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ABSTRACT:To investigate the effects of fermented formula (FF) with Bifidobacterium breve C50 and Streptococcus thermophilus 065 on thymus size and stool pH of healthy term infants, ultrasound examinations and evaluations of thymus sizes and thymus indices (TI) and measurements of stool pH were performed in the same 90 term neonates on the 3rd d of life and on the 1st, 2nd, 3rd, and 4th mo of life. Thirty newborns were exclusively breast-fed while the remaining 60 were randomly assigned to receive either a FF or a standard formula (SF). The fecal pH of the breast-fed group was lower than the SF group (p Ͻ 0.05), although it was similar to that of the FF group on the third postnatal day, persisting for the entire 4 mo of the study. The difference in TI was statistically significant over repeated measurements among the groups. The FF infants showed a TI similar to the breast-fed newborns. Probiotic fermentation products have effects comparable to those of the bacteria composing the intestinal microflora supporting the idea that intestinal bacterial balance plays an important role in improving host immune responses. T he principal components of human milk modulating immune responses are immunoglobulin immune cells -macrophages, neutrophils, and lymphocytes -and humoral factors -lactoferrin, lysozyme , and hormones (1,2) that interact with the intestinal microflora during postnatal breast-feeding. The stool microflora of the breast-fed infant is predominantly composed of bifid-bacteria (3). The thymus provides the environment for T lymphocyte maturation. Sonographic studies show that the thymus grows until 8 mo of age decreasing to a stable size around 12 mo of age (4,5). Thymus size is dependent on whether the infant is breast-fed; the thymus size of breast-fed infants is twice the size of formula-fed infants at 4 mo of age (6). Now it is clearly known that infant feeding can modify the balance of intestinal flora and thus influence local and general immune response. One way to achieve this is using fermented formula, or formula containing probiotics or prebiotics (7,8). These products have been shown to have an effect on intestinal homeostasis and intestinal inflammation (9) and have been used to prevent and treat acute diarrhea. A new infant formula fermented with Bifidobacterium breve C50 and Streptococcus thermophilus 065 (FF) has been developed. These particular lactic-acid producing bacteria were selected because in vitro -in animal and human studies -they have been shown to have an effect on immune response and exert antiinflammatory effects on gut-associated lymphoid tissue (GALT) (10,11). We hypothesized that fermented formula would result in a higher thymus index (TI) and a lower fecal pH over the first 4 months after birth mimicking the effects of breast milk. MATERIALS AND METHODSInclusion and exclusion criteria. Over a period of 6 mo, healthy newborns born at the Department of Neonatology of the University of Bari were considered eligible to be included in the study. Newborns were selected on the basi...

Cystic hygroma and lymphangioma, currently defined as ‘lymphatic malformations', are developmental abnormalities of the lymphoid system with potential for rapid expansion. The management of these abnormalities depends on the site and extent of the lesion. A different disease is diffuse lymphangiomatosis. It is very rare at birth and its treatment remains controversial. A lymphatic malformation (cystic hygroma) of the neck of a newborn girl as the first sign of diffuse lymphangiomatosis and treatment of the latter condition with sirolimus are presented. A newborn girl with a presumed isolated lymphatic malformation of the neck and significant respiratory involvement was diagnosed via total-body nuclear magnetic resonance imaging to be affected by diffuse lymphangiomatosis; she was treated with sirolimus. The treatment with sirolimus was found to be very effective, with complete resolution of the disease, good tolerability, and no side effects. This report suggests the need to explore the possibility of diffuse lymphangiomatosis in neonates with apparently isolated lymphatic malformations. In the presence of clinical deterioration, sirolimus treatment may achieve excellent results with no adverse events.

A decreased perfusion index value in the preanesthesia phase of elective cesarean section is a maternal predictor of increased neonatal morbidity and is significantly related to subclinical placental inflammatory disease. These observations suggest the feasibility of a noninvasive pulse oximeter prenatal screening of the high-risk fetus/newborn in elective cesarean section.