Both nutritional status and growth were well within reference values in the 2 groups, and the selection of a formula can largely be made on the basis of infant tolerance to the formulas.
Earlier diagnosis and stricter dietary regimes improved the survival rates and clinical course of patients with LCHADD in Finland. However, improvements in therapy are still needed to prevent the development of long-term complications, such as retinopathy and neuropathy.
The nutritional status of children with cow's milk allergy was followed during an elimination diet in 19 children (9 boys and 10 girls) beginning at the mean age of two years (range 0.6-4.1 years). The cow's milk allergy had been verified in hospital by a challenge test at a mean age of 0.9 years (range 0.2-1.9 years). Weight, height and laboratory indices to test protein, mineral and vitamin status were measured at three follow-up visits at three-month intervals. In addition to cow's milk allergy all these children had some other food allergies, and six of the 19 children were allergic to soy protein. Only two of the 19 children were given a soy-based formula. In the diets of the other children, cow's milk was replaced by increasing amounts of other foodstuffs and supplementary calcium. At the beginning of the study the relative heights of the children were slightly retarded (-0.6 SD) and remained unchanged during follow-up (-0.8 SD at the end of the study). The relative weights were found to be decreased during follow-up (p less than 0.05). There was a significant reduction in serum prealbumin values; eight of the 19 children showed abnormally low values. Low serum zinc values were seen in 12 children. Serum iron concentration was low in two children and two had high serum alkaline phosphatase values. Seven-day food recording indicated that dietary intake of energy was below the recommendation in some children, but protein intake was high. Some children had low intakes of riboflavin.(ABSTRACT TRUNCATED AT 250 WORDS)
Insufficient energy and nutrient intake is common in children with motor disability. This may have adverse health effects especially when associated with low vitamin D intake. Energy and vitamin D supplements should be considered.
Both nutritional status and growth were well within reference values in the 2 groups, and the selection of a formula can largely be made on the basis of infant tolerance to the formulas.
The most demanding patient population on peritoneal dialysis (PD) consists of children under 2 years of age. Their growth is inferior to that of older children and maintaining euvolemia is difficult, especially in anuric patients. In this prospective study reported here, we enrolled 21 patients <2 years of age (mean 0.59 years) at onset of PD and monitored their uremia parameters and evaluated their nutrition. Since no good instrument currently exists for estimating intravascular volume status, we used traditional blood pressure measurements, echocardiography, and N-terminal atrial natriuretic peptide measurements. Growth was compared with midparental height. Metabolic control was good. Long-term hypertension was seen in 43% of the patients, but left ventricular hypertrophy decreased during the study period. Mean weekly urea Kt/V was 3.38 ± 0.66 and creatinine clearance was 49 ± 20 L/week per 1.73 m2. Catch-up growth was documented in 57% of the patients during PD. However, these children did not attain their midparental height at the end of PD at a mean age of 1.71 years. Although favorable metabolic control and good growth were achieved during PD, these children lagged in term of their midparental height. We conclude that several instruments are needed for determining the management of intravascular volume status and that the control of calcium–phosphorus status is demanding.
Gas chromatography has been applied for the analysis of organochlorine compounds of 49 samples of human milk. The average total DDT (2,2-bis(4-chlorophenyl)1,1,1-trichloroethane) content in human milk was found to be 0.058 mg/kg (1.57 mg/kg milk fat, with a range of 0.54-4.00 mg/kg). Thirty-four cases contained traces of dieldrin, but the content of dieldrin reached 0.008 mg/kg in only one milk sample. The average content of PCB (polychlorinated biphenyls) was 0.024 mg/kg of human milk, with a range of 0.011-0.054 mg/kg (0.65 mg/kg of milk fat with a range of 0.33-1.10 mg/kg). The ratio of DDT metabolites/DDT varied from 1.1 to 7.8 (mean 2.8). Studies were also made of the effect of the weight, weight loss, diet, smoking habits and parity of the nursing mother upon the content of organochlorine compounds in human milk. A significant positive correlation was observed between the DDT content of human milk fat and cigarette smoking. The average daily intake of total DDT for Finnish breastfed babies was calculated to be 0.0093 mg/kg, 1.9 times more than the daily intake of 0.005 mg/kg indicated by FAO/WHO as the acceptable value.
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