Mo Of Life Research Articles

Rapid Weight Gain and Feeding Practices in the First 6 Months of Life Are Associated with Dysbiosis of the Gut Microbiome in Toddlerhood (P21-032-19)

ObjectivesNearly 10% of infants and toddlers carry excess weight for their length. Rapid weight gain (RWG; >+0.67 change in weight-for-age Z-score) and feeding practices from 0–6 months (mo) of life are strong determinants of obesity. Both RWG and feeding practices may influence the gut microbiome (GM), which in turn can affect obesity risk by increasing susceptibility to weight gain during infancy. Our goal was to evaluate differences in GM community structure at 36 months of age in relation to feeding practices and RWG in infancy. MethodsPregnant, obese Latinas (n = 36) recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children program took part in a larger randomized health education trial designed to prevent infant overweight. The intervention was delivered from 0–12 mo and participants were followed until 36 mo of age. At one, 6, and 12 mo, mothers reported infant feeding practices. RWG was categorized as >0.67 positive change in weight-for-age Z-score over the first 6 months of life. Microbial DNA from feces collected at 36 mo were sequenced using primers for the 16S rRNA gene V4 region. GM diversity metrics were examined using Kruskal-Wallis and PERMANOVA comparisons, adjusted for multiple comparisons, via Qiime2. ResultsOf the cohort, 12 children experienced RWG in the first 6 mo of life. Within-sample species number (richness, Shannon Diversity Index: P = 0.014) and evenness (Pielou’s Index: P = 0.019) were significantly lower at 3 years among children experiencing RWG in infancy. Upon comparing GM community structure (beta-diversity), exclusively breastfed infants (N = 9) formed a separate cluster from combination or formula-fed infants driven by phylogenetic diversity and species presence/absence (unweighted UniFrac: P = 0.033; Jaccard: P = 0.014). Children introduced to solid foods before (N = 30) vs. after (N = 6) 6 mo (Bray Curtis: P = 0.056; weighted UniFrac: P = 0.071). ConclusionsRWG and feeding practices in the first 6 mo of life appear to shape the GM in ways that last into toddlerhood. Identifying specific microbes may provide insights for intervention to prevent RWG. How shifts in the GM influence risk for childhood and adult obesity remain an area for exploration. Funding SourcesR01DK096488 and ASU Obesity Solutions, Virginia G. Piper Foundation.

New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life

Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30+1 to 41+6 wk) and postnatal age at measurement (1-27 wk). The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.

Selection of Calf Bedding Sites by Female Elk in the Central Appalachian Mountains

AbstractAcross eastern North America, Rocky Mountain elk Cervus canadensis nelsoni have been reintroduced to 11 states and provinces that were previously occupied by the extinct eastern elk C. canadensis canadensis. Outside of Kentucky, these elk reintroductions have resulted in small populations, typically numbering fewer than 1,000 elk per state. Limited information is available about the demographics and habitat selection within these small eastern populations. The availability of high-quality habitat during the first weeks of life is important for promoting annual recruitment and the identification of these characteristics should aid in management efforts. We characterized habitat at two spatial scales surrounding the bedding sites of 83 elk calves (≤ 7 d old) in the Pennsylvania Elk Management Area during the annual calving seasons of 2005–2008. A concurrent study found that calves in this area experienced high survival (92%) during the first 4 mo of life, despite occupying an area with high predator densities. At a local scale, bedding sites used by calves were closer to ecotones, had less leaf litter, and had greater density of vegetation below 1 m compared to random sites (n = 82). At a landscape scale, calf habitat surrounding bedding sites had greater density of edges between forest and open vegetation and less coniferous forest compared to random areas. The selected habitats appear to balance the high energetic needs of lactating females at the landscape scale and the need for cover to conceal calves and reduce predation risk at a local scale. Conclusions drawn from our models suggest future habitat management include enhancements of transitional vegetation along ecotones between forest and herbaceous openings that address the needs of both lactating females and recently born calves. We recommend that managers periodically evaluate the availability of calf habitat and calf survival rates. These monitoring activities will provide insight necessary to adaptively manage elk and the habitats driving their population growth to maintain their viability in the central Appalachian Mountains.

Maternal Serum Cobalamin at 18 Weeks of Pregnancy Predicts Infant Cobalamin Status at 6 Months—A Prospective, Observational Study

An adequate maternal cobalamin status is crucial for fetal and infant neurodevelopment. Pregnancy-induced physiologic changes make evaluation of maternal cobalamin status in pregnancy difficult. We have investigated maternal cobalamin status during pregnancy in order to establish a maternal cobalamin concentration which secures an optimal infant cobalamin status during the first 6 mo of life. In an observational, prospective study, markers of cobalamin status including serum cobalamin, plasma total homocysteine (tHcy), and plasma methylmalonic acid (MMA) were assessed in healthy pregnant women (n=114) from week 18 of pregnancy through 6 mo postpartum and related to infant cobalamin status at 6 mo. Healthy, never-pregnant women aged 18-40 y (n=123) were included as controls. Compared to controls, all markers of cobalamin status were lower in pregnant women. Median serum cobalamin concentration progressively decreased from week 18 to week 36 of pregnancy (356 to 302 pmol/L, P<0.001) and increased by >40% by 6 wk postpartum (518 pmol/L). The metabolic markers increased from week 18 of pregnancy to 6 wk postpartum: median plasma tHcy 3.9 to 7.7 μmol/L (P<0.001), and MMA 0.13 to 0.17 μmol/L (P<0.001). The serum cobalamin concentration of infants at age 6 mo correlated with maternal serum cobalamin concentration during pregnancy and postpartum (rho=0.36-0.55, P<0.001). A maternal serum cobalamin concentration <394 pmol/L during week 18 of pregnancy was associated with an increased risk (OR: 4.2; 95% CI: 1.5, 11.5) of infant biochemical cobalamin deficiency at 6 mo (defined as tHcy ≥6.5 μmol/L). The maternal serum cobalamin concentration in early pregnancy is a strong predictor for later maternal and infant cobalamin status. To secure an optimal infant cobalamin status during the first 6 mo of life, we recommend a maternal serum cobalamin concentration >394 pmol/L at week 18 of pregnancy. This should be confirmed in an intervention study. This trial was registered at clinicaltrials.gov as NCT03272022.

Micronutrients in Human Milk: Analytical Methods

Exclusive breastfeeding is recommended by the WHO for the first 6 mo of life because human milk protects against gastrointestinal infections and supplies balanced and adequate nutrient contents to the infant. However, reliable data on micronutrient concentrations in human milk are sparse, especially because some micronutrients are affected by maternal diet. Microbiological and competitive protein-binding assays, nuclear magnetic resonance or inductively coupled plasma spectroscopy, and chromatographic analyses are among the methods that have been applied to human-milk micronutrient analysis. However, the validation or evaluation of analytical methods in terms of their suitability for the complex human-milk matrix has been commonly ignored in reports, even though the human-milk matrix differs vastly from blood, plasma, or urine matrixes. Thus, information on the validity, accuracy, and sensitivity of the methods is essential for the estimation of infant and maternal intake requirements to support and maintain adequate milk micronutrient concentrations for healthy infant growth and development. In this review, we summarize current knowledge on methods used for analyzing water- and fat-soluble vitamins as well as iron, copper, zinc, iodine, and selenium in human milk and their different forms in milk; the tools available for quality control and assurance; and guidance for preanalytical considerations. Finally, we recommend preferred methodologic approaches for analysis of specific milk micronutrients.

Determinants of primary healthcare seeking behaviours for children during the first 18 months of life in Benin.

Primary healthcare is a key element of management of childhood illness in Africa. The objectives were to identify primary care seeking determinants among infants and young children up to 18 mo in a birth cohort from Benin. From 2007 to 2009 in Benin, a birth cohort was followed until the age of 18 mo in three health centres. Multilevel Poisson regression models were fitted to identify the factors related to the monthly number of consultations. Maternal and newborn characteristics and infant general health parameters were considered. A total of 566 children were followed. On average, 0.46 consultations per month per child were recorded. The number of consultations was significantly lower after the first 6 mo of life (p<0.001). A distance >1000 m was associated with fewer consultations (p=0.01). Primiparity was significantly associated with higher care seeking (relative risk 1.17 [95% CI 1.05 to 1.30], p<0.01). No child characteristics at birth were significantly associated with the number of consultations (all p>0.16). Development of health structures and improvement of access remain important goals for strengthening of the primary care health system. Studying factors of care seeking behaviour, like parity, can help to identify women more prone to seek care for their child during the first year of life.

Plane of nutrition before and after 6 months of age in Holstein-Friesian bulls: I. Effects on performance, body composition, age at puberty, and postpubertal semen production

The aim of this study was to examine the effect of plane of nutrition (1) during the first 6 mo of life and (2) from 6 mo of age to puberty on early growth characteristics, age at puberty, and postpubertal semen production in Holstein-Friesian bulls. Holstein-Friesian bull calves (n = 83) with a mean (standard deviation) age and body weight of 17 (4.4) d and 52 (6.2) kg, respectively, were assigned to a high (Hi) or low (Lo) plane of nutrition for the first 6 mo of life. The Hi and Lo calves received 1,200 and 450 g of milk replacer, respectively; Hi calves were fed concentrate ad libitum and Lo were fed a maximum of 1 kg concentrate daily, and concentrate allowances remained the same after weaning. At 24 wk of age, bulls were reassigned within treatment to either remain on the same diet or to switch to the opposite diet until puberty, resulting in 4 treatment groups: Hi-Hi, Hi-Lo, Lo-Lo, and Lo-Hi. After puberty, all bulls were fed a moderate plane of nutrition until 60 wk of age; thereafter, the diet was ad libitum concentrates until slaughter at 72 wk of age. Bulls were weighed weekly before weaning and every 2 wk after weaning. Scrotal circumference (SC) was measured every 2 wk, beginning at 15 wk of age. Beginning at a SC of 24 cm, electro-ejaculation was carried out every 2 wk to establish the onset of puberty. Semen collection continued monthly after puberty. Thermal images of the scrotum were taken monthly from 28 to 36 wk of age. Scrotal skin thickness (SST) was measured monthly (from 16 wk of age to puberty) using a digital calipers. Bulls on the Hi diet had a higher scrotal temperature and SST at each time point than those on the Lo diet. Average daily gain (ADG) was greatest in Hi-Hi bulls, with Hi-Lo and Lo-Hi having similar ADG but both being greater than Lo-Lo. Bulls on the Hi diet pre-6 mo of age were younger at puberty, regardless of diet offered post-6 mo of age. Bulls offered a Hi diet post-6 mo were heavier at puberty. Neither scrotal temperature nor dietary treatment affected postpubertal semen production variables. In conclusion, a high plane of nutrition during the first 6 mo of age hastened the onset of puberty and the availability of saleable semen, regardless of plane of nutrition post-6 mo of age.

Plane of nutrition before and after 6 months of age in Holstein-Friesian bulls: II. Effects on metabolic and reproductive endocrinology and identification of physiological markers of puberty and sexual maturation

The aim of this study was (1) to examine the effect of plane of nutrition during the first and second 6 mo of life on systemic concentrations of reproductive hormones and metabolites in Holstein-Friesian dairy bulls, and (2) to establish relationships with age at puberty and postpubertal semen production potential. Holstein-Friesian bull calves (n = 83) with a mean (standard deviation) age and body weight of 17 (4.4) d and 52 (6.2) kg, respectively, were assigned to a high or low plane of nutrition for the first 6 mo of life. At 24 wk of age, bulls were reassigned, within treatment, either to remain on the same diet or to switch to the opposite diet until puberty, resulting in 4 treatment groups: high-high, high-low, low-low, and low-high. Monthly blood samples were analyzed for metabolites (albumin, urea, total protein, β-hydroxybutyrate, glucose, nonesterified fatty acid, triglycerides and creatinine), insulin, insulin-like growth factor-1, leptin, adiponectin, FSH, and testosterone. A GnRH challenge was carried out at 16 and 32 wk of age (n = 9 bulls per treatment). Blood was collected at 15-min intervals for 165 min, with GnRH administered (0.05 mg/kg of body weight, i.v.) immediately after the third blood sample. Blood samples were subsequently analyzed for LH, FSH, and testosterone. Stepwise regression was used to detect growth and blood measurements to identify putative predictors of age at puberty and subsequent semen quality traits. Metabolic hormones and metabolites, in general, reflected metabolic status of bulls. Although FSH was unaffected by diet, it decreased with age both in monthly samples and following GnRH administration. Testosterone was greater in bulls on the high diet before and after 6 mo of age. Testosterone concentrations increased dramatically after 6 mo of age. Luteinizing hormone was unaffected by diet following GnRH administration but basal serum LH was greater in bulls on a high diet before 6 mo of age. In conclusion, the plane of nutrition offered before 6 mo of age influenced metabolic profiles, which are important for promoting GnRH pulsatility, in young bulls.

THE PROTHROMBIN TEST AND PIVKA-II IN BREASTFEDINFANTS AGED THE FIRST 6 MONTHS OF LIFE

The aim of the research was to study vitaminK-dependent indices of the prothrombin complex of hemostasis and the content of PIVKA-II substance, as a marker of vitamin K deficiency in children receivingbreastfeeding from birth to 6 months of life.Materials and methods. The study involved 247 children. The main cohort comprised 243 infants, approximately equally boys and girls who were born on the 38-40th week of gestation in a natural way withoutbirth trauma with an assessment ву the V. Apgar score of 7-10 points and who received exclusively breastfeeding from the moment of birth and up to 6 months of life. All of them at the time of birth were found healthy. In 67 breastfed infants the capillary blood were examined forprothrombin time (PTT),prothrombin by Quick ( PT ), international normalized ratio(INR).The concentrations of PIVKA-II in the serum of venous blood were studied in 180 newborn and infants.Results. The parameters of the prothrombin complex were highly correlated with each other and with the concentration of PIVKA-II. In newborns, PTT and PT had only a tendency to exhibit hypocoagulationproperties, whether they received or did not receive a prophylactic intramuscular injection of vitaminК1in the amount of 1 mg. In children aged 1- 2 mo and 3 to 6 mo, PT was significantly higher than one prone to adults while PT was at the lower acceptable limits regardlessof the fact of vitaminК1 administration. Also the INR in neonates and especially in infants 1- 2 mo of life was characterized by values of the obvious hypocoagulation. Abnormal high plasma concentrations of PIVKA-II – (67,9 ± 10,8) Au / ml were detected in newborns who didnot receive preventive dose of vitamin K immediately after birth. In contrast children who have received a prophylactic dose of phyloqinone were almost identical to normal PIVKA-II values 45.7 ± 5.4 Au / ml. Infants aged of 1-6 mo after the course of antibacterial therapyhave demonstrated laboratory signs of significant hypocoagulation quite sufficient for the development of late neonatal hemorrhagic disease.Conclusions. Vitamin-K-dependent parameters of the prothrombin test as a INR, PTT, PT and PIVKAII in the overwhelming number of children of the first month of life who did not receive a prophylactic dose of vitamin K after birth, reveal hypocoagulation due to congenital vitamin K deficiency. In age of 1-2 months the PIVKA-II in healthy exclusively breastfed children gets normal. Simultaneously INR and PT are characterized by considerable variability and reach the value ofhypocoagulation despite the vitamin K administration after the birth.The development of intestinal microbial biocinosis contributes to the establishment of normal prothrombin test and PIVKA-II concentrations. The use of antibiotics in children of the first 6 months of life who receive breastfeeding can lead to the renewal of vitamin-K deficiency and the development of antibioticassociated disorders of plasma coagulation factors.

How to Keep a Child Healthy?

Keeping a child healthy is the most important priority of every parent. The child can be kept healthy by ensuring exclusive breastfeeding for first 6 mo of life, maintaining healthy weight throughout the childhood, providing adequate and balanced diet, promoting regular physical activity and adequate sleep, keeping a watch on all the parameters of development and referring the child to the specialist whenever deviation from normal is suspected. Proper and timely immunization as per the prevailing guidelines must be done to prevent serious infections. Stress should also be given on promoting oral as well as mental health besides other important general measures to improve the health of the child.

Analysis of the lifetime and culling reasons for AI boars

BackgroundThe aim of the study was to analyze the lifetime and culling reasons for boars used in insemination centers (AI centers).MethodsThe data collected from 355 culled boars from 1998 to 2013 included: age at start of semen collection, boar herd life, culling reason, daily gain and lean meat content, and number of ejaculates not meeting sales requirements after dilution. Culling reasons were divided into 7 groups: low semen value (LSV), low or lack of libido (LL), leg problems (LP), infectious diseases (ID), old age (OA), reduced demand for semen from the given boar (RD), and others (OT).ResultsThe most common culling reasons for boars were LSV (23.7%) and RD (22.5%). It was observed that the lowest daily gains were noted in boars culled due to OA. Boars culled due to OA and RD were maintained in production for the longest time (over 1000 d), for LSV and ID retention was about 700 d, and due to LL below 400 d. The survival probability was over 0.9 until 1.5 yr, and just over 0.2 until 4 yr. The highest relative frequency was observed in the 36th and 42nd mo of life (over 16%). Hazard risk analysis revealed a more than 10 times higher risk of culling in the case of LL, ID or OT, in comparison to OA.ConclusionsThe results can be used as a direct point of reference for the identification of emerging problems in AI boar exploitation and the development of an appropriate culling policy in AI centers.

Effects of preweaning nutrient intake in the developing mammary parenchymal tissue

Historically, mammary gland growth has been considered isometric the first 2 mo of life and then allometric until peripuberty. However, recent work indicated that the mammary gland might be responsive to nutrient intake preweaning. The objectives of this study were to describe the effects of nutrient intake preweaning on mammary gland development and to investigate cell specific proliferation during this phase of development. Twelve dairy heifer calves were fed either a fixed amount of milk replacer (MR; control, n = 6) or an amount of MR adjusted for BW (enhanced, n = 6). Control calves received a constant amount of a 28% crude protein, 15% fat milk MR per day that was equivalent to 2.8 Mcal of metabolizable energy intake per day; enhanced calves received 0.3 Mcal of metabolizable energy intake per kilogram of metabolic body weight (from 4.2 to 8.4 Mcal of metabolizable energy intake per day). All calves had constant access to water and a 22% crude protein commercial calf starter. Calves were killed at 54 ± 2 d. Control calves consumed 32.6 ± 2.4 kg of MR and 6.7 ± 0.5 kg of calf starter per calf, whereas the enhanced calves consumed 69.5 ± 2.4 kg of MR and 1.9 ± 0.5 kg of calf starter per calf over the 54-d period. Further, to evaluate putative stem cell proliferation, BrdU (5-bromo-2'-deoxyuridine; 5 mg/kg) was injected intramuscularly once per day between 12 to 15 d and again once per day between 24 to 27 d of life. Initial and final body weight for the control and enhanced treatments were 39.2, 61.0, 39.7, and 83.2 kg, respectively. At euthanasia, weights of liver, kidneys, pancreas, whole skinned mammary gland, and mammary parenchyma were measured. The growth rate of each organ was calculated using the concept of allometry as the difference in the change in organ weight as a percentage of body weight. The mammary glands of calves fed the enhanced diet were significantly heavier at euthanasia; when mammary parenchymal weight was analyzed, enhanced calves had 5.9 times greater mammary parenchymal mass, indicating the mammary gland was responsive to nutrient intake before weaning. Allometric growth of the mammary gland was initiated preweaning in the calves fed the enhanced treatment. Further characterization of mammary cells that retained BrdU label revealed no significant differences among the tissue slices analyzed between treatments; however, as calves fed the enhanced diet had more mammary parenchymal mass, if the number of label-retaining cells per counted slide were similar between treatments then the enhanced calves had a larger total population of putative mammary stem cells present in the mammary gland.

Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants

BackgroundThe WHO recommends exclusive breastfeeding (EBF) for the first 6 mo of life. ObjectiveThe objective of this study was to assess the benefit of EBF to age 6 mo on growth in a large sample of rural Gambian infants at high risk of undernutrition. MethodsInfants with growth monitoring from birth to 2 y of age (n = 756) from the ENID (Early Nutrition and Immune Development) trial were categorized as exclusively breastfed if only breast milk and no other liquids or foods were given. EBF status was entered into confounder-adjusted multilevel models to test associations with growth trajectories by using >11,000 weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z score observations. ResultsThirty-two percent of infants were exclusively breastfed to age 6 mo. The mean age of discontinuation of EBF was 5.2 mo, and growth faltering started at ∼3.5 mo of age. Some evidence for a difference in WAZ and WHZ was found between infants who were exclusively breastfed to age 6 mo (EBF-6) and those who were not (nEBF-6), at 6 and 12 mo of age, with EBF-6 children having a higher mean z score. The differences in z scores between the 2 groups were small in magnitude (at 6 mo of age: 0.147 WAZ; 95% CI: −0.001, 0.293 WAZ; 0.189 WHZ; 95% CI: 0.038, 0.341 WHZ). No evidence for a difference between EBF-6 and nEBF-6 infants was observed for LAZ at any time point (6, 12, and 24 mo of age). Furthermore, a higher mean WLZ at 3 mo of age was associated with a subsequent higher mean age at discontinuation of EBF, which implied reverse causality in this setting (coefficient: 0.060; 95% CI: 0.008, 0.120). ConclusionsThis study suggests that EBF to age 6 mo has limited benefit to the growth of rural Gambian infants. This trial was registered at http://www.isrctn.com as ISRCTN49285450.

Insulin sensitivity in calves decreases substantially during the first 3 months of life and is unaffected by weaning or fructo-oligosaccharide supplementation

Veal calves at the age of 4 to 6 mo often experience problems with glucose homeostasis, as indicated by postprandial hyperglycemia, hyperinsulinemia, and insulin resistance. It is not clear to what extent the ontogenetic development of calves or the feeding strategy [e.g., prolonged milk replacer (MR) feeding] contribute to this pathology. The objective of this study was therefore to analyze effects of MR feeding, weaning, and supplementation of short-chain fructo-oligosaccharides (FOS) on the development of glucose homeostasis and insulin sensitivity in calves during the first 3 mo of life. Thirty male Holstein-Friesian calves (18±0.7 d of age) were assigned to 1 of 3 dietary treatments: the control (CON) group received MR only, the FOS group received MR with the addition of short-chain FOS, and the solid feed (SF) group was progressively weaned to SF. The CON and FOS calves received an amount of MR, which gradually increased (from 400 to 1,400 g/d) during the 71-d trial period. For the SF calves, the amount of MR increased from 400 to 850 g/d at d 30, and then gradually decreased, until completely weaned to only SF at d 63. The change in whole body insulin sensitivity was assessed by intravenous glucose tolerance tests. Milk tolerance tests were performed twice to assess changes in postprandial blood glucose, insulin, and nonesterified fatty acid responses. Whole-body insulin sensitivity was high at the start (16.7±1.6×10−4 [μU/mL]−1), but decreased with age to 4.2±0.6×10−4 [μU/mL]−1 at the end of the trial. The decrease in insulin sensitivity was most pronounced (~70%) between d 8 and 29 of the trial. Dietary treatments did not affect the decrease in insulin sensitivity. For CON and FOS calves, the postprandial insulin response was 3-fold higher at the end of the trial than at the start, whereas the glucose response remained similar. The SF calves, however, showed pronounced hyperglycemia and hyperinsulinemia at the end of the trial, although weaning did not affect insulin sensitivity. We conclude that whole body insulin sensitivity decreases by 75% in calves during the first 3 mo of life. Weaning or supplementation of short-chain FOS does not affect this age-related decline in insulin sensitivity. Glucose homeostasis is not affected by supplementation of short-chain FOS in young calves, whereas postprandial responses of glucose and insulin to a MR meal strongly increase after weaning.

Hematology, Serum Chemistry, and Early Hematologic Changes in Free-Ranging South American Fur Seals ( Arctocephalus australis ) at Guafo Island, Chilean Patagonia.

The establishment of clinical pathology baseline data is critical to evaluate temporal and spatial changes in marine mammal groups. Despite increased availability of studies on hematology and biochemistry of marine mammals, reference ranges are lacking for many populations, especially among fur seal species. During the austral summers of 2014 and 2015, we evaluated basic hematologic and biochemical parameters in clinically healthy, physically restrained South American fur seal ( Arctocephalus australis ) lactating females and 2-mo-old pups. We also assessed the temporal variation of hematology parameters on the pups during their first 2 mo of life. Reference ranges of lactating females were similar to those previously reported in other fur seal species. In the case of pups, reference ranges are similar to values previously reported in sea lion species. As expected, most biochemical and hematologic values differ significantly between adult females and pups. As in other otariids, South American fur seals pups are born with higher values of total red blood cells, hemoglobin, and packed cell volume, and lower numbers of total leukocytes, neutrophils, lymphocytes, and eosinophils. To the best of our knowledge, data on hematology reference values for South American fur seals has not been previously reported and is useful for continued health monitoring of this species, as well as for comparisons with other otariid groups.

A case of transient neonatal diabetes due to a novel mutation in ABCC8.

Neonatal diabetes mellitus (NDM), characterized by hyperglycemia and the need for insulin treatment within the first 6 mo of life, is a rare monogenic form of diabetes with an estimated incidence of 1 in 90,000 neonates (1). Approximately half of NDM cases are transient and resolve at a median age of 3 mo (transient NMD: TNDM), while the remaining cases develop into a permanent form of diabetes (permanent NDM: PNDM; MIM # 606176). Adult onset non-autoimmune diabetes occurs in a significant number of patients with TNDM (2). Most cases of TNDM (approximately 70%) are caused by abnormalities in chromosome 6q24, including paternal duplications, paternal uniparental isodisomy, and loss of methylation. In a few patients, activating mutations in the genes, which encode the two subunits of the β-cell ATP-sensitive potassium channel, i.e. ABCC8 and KCNJ11, have been reported to be associated with TNDM. Interestingly, recent studies have shown that familial analysis of TNMD with ABCC8 mutations revealed that their family members with adult onset non-autoimmune diabetes also have the same mutations (3). Here, we present a Japanese case with TNDM harboring a novel p.Glu350Asp mutation in ABCC8. Familial analysis revealed that his non-symptomatic sister and mother, other family members with adult-onset diabetes without neonatal episodes of hyperglycemia, also possessed the same mutation.

Childhood growth in boys with congenital hypogonadotropic hypogonadism.

We describe childhood growth patterns in a series of well-characterized patients with congenital hypogonadotropic hypogonadism (CHH) with special emphasis on genotype-phenotype correlation. We retrospectively evaluated the growth charts of 36 males with CHH (27 from Finland and 9 from Denmark). Fifteen patients (42%) had representative growth measurements during the first year of life. Genetically verified diagnosis of CHH was made in 15 (42%) patients (KAL1, FGFR1, GNRHR, or PROK2). We found a deceleration of growth rate during early childhood. The mean (SD) length standard deviation score (SDS) at birth (0.2 (1.6) SDS) decreased significantly during the first 3 (to -0.9 (1.2) SDS) and 6 mo of life (to -0.7 (1.3) SDS). At the average age of 3 y, mean height SDS (-0.2 (1.3) SDS) did not differ from mid-parental target height (MPH). Mean height SDS reached its nadir (-1.7 (1.4) SDS) at an average age of 15.8 (0.8) years reflecting pubertal failure. Final heights did not differ from MPH. No clear genotype-growth associations emerged. Moderate postnatal length deflection is a novel feature of CHH and may reflect early androgen deficiency. Childhood growth patterns are not of clinical value in targeting molecular genetic diagnosis of CHH.

Serum hepcidin in infants born after 32 to 37 wk of gestational age.

Preterm infants are at risk of iron deficiency (ID). Hepcidin has been suggested as a good additional indicator of ID in preterm infants, next to ferritin. In a prospective observational study, we analyzed serum hepcidin in 111 infants born after 32+0 to 36+6 wk gestational age during the first 4 mo of life. Hepcidin concentrations decreased during the first 4 mo of life, and concentrations were lower in infants with ID compared to those without ID. Infants who developed ID at the age of 4 mo had already significantly lower levels of hepcidin at 1.5 mo of age, while ferritin was already significantly lower at the age of 1 wk. Hepcidin concentrations of late preterm infants decrease during the first 4 mo of life. This decrease, which parallels a decrease of ferritin concentration, we interpret as a physiological response, aiming to increase iron availability. Hepcidin concentrations are lower in infants with ID compared with those without ID, with a notable change already observed at 1.5 mo of age. Hepcidin can be used as an early marker of ID, although an additive value of hepcidin over ferritin in the diagnosis of ID is not present.

Associations between human milk oligosaccharides and infant body composition in the first 6 mo of life

Evidence linking breastfeeding to reduced risk of developing childhood obesity is inconclusive, yet previous studies have not considered variation in specific components of breast milk that may affect early development. We examined whether differences in the composition of human milk oligosaccharides (HMOs) correlate with infant growth and body composition at 1 and 6 mo of age. Twenty-five mother-infant dyads were recruited from the University Hospital at the University of Oklahoma Health Sciences Center. Infants were breastfed for 6 mo. Breast-milk and infant measures were obtained at 1 and 6 mo of infant age. HMO composition was analyzed by high-pressure liquid chromatography, and infant growth (length and weight) and body composition (percentage fat, total fat, lean mass) were measured by dual-energy X-ray absorptiometry. Relations between HMOs and infant growth and body composition were examined by using multiple linear regression. A priori covariates included maternal prepregnancy body mass index, pregnancy weight gain, and infant age and sex. Higher HMO diversity and evenness at 1 mo were associated with lower total and percentage fat mass at 1 mo. At 1 mo, each 1-μg/mL increase in lacto-N-fucopentaose (LNFP) I was associated with a 0.40-kg lower infant weight (P = 0.03). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 1.11-kg lower weight (P = 0.03) and a 0.85-g lower lean mass (P = 0.01). At 6 mo, each 1-μg/mL increase in LNFPI was associated with a 0.79-g lower fat mass (P = 0.02), whereas disialyl-lacto-N-tetraose and LNFPII were associated with a 1.92-g (P = 0.02) and 0.42-g (P = 0.02) greater fat mass, respectively. At 6 mo, each 1-μg/mL increase in fucosyl-disialyl-lacto-N-hexaose and lacto-N-neotetraose was associated with 0.04% higher (P = 0.03) and 0.03% lower (P < 0.01) body fat, respectively. These findings support the hypothesis that differences in HMO composition in mother's milk are associated with infant growth and body composition. This trial was registered at clinicaltrials.gov as NCT02535637.

Generalized epilepsy and febrile seizures plus (GEFS+) in a series of 22 patients

Genetic epilepsies and their cognitive-behavioral traits have been described in various reviews. Nevertheless, it is difficult to find studies about generalized epilepsy and febrile seizures plus (GEFS+) displaying detailed descriptions of its neuropsychological comorbidities. We intend to describe the clinical picture of children with GEFS+, and its comorbidities, emphasizing cognitive-behavioral conditions, and also to find associations that may contribute to the development of these disorders. We reviewed clinical records from 22 patients diagnosed with GEFS+, based on clinical and family history (no genetic tests were conducted). Most of follow-up visits were with one of us (M. Devilat), over the period 1996–2011. Mean follow-up time was 5.3 yr (1–11 yr). Our investigation focused on the associated diagnoses: conduct disorder, attention deficit/hyperactivity disorder (ADHD), specific language impairment (SLI), specific learning disorders and intellectual disability (ID). Assessment for possible associations (i.e. age at onset, seizure-free period) was conducted. A total of 15 patients (68.18%) fulfilled the diagnostic criteria of these co-morbidities. The prevalence for each disorder was as follows: ADHD-six patients (27.27%); conduct disorder-five patients (22.73%); ID, SLI and specific learning disorders-four patients (18.18%) each. Among associated factors, long-lasting seizures and onset of seizures before 12 mo of life were statistically related to ID (P = 0.02 and P = 0.04, respectively). A normal electroencephalogram was predominant in patients with SLI (P = 0.01). We conclude that neuropsychological disorders are common among patients with GEFS+, ADHD being the most frequent diagnosis. Various factors including long-lasting epilepsy and early age of onset may be associated with cognitive disorders.