the same order of the 6 groups as that in body weight.Blood hemoglobin values were all normal (control groups 13.4 and 13.9g per 100 ml; experimental groups 13.9, 14.2, 13.0 and 13.0g).The weight of pancreas in the 4 experimental groups were all normal. It showed that the activity of trypsin inhibitor had been destroyed. Weights of thyroid of the rats were all within the normal range except group 1,2,3, which were a little bit heavier. Potassium iodide was.added into formula 1,2 and 3, to prevent hyperthyroidism but since potassium iodide is easily to evaporate, so it would be perferable to use potassium iodate instead.The above results indicated that the growth promoting effect of the 4 weaning foods is lower than the two baby powder, but they are good weaning foods for baby after six months. "Baobao Le" and formula No 6 are much better.

Survey on the Pattern of Food Intake during Early Childhood and Allergic Disease / 소아알레르기및호흡기학회지

PURPOSE: Change of foods intake during infancy and early childhood is being indicated as a causal factor for recent dramatic increase in the number of allergic diseases in children. The food allergens may have an important role for the development of allergic diseases including atopic dermatitis in children. Early prevention and treatment of atopic dermatitis are important to prevent of allergic disease later in life. METHODS: The questionaire survey about the diet patterns of their children and the parents' awareness and knowledge on the relationship between food and allergy was performed for the parents of 316 patients aged under 48 month old at 7 university hospitals (4 allergy clinics and 3 general clinics) or 4 private clinics in September, 2002. RESULTS: Formular fed is more common in all age group and it comprised over 70% in the group under age 6 month old in compare with breast milk fed. The mean age of the start of weaning was 5.2+/-1.8 months in a child with a history of allergy, and 4.6+/-2.0 months who had no allergy history. The most common reason to start weaning was nutritional supplement and the next was to train for adult foods. Fruit juice was the first introduced weaning food in most cases. Among 316 children, 108 children had experience of having grain diet, live diet or natural diet for better nutrition. More than half of the parents had relatively correct knowledge about allergy such as the relationship between food and allergy especially in the group with a allergic disease. Many parents started grain diet, live diet, a soup of bone, and the white of an egg to their children under 12 months of age. CONCLUSION: In general, most of the parents enrolled had relatively correct information about the time and the purpose of weaning. However, their knowledge about the kinds of food and time of first exposure is at issue to be pointed out. Especially as a point of view for early intervention of allergic disease, continued more active education about the food allergens and their relation to allergic diseases are strongly recommended.

THE RELATIONSHIP BETWEEN THE DIET AND THE GROWTH OF INFANTS DURING THE WEANING PERIOD (6-18 MONTHS) / 营养学报

The growth curves and diet of 185 babies in rural area near Beijing from 6 months to 18 months old have been studied. Infants were divided into 3 groups according to their diet taken:(1) 89 babies had breast milk only;(2) 66 babies took more than 250g animal milk per day besides breast milk;(3) 30 babies who did not have breast milk and only animal milk was taken. All the babies were gradually transferred to an ordinary cereal based diet during the weaning period. To half of them a soybean and cereal based formula fortified with minerals and vitamins was supplied, which would provide 6.6g protein and 141 kcal and some other nutrients per day.The results showed that the growth curves of body weight and height of children were much better than the data obtained in 1975, but still lagged behind that of the urban children, especially for the body weight. The weight curves of the babies who took animal milk seemed higher than the other groups. Female babies who were fed with breast milk and supplemented with the weaning food have a better weight and height curves than non-supplemented ones, but this was not seen in males. The hemoglobin contents of the babies who took animal milk when they were 18 months old were lower than that of the 6 months old, but there were no differences in the breast milk groups, and the lowering of the hemoglobin level in the animal milk groups could be corrected by adding weaning food in the diet. When the babies were 6 months old, 39.3% of them had a hair zinc content below the lower limit of the normal range, and it became to 47.6% when they were 18 months old. So zinc deficiency of the babies were present in this local area, and it should be fortified into the weaning food.