Summary and conclusionsThe patterns of response of oxytocin to a breast feed were studied in 10 mothers in the first week post partum. The initiation of lactation did not appear to be related to release of oxytocin. In established lactation an oxytocin response did not appear to be essential for adequate milk flow and did not occur always at the time of peak milk flow. The only factor identified that positively correlated with release of oxytocin was multiparity. In those subjects who showed a response the hormone was released in surges, some of which persisted in the circulation for less than one minute.These findings cast some doubt on the conventional view that release of oxytocin is essential for satisfactory milk flow during breast-feeding.
lation in target organs and to establish the role of aggregated immunoglobulins and heparin in complement activation.We thank our surgical colleagues Mr J R W Keates and Mr A Forsyth for permission to study patients in their care and all the technical staff of the cardiothoracic unit under the direction of Mr A Pastellopoulos. We are grateful to Miss D J Wright for the statistical computations. This study was funded by the British Heart Foundation and by the King's College Hospital joint research committee for locally organised research. Latent anaphylactic sensitisation of infants of low birth weight to cows' milk proteins A LUCAS, P McLAUGHLAN, R R A COOMBS Abstract Latent systemic anaphylactic sensitisation to cows' milk was assessed in 61 preterm infants who were randomly assigned to receive either a special formula for preterm infants based on cows' milk or banked breast milk or one or other of these as a supplement to maternal milk. A single sample of venous blood was taken near to the time of discharge from the neonatal intensive care unit, and the histamine release by blood basophils in response to in vitro challenge with cows' milk and anti-IgE was measured. Compared with the blood from infants fed on human milk, that from infants fed on preterm formula showed a significant increase in histamine release to challenge with cows' milk, the response being greater in blood from infants of lower birth weight and gestational age. A smaller but significant increase in blood histamine release with anti-IgE challenge was observed in the group fed on preterm formula. Infants of low birth weight fed on preterm formula based on cows' milk may develop latent systemic sensitisation more rapidly than infants born at term. The clinical importance of this requires further investigation. References
An investigation was made of long-term variation in oxygen consumption rate (VO2) in preterm infants. Four subjects (gestational age 27–34 weeks, postnatal age 17–38 days, weight at study 1.1–2.6 kg) were studied for 5 days each using open-circuit, indirect calorimetry. The mean VO2 for each subject (11.0–11.5 litres/kg/day) was within the reported range. However, the between-subject coefficient of variation during the study (2.1 %) was smaller than the mean between-measurement coefficient of variation for daily VO2 (3.8%, range 1.7–6.3%). In addition, the between-measurement coefficient of variation was increased further for measurement intervals of less than 24 h (reaching a mean of 8.3% for 1-hour periods), and a relationship between measurement duration and the precision of estimating VO2 over 3 or 5 days is described. Thus, even 24-hour measurements of VO2 in these preterm infants were less representative of the individual’s VO2 over 3 days than the group mean estimate. This finding is of relevance to future studies in this area, particularly those in which short-term measurements of energy expenditure are combined with a nutrient balance study to determine the composition of weight gain, because even small errors in the estimate of total energy expenditure can lead to unacceptably large errors in calculated energy deposition.
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