Mo Of Life Research Articles

WS11.7 Feeding, growth and nutritional status of infants with CF diagnosed through newborn screening (NBS): Findings from a new multi-center study in the USA

Objective NBS for CF became universal in the USA in 2010. To identify optimal feeding for CF infants, a multi-center prospective study known as FIRST (Feeding Infants Right … from the STart) was initiated in 2012 to enroll 160 infants by 2016 at 5 CF Centers (Madison and Milwaukee, WI; Indianapolis, IN; Salt Lake City, UT; and Boston, MA). Method Nutritional status in the first year of life from 91 infants (52% boys) enrolled at 1.4±0.6 mo to FIRST was assessed biochemically and anthropometrically. By 31/12/14, 80 infants were 6 mo and 60 infants were 12 mo old. Result Growth was normal at birth [3210±505 g (41 st %tile) and 50.1±2.8 cm (63 rd %tile)] but declined to the 18 th %tile at age 2 mo. Catch-up growth was observed; weight increased to 33 rd %tile at 6 mo and 64 th %tile at 12 mo, but length did not fully recover at 12 mo (44 th %tile). At birth, 73% were breastfed: 65% exclusive (exB) and 8% combined with formula (B&F). The rate of exB decreased to 41% by 1 mo and 16% by 6 mo, while B&F and exF increased to 27% and 57%, respectively, at 6 mo. In the first 6 mo of life, 60% of infants received fortified breast milk or high caloric density formula (22–30 kcal/oz). Abnormal essential fatty acid status was common before age 3 mo with 18% deficient [triene-tetraene (T/T) ratio >0.02] and another 18% insufficient (T/T ratio >0.01). Low vitamin D [25(OH)D Conclusion This new infant study shows that early diagnosis/care leads to substantial catch-up growth but biochemical nutritional status remains suboptimal. (Funded by NIH/CFF).

Diet Influences the Oral Microbiota of Infants during the First Six Months of Life

Oral bacteria and fungi contribute to oral health and establishment of the distal gastrointestinal tract microbiota; however, the impact of diet on the oral microbiota of infants is under‐investigated. We aimed to characterize the influence of feeding method (exclusive human milk [HM], formula [FF], HM + FF [mixed], and solid foods) on oral bacterial and fungal communities in vaginally delivered infants during the first 6 mo of life. Infant (N=12) feeding records and tongue and cheek swabs were collected within 24 hr of birth, and at 2, 4, and 6 mo of age. DNA was extracted, sequenced on an Illumina MiSeq, and analyzed with QIIME 1.8 and SAS. Bacterial diversity was lowest in HM and highest in FF and solid food fed infants (p<0.01). Principal coordinates analysis (PCoA) of UniFrac distances between samples based on their 97% OTU composition and abundances indicated that bacterial communities were impacted by feeding method (p<0.005). Infants fed HM or mixed diets had reduced relative abundances of Bacteroidetes while solid foods increased Fusobacteria (p<0.05). Infants had greater proportions of Proteobacteria at birth compared to other time points (p<0.05). Among genera, Streptococcus predominated in all infants, with the highest proportions in HM or mixed diets. Compared to HM, the relative abundances of Prevotella were increased with FF (p=0.01) and solid foods (p=0.02). Fungal communities were not impacted by diet. Five infants had detectable levels of fungi within 24 hr of birth, 4 at 2 mo, 9 at 4 mo, and 10 at 6 mo. These novel findings demonstrate that the oral microbiota of infants differs depending on dietary composition during the first 6 mo of life. Funded by Hatch Project #ILLU‐971‐350.

Protecting a woman's right to breastfeed: the extension of maternity leave in Vietnam

Exclusive breastfeeding in the first six mo of life is critical to child development and health. Effective from May 1, 2013, Vietnam became one of the first lower‐ to middle‐income countries to offer 6‐month paid maternity leave (6mo‐PML). We analyzed data from different sources to 1) describe the process of adopting the 6mo‐PML policy, 2) examine perceptions of employed women about this policy, and 3) assess the association between maternity leave and the exclusive breastfeeding practice. Five key components leading to policy change were the establishment of partnerships, consensus building among various stakeholders, evidence‐based policy advocacy, development of messages and materials, and engaging the media. An online survey (n = 1,005) showed employed women believed that 6mo‐PML was beneficial for infant's health (72%), mother's health (59%), society (45%) and family (34%). To avail of 6mo‐PML, mothers needed support from employers to maintain positions (80%) and hire temporary staff (48%). Findings from an onsite survey (n = 6,240) show that the percent of mothers who returned to work when the infant was < 4 mo, 4 mo and 5 mo were 5%, 15% and 22%, respectively. Mothers who returned to work had a statistically lower prevalence of exclusive breastfeeding than those who did not in the overall sample (20% vs. 34%) and for all age groups (< 4 mo: 35% vs. 42%; 4 mo: 19% vs. 26%; and 5 mo: 9% vs. 15%). Adjusted OR for returning to work was 0.65 (95%CI 0.53, 0.80). With increasing numbers of women entering the labor force, adoption of maternity protection policies is critical to enabling working mothers to optimally breastfeed their children.Funding: Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI 360

A possible link between early probiotic intervention and the risk of neuropsychiatric disorders later in childhood: a randomized trial.

Recent experimental evidence suggests that gut microbiota may alter function within the nervous system providing new insight on the mechanism of neuropsychiatric disorders. Seventy-five infants who were randomized to receive Lactobacillus rhamnosus GG (ATCC 53103) or placebo during the first 6 mo of life were followed-up for 13 y. Gut microbiota was assessed at the age of 3 wk, 3, 6, 12, 18, 24 mo, and 13 y using fluorescein in situ hybridization (FISH) and qPCR, and indirectly by determining the blood group secretor type at the age of 13 y. The diagnoses of attention deficit hyperactivity disorder (ADHD) and Asperger syndrome (AS) by a child neurologist or psychiatrist were based on ICD-10 diagnostic criteria. At the age of 13 y, ADHD or AS was diagnosed in 6/35 (17.1%) children in the placebo and none in the probiotic group (P = 0.008). The mean (SD) numbers of Bifidobacterium species bacteria in feces during the first 6 mo of life was lower in affected children 8.26 (1.24) log cells/g than in healthy children 9.12 (0.64) log cells/g; P = 0.03. Probiotic supplementation early in life may reduce the risk of neuropsychiatric disorder development later in childhood possible by mechanisms not limited to gut microbiota composition.

Does nerve repair or transfer really help in birth associated brachial plexus injury (obstetric palsy)? Current evidence

Brachial plexus birth palsy occurs in 0.1–0.4% of live births, with most showing signs of recovery in the first 2 mo of life. In infants who do not recover in the first 3 mo of life have a considerable risk of long-term disability. If recovery extends beyond 6 mo, surgery may be indicated, based on the type of nerve injury. Avulsion injuries are mainly treated with nerve transfers. Ruptures have varying degrees of recovery, and their treatment remains controversial concerning indications and timing of surgery. This article reviews nerve repair, timing of surgery, technique, and results.

Morbidity in relation to feeding mode in African HIV-exposed, uninfected infants during the first 6 mo of life: the Kesho Bora study

Refraining from breastfeeding to prevent HIV transmission has been associated with increased morbidity and mortality in HIV-exposed African infants. The objective was to assess risks of common and serious infectious morbidity by feeding mode in HIV-exposed, uninfected infants ≤6 mo of age with special attention to the issue of reverse causality. HIV-infected pregnant women from 5 sites in Burkina Faso, Kenya, and South Africa were enrolled in the prevention of mother-to-child transmission Kesho Bora trial and counseled to either breastfeed exclusively and cease by 6 mo postpartum or formula feed exclusively. Maternal-reported morbidity (fever, diarrhea, and vomiting) and serious infectious events (SIEs) (gastroenteritis and lower respiratory tract infections) were investigated for 751 infants for 2 age periods (0-2.9 and 3-6 mo) by using generalized linear mixed models with breastfeeding as a time-dependent variable and adjustment for study site, maternal education, economic level, and cotrimoxazole prophylaxis. Reported morbidity was not significantly higher in nonbreastfed compared with breastfed infants [OR: 1.31 (95% CI: 0.97, 1.75) and 1.21 (0.90, 1.62) at 0-2.9 and 3-6 mo of age, respectively]. Between 0 and 2.9 mo of age, never-breastfed infants had increased risks of morbidity compared with those of infants who were exclusively breastfed (OR: 1.49; 95% CI: 1.01, 2.2; P = 0.042). The adjusted excess risk of SIEs in nonbreastfed infants was large between 0 and 2.9 mo (OR: 6.0; 95% CI: 2.2, 16.4; P = 0.001). Between 3 and 6 mo, the OR for SIEs was sensitive to the timing of breastfeeding status, i.e., 4.3 (95% CI: 1.2, 15.3; P = 0.02) when defined at end of monthly intervals and 2.0 (95% CI: 0.8, 5.0; P = 0.13) when defined at the beginning of intervals. Of 52 SIEs, 3 mothers reported changes in feeding mode during the SIE although none of the mothers ceased breastfeeding completely. Not breastfeeding was associated with increased risk of serious infections especially between 0 and 2.9 mo of age. The randomized controlled trial component of the Kesho Bora study was registered at Current Controlled Trials (www.controlled-trials.com) as ISRCTN71468401.

Feeding patterns before 6 months of age: the relative validity of recall from interviews of mothers of Guatemalan infants and toddlers.

The WHO recommends exclusive breastfeeding during the first 6 mo of life; however, deviations from this recommendation are widespread. The objective of the current study was to evaluate exclusive and predominant breastfeeding rates, as defined by the WHO, in a cross-sectional sample of Guatemalan children using retrospective records on the temporal pattern of introducing foods and beverages before 6 mo. Mothers of 150 infants, aged 6 to 23 mo, attending a public health clinic were interviewed about early life feeding practices with a structured questionnaire. In addition, the plausibility of the reported offering of liquids and foods, other than breast milk, since birth was checked against reported current feeding practices. We observed that estimated exclusive breastfeeding was rare with 14% of infants receiving exclusive breastfeeding for 5 mo, and only 9% for the recommended 6 mo. The proportion of infants with predominant breastfeeding, which allows certain liquids such as water, juices and ritual fluids, was 33% through 5 mo and 23% through 6 mo. One-quarter of mothers (n=38) reported implausible answers concerning age-of-introduction of liquids and foods. Nevertheless, retrospective reports at up to 2 y give credible outcomes for estimations of feeding pattern at 6 mo of age. Our findings match the findings of other studies conducted in Guatemala. Overall adherence to the WHO guidelines for feeding in the first semester of infancy was much less than ideal and in need of strengthening.

Traditional Oral Remedies and Perceived Breast Milk Insufficiency Are Major Barriers to Exclusive Breastfeeding in Rural Zimbabwe

Only 5.8% of Zimbabwean infants are exclusively breastfed for the first 6 mo of life despite substantial investment in exclusive breastfeeding (EBF) promotion throughout the country. We conducted a survey of 295 mothers of infants <6 mo of age who were recruited from rural immunization clinics and outreach sites in the Midlands Province of Zimbabwe. We explored infant feeding knowledge, beliefs and attitudes, and details regarding facilitators for EBF mothers and first foods fed by non-EBF mothers to identify and understand barriers to EBF. Among mothers of infants <1 mo, 1 to <2 mo, and 2–6 mo of age, 54%, 30%, and 12%, respectively, were practicing EBF. In adjusted multivariate analyses, EBF practice was positively associated with belief in the sufficiency of EBF (P = 0.05), belief in the avoidance of cooking oil feeding (a common traditional practice) in the first 6 mo (P = 0.001), and perceived pressure from others regarding infant feeding and traditional medicine use (P = 0.03). Psychosocial support and viewing breast milk as sufficient were reported as primary facilitators of EBF practice. Maternal responses to open-ended questions identified protection, nutrition, and crying as the main reasons for EBF interruption. During the first 2 mo of life, “protection feedings” using traditional oral remedies (such as cooking oil and water) to prevent or treat perceived illness, specifically colic and sunken/depressed fontanel, made up 78.5% of the non-breast milk feeds. From the second month of life, “nutrition feedings,” mainly of water and porridge, were given when mothers believed their breast milk was insufficient in quantity or quality to meet the hunger or thirst needs of their infants. Our findings underscore the importance of exploring cultural beliefs and practices as they pertain to infant feeding and care and present insights for designing and targeting EBF promotion interventions.

Wideband absorbance in young infants (0-6 months): a cross-sectional study.

Wideband acoustic immittance (WAI) studies on infants have shown changes in WAI measures with age. These changes are attributed, at least in part, to developmental effects. However, developmental effects in young infants (0-6 mo) on WAI have not been systematically investigated. The objective of this study was to compare wideband absorbance (WBA) in healthy neonates and infants aged 1, 2, 4, and 6 mo. This was a prospective cross-sectional study. All participants were assessed by using 1-kHz tympanometry, distortion product otoacoustic emission (DPOAE) tests, and WBA tests. Participants included 35 newborns (35 ears), 16 infants aged 1 mo (29 ears), 16 infants aged 2 mo (29 ears), 15 infants aged 4 mo (28 ears), and 14 infants aged 6 mo (27 ears). For each participant, the ears that passed both high-frequency (1-kHz) tympanometry and DPOAE tests were included for analysis. WBA was recorded at ambient pressure conditions, and the response consisted of 16 data points at 1/3-octave frequencies from 0.25 to 8 kHz. A mixed-model analysis of variance (ANOVA) was applied to the data in each age group to evaluate the effects of sex, ear, and frequency on WBA. WBA was compared between various age groups. In addition, a separate mixed-model ANOVA was applied to WBA data, and post hoc analyses with the Bonferroni correction were performed at each of the 16 data points at 1/3-octave frequencies across age groups to examine the effect of age on WBA. For all age groups, WBA was highest between 1.5 and 5 kHz and lowest at frequencies of less than 1.5 kHz and greater than 5 kHz. A developmental trend was evident, with both the 0- and 6-mo-old infants being significantly different from other age groups at most frequencies. The WBA results exhibited a multipeaked pattern for infants aged 0 to 2 mo, whereas a single broad peaked pattern for 4- and 6-mo-old infants was observed. The difference in WBA between 0- and 6-mo-old infants was statistically significant across most frequencies. In contrast, the WBA results for 1- and 2-mo-old infants were comparable. There were no significant sex or ear effects on WBA for all age groups. Developmental effects of WBA were evident for infants during the first 6 mo of life. The WBA data can be used as a reference for detecting disorders in the sound-conductive pathways (outer and middle ear) in young infants. Further development of age-specific normative WBA data in young infants is warranted.

Understanding the developmental course of the acoustic properties of the human outer and middle ear over the first 6 months of life by using a longitudinal analysis of power reflectance at ambient pressure.

As shown by tympanometric and wideband acoustic immittance (WAI) measures, developmental changes that occur in the middle ear and the external auditory canal can affect the mechano-acoustic properties of the middle ear system during the first 2 years of life. However, these observed differences and the specific course of maturation have not been fully investigated. The overall goal of the current study was to define the time course and rate at which functional maturation of the middle ear occurs in human infants through wideband acoustic immittance (WAI). It was also within the scope of this study to establish normative data to characterize acoustic properties of the normal middle ear in infants from birth to 6 mo of age. Newborns were tested longitudinally at 1-mo intervals up to 6 mo of age for a total of six visits. All babies passed transient evoked otoacoustic emission screening on each visit. Tympanograms and WAI were recorded, and the distributions of WAI patterns were analyzed as a function of age. WAI was measured across a wide range of frequencies from birth to 6 mos of age in a cohort of 31 infants. Test-retest differences for WAI were also evaluated. Thirty-one newborns were recruited. A repeated-measure analysis of variance was conducted to investigate whether the variations observed in power reflectance at ambient pressure across the six visits were statistically different. All significant findings were subject to Greenhouse-Geisser correction for repeated-measures sphericity and inflated type-I error. RESULTS showed that power reflectance increased (closer to 1) at low frequencies (<400 Hz) and decreased (closer to 0) at high frequencies (>2000 Hz) as a function of age. There was very little change in power reflectance from 600 to 1600 Hz across the first 6 mo of life. Most group changes that were observed were also consistently shown in longitudinal changes observed within individual subjects. The overall maturation of the middle ear can result in a lower reflectance at higher frequencies and a higher reflectance at lower frequencies. This could be explained by known changes in ear-canal and/or middle-ear structures across this time period, which could lead to changes in mass and resistance. An increase in volume in the middle-ear cavity, reduction of middle-ear debris, and overall decrease in resistive elements might be contributing to these changes. Significant differences were observed between each visit, which could warrant the use of age-specific norms when applying WAI data to infants less than 6 mo of age.

Length‐for‐age (HAZ) progression from the 1st to the 4‐6th month among rural and urban infants in the Western Highlands of Guatemala: longitudinal and cross‐sectional perspectives (620.11)

Background: We have recently signaled the poorly recognized high prevalence of stunting at birth ‐ a challenge for prevention of linear growth retardation.Objectives: To assess and compare the progression of mean HAZ and stunting rates between the 1st and the 4th‐6th mo in rural R and urban U infants in the Western Highlands of Guatemala.Methods: Two field studies in the Province of Quetzaltenango ‐ Mam‐Mamas (a saturation survey in 8 R Mam‐Mayan‐speaking communities) and Xela‐Babies (a convenience sample from an U health clinic) ‐ included anthropometry measurement in the first 45 and at 131‐182 days of life, in a longitudinal format in both locations and in a transverse manner at the R site only. Stunting was defined as &lt;‐2 SD of HAZ (2006 WHO growth standards).Results: In the cohort series, the HAZ declined at the R site from an initial median of ‐1.61 (stunting prevalence 34.9%) to ‐1.79 (39.8%) (n=129; ΔHAZ ‐0.009±0.070 units/wk); and rose at the U site from ‐1.45 (25.0%) to ‐1.38 (28.3%) (n=60; ΔHAZ +0.011±0.046 u/wk). The stunting prevalence was significantly higher at 4‐6 mo at the R vs U site (p=0.012); HAZ progression was not statistically significant at either site. In the cross‐sectional samples from the R site, the progression was ‐1.89 (40.8%) (n=71) to ‐2.06 (50%) (n=60; ΔHAZ ‐0.010 u/wk).Conclusions: This, to our knowledge, is the first report on the progression of linear growth failure within the first 6 mo of life. Within our study setting, stunting begins in utero, and is worse at the R site, with no statistically significant progression in HAZ scores between the first 6 mo of life.Grant Funding Source: Supported by Graduate Women in Science, McGill Univ Grad Travel Award, GHR‐CAPS Doctoral Fellowship

The first ‘lost year’ of Mediterranean sea turtles: dispersal patterns indicate subregional management units for conservation

Identifying highly frequented areas is a priority for sea turtle conservation, and the distribution of young individuals in open waters represents a major knowledge gap due to methodological biases. The drift of hatchlings from 38 loggerhead Caretta caretta and 10 green Chelonia mydas turtle nesting sites in the Mediterranean was simulated for the first 6 mo of life, with simulations repeated for 5 different years (2001 through 2005). Results indicate that hatchlings from the Levantine and south-central Mediterranean sites are mainly retained in the same areas of origin, while those from the Ionian area mainly disperse to the Ionian, Adriatic and southcentral Mediterranean areas. Combining hatchling dispersal with existing empirical information on juveniles and adults, a general distribution model among nesting sites, and oceanic and neritic foraging grounds for Mediterranean sea turtles is proposed. The Levantine zone may be particularly key for the conservation of the Mediterranean populations of both species, since it may host the highest concentration of individuals. Subregional management units identified by dispersal patterns may facilitate turtle conservation through a relatively small-scale international approach. In-water studies in specific zones are identified as a research priority for improving current knowledge and informing conservation plans.

B Cell–Specific Loss of Lyn Kinase Leads to Autoimmunity

The Lyn tyrosine kinase regulates inhibitory signaling in B and myeloid cells: loss of Lyn results in a lupus-like autoimmune disease with hyperactive B cells and myeloproliferation. We have characterized the relative contribution of Lyn-regulated signaling pathways in B cells specifically to the development of autoimmunity by crossing the novel lyn(flox/flox) animals with mice carrying the Cre recombinase under the control of the Cd79a promoter, resulting in deletion of Lyn in B cells. The specific deletion of Lyn in B cells is sufficient for the development of immune complex-mediated glomerulonephritis. The B cell-specific Lyn-deficient mice have no defects in early bone marrow B cell development but have reduced numbers of mature B cells with poor germinal centers, as well as increased numbers of plasma and B1a cells, similar to the lyn(-/-) animals. Within 8 mo of life, B cell-specific Lyn mutant mice develop high titers of IgG anti-Smith Ag ribonucleoprotein and anti-dsDNA autoantibodies, which deposit in their kidneys, resulting in glomerulonephritis. B cell-specific Lyn mutant mice also develop myeloproliferation, similar to the lyn(-/-) animals. The additional deletion of MyD88 in B cells, achieved by crossing lyn(flox/flox)Cd79a-cre mice with myd88(flox/flox) animals, reversed the autoimmune phenotype observed in B cell-specific Lyn-deficient mice by blocking production of class-switched pathogenic IgG autoantibodies. Our results demonstrate that B cell-intrinsic Lyn-dependent signaling pathways regulate B cell homeostasis and activation, which in concert with B cell-specific MyD88 signaling pathways can drive the development of autoimmune disease.

HIV Infection, Viral Load, Low Birth Weight, and Nevirapine Are Independent Influences on Growth Velocity in HIV-Exposed South African Infants1,2

Data from a prospective multisite cohort study were used to examine the effect of HIV exposure, untreated HIV infection, and single-dose nevirapine on infant growth velocity. The 2009 WHO growth velocity standards constitute a new tool for this type of investigation and are in need of functional validation. In period 1 (3–24 wk), 65 HIV-infected, 502 HIV-exposed uninfected (HEU), and 216 HIV-unexposed infants were included. In period 2 (25–36 wk), 31 infants moved from the HEU group to the HIV-infected group. We compared weight velocity Z-scores (WVZ) and length velocity Z-scores (LVZ) by HIV group and assessed their independent influences. In period 1, mean WVZ (95% CI) was significantly (P < 0.001) lower in infected [−0.87 (−1.77, 0.04)] than HEU [0.81 (0.67, 0.94)] and unexposed [0.55 (0.33, 0.78)] infants. LVZ showed similar associations. In both periods, sick infants and those exposed to higher maternal viral loads had lower WVZ. Higher mean LVZ was associated with low birth weight. Infants that had received nevirapine had higher LVZ. In conclusion, HIV infection and not exposure was associated with low WVZ and LVZ in period 1. Eliminating infant HIV infection is a critical component in averting HIV-related poor growth patterns in infants in the first 6 mo of life.

A Retrospective Analysis of the Growth Pattern in Patients with Salt-wasting 21-Hydroxylase Deficiency.

The objective of this study was to investigate the growth pattern of children with the salt-wasting form of congenital adrenal hyperplasia caused by 21-hydroxylase deficiency (21-OHD). We reviewed the medical records of 13 patients in whom salt-wasting 21-OHD was diagnosed during the first 2 mo of life at our hospital from 1980 through 2008. Six reached adult height. Growth patterns, bone age, biochemical data, and the hydrocortisone dose at each growth stage were analyzed retrospectively. The mean adult height was 155.1 ± 6.5 cm (mean ± SD) in females and 158.1 ± 7.1 cm in males. Although length at birth was normal or longer than the national mean in almost all patients, the mean height SD score of both boys and girls decreased to below 0 SD during infancy. Subsequently, both boys and girls transiently showed growth acceleration and reached their peak growth velocity at 3–10 yr of age. In conclusion, in addition to suppression of growth during infancy, there was inappropriate growth acceleration during childhood. Especially from 3 mo to 3 yr of age, decreasing the hydrocortisone dose in patients who exhibit slower growth may lead to satisfactory height outcomes. Also, strict adjustment of the hydrocortisone dose to avoid accelerated growth from childhood to adolescence might improve adult height outcomes of patients with 21-OHD.

Neural tuning of human face processing

Within the first 6 mo of life, our vision improves many times over and continues to improve during childhood (1). During these early years, we encounter multiple and varied sensory experiences, whose overall patterns can differ considerably between individuals. For example, some of us grow up among a large social group with many races and languages, whereas others grow within a smaller, more uniform cohort. Nevertheless, despite the multitude of environments in which we are raised, there is a surprising convergence in our behavioral capacities. One such capacity is recognizing individual faces. Like other visual skills, face recognition requires experience. Although we have a reasonable idea of when our perception of faces gets refined behaviorally and even some of its neural correlates (2, 3), we don’t really know the mechanisms by which experience tunes our face-processing circuits. Part of the problem, of course, is that one cannot do perturbation experiments in humans as we would with an animal model system (4). A new electrophysiology study by Roder et al. (5) capitalizes on a naturally occurring experiment: a unique clinical population of individuals born blind because of cataracts, who then later have their sight restored following cataract removal (5). The study revealed that the neural signature for face processing is present in these individuals but not sufficiently tuned by experience.

Mothering Style and Infant Behavioral Development in Yunnan Snub-Nosed Monkeys (Rhinopithecus bieti) in China

Considerable variation in mothering styles is found among primate species, which may be directly related to species-typical differences in social structure, dominance style, patterns of infant development, and rates of intragroup aggression. We predicted that, as egalitarian Asian colobines, mothers of Yunnan snub-nosed monkeys (Rhinopithecus bieti) would adopt a mothering style characterized by low restrictiveness and low rejection. We followed six mother–infant dyads in a provisioned group of Rhinopithecus bieti inhabiting the Baimaxueshan National Nature Reserve, Yunnan, China, and collected 717.2 h of observational data on maternal care and infant development. In the first month after birth, infants were completely dependent on their mothers for nutrition and movement. They began to locomote clumsily during their second month of life. Mothers restricted the movements of their infants only during their first 2 mo of life. Maternal rejection occurred infrequently and never exceeded a mean of two events per hour for a given infant over any 1-mo period. Most rejections were mild, and did not result in a cessation of nursing. Infants were not weaned when they were 12 mo old. Our study offers support for the contention that females of Rhinopithecus bieti adopt a relaxed mothering style in caring for offspring during their first year of life.

Stunting at birth: An under‐recognized phenomenon with implications for maternal health and nutrition

BackgroundMeasurements of length at birth or in the neonatal period are challenging to obtain and often discounted for lack of standardization and validity. Classical “under‐five” stunting rates derive from surveys on children from 6 to 59 mo of age.ObjectiveTo assess length‐for‐age (LAZ) within the first 1.5 mo of life among infants from urban (U) and rural (R) sites in the Quetzaltenango Province in the Western Highlands of Guatemala.MethodsSupine length was measured to the nearest 0.5 cm by standardized anthropometrics on a SECA 210 infantometer. 104 infants (39% F) were enrolled in 8 rural Mam‐speaking R villages at 2–46 d of life. 106 infants (50% F) were recruited at an urban U health clinic at 4–33 d of life. Stunting was defined as ≤2 SD of LAZ in relation to the 2006 WHO growth standards.ResultsIn R sites, 100% were indigenous (Mam); in the U site, 27% were of indigenous ascent and 73% non‐indigenous. The median R LAZ was −1.55 and prevalence of stunting was 36.5%; the respective U values were −1.41, and 25.5%. The Pearson correlation coefficient of LAZ vs maternal stature for combined U+R was r=0.202 (n=210, p=0.02).ConclusionAs linear growth failure in this setting begins in utero, its prevention cannot begin at birth, but must be linked to maternal care strategies during gestation, or even before. Funded by the Nestle Foundation, McGill University, and Graduate Women in Science

Decreasing Breastfeeding trends in Mexico: 1999–2012

Breastfeeding (BF) saves lives, especially when exclusive during the first 6 mo of life (EBF&lt;6m). Governments must protect infants so that they can reach their potential health &amp; survival. Mexican representative 1999, 2006 and 2012 National Health &amp; Nutrition Surveys (NNS99, NHNS06, NHNS2012 respectively) data were used. BF indicators were collected according to WHO‐2008 recommendations. Statistical tests and results are presented adjusted for sample design. Participants were 12–49 y mothers of children &lt;2y; n=3,191 for NNS99, n=2,953 for NHNS06 &amp; n=4,097 for NHNS12. Three‐mo mobile means were used to estimate median duration (MD). Data were analyzed and presented by urban/rural and socioeconomic level (SEL). BF MD has remained stable throughout the last 13 y (9.7, 10.4 &amp; 10.2 mo for successive surveys) but EBF&lt;6m has declined sharply form 20.0% in NNS99 &amp; 23.3% in NHNS2006 to 14.4% in NHNS12, decline explained by increases in early formula and water consumption. EBF&lt;6mo decrease was sharpest in the most vulnerable population; e.g. in rural area EBF&lt;6mo went form 32.7 &amp; 36.9% in the first two surveys, to 18.5% in NHNS12 (p&lt;0.05 between last 2 surveys, declines similar in lowest SEL). Though formula industry has pledged endorsement of the International Marketing Code, it is not a law in Mexico and decreasing EBF&lt;6mo BF rates reflect the lack of effective widespread BF support. Policy to improve rates that halt the sharp EBF&lt;6mo decline must include all BF intervening partners, including government, industry, academia and society at large, following the WHO proposed strategy to improve infant feeding. Mexico has accomplished uncontestable recent improvements in undernutrition, so that similar nation‐wide efforts with coordination &amp; leadership are well within its capabilities. Funding for the National Health and Nutrition Survey was obtained from the Mexican Secretariat of Health

Transcriptional modulation of the developing immune system by early life social adversity

To identify molecular mechanisms by which early life social conditions might influence adult risk of disease in rhesus macaques (Macaca mulatta), we analyze changes in basal leukocyte gene expression profiles in 4-mo-old animals reared under adverse social conditions. Compared with the basal condition of maternal rearing (MR), leukocytes from peer-reared (PR) animals and PR animals provided with an inanimate surrogate mother (surrogate/peer reared, SPR) show enhanced expression of genes involved in inflammation, cytokine signaling, and T-lymphocyte activation, and suppression of genes involved in several innate antimicrobial defenses including type I interferon (IFN) antiviral responses. Promoter-based bioinformatic analyses implicate increased activity of CREB and NF-κB transcription factors and decreased activity of IFN response factors (IRFs) in structuring the observed differences in gene expression. Transcript origin analyses identify monocytes and CD4(+) T lymphocytes as primary cellular mediators of transcriptional up-regulation and B lymphocytes as major sources of down-regulated genes. These findings show that adverse social conditions can become embedded within the basal transcriptome of primate immune cells within the first 4 mo of life, and they implicate sympathetic nervous system-linked transcription control pathways as candidate mediators of those effects and potential targets for health-protective intervention.