Ounces Of Milk Research Articles

The State Of Nurse Education: A Critical, yet Missing, Component

For several decades now it has been clear in the literature that nurses experience some of the highest levels of job-related stress compared to other health professions [1]. This is also supported by the high rates of burnout also found within the profession [2,3]. More recently, researchers have taken on an exploration of the stress-levels of nursing students to explore the onset of these highlevels of stress to discern where this population starts to differ.

Increase in SARS-CoV-2 RBD-Specific IgA and IgG Antibodies in Human Milk From Lactating Women Following the COVID-19 Booster Vaccination.

The United States Centers for Disease Control and Prevention recommended a third dose or booster of the Pfizer-BioNTech Comirnaty (BNT162b2) COVID-19 mRNA vaccine in September 2021 for high-risk individuals. Pregnant and high-risk lactating women were encouraged to receive the booster to obtain potential prolonged protection for themselves and their infants. To investigate the ability of the booster vaccine to increase IgA and IgG antibodies specific to the receptor-binding domain of the SARS-CoV-2 spike protein in human milk compared to levels pre-booster. This was a prospective one-group study with a pretest-posttest design. Six of 12 participants were recruited prospectively. Participants were instructed to collect ≥ 2 ounces of milk in the morning at 30 days and 1-day pre-booster, and 7, 14, 21, 30, 45, and 60 days post-booster. Levels of IgA and IgG antibodies specific to the receptor-binding domain of the SARS-CoV-2 spike protein were quantified in human milk via an ELISA assay. We found a significant increase in anti-receptor-binding domain-specific IgA and IgG antibodies in human milk 1-2 weeks after the Pfizer-BioNTech booster and at the study endpoint (45- and 60-days post-booster). This suggests that the booster vaccination enhances SARS-CoV-2 specific immunity in human milk, which may be protective for infants.

Abnormal Calcium, Calcinosis, and Creatinine in Down's syndrome

The hypercalcaemia in association with trisomy 21 (Down's syndrome) is often not recognised and therefore underdiagnosed. Patients present with the tetrad of hypercalcaemia, Down’s syndrome, renal impairment, and nephrocalcinosis. 1-3 A 30-month old child with Down’s syndrome had a long history of nonspecific symptoms, constipation and feeding difficulties. He was on excessive bottle feeds, taking 14 bottles daily, each with six ounces of milk. He presented with a cardiac arrest having been unwell with an acute illness. Blood tests showed hypercalcemia, raised urea and creatinine which were not explained by any other aetiologies. Post-mortem analysis showed acute pyelonephritis and nephrocalcinosis. In children with Down’s syndrome, early detection of hypercalcaemia and introduction of low calcium feeds may prevent morbidity and mortality. Awareness and monitoring of serum calcium levels along with routine thyroid function tests in children with Down syndrome, would be important to prevent such occurrences.

Milk Consumption and Waste Across 5 Montana High School Lunch Programs.

Few studies document milk selection and waste among high school lunch programs. This observational research assesses the types of milk selected and wasted among 5 Montana high school lunch programs. Over 6 days across the 2014-2015 school year, 3842 milk cartons were collected. Direct weighing was used to assess the ounces of milk wasted and consumed by milk type. Outcomes included the number of milks selected by type at each school, ounces of milk consumed and wasted on average per student. Descriptive and inferential statistics were used to assess demographics of school lunch participation, milk consumption and waste, and the amount of waste per type of milk. Students were most likely (p < .05) to select fat-free flavored milk, followed by 1% plain milk, and fat-free plain milk. Fat-free flavored (mean=0.86, SD=0.55) was the least wasted, followed by fat-free plain (mean=1.08 oz, SD=1.55), and 1% plain (mean=1.26 oz, SD=1.02). Across all milk options, milk waste was low. The findings indicate that high school students are more likely to select and consume greater amounts of, and waste less, fat-free flavored milk.

The Impact of a District-Wide Chocolate Milk Removal Policy on Secondary Students’ Milk Purchasing and Consumption

Abstract Objectives Removing chocolate milk from school cafeterias is an increasingly popular policy approach for reducing youth sugar-sweetened beverage consumption and improving health. Evidence on the impact of such policies in urban secondary schools, which is needed to inform future school-based health improvement efforts targeting our highest-need youth, is lacking. The objective of this study is to determine the impact of a school district's chocolate milk removal policy on racially/ethnically and socioeconomically diverse middle and high school students’ milk, calcium, and added sugar consumption. Methods Student-level lunch data were collected in the springs of 2016 (pre-chocolate milk removal policy) and 2018 (post-policy) during one lunch period each in 24 middle and high schools in a diverse urban school district. Linear mixed effects models adjusted for school-level demographic characteristics were used to assess changes in the proportion of students who purchased milk; the proportion of milk consumed; and the average grams of added sugar, ounces of milk, and grams of calcium consumed per student. Results Pre-policy, 3,158 students (mean 132 per school) participated in lunch data collection across all 24 schools; post-policy, 2,966 students (mean 124 per school) participated. There was a 13.6% (95% CI −16.4, −10.8) decrease in the proportion of students who purchased milk pre-policy (89.5%) to post-policy (75.9%). The proportion of milk consumed remained stable pre- (68.3%) and post-policy (66.3%; 95% CI for difference −4.1, 0.01). There was a statistically significant 3.8g decline in added sugar consumed post- policy (95% CI for change −3.9g, −3.6g) and no significant changes in ounces of milk or grams of calcium consumed. Conclusions Immediately post-chocolate milk removal from school cafeterias, fewer secondary students purchased milk. However, among students who purchased milk, consumption remained stable pre- and post-policy, and added sugar consumption significantly declined. Evidence on the longer-term impact of chocolate milk removal policies is necessary. Funding Sources This work was funded by the United States Department of Agriculture, National Institute of Food and Agriculture, (Grant ID: 2015-68001-23236); Technology and Design Innovation to Support 21st Century School Nutrition.

Associations Between Child and Adolescent Beverage Intakes and Age 17-year Percent Body Fat (P21-064-19)

ObjectivesObservational studies in children and adolescents suggest that sugar-sweetened beverage (SSB) intakes are a risk factor for obesity, with obesity generally assessed using body mass index. Our objective was to investigate associations between child and adolescent beverage intakes collected longitudinally and % body fat at age 17. MethodsIowa Fluoride Study/Iowa Bone Development Study participants were recruited at birth and followed longitudinally with detailed questionnaires sent at least every 6 months. Mean daily (area under the curve) beverage intakes of participants (n = 174 male, n = 201 female) were calculated for the age ranges 1.00–3.00, 3.01–5.00, 5.01–9.00, 9.01–11.00, 11.01–13.00, 13.01–15.00, and 15.01–17.00 years from beverage questionnaire-reported intakes of milk, 100% juice, SSBs and water-based sugar-free beverages (WBB). Three-day diaries and food frequency questionnaires were used to calculate mean energy intakes for these age ranges. Percent body fat (%BF) was assessed by dual energy x-ray absorptiometry (DXA) at age 17-year clinic exams. Generalized linear models based on the gamma distribution and a log link function were used to examine associations between the independent variables of beverage intakes (at a specific age range), baseline socioeconomic status (SES), sex, and energy intakes, and the dependent variable %BF at age 17. ResultsAdolescent, but not early childhood, milk and 100% juice intakes were negatively associated with mean %BF at age 17. For example, the estimated effect of 8 additional ounces of milk daily at ages 15.01–17.00 years was a 4% decrease in %BF at age 17 (95% CI 6% decrease, 1% decrease), and the estimated effect of 8 ounces of 100% juice was an 11% decrease in %BF (95% CI 18% decrease, 3% decrease). Neither childhood nor adolescent SSB or WBB intakes were meaningfully associated with %BF at age 17. Adjustment for baseline SES, sex and energy intakes had a marginal impact on estimated effects. ConclusionsAdolescent milk and 100% juice, but not SSB or WBB, intakes were associated with lower %BF at age 17. The results suggest that associations between beverage intakes and obesity may depend on how obesity is measured. Funding SourcesNational Institutes of Health (R03-DE023784, R01-DE12101, R01-DE09551, UL1-RR024979, UL1-TR000442, UL1-TR001013, M01-RR00059); The Roy J. Carver Charitable Trust; Delta Dental of Iowa Foundation.

Gastric and Duodenal Diclofenac Concentrations in Healthy Volunteers after Intake of the FDA Standard Meal: In Vivo Observations and in Vitro Explorations.

This study investigated gastrointestinal drug concentrations of the weakly acidic drug diclofenac when dosed to healthy volunteers after intake of the FDA standard meal. In gastrointestinal aspiration studies, postprandial conditions are usually achieved using liquid or homogenized meals. However, these liquid meals may have a substantially different impact on the gastrointestinal physiology compared to a solid meal. To evaluate the effect of a solid mealon the gastrointestinal behavior of diclofenac, five healthy volunteers were recruited into a clinical study. Twenty minutes prior to diclofenac ingestion (Cataflam, 50 mg of potassium diclofenac), the volunteers were asked to eat a solid meal with the following composition corresponding to the FDA standard meal: 2 eggs, 2 bacon strips, 2 toasts, 4 ounces of hash brown potatoes, and 8 ounces of milk. Gastric and duodenal fluids were collected as a function of time, and blood samples were collected to link the gastrointestinal behavior to systemic exposure. In vivo observations were complemented with in vitro research to obtain a mechanistic understanding of diclofenac's intraluminal behavior. Ingestion of the solid meal resulted in intraluminal pH-profiles similar to earlier studies with a liquid meal. However, intraluminal drug disposition differed. In the stomach, a substantial fraction of diclofenac appeared dissolved, despite an unfavorable acidic pH. Successive in vitro tests suggested that the dissolution of diclofenac is higher in the complex gastric medium resulting from FDA standard meal ingestion compared to liquid meal ingestion. Despite the favorable pH and in contrast to a previous study with a liquid meal, significant amounts of non-dissolved diclofenac were observed in the intestine. Further in vitro tests revealed adsorption of dissolved diclofenac molecules to bacon fragments present in the FDA standard meal. This adsorption negatively affected the permeation of diclofenac across a physical barrier, suggesting that in vivo absorption is affected as well. Being the first time a gastrointestinal aspiration study is combined with the administration of a solid meal, the present study demonstrates that the intraluminal behavior of diclofenac (and possibly other drugs) heavily depends on the consistency and composition of the accompanied meal.

Student Acceptance of Plain Milk Increases Significantly 2 Years after Flavored Milk Is Removed from School Cafeterias: An Observational Study

BackgroundPrevious studies document decreases in lunchtime milk consumption immediately after flavored milk is removed. Less is known about longer-term effects. ObjectivePlain milk selection and consumption were measured the first year flavored milk was removed in a school district (2010 to 2011 [Time 1]) and 2 years later (2012 to 2013 [Time 2]). Four behavioral economic interventions to promote milk were tested in one school at Time 2. DesignThis was a longitudinal, observational study. Participants/SettingParticipants were kindergarten through grade 8 students in two schools in an urban district. Primary data were collected 10 times per school year at Time 1 and Time 2, yielding 40 days of data and 13,883 student observations. The milk promotion interventions were tested on 6 additional days. Main outcome measuresOutcomes were the percentage of students selecting milk at lunch, the ounces of milk consumed per carton, and the ounces of milk consumed school-wide per student. Statistical analysesLogistic regressions were used to assess how sex, grade, time, availability of 100% juice, and behavioral interventions affected milk selection and consumption. ResultsAt Time One, 51.5% of students selected milk and drank 4 oz (standard deviation=3.2 oz) per carton, indicating school-wide per-student consumption of 2.1 oz (standard deviation=3.0 oz). At Time Two, 72% of students selected milk and consumed 3.4 oz per carton (standard deviation=3.2 oz), significantly increasing the school-wide per-student consumption to 2.5 oz (standard deviation=3.1 oz). Older students and boys consumed significantly more milk. Availability of 100% fruit juice was associated with a 16–percentage point decrease in milk selection. None of the behavioral economic interventions significantly influenced selection. ConclusionsThese data suggest that after flavored milk is removed from school cafeterias, school-wide per-student consumption of plain milk increases over time. In addition, the presence of 100% juice is associated with lower milk selection.

Severe Iron Deficiency Anemia in Infants and Young Children, Requiring Hospital Admission.

Objective. This study evaluated patient characteristics, milk intake, and associated lab findings of children 6 months to 5 years old, admitted to a children’s hospital with severe iron-deficiency anemia (IDA). Methods. A chart review was conducted on patients admitted with microcytic anemia (hemoglobin concentration less than 7 g/dL), accompanied by a low serum ferritin and/or low serum iron level between January 2000 and December 2006. Results. A total of 18 children with severe IDA were evaluated. Many had parents with private insurance and jobs. Almost all children drank >24 ounces of milk daily. Hemoglobin on admission was 3.8 g/dL, and the mean of the patients’ mean corpuscular volume was 52.8 fL. Median iron levels were 4 µg/dL. Conclusions. Severe IDA is still prevalent in children, yet physicians may not perform necessary testing. The devastating long-term effects of severe IDA should prompt clinicians to screen for severe IDA in children regardless of absent risk factors.

Abstracts fromThe Academy of Breastfeeding Medicine 18th Annual International MeetingPhiladelphia, PennsylvaniaNovember 21–24, 2013

Abstracts fromThe Academy of Breastfeeding Medicine 18th Annual International MeetingPhiladelphia, PennsylvaniaNovember 21–24, 2013

Buying Human Milk via the Internet: Just a Click Away

For past centuries, infants have been fed the milk of mothers who are not their own by latching to another woman's breast. Today, the majority of lactating women use electric pumps to extract milk from their breasts; thus, an infant now may be fed another woman's milk via a bottle or cup. The Internet is an emerging avenue to acquire pumped human milk. The purpose of our study was to participate in and describe the process of buying milk via the Internet. Our goal is to help those involved with the clinical care, research, and public health policy of mothers and infants better understand that families may be buying milk in this way. We anonymously bought 102 human milk samples via the Internet. We characterized the outside box, packing materials, milk container, temperature and condition of the milk, and cost. We bought 2,131 ounces of milk at a total cost of $8,306. Eighty-nine percent of the milk arrived above the recommended frozen temperature of -20°C; 45% of it was even above the recommended refrigerator temperature (4°C). The mean surface temperature of the milk samples in each shipment was correlated with the cost of shipping, time in transit, and condition of the milk containers. The prevalence and potential risks of this practice currently are unknown. Research related to milk quality and infant outcomes related to milk buying via the Internet is urgently needed.

Impact on Milk Consumption and Nutrient Intakes From Eliminating Flavored Milk in Elementary Schools

In Brief American children are overweight and undernourished. It is critical that school meals provide foods that help children achieve a healthy, balanced diet, and in recent years, some schools have removed flavored milk. The primary goal of this study was to quantify the impact of changes in flavored milk availability on school children’s milk consumption. A secondary goal was to explore potential implications on nutrient intakes at school meals and cost to schools as a result of changes in milk consumption. Measurements of milk sold and the cumulative ounces of milk discarded at school breakfast and lunch were recorded on an average of 12 observation days at 49 elementary schools that had changed flavored milk availability over the past 2 years. When flavored milk was removed on 1 to all days of the week, there was a 26.0% reduction in milk sales and an 11.4% increase in the percentage of milk discarded, resulting in a 37.4% decrease in milk consumption. The Jefferson County school district in Colorado was further evaluated to determine what foods could hypothetically replace the nutrient deficit from lower milk consumption without adding extra calories, fat, or sugar. Alternate foods commonly served at the schools were selected, and the nutrient changes were examined using the US Department of Agriculture National Nutrient Database. The resulting changes in cost were also determined using actual food prices from this school district. It would require 3 to 4 additional foods, resulting in more calories and fat, to replace the nutrient deficit from this decline in milk consumption, a cost increase of up to $4600 more per 100 students per year in their district. Removing flavored milk from schools had significant unintended consequences on children’s milk consumption, which could negatively impact nutrient intake and should be further evaluated. Time to recognize that f lavored milk may have an important place in elementary schools

Storage of Leftover Unpasteurized and Pasteurized Human Milk

The current human milk storage guidelines recommend that leftover HM be discarded immediately or soon after an infant is finished feeding. There is limited research to support this recommendation. The objective was to observe the difference in bacterial growth in leftover unpasteurized human milk (HM) and leftover pasteurized milk (PHM). Five mother‐baby dyads participated in the study. Each baby was fed 1 – 2 ounces of milk from a bottle prepared with the mother's pasteurized milk and the mother's unpasteurized milk. Leftover milk was collected in sterile containers and analyzed for bacterial growth at specific time points during storage. Acceptable levels of bacteria were chosen as 10^5 colony‐forming units per milliliter (CFU/ml). HM was stored from 6 to 9 hours and PHM from 9 to 24 hours at 24°C before reaching 10^5 CFU/ml. HM was stored from 4 to 6 days and PHM was stored at least 6 days at 4°C before reaching 10^5 CFU/ml. More research is needed with a larger number of participants and focusing on the growth of specific strains of pathogenic bacteria in leftover human milk so that consumer recommendations can be made. The data show that bacteria originating from the mother are greater than bacteria originating from contamination by an infant.

Case Report of Endosonographic Doppler Interrogation of Blue Rubber Bleb Nevus Syndrome

Purpose: Description of endosonogrpahic doppler interrogation of blue rubber bleb nevus syndrome. Methods: Case report Results: Blue rubber bleb nevus syndrome is an uncommon, but well documented cause of GI blood loss in children. Low flow vascular lesions may occur throughout the GI tract, most commonly in small bowel. There are currently no reports documenting the endosonographic Doppler interrogation of these lesions. We report the case of an eight year old with increasing fatigue and pallor found to have a microcytic anemia (Hgb 6.0 g/dL, MCV 61). The patient reported daily soft brown stools. The patient had a similar episode 18 months prior to this presentation: Hgb was 5.1 with MCV of 54. At that time the child was noted to drink approximately forty ounces of milk a day. The patient was transfused and begun on iron therapy. The child remained completely asymptomatic and was documented to have a hemoglobin of 11.8 g/dL three months prior to this presentation. On evaluation at this presentation stools were guaiac positive. Endoscopy was performed. On upper endoscopy the patient was noted to have two vascular lesions: a ten millimeter lesion on the greater curvature of the stomach and a larger, fifteen millimeter vascular lesion in the second portion of the duodenum. Wireless capsule endoscopy demonstrated six additional lesions throughout the jejunum and ileum. Endoscopic ultrasound was performed to further delineate the nature of the lesions prior to intervention. The gastric lesion was noted to be an intramucosal vascular lesion in the second layer. Doppler interrogation revealed arterial flow to the vascular lesion: an arterial vessel arising in the muscularis (fourth layer) was documented to pass through the third layer and into the intramucosal vascular lesion. After multidisciplinary evaluation, the patient continues on iron. Balloon enteroscopy with endoscopic ablation or endoscopically assisted laparascopic ablation will be considered if anemia becomes intractable. Conclusion: This is the first report of documentation of flow in blue rubber bleb nevus syndrome.Figure: Intramucosal vascular lesion seein in layer 2 on endoscopic ultrasound

Brief report: Use of an antecedent procedure to decrease night awakening in an infant: A replication.

Borowski, Hunter, and Johnson (2001) found that an antecedent strategy such as white noise could decrease sleep awakenings for infants in the natural home environment. This study attempts to replicate the findings using an ABAB reversal design. A five month and one week old child, who had difficulty with waking an average of four times per night, was placed on a white noise program. This program consisted of the parents placing a FamilyCare air purifier and ionizer next to the infants crib and turning the machine on just before the infant parents began to rock the infant and then place the infant in the crib for sleep. This antecedent procedure was successful in reducing the number of infant wakening to 1.3 episodes/ night. Keywords: Infant sleep, nightime wakening, stimulus/antecedent control procedure, behavioral intervention, replication. Introduction As a greater reliance on functional assessment is occurring in behavior therapy (Sturmey, 1996), behavioral interventionists are placing growing weight on neutralizing routines and antecedent control strategies as alternatives to contingency management strategies. As part of this trend, a greater emphasis is being placed on establishing positive routines (Adams & Rickert, 1989; Milan, Mitchell, Berger, & Peirson, 1981), neutralizing routines at the onset of problems (Cautilli & Dziewolska, 2004), and antecedent control strategies (Rolider & Axelrod, 1999; Cautilli & Tillman, 2004). This research stretches across many areas but one area of particular importance for new parents is that of sleep. Establishing a sleep wake cycle in infants is an important part of parenting (Novak & Pelaez, 2004) and typically one of parents' earliest challenges. Sleep problems for typical children are common (Kuhn & Weidinger, 2000). One of the earliest interventions tried was the use of white noise (Borkowski, Hunter & Merele, 2001; Schmidt, 1975). The white noise procedure is the simple use of continuous sounds to block out the occurrence of other sounds and to create an airy sound effect (For a complete theoretical analysis of white noise seeBorkowski and colleagues, 2001 but the producer builds on a combination of stimulus control in which sleep is seen as a reinforcer and respondent conditioning. Continued sleep is seen as a factor of behavioral momentum). Borkowski and colleagues (2001) explored the use of white noise as an antecedent for sleep time combined with scheduled bedtime routines for five infants, who were four months old. They found the intervention helpful in three infants who were bottle-fed but not helpful for the two infants who were breast-fed. This study attempted to replicate their findings in clinical practice with a five month, one week old child. Method Participant The participant was an only child in his family and typically developing. The child was mostly breast feed, however, due to hectic life schedules the parents fed formula at least three times/week. The child was fed between four and six ounces of milk during the last feeding before sleep. The participant was a five month and one week old child with a history of difficulty with waking during the night after his parents placed him in his crib for sleep. The participant was roughly averaging four instances of waking each night. The instances of problems sleeping reached the point of being so severe that the parents brought the participant to the hospital emergency room in order to determine if a physical problem was present. After the physician told the parents that waking during the night was common, the physician sent the parents and the participant home. Two days later, the infant's parents sought out the aide of the first author by email on the Internet. Setting The participant slept in parent's room. The setting was a standard 12x14 room. The room housed one standard crib for the infant and a queen-sized bed. …

Beverage choices affect adequacy of children's nutrient intakes.

To assess the relationship between beverage choices and the adequacy of nutrient intakes among children and adolescents. Beverages reported in 24-hour recall records were classified as milk, 100% juice, fruit-flavored drinks, or carbonated sodas. Recommended intakes were based on Recommended Dietary Allowances or Dietary Reference Intakes. Four thousand seventy children aged 2 to 5, 6 to 11, and 12 to 17 years participating in the 1994-96 Continuing Survey of Food Intakes by Individuals. The likelihood of achieving recommended intakes of selected nutrients on the day of recall was assessed with multiple logistic regression including ounces of milk, juice, fruit-flavored drinks, and carbonated sodas in the model while controlling for sex, age in years, race/ethnic group, household income, and total energy intake. Milk consumption was positively (P<.0001) associated with the likelihood of achieving recommended vitamin A, folate, vitamin B(12), calcium, and magnesium intakes in all age strata. Juice consumption was positively (P< or =. 001) associated with achieving recommended vitamin C and folate intakes in all age strata and magnesium intakes among children aged 6 years and older. Carbonated soda consumption was negatively (P< or =. 01) associated with achieving vitamin A intake in all age strata, calcium in children younger than 12 years, and magnesium in children aged 6 years and older. Beverage choice can have a significant effect on the nutrient adequacy of the diets of children and adolescents.

A year of remarkable growth for donor milk banking in North America.

In 1999, approximately 322,700 ounces of milk were processed and distributed by the 7 member banks of the Human Milk Banking Association of North America. One new bank opened, and 2 medical centers in the United States are considering opening donor banks. The majority of the recipients were preterm and sick infants, but milk was also ordered for older babies and for children with a variety of medical needs, including metabolic disorders, severe food allergies or feeding intolerance, short gut syndrome secondary to necrotizing enterocolitis, growth failure on formula, and intractable rotavirus, and during chemotherapy for cancer. Donor milk was also ordered for adopted infants who did not have medical problems and for some adult cancer patients. Member banks serum screened 770 potential donors. One donor was excluded for a positive Hepatitis C test, and 3 were excluded for positive HTLV results. Further confirmatory tests were negative for these 4 potential donors.

95 HOW FLOWS THE MILK OF HUMAN KINDNESS?

Establishment of a human milk supply is the sine qua non for the development of a Human Milk Bank. In response to a plea for donors, 568 lactating mothers volunteered to donate milk to the NSUH Human Milk Bank without financial recompense. Of the 568 volunteers, 309 failed to complete the medical screening process; 97 never submitted the medical forms; and 4 completed the medical screening process but were dropped for medical reasons, leaving 158 qualified donors. Of the 158, 81 actually donated milk. All were white; 52% were between 26-30 years of age; 35% were working mothers of which 41% were registered nurses. Seventy-five of the 81 donors donated 2,813 ounces of milk (37%) while 6 donated 4,765 ounces or 63% of the total milk received! The longest time a donor supplied milk was 10 months. By the end of the first 10 months, 59 of the 81 donors had abandoned the effort, for a drop-out rate of 73% in 10 months. The milk of human kindness is hard to find and depends upon the generosity of a few dedicated individuals.

A guide to good eating the vegetarian way

In response to an expressed need for help in selection of nutritionally adequate meals by those who have recently turned to vegetarianism, a set of guidelines was developed. Work began with trial menus for a 70-kg man for one week, all providing 12 ounces of milk and one and one-half eggs daily. Computer checks of energy and nutrient levels indicated needed adjustments for adequacy according to Canadian Dietary Standard (CDS). Serving sizes were altered for other age and sex categories of the CDS and their adequacy checked. Foods of similar composition were classified in four groups, standard servings described, and numbers of servings for each family member tabulated. Instructional material assists beginning vegetarians in selecting nutritionally adequate, varied, and appetizing meals. While evaluation prior to publication in booklet form has been carried out, large scale feedback at the consumer level is invited.

Intolerance of Eight Ounces of Milk in Healthy Lactose-Intolerant Teen-Agers

The ability of lactose-intolerant individuals to tolerate 8 ounces of milk was determined in healthy teen-agers. Thirty-two blacks were studied with 50-gm lactose tolerance tests. Nineteen (59%) had a flat blood sugar curve and 13 (39%) also developed bloating, cramps, loose stools, or diarrhea with the test. These latter 13 were defined as lactose-intolerant. Seven of the 13 lactose-intolerant teen-agers (54%) developed abdominal bloating and/or cramps after drinking 8 ounces of milk (half-pint). None had diarrhea. Eight were symptomatic with the equivalent amount of lactose (12 gm) while only one had symptoms with the monosaccharide components of lactose, glucose and galactose. The symptoms with milk and 12 gm of lactose were less severe than with the 50-gm tolerance test. A history of a prior awareness of milk intolerance was obtained from 11 of the 13 lactose-intolerant subjects. At least one half of lactose intolerant teen-agers might be expected to be symptomatic after drinking 8 ounces of milk without other food. Milk intolerance should be considered in the nutritional planning for teen-agers with special attention to members of population groups with a high prevalence of lactose intolerance.