Regurgitation Of Milk Research Articles

Awareness about Neonatal Lactose Intolerance among Chinese Neonatologists in Outpatient Settings: A Multi-Center Survey.

This study aimed to identify the specific areas of knowledge gaps regarding lactose intolerance among neonatologists in Chinese outpatient settings as well as to assess the availability of lactose intolerance testing in hospitals. A total of 278 neonatologists in outpatient settings from 144 hospitals were surveyed. To explore the awareness level, diagnosis, and treatment of neonatal lactose intolerance among neonatologists in outpatient settings, a multicenter cross-sectional survey was designed. Descriptive analysis based on frequency and percent distribution was performed for all variables. Most respondents were senior doctors (256, 92.09%) from general hospitals and maternity/maternal and child health hospitals, had over 10 years of experience, and were dominantly associate chief physicians and chief physicians (211, 75.90%). A significant proportion of the participants (236, 84.89%) believed that neonatal lactose intolerance tends to be overlooked during clinical practice. When the most common symptoms of neonatal lactose intolerance were surveyed, diarrhea was selected by 142 (51.08%) respondents, followed by bloating and milk regurgitation or emesis (71, 25.54%). Other symptoms included unexplained crying (36, 12.85%), stool with milk flap or foam (15, 5.40%), and increased venting (14, 5.04%). Furthermore, the survey results indicated that the most common method for diagnosing neonatal lactose intolerance in the respondents' hospitals was qualitative test for urinary galactose (78, 28.06%). Of the respondents, 137 (49.28%) stated that their hospital could not test for lactose intolerance. For treating lactose intolerance, the neonatologists primarily opted for exogenous lactase rather than lactose-free formula milk. This study sheds light on Chinese neonatologists' awareness of neonatal lactose intolerance, revealing some knowledge gaps. The expeditious popularization and conduct of lactose intolerance-related examinations in hospitals will have a positive stimulative effect on the management of lactose intolerance in newborns.

Assessment of Incidence of Aspiration Pneumonia in Infants with Cleft Palate

Background: A cleft lip (CP) is characterized by a split in upper lip, which may extend into the nose. These abnormal fissures can cause difficulties with nutrition, hearing, speaking and recurrent respiratory and ear infections. Objectives: The study assessed the complications associated with the cleft palate in infants and the incidence of aspiration pneumonia. Methods: The study was conducted in tertiary care hospitals and pediatric clinics at District Dera Ismail Khan, from February 2021 to September 2022, comprising 141 CP patients. Results: The incidence of CP was seen 7.90% in District Dera Ismail Khan, which was higher in males (68.08%) than in females (31.91%). The mean age of the study group was 4.35+3.12, with birth weight and weight at the time of assessment being 3.85+1.78 and 23.78+15.19, respectively. Their mean maternal age and weight at the time of delivery were 32.91+9.07 and 61.65+21.56, respectively. A significant proportion (p<0.05) suffered from aspiration pneumonia (64.53%), while 19.85% of the patients had complained of recurrent pneumonia due to CP. Other complications included chest infection (43.26%), ear infection (8.51%), nasal obstruction (31.91%), vomiting during feeding (26.95%) and regurgitation of milk and other food materials (12.05%). Ten CP patients died (7.09%) due to the complications associated with this disorder. Practical implications: For infants with orofacial clefts, the incidence of LRTIs is potentially high, thus accumulated breastfeeding length might mediate the connections of CP. Conclusion: It was concluded that CP was significantly associated with pulmonary defects and caused fatal LRTIs in the affected population, especially in breastfeeding infants. Keywords: Cleft palate; Ear infections; Fetal defects; Genetic Disorders; Pulmonary infections.

Gastric aspiration in sudden unexpected infant death of Prader–Willi syndrome: immunohistochemical detection of feeding components

Prader–Willi syndrome (PWS) in infants is characterized by hypotonia and poor sucking with feeding difficulties. Two autopsy cases of sudden unexpected death during sleep after tube feeding are described herein. For one, gastric aspiration caused by the possible milk regurgitation was suspected. Immunohistochemical examination of lung sections was performed using three antibodies to human α-lactalbumin, human gross cystic disease fluid protein 15, and cow whey β-lactoglobulin. Five cases of sudden unexpected infant death occurring earlier than at 6 months old were selected as controls. Marked immune-staining for infant formula in one PWS subject was evident within terminal bronchioles and alveoli with granular and amorphous features. However, no positive staining was apparent in the other subject, who exhibited contrasting features in milk distribution. Among control cases, one showed mild staining in the bronchiole, but the others did not. The antibody to β-lactoglobulin reacted specifically with formula, with no nonspecific background. Gastric contents in the airway can be a difficult issue because of the consequent terminal gasping. However, because of an episode of antemortem symptoms of potential regurgitation, and from findings at autopsy such as petechiae, we inferred that fatal regurgitation occurred in this PWS infant after tube feeding. Several clinical reports have described milk aspiration, but this pathological report is the first related to aspiration in PWS during tube feeding.

Oesophageal ectasia as a cause of dysphagia and milk regurgitation in a neonatal foal

SummaryDysphagia and milk regurgitation are relatively infrequently observed clinical signs in neonatal foals but, when present, can commonly arise from anatomic or functional disorders of the upper airway. Less commonly, milk regurgitation can be caused by anatomic or neuromuscular disorders of the oesophagus. In the report presented here, a neonatal foal was examined for milk regurgitation at 4 days of age and was diagnosed with transient oesophageal ectasia via oesophagoscopy and contrast radiography. Aspiration pneumonia was treated with broad‐spectrum antimicrobials and the owner was instructed to intermittently elevate the forelimbs to facilitate passage of milk out of the dilated oesophagus. The milk regurgitation resolved and reassessment of the foal at 6 weeks of age documented the absence of oesophageal ectasia and resolution of aspiration pneumonia. The foal was reported to be healthy and consuming food normally 6 months after initial examination and was in good body condition. This case is unique in that the oesophageal ectasia improved with time; furthermore, other potential causes of dysphagia and milk regurgitation of oesophageal origin in neonatal foals are discussed.

A Rare Case of Bilateral Microtia

Microtia is a congenital deformity, where the pinna is underdeveloped. A completely undeveloped pinna is referred to as anotia. Since microtia and anotia have the same origin, it can be referred to as ‘Microtia-Anotia’. When microtia is present, there is usually no ear canal present, and this condition is called atresia. Microtia is rare; it affects only 1 to 5 of every 10,000 babies. It usually affects only one ear and most often, it is the right ear. When it affects one ear, it is called unilateral microtia and when it affects both ears, it is called bilateral microtia. This case report concerns a newborn baby diagnosed with a grade-3 bilateral microtia. A 16-day-old newborn baby was admitted at the pediatric ward on August 2, 2017 at Hakeem Abdul Hameed Centenary Hospital (HAHC), New Delhi, India, with the complaints of unable to take feed from birth, having cough, eye discharge, hearing problem, and regurgitation of milk via nose and mouth. On examination, it was revealed that the baby was having grade-3 bilateral microtia. The blood tests revealed changes from the normal value, sepsis was developed and BAER test (Brain Stem Auditory Response Test) results indicated bilateral conductive hearing loss. The doctor advised the parents regarding reconstruction of the ear for the child and the surgery was planned, once the baby’s age reached 4-5 years or above.

Milk regurgitation caused by oesophageal stricture in foals

Milk regurgitation caused by oesophageal stricture in foals

The Physiological Basis of Parental Feeding Behavior in the Ring Dove (Streptopelia Risoria)

Ring doves feed their squabs by regurgitation of milk, a mass of desquamated cells from the crop epithelium. The reproduction and sloughing off of the cells is elicited by prolactin secreted by the bird's hypophysis. The purpose of the present study is to determine the role of prolactin in the organization of regurgitation-feeding, and to analyze the mechanism of its action. 12 adult ring doves, each of which had bred twice (in six pairs), were injected subcutaneously with 450 I. U. of prolactin, dissolved in distilled water, divided into 7 daily injections. Control birds were injected similarly with distilled water. Each bird was in an individual cage. On the day following the last injection, a squab was placed in the cage, in a normally-located nest. Of the 12 prolactin-injected birds, 10 fed the squabs; of the 12 control birds, none fed the squabs. (x 2 = 13.89, p = .001). In a second experiment, 12 adult ring doves, of the same age as those used in the first experiment, but without breeding experience, were tested by an identical procedure. The control gropp consisted of 12 birds, also with no breeding experience, injected with distilled water. None of the birds in either the experimental or the control group fed the squabs. (For a comparison of the inexperienced birds with the experienced birds of the first experiment, both injected with prolactin, x 2 = 13.89, p = .001.) In a third experiment, 12 adult ring doves, each of which had bred twice, were injected with prolactin and tested as in the first experiment, except that, starting 2 days before the test, their crops were anesthetized with Efocaine, a long-acting local anesthetic. A control group was injected with the same amount (.5 cc) of Efocaine elsewhere in the body, in order to control for possible systemic effects of the anesthetic. The crop-anesthetized birds fed the squabs significantly less often than did the birds anesthetized elsewhere (p. = .05). The results strongly suggest that prolactin elicits parental regurgitation-feeding in these circumstances (squab presented to adult when adult was not already sitting on the nest—unlike the natural situation) only if the adult bird has already had experience of feeding squabs. The prevention of the prolactin-induced response to the squab in a majority of birds by anesthetization of the crop suggests that the prolactin does not elicit the parental response primarily by its action on a brain center, but by its action on the crop. Additional data bear on the role of learning in the development of regurgitation-feeding, and on the origin of the parent's responses to visual and/or auditory stimulation by the squab: The first regurgitation of food to the squab after it emerges from the egg may follow tactual stimulation of the breast by the squab's head, or it may be at the initiative of the parent, apparently in response to non-tactual stimulation from the squab. In 41 cases of birds breeding for the first time, regurgitation was always to tactual stimulation. In 49 cases of birds breeding for the second time (this sample independent of the sample of 41 inexperienced birds), regurgitation occurred without tactual stimulation 12 times. x 2 for a comparison between birds breeding for the first and for the second time is 9.56, p = .01. By the time squabs are 6 days old, there is no difference in responsiveness to non-tactual stimulation between parents breeding for the first and for the second time (x 2 = 1.08, p = .3). Observations of the latency of regurgitation response (time from hatching of egg to first feeding of squab) of birds breeding for the first time, and of the same birds when breeding for the second time, show a reliable decrease in the latency between first and second breedings (p = .01). These data indicate that the regurgitation response of parents to the squabs, in normal breeding, is probably at first to tactual stimulation alone, but quickly becomes conditioned to visual and auditory stimuli. In addition, it appears that learning causes marked changes in the mode of first response to the squab between first and second breeding experiences. Conclusions. Prolactin acts to elicit parental regurgitation-feeding primarily because it causes engorgement of the crop and suppression of sexual behavior, rather than through an effect on central nervous mechanisms specific for parental behavior. The engorgement of the crop makes it sensitive to emetic stimuli provided by movements of the squab's head against the parent's breast. In addition, this crop-engorgement acts as a drive stimulus through which the dove learns to respond to the sight and/or sound of the squab.

STENOSIS OF THE PYLORUS IN INFANCY.AN ANALYSIS OF 115 CASES.

"The pylorus was invested with a hard, compact substance or schirrhosity, which so completely obstructed the passage into the duodenum as to admit with the greatest difficulty the finest probe." Thus wrote Hezekiah Beardsley¹in 1788 from New Haven, Conn., after having examined the stomach of a child who had had "puking and regurgitation of milk" from birth, but who, although much emaciated, had lived, in spite of this rejection of food, until she was 5 years old. Beardsley's case of 1788 is the first recorded instance of obstruction at the pylorus occurring in infancy. It is a record of importance. In 1841 Williamson²recorded the second case of pyloric stenosis. The child died when five weeks old. In 1842 Dawoski³reported the third instance. This case likewise died when five weeks old. From the time of the case of Dawosky to that of Hirschsprung⁴of Copenhagen in 1888, a