This work was car'red out in the Neonatal Intensive Care Unit at Groote Schuur Hospital, Cape Town, from July, 1972, to December, 1973, under the guidance of Dr. A.F. Malan. This was a newly opened Unit for Coloured and African Neonates requiring special care, well-equipped with trained staff and good monitoring apparatus. For the first time it was possible to provide facilities for patient care in line with those available abroad. The problem of feeding preterm infants has interested many authors (Abramowicz, 1966; Babson, 1971; Gamsu, 1972). The ideal quantity, content of nutrients, calorific value and mode of administration of feeds remains, at best, approximate. With the advent of Total Parenteral Nutrition (TPN) and the availability of relatively safe solutions of fats and amino-acids for intravenous use, interest has been stimulated in the optimal nutrient and caloric requirements of the growing infant.

No description available.

The continent of Africa is inhabited by about 270 million persons of whom about 60 million are Bantu. They dwell mainly south of the Equator. South African Bantu number about 11 million persons, of whom under a third are urbanised, and over a third each work on farms of Whites or live in the Native Reserves. These local Bantu are comprised of several ethnic groups, the largest of which are Zulu and Xhosa. While some communities of rural Bantu still live in a primitive manner. others, mainly in urban areas, tend progressively to adopt a westernised type of diet and manner of life. The Bantu may therefore be observed in all stages of transition, in relation to patterns of diet, metabolism, and pathology. The studies undertaken and to be described concern primarily the nutrition of infants and children, the prevalence of certain deficiency diseases, and the handicap imposed by parasitism on nutritional state and other parameters.

WIC food packages are undergoing major revisions to accommodate the unique requirements of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the twenty-first century. This dissertation is an evaluation of the impact of the revised WIC food packages through national-level surveys obtaining data before and after food package changes. In addition, a community-level metabolic/dietary study of obese women consuming either the original or revised food packages was performed. Since WIC has never revamped its entire program before, this is an opportunity to learn more about the impact of the revisions on WIC participants across the country, including Native Americans from Indian Tribal Organizations (ITOs). The National Food and Nutrition food frequency questionnaire (NATFAN) evaluates food and consumption practices of WIC participants, including Native Americans, for both the original and revised WIC food packages. The baseline surveys (NATFAN') were administered before the 2009 rollout of the revised WIC food packages (dates varied by state program). The post-rollout surveys (NATFAN'') were administered spring through winter of 2010-2011, and at least six months after the implementation of the revised WIC food packages. Hierarchical linear modeling, with restricted maximum likelihood approximation, was used to evaluate 100% juice, fruit, and vegetable frequency of consumption based upon NATFAN' and NATFAN'', including samples from states, territories, and ITOs. This research is important because it was national in scope and analyzed nutritional behaviors of a Native American subpopulation of WIC that is seldom documented in national nutrition research. For the metabolic/diet study, obese women 185% of the poverty level were given the original or revised WIC food packages (n=3). Three venous blood serum collections (0, 6, 12 weeks) were biomarker tested (cholesterol, glucose, C-reactive protein, etc.) in lipid and metabolic panels. Three, seventy-two hour dietary recalls were also assessed to determine fruit and vegetable consumption changes over the course of the study. This phase was important because it focused on the individual's actual consumption behaviors of specific WIC foods dispensed in the WIC food packages and assessed how such consumption affected the health of the individual.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 68-72).

MSc (Med), Child Health, Faculty of Health Sciences, University of the Witwatersrand, 2011 / Background: The long term effect of infant nutrition on later body composition has gained global attention since the developmental origins of health and disease because of the association between early life outcomes and later adult health (1). Under-nutrition and growth faltering during prenatal and infant periods have been reported to be related to subsequent growth faltering, high fat mass, and low lean and bone mass. Early life nutritional environmental cues may cause permanent effects on the physiology, metabolic and endocrine system of the body. Objective: We investigated the association of infant nutrition and anthropometry with subsequent child anthropometry and body composition at age 9/10 years. Design: This study comprised of 140 children who had infant growth measures and dual-energy X-ray absorptiometry (DXA) conducted at age 9/10 years. They were selected from the Bone health sub-study of 408 black children of the Birth-Twenty longitudinal study cohort comprising of children born in Soweto, Johannesburg in 1990. Data collection and analysis: Data was collected on following variables; infant feeding, socio-economic status at delivery, anthropometry (birth weight, height and weight at ages 1, 2, 9/10 years). Body composition data was obtained from DXA scans. Food frequencies questionnaires were used for dietary patterns data collection. Data cleaning and analysis of data which encompassed descriptive, bivariate and multivariate analyses were done in STATA 10 and the 5% level of significance was used for statistical significance. Results: Children were breast-fed on average for 13 months in boys and 16 months in girls (p=0.009) while those bottle fed had a duration of 10 months for both sexes. Introduction of solid foods was around 3 months while the approximate mean dietary diversity score (the number of food groups consumed by an infant in a 24-hour recall period) was 1 and the food iv variety score (the number of food items consumed by an infant in a 24-hour recall period) was 2 for both girls and boys. Prevalence of stunting, wasting and underweight at 1 year was 8.6%, 3.6% and 8.6% respectively. At age 2 years, the prevalence was 15.7%, 8.6% and 16.4% for stunting, wasting and underweight, respectively. All the associations between infant nutrition variables and subsequent growth and body composition at age 9/10 years were statistically non-significant. In the multivariate model, increase in birth weight predicted an increase in weight and height at ages 1, 2 and 9/10 years, lean mass (β=0.20, CI=0.01-0.03, p=0.007), radius (β=0.02, CI=0.00-0.04, p=0.039) and lumbar spine (β=0.03, CI=0.01-0.05, p=0.018). Infant weight and height at 1 year were significantly positively associated with subsequent growth at 2 and 9/10 years and with body composition variables. Stunting at age 1 year was significantly associated with lower fat mass (β= -0.18, CI= -0.03 to -0.06, p=0.003) while stunting at age 2 years predicted lower fat only (β= -0.12, CI= -0.22 to -0.03, p=0.011) after adjusting for confounders. Being underweight at age 2 years predicted lower fat mass in the multivariate model. Conclusion: Infant nutrition had no significant influence on subsequent growth and body composition. Birth weight and infant anthropometry; particularly height, weight, stunting and underweight are the main predictors of body composition at age 9/10 years. There is need for promotion of optimal prenatal and infant growth in children to reduce risk of chronic diseases like Type 2 diabetes, hypertension and osteoporosis in later life.

Background: Docosahexaenoic acid (DHA), choline and uridine-5-monophosphate (UMP) are important brain nutrients which form phosphatidylcholine, the most abundant brain membrane phospholipid. DHA, choline and UMP supplementation increases rodent brain phospholipids, synaptic components, functional brain connectivity and cognitive performance. This novel pilot study supplemented infants at risk of neurological impairment (ARNI) with a nutrient combination containing these neurotrophic compounds. Aims: 1) In a double blind randomised control trial (RCT), investigate if intake of a specific nutrient combination improves neurodevelopmental and visual outcome in infants ARNI. 2) Using novel measures of cortical visual function, investigate the effect of perinatal brain injury severity, gestational age at birth and sex upon visuocognitive development in infants at risk of neurodevelopmental impairment. Method: Recruitment was from UK neonatal units. Eligibility: ≤ 31 weeks, weight < 9th percentile; < 31 weeks with ≥ Grade II intraventricular haemorrhage (IVH) or preterm white matter injury (PWMI); 31-40 weeks with ≥ Grade II IVH or PWMI, ≥ Sarnat Grade II HIE or defined brain MRI abnormalities. Stratification was by sex, gestation and brain injury severity. Randomised infants received neurotrophic supplementation or placebo, for 2 years. Primary outcome was Bayley Scales of Infant Development III (BSID III) composite cognitive score (CCS) after 2 years. Secondary outcomes included BSID III composite language score (CLS) and BSID III composite motor score (CMS). Cortical visual measures were pattern reversal visual event related potential (PR-VERP) latency (transient and calculated), orientation reversal visual event related potentials (OR-VERP), and the Fixation Shift test (FS). Functional behavioural vision was assessed using the Atkinson Battery of Child Development for Examining Functional Vision (ABCDEFV). Local Ethics Committee approval was granted. Results: 62 neonates were recruited. After 2 years, mean CCS in the intervention group was 87.7 (SD 20.4) and 81.6 (SD 18.5) in the placebo group (mean difference = 2.28, p=0.13; -0.2, 18.2). Mean CLS in the intervention group was 91.5 (SD 20.1) and 83.2 (SD 19.6) in the placebo group (mean difference = 2.74, p=0.1; -2.4, 18.3). CMS was similar in both groups. In relation to trial visual outcome measures, more infants in the placebo group gave a statistically significant OR-VERP response than in the intervention group (p=0.03). There were no statistically significant differences between the placebo and intervention on any other trial visual outcome measure. Cohort analyses indicate that transient PR-VERP latency is prolonged in children at risk of neurodevelopmental disability compared to typically developing infants (mean difference = -23.3, p=0.015, 95% CI -42.10 - -4.54). Calculated PR-VERP latency is prolonged to an even greater extent in children at risk of neurodevelopmental disability compared to typically developing infants (mean difference -148.6, p=0.000, 95% CI -179.7- -117.43), and remains prolonged across the age range tested. Conclusions: 1) The difference in CCS and CLS between intervention and placebo groups represents a clinically significant effect size. Use of neurotrophic micronutrient supplementation in infants ARNI warrants exploration in a large multicentre RCT. 2) Calculated PR-VERP latency may be a more appropriate outcome measure of cortical visual function than transient PR-VERP latency in infants at risk of neurodevelopmental disability.

Thesis (Ph.D.). / Written for the School of Physical and Occupational Therapy. Title from title page of PDF (viewed 2008/01/12). Includes bibliographical references.

In early Infancy, limited ingestion of vitamin E, especially the α-tocopherol form, and/or a high, intake of polyunsaturated fatty acids are reflected as a low serum tocopherol level. This vitamin E deficiency state is probably responsible for the development of an anemia characterized by abnormal erythrocyte hemolysis. Edema and skin changes may also be present. In order to ascertain the tocopherol status of infant formulas available in Canada, thirty-six representative formulas were chemically analyzed for vitamin E and polyunsaturated fatty acid contents. For the tocopherol analysis, a combination of the Emmerie-Engel procedure and two-dimensional thin-layer chromatography was used. An alkaline isomerization technique was chosen for the polyunsaturated fatty acid analysis. The vitamin E status of the various formulas was assessed in relation to three criteria of tocopherol adequacy - the α-tocopherol-to-PUFA ratio, the α-tocopherol content, and the level of International Units of vitamin E. With the exception of one formula which was supplemented with vitamin E, the twenty-one formulas based on fresh or modified cow's milk often contained insufficient tocopherol to meet the various criteria of adequacy. A large per cent of the vitamin E content in these formulas was present as α-tocopherol. The polyunsaturated fatty acid content was relatively low. In general, the fifteen proprietary formulas had much higher levels of vitamin E and polyunsaturated fatty acids than the formulas based on fresh or modified cow's milk. For many of the proprietary products, α-tocopherol constituted only a small part of the vitamin E content. Four of the proprietary formulas (including three which had been fortified with vitamin E) contained sufficient amounts of vitamin E to satisfy the three standards of adequacy. On the basis of the chemical analysis results, it is recommended that all infant formulas be supplemented with sufficient amounts of vitamin E. to meet the various criteria of adequacy. In this way, the risk of vitamin E deficiency in early childhood should be minimal. The present study is also concerned with past, present, and future trends in infant feeding practices. In the 1960's, the ready-to-feed hospital feeding systems, which are usually based on a proprietary preparation,were introduced in Canada. A survey conducted among Canadian hospitals indicated that the use of such systems has become widespread. At the same time, the popularity of the hospital-prepared formula system has declined. Consequently, the use of modified cow's milk formulas has declined in Canadian hospitals. However, such formulas are frequently used for home-feeding of infants. No definite trends were noted in the frequency of breast-feeding. / Land and Food Systems, Faculty of / Graduate

Background: The introduction of solid foods is an important dietary event during infancy and is associated with a time of dramatic shifts in gut microbial composition. The influence of solid food introduction on gut bacterial dynamics remains understudied. Methods: 15 healthy, full-term, vaginally born, and breast-fed infants of the Baby, Food and Mi sub-study of the Baby & Mi Study were investigated. Caregivers were asked to collect daily stool samples and food diaries for 17 days, commencing three days prior to the introduction of solids. Additional stool samples were available up to one year as part of the Baby and Mi study. The exposure of interest, nutritional patterns, was analyzed using food composition output from ESHA’s Food Processor. The number of food items and food groups introduced were used to calculate dietary diversity scores. The outcome of interest, gut bacterial dynamics, was analyzed using RStudio. Results: The mean (SD) age at the introduction of solid foods is 5.5 (0.66) months (n = 15). Over the study period, the proportion of estimated energy intake from solid foods was low (7.5%; SD 6.74%) (n = 14). Alpha diversity increased over time and was highest at 1 year. The gut microbial community influenced by dominant bacterial taxa changed with increasing age. With introduction of solids, individual community composition changed, though to a varying extent. Shannon alpha diversity was directly associated with calories from carbohydrates, particularly daily fiber intake. The infant’s dietary diversity score was directly associated with alpha diversity and was also positively associated with the degree of change occurring in this time period. Conclusion: Fiber intake and the dietary diversity scores had the closest relationships to the gut microbiome’s alpha diversity and community structure in infants at the time of solid food introduction. / Thesis / Master of Science (MSc) / The introduction of solid foods is an important life-event during infancy. This is also when the gut microbiome is developing to its mature state. Since nutrition is an important factor influencing the microbiome, investigating the dietary choices at the introduction to solid foods is the aim of the following study. Here, daily stool samples and food diary entries were collected for 15 healthy, breast-fed infants. It is important to measure the diversity of the bacteria in the gut of an individual (alpha) and between people (beta), as well as bacteria present. Carbohydrates drive the change in alpha diversity, especially fiber. Feeding infants a diet with many different foods shows increased alpha diversity and change in the microbiome immediately after introduction. Interestingly, the infant gut microbiome reacts to fiber in a manner comparable to the adult gut microbiome, i.e. increased bacterial diversity, which is associated with better health outcomes in adults.