Physical Growth Of Infants Research Articles

Association between gestational arsenic exposure and infant physical development: a prospective cohort study

BackgroundArsenic pollution is widespread worldwide. The association between gestational arsenic exposure and adverse birth outcomes has been demonstrated in previous studies; however, few investigations have examined whether gestational arsenic exposure has adverse effects on infant growth and development after birth.ObjectiveOur study was designed to evaluate particular associations between gestational arsenic exposure during pregnancy and newborn birth size and to investigate whether these associations continue to affect infants after birth.MethodsAn ongoing prospective cohort study of 1100 pregnant women was conducted at the Wuxi Maternity and Child Health Care Hospital. The total urinary arsenic concentrations in the 2nd and 3rd trimester were determined using atomic fluorescence spectrometry. The relationships between urinary arsenic concentration and foetal growth parameters (birth weight, head circumference, length, and ponderal index), SGA (Small for gestational age), and physical growth of infants within one year after birth were analysed.ResultsUrinary arsenic concentration in the 3rd trimester was associated with an increased incidence of SGA [adjusted model: OR = 2.860 (95% CI: 1.168, 7.020), P = 0.021)]. Arsenic exposure in late pregnancy had an adverse effect on the physical development of infants before the age of 1 year, and there was an interaction effect with the sex of infants. The weight and length of boys at 6 and 12 months negatively correlated with maternal urinary arsenic levels during late pregnancy.ConclusionsIn addition to affecting foetal growth, exposure to arsenic in the 3rd trimester also negatively affected the growth of offspring within the first year of life.

Longitudinal assessment of growth and neurodevelopment of children with in utero severe acute respiratory syndrome coronavirus 2 exposure: A prospective cohort study

Introduction Research related to the impact of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on fetuses and neonates remains limited. The majority of previous studies have focused on immediate outcomes. We conducted this prospective cohort study to evaluate the effect of in utero SARS-CoV-2 exposure on the growth and neurodevelopment of infants, considering the scarcity of long-term follow-up studies in the literature. Primary Objective The primary objective of the study was to compare neurodevelopment and growth up to the age of 1 year among coronavirus disease COVID-positive and COVID-negative neonates born to COVID-positive mothers. Secondary Objectives The secondary objectives of the study were to assess the status of exclusive breastfeeding in infants at the age of 6 months and to assess the risks of vertical and horizontal transmission of COVID-19 infection. Methods We included live neonates with gestational age >28 weeks born to pregnant women who tested positive for COVID-19 by reverse transcription polymerase chain reaction and delivered at the institute in this prospective observational cohort study. Details related to delivery and neonatal profile, including the neonatal COVID status were collected. Neonates were followed up at 6 months and 1 year for physical growth profile and neurodevelopmental profile using World Health Organization growth charts and the Baroda Development screening test (BDST). Results A total of 6 SARS-CoV-2-positive and 82 SARS-CoV-2-negative neonates were followed until the age of 1 year. There was no statistically significant difference between the SARS-CoV-2-positive and SARS-CoV-2-negative cohorts concerning gestational age (P-value 0.300), birth weight (P-value 0.988), and neonatal intensive care unit admission (P-value 0.288). Approximately 65.9 and 45.4% of infants were still exclusively breastfeeding at the ages of 6 months and 1 year, respectively. No difference was observed in wasting (P-value 0.393) and stunting at the ages of 6 months (P-value 0.656) and 1 year between the two cohorts. Furthermore, no significant difference was observed in neurodevelopmental status at 6 months (P value for BDST score 0.236; P value for developmental quotient (DQ) 0.446) and 1 year (P value for BDST score 0.635; P value for DQ 0.666) between the two groups. Conclusion Our study generated evidence that in utero exposure to SARS-CoV-2 infection does not seem to affect the growth and neurodevelopment of neonates born to SARS-CoV-2-positive mothers; however, further studies including nonexposed controls, are warranted to support our findings. Furthermore, the benefits of rooming-in and breastfeeding on the neurodevelopment and physical growth of infants far outweigh the minimal risk of horizontal transmission.

Association between maternal postpartum depressive symptoms, socioeconomic factors, and birth outcomes with infant growth in South Africa

This study aimed to investigate the association between maternal postpartum depressive symptoms, household demographic, socioeconomic, and infant characteristics with infant physical growth, and how these factors correlate to determine latent factors. This study was based on the baseline data of a 6-month randomised controlled trial aimed at providing an egg a day to infants aged 6 to 9-months from a low socioeconomic community in South Africa. Information collected on household demographic, socioeconomic, and infant characteristics was by face-to-face structured interviews, and trained assessors took anthropometric measurements. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal postpartum depressive symptoms. The analysis was based on 428 mother-infant pairs. Total EPDS score and its subscales score were not associated with stunting or underweight risk. However, a three- to four-fold increased risk of stunting and underweight, respectively was observed for premature birth. Low birthweight was associated with an estimated six-fold increased risk of underweight and stunting. Being female was associated with about 50% reduced risk of stunting and underweight. In conclusion, more robust studies are needed to substantiate these findings, with more awareness creation on the consequences of LBW and prematurity on the physical growth of infants from resource-limited settings.

Correlation between Parenting Style, Anemia, and History of Chronic Infection with Anthropometric Index for Toddlers 0-59 Months in Oesapa Health Center Work Area

Physical growth in infants and toddlers is often used as an indicator in measuring nutritional status. Parents and caregivers are very influential in the nutritional state of children. Children under five who have abnormal nutritional status have immune systems that can weaken, so they are susceptible to infectious diseases such as diarrhea and fever, and can also experience anemia. This research was conducted at the Oesapa Health Center. This research is analytic observational research design with a cross sectional approach. The number of respondents is 93 people taken using the technique simple random sampling. Retrieval of data using a questionnaire. From the results of statistical tests using Chi Square, it was found that there was a relationship between a history of chronic infection and the anthropometric index of TB/U toddler aged 0-59 months (p=0.021) and there was a relationship between a history of chronic infection and the anthropometric index of BB/TB toddler 0-59 month (0.001). The interventions carried out are providing education, counseling or leaflets to pregnant women, mothers who have babies under five regarding the problem of stunting and wasting, fostering Posyandu cadres to provide counseling on stunting, wasting, nutritional knowledge, maternal parenting and environmental hygiene and height measurement bodies routinely at posyandu activities every month to monitor the nutritional status of children at height/age on a regular basis.

Improving Underweight Mothers' Essential Newborn Care During Early Infancy: A Single-Blinded, Parallel-Randomized, Controlled Trial

To evaluate the effectiveness of using a standardized Essential Newborn Care (ENC) module taught by pediatric residents on ENC skills and growth of offspring born to underweight primigravida mothers. This facility-based, single-blinded, parallel, randomized controlled trial was conducted between May 2018 and March 2019. Eighty-eight underweight primigravida mothers and their vaginally delivered offspring were blindly allocated into the intervention group (IG) or control group (CG). The IG mothers received education on ENC through pictorial aids, demonstrations, and practice sessions. All mothers received information from ongoing public health programs. A trained hospital nurse, blinded to the study, assessed the mothers' neonatal care skills on the second postnatal day. The infants were followed until 6months. Weight, length, and head circumference were measured at birth and age 6weeks, 10weeks, 14weeks, and 6months (±1week). Mothers in the IG had significantly better ENC skills in all domains (P<.001). Their infants had a statistically significant increase in weight (at 10 and 14weeks and 6months), length (at 14weeks and 6months), and head circumference (at 6months). Infants' z-scores indicated significant improvements in anthropometry in the IG compared with the CG. At age 6months, the number of infants with weight <3rd percentile decreased in the IG (from 20 of 44 to 5 of 41) and increased in the CG (from 17 of 44 to 22 of 42) compared with birth percentiles. An educational intervention to strengthen maternal ENC knowledge and skills soon after delivery improved physical growth in infants born to underweight primigravida mothers. Clinical Trials Registry-India: CTRI/2018/04/013096.

Blood lead concentrations in children with iron deficiency anemia: a systematic review and meta-analysis.

Iron deficiency is the most common nutritional disorder detrimentalto the behavior, cognitive performance, immune system, and physical growth of infants and preschool- and school-age children.Iron deficiency anemia (IDA)increaseschildren's susceptibility to some metals, including the highly toxic lead (Pb), but the character of this relationship is still disputed. Thus, this study aimed to review and meta-analyze the association between the IDA and blood lead levels (BLL) among children, based on papers indexed by international scientific databases and published up to September 2021. A search was performed of the literature in several databases including the ISI Web of Science, PubMed, and Scopus. The final papers were assessed concerning their quality based on the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Moreover, analyses were performed using R statistical software with the "meta" package. Of the 1528 articles found, only 12studies met the inclusion criteria and were considered in the meta-analysis. Significantly higher BLL in IDA children (SMD = 2.40; CI 95%, 0.93-3.87µg/L; p = 0.0014) was seen when compared to non-IDA children. Moreover, the pooled OR is equal to 2.75 (CI 95%, 1.10-6.85µg/L; p = 0.0303) suggesting a higher risk of IDA development among children with BLL > 10µg/dL.Thus, we recommend systematic monitoring of Fe and Pb levels among children, especially in countries with limited sources of nutritious food. Since only a few studies were available for this meta-analysis, further studies are necessary to examine the association between IDA and BLL in detail.

Longitudinal association of actigraphy-assessed sleep with physical growth in the first 6 months of life.

Suboptimal sleep is associated with obesity and its sequelae in children and adults. However, few studies have examined the association between sleep and physical growth in infants who experience rapid changes in sleep/wake patterns. We examined the longitudinal association of changes in objectively assessed sleep/wake patterns with changes in growth between ages 1 and 6 months. We studied 298 full-term infants in the longitudinal Rise & SHINE cohort study. Changes from 1 and 6 months in nighttime sleep duration, wake after sleep onset (WASO), and number of waking bouts ≥5 min were assessed using ankle actigraphy. Overweight was defined as age- and sex-specific weight for length ≥95th percentile. Generalized estimating equation analyses adjusted for infants' and mothers' characteristics. The mean (SD) birth weight was 3.4 (0.4) kg; 48.7% were boys. In multivariable adjusted models, each 1-h increase in nighttime sleep duration between months 1 and 6 was associated with a 26% decrease in the odds of overweight from 1 to 6 months (odds ratio [OR] = 0.74; 95% confidence interval [CI, 0.56, 0.98]). Each 1-unit decrease in number of waking bouts was associated with a 16% decrease in the odds of overweight (OR = 0.84; 95% CI [0.72, 0.98]). Changes in WASO were not associated with the odds of overweight. Greater increases in nighttime sleep duration and more consolidation of nighttime sleep were associated with lower odds of overweight from 1 to 6 months. Adverse sleep patterns as early as infancy may contribute to excess adiposity.

598 Sleep Variability and Infant Anthropometry during the First 6 Months

Abstract Introduction Sleep plays a crucial role in children’s health and development, and emerging evidence suggests that sleep disturbances during infancy negatively impact both the neurocognitive and socioemotional outcomes later in life. However, no study has taken the variability of sleep into account when examining physical growth in infancy, which is a critical period for both healthy sleep and weight development. The purpose of the study was to examine the association between sleep variability and physical growth in infants aged 6 months. Methods 316 healthy infants recruited during their 6-month well-child checkups had their weight and length measured, and wore an actigraph on the ankle for a week. Average weekday, weekend, and all week sleep duration were computed, with infants categorized into three groups: regular sleep, weekend catch-up sleep, and weekend sleep curtailment. General linear model analyses were performed with sleep variability as the primary predictor variable of interest and infant anthropometry as the dependent variable. Results Average weekday daily sleep duration was 10.76 (1.06) hours which was similar to the average weekend daily sleep duration of 10.68 (1.06) hours. In both unadjusted and adjusted models controlling for potential confounding variables, infants in the weekend catch-up sleep group (30.4%) and those in the weekend sleep curtailment group (34.5%) had significantly higher weight-to-length ratios, body mass index, and weight-for-age z scores when compared with infants in the regular sleep group (35.1%, all p &amp;lt; 0.05). Conclusion Weekday-weekend sleep pattern differences exist even as early as in the first 6 months of life, and either weekend catch-up sleep or weekend sleep loss is associated with higher infant anthropometric markers. Our findings suggest that sleep assessments in infants in well-child checkups should include not only global assessments of average sleep duration but also address sleep pattern regularity. Support (if any) This study was funded by the National Health Research Institutes, Taiwan, NHRI-EX102-10229PC.

Rancangan Grafik Ukuran Antropometri, Ketebalan Lemak Dan Kecukupun Gizi Berdasarkan Metode Regresi Spline Sebagai Prediktor Kondisi Stunting Pada Balita

In the period of 24-59 months of age, the sensory system of toddlers is ready to face various stimulations and growths, such as learning to speak more fluently and recognizing environmental conditions, physical and psychological growth. Not all toddlers can grow optimally. One form of growth failure during toddlerhood is stunting. Indonesia is the country with the fifth-highest stunting condition in the world in the last decade. Around 37% (nearly 9 million) of children under five in Indonesia are stunted. Stunting can of course be avoided by knowing the possible causes and signs such as 1) Under-standard anthropometric measures, 2) Low nutritional adequacy, 3) Body Mass Index for Parents, 4) Age at high risk during pregnancy, 5) Poor environmental sanitation. well preserved. Anthropometric measurement indicators such as height, weight, and head circumference are used as the main criteria for assessing the adequacy of nutritional intake and physical growth of infants and toddlers. In Indonesia, the growth curve for children under five that is commonly used is KartuMenujuSehat (KMS). The KMS curve is designed based on references from the World Health Organization (WHO) and the Nations International Children's Emergency Fund (NCHS). Based on this mismatch, this study aims to design a graph of physical growth standards for toddlers based on anthropometry (height, weight, head circumference, chest circumference, calf circumference), fat thickness, and nutritional adequacy of toddlers according to the average physical size of toddlers in Indonesia. Also, it assesses the adequacy of nutrition in areas that have inhibiting factors for nutrient intake. This growth standard graph is designed using the spline regression method. This study used a cross-sectional design where measurements were carried out once. The sample in this study were children under five who were in the study who met the inclusion criteria. Based on the results of data analysis and the design of the curve mode, the third-order cubic spline mode is obtained with a combination of two knots, namely 9 and 21 knots, and a minimum GCV value of 2.1267. The linear assumption value is fulfilled with a value of R2 = 82.54. i.e. linearity, normality, and a constant zero residue are met.

Projecting Infant Weight Gain per Day to 112 Days from First 35 Days of Life

Abstract Objectives The American Academy of Pediatrics Task Force on Clinical Testing of Infant Formulas [1] stated, “Determination of rate of gain in weight is the single most valuable component of the clinical evaluation of an infant formula” and “recommends, that weight gain be determined over an interval of 3 to 4 months.” A gastrointestinal tolerance study (denoted ST) measured infants' weight gain per day from 14 to 35 days of age (CW2). The objectives of this project were 1) to estimate weight gain per day from 14 to 112 days of age (CW5) using the CW2 in ST and historical data from seven 4-months growth and tolerance studies by simulation and bootstrap, and 2) to determine if ST would have supported normal physical growth in infants had the study been continued to 112 days of age by showing that the experimental formula is non-inferior to the control formula using weight gain accretion of 3 g/day as the non-inferiority margin. 1. American Academy of Pediatrics, Committee on Nutrition, (CON-AAP). “Clinical Testing of Infant Formulas With Respect to Nutritional Suitability for Term Infants.” June 1988 (Report prepared under FDA contract 223-86-2117) (available at https://wayback.archive-it.org/7993/20170722090324/https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/InfantFormula/ucm170649.htm) (accessed May 23, 2019). Methods The simulation made use of the observed linear relationship between CW2 and CW5 from growth data in the historical studies, which included 16 formula groups. The simulated data for CW2 and CW5 were generated using multivariate normal distribution with mean vector μ and covariance matrix ∑, estimated from ST and the historical studies. In addition, the bootstrapped distribution of the difference in mean CW5 between the experimental and control groups in ST was derived using the historical studies. Software SAS® 9.4 and SAS® Enterprise Guide 7.1 (SAS Institute Inc, Cary, NC) were used for this report. Results Based on the analyses, we conclude that growth observed from 14 to 35 days of age in ST when extended to 112 days of age will demonstrate normal physical growth with high probability (&amp;gt; 98%). Conclusions Using such a predictive model may be a complementary solution for bridging growth and tolerance studies of shorter duration to 4 months for minor changes to infant formulas. Funding Sources Abbott Laboratories.

0318 Prospective Association of Actigraphy-Assessed Sleep with Physical Growth in the First 6 Months of Life

Abstract Introduction Suboptimal sleep is associated with weight gain and related chronic diseases in adults, adolescents, and older children. However, little is known regarding the associations between sleep and physical growth in infants. We investigated prospectively the associations between objectively-measured sleep patterns at 1 month and physical growth in the first 6 months of life. Methods We studied 344 full term infants in the ongoing longitudinal Rise &amp; SHINE (Sleep Health in Infancy &amp; Early Childhood) birth cohort study. At 1 month, infants underwent 7-day ankle actigraphy, estimating average sleep duration (24-hour, nighttime, and daytime) and sleep fragmentation (number of nighttime awakenings). Weight and length were measured at birth and 6 months and used to calculate weight-for-length z (WFL-z) scores. We used linear and logistic regression analyses to examine the associations between sleep patterns at 1 month with WLF-z at 6 months and rapid weight gain from birth to 6 months, defined as an increase in WFL-z greater than or equal to 0.67, controlling for covariates. Results Each 1-hour increase in 24-hour sleep duration was associated with a 0.07-unit (95% CI [0.01, 0.12]) increase in WFL-z at 6 months. Daytime, but not nighttime, sleep duration was positively associated with WFL-z. Greater number of nighttime awakenings was associated with higher WFL-z (beta = 0.28; 95% CI [0.08, 0.49]). 24-hour and nighttime sleep duration were positively associated with a 18.5% (95% CI [1.04, 1.35]) and a 23.4% (95% CI [1.02, 1.49]) higher odds of rapid weight gain from birth to 6 months, respectively. Conclusion Longer 24-hour sleep duration was associated with higher 6-month WFL-z and more rapid increases in WFL-z from birth to 6 months. Greater nighttime sleep fragmentation was associated with higher 6-month WFL-z. Sleep at 1 month might provide modifiable targets to help avoid lifetime complications of excess weight. Support R01DK107972.

Prenatal exposure to mixture of bisphenol A and mono(2-ethyl-5-hydroxyhexyl) phthalate increases body mass index of 6 month-age infants

TPS 632: Health effects of flame retardants and plasticizers, Johan Friso Foyer, Floor 1, August 27, 2019, 3:00 PM - 4:30 PM Background: Bisphenol A (BPA) and phthalates metabolites have endocrine-disrupting properties that may implicate weight dysregulation even at low doses of exposure. Studies have reported that individual prenatal exposure to BPA and phthalates have been associated with increased body mass index and adiposity while their knowledge gap on effect of co-exposure of BPA and phthalates exists. Thus, in this study we evaluated the exposure of mixture of BPA and phthalates and their influence on physical growth in infants. Methods: Among the participants (N=399) from:the Mothers and Children’s Environmental Health study in South Korea., we evaluated the effect of co-exposure and interaction of first, third trimester of pregnancy and at birth urinary BPA, mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-n-butyl phthalate (MBP) on z-scores of height, weight and body mass index (BMI) at 6 months using linear regression, generalized additive model and Bayesian kernel machine regression(BKMR). Results: BPA at birth (β=0.08) and BPA in late pregnancy (β= 0.04) was significantly associated with weight at 6 months of age, while BPA at birth was associated with an increase in BMI at 6 months (β=0.15, p<0.05). Significant interaction (p<0.05) was found for BPA and MEHHP at birth affecting weight and BMI at 6 months. BKMR analysis showed significant effect of mixture of BPA and phthalate exposure (>90 percentile) at birth on weight (estimate= 0.25) and BMI (estimate=0.47) at 6 months. Also, BKMR analysis replicated the results for effect of BPA on weight and BMI at 6 months and for the interaction between BPA and MEHHP. Conclusion: Our results identified the effect of prenatal exposure to mixture of BPA, phthalates and their interaction on z-scores of weight and BMI at 6 months. Further studies are needed to explore the interaction of BPA and phthalates. Acknowledgement: This study was supported by Ministry of Environment, Korea.

Multiple micronutrient supplementation using spirulina platensis and infant growth, morbidity, and motor development: Evidence from a randomized trial in Zambia.

In developing countries, micronutrient deficiency in infants is associated with growth faltering, morbidity, and delayed motor development. One of the potentially low-cost and sustainable solutions is to use locally producible food for the home fortification of complementary foods. This study aimed to test the hypothesis that locally producible spirulina platensis supplementation would achieve the following: 1) increase infant physical growth, 2) reduce morbidity, and 3) improve motor development. We randomly assigned 501 Zambian infants into the control group or the spirulina group. Children in the control group (n = 250) received a soya-maize-based porridge for 12 months; those in the spirulina group (n = 251) received the same food with the addition of spirulina. We assessed the change in infants’ anthropometric status, morbidity (probable pneumonia, cough, probable malaria, and fever), and motor development over 12 months. The baseline characteristics were not different between the two groups. The attrition rate (47/501) was low. The physical growth of infants in the two groups was similar at 12 months of intervention, as measured by height-for-age z-scores and weight-for-age z-scores. Infants in the spirulina group were 11 percentage points less likely to develop a cough (CI: -0.23, -0.00; P < 0.05) and were more likely to be able to walk alone at 15 months (0.96 ± 0.19) than infants in the control group (0.92 ± 0.28). Home-fortification of complementary foods using spirulina had positive effects on upper respiratory infection morbidity prevention and motor milestone acquisition among Zambian infants.

Effect of maternal pre-pregnancy BMI and weekly gestational weight gain on the development of infants

ObjectiveThe aim of the present study is to identify the average effect across different time points and to specify the time effects of maternal pre-pregnancy BMI and weekly gestational weight gain on the mental development and physical growth of infants.MethodsThe present cohort study used a repeated measures study design that began in 2004 with follow up at 3, 6, 12, 18, and 24 months of age. The participants were a subset from a controlled, cluster-randomized, double-blind trial. Bayley Scales of Infant Development (BSID) were used to estimate the mental development of infants. A generalized estimating equation linear model was used to estimate the effects of maternal BMI and weight gain.ResultsThe average effect of maternal BMI and weight gain on the weight for age Z scores (WAZ), length for age Z scores (LAZ) and mental development index (MDI) across the different time points of infants was significant. In addition, the maternal BMI and weight gain were positively and significantly associated with the WAZ and LAZ in infants of different ages. However, the effect of weekly gestational weight gain was significant only during the earlier period of life (3 months, Coefficient: 11.15, 95%CI: 4.89–17.41).ConclusionsOur results indicate positive effects of pre-pregnancy and prenatal nutrition on the physical growth of infants. Weekly gestational weight gain of the pregnant women had a positive effect on the mental development of the infants, but this effect appears to decline over time.

To Assess the Knowledge of Anaemia among Studied Population of Shimla Hills

Anaemia is one of the major public health problems, affecting both sexes and all ages. It adversely affects the cognitive performance, behaviour, and physical growth of infants, preschool and school-aged children. In view of the immense public health consequences of anaemia this study was conducted in the field practice areas of Department of Community Medicine, IGMC, Shimla, for a period of one year. A total of 421 girls were studied. They were clinically examined, & predesigned & pre tested proformas were filled up. Haemoglobin assessment was done using Filter paper Cyanmethemoglobin technique. It was concluded that girls who were aware about sources of iron rich diet, adverse effect of anaemia on academic performance and increased requirement of iron by the girls, were less likely to be anaemic.

Effects of Nutritional variables in children with iron deficiency anemia

Introduction: Iron deficiency (ID) is the most prevalent nutritional disorder in the world. The prevalence of iron deficiency anemia (IDA) is about 9% in toddlers, 9-11% in adolescent girls and less than 1% in teenage boys. IDA presents when there is not sufficient iron for haemoglobin synthesis. In particular it has negative effects on the behavior, cognitive performance, immune system and physical growth of infants, preschool and school age children. Material and Methods: Blood samples of 337 randomly selected children (6-59 months) living in the Ahwaz, Khuzestan province, were taken. Serum ferritin, Complete Blood Cell (CBC) and hematological indices were measured Results and Discussion: In this study 61.1% of the children had serum ferritin less than 12mcg/dl. Prevalence of IDA were 29.1 %. The results showed that most children with IDA were at 12-23 months. Families with more than 6 children had 4.49 times greater chance of IDA. The mean of breast-feeding in non-IDA children was higher than IDA children (17.6 and 16.3 months respectively, P>0.05). In this study families who gave tea to their children for 1-11 months had the highest prevalence of IDA. Conclusion: There are several main risk factors for ID & IDA in the children. Parent's illiteracy, family income and using cow's milk before 12 months are among most important risk factors for iron deficiency for children.

The effects of family feeding pattern on the physical growth of infants

Objective To explore the relationship between physical growth of infants and family feeding be -havior.Methods Demographic information was collected from 516 objects.Height,weight,head circumference,chest circumference were measured and feeding behavior was evaluated using prospective observational study method . Results （1） Feeding behavior score was positively associated with infant physical development indicators ,the be-tween groups differences of infant age ,body weight,body length were statistically significant （P〈0.05）.（2）The re-sults of Pearson correlation analysis showed that weight , head circumference of infants at 18 months and length at 24 months were significantly correlated with feeding behavior score （P〈0.05）.（3）The analysis of feeding behavior factors found that food preparation was associated with weight infants at 18 months（P〈0.05）;behavior of infants and height,weight,head circumference,chest circumference of children in the 18 months of age were related（P〈0.05）;infant feeding environment in the 18-month-old was related with their height,weight,head circumference（P〈0.05）. Conclusion It is suggested that well family feeding pattern might be a certain stimulative role in young children ′s physical growth and development . Key words: Enteral Nutrition; Behavioral Research; Child Development

Diencephalic syndrome due to astrocytoma in three infants with failure to thrive

Diencephalic syndrome (DS) is a group of conditions characterized by major features (severe emaciation despite normal or slightly decreased caloric intake, locomotor hyperactivity and euphoria) and minor features (skin pallor without anemia, hypoglycemia and hypotension). 1 Most of the reported cases showed clinical symptoms before the age of 2 years. An early sign of nystagmus leads to early recognition of this condition.We report three infants with poor oral intake, failure to thrive and nystagmus who were diagnosed with DS due to astrocytoma. The major point of this report emphasizes the recommendation that brain tumor should be thought to be a cause of unexplained failure of physical growth in infants. Patient 1 A 1-year-old female infant with failure to gain weight since the age of 7 months was brought to our hospital due to a need for another opinion. At 6 months of age, she developed poor oral intake and vomiting while being provided with a cow’s milkbased infant formula. Diagnosis of cow’s milk protein allergy (CMPA) was made by a primary physician.Although such cow’s milk-based infant formula was eliminated and an extensively hydrolyzed casein formula (EHF) was introduced, she still consumed little volume and vomited. On detailed history taking, the presence of involuntary rapid eye movement for 5 months led to suspicion of brain tumor; then nystagmus and atrophy of the left optic disc were detected. Her growth parameters are shown in Table 1. Investigations for panhypopituitarism and tumor markers were negative. Cranial computerized tomography (CT) revealed an illdefined non-enhancing hypodense lesion at the suprasellar region measuring 3.8 ¥ 3.8 cm in diameter with the absence of calcification. Subsequently, magnetic resonance imaging (MRI) of the brain revealed a well-defined, lobulated mass at the suprasellar region, involving the optic nerve, optic chiasm and hypothalamus with neither calcification nor a cystic component (Fig. 1). A spinal MRI demonstrated spinal metastasis at multi-levels of the cervical-thoracic-lumbar vertebra to the conus medullaris. Tumor biopsy was performed and the pathological report showed pilomyxoid astrocytoma (World Health Organization (WHO) grade II). Subtotal tumor removal was then performed. Enteral feeding with a medical formula had been provided via a nasogastric tube in combination with parenteral nutrition since admission. Chemotherapy consisting of vincristine and carboplatin was administered. After the operation, panhypopituitarism developed and was subsequently treated. Unfortunately, blindness also occurred. Appetite gradually increased and she could eat orally, so enteral feeding and parenteral nutrition were ceased. Five months later, her weight and length gain were 1720 g and 2 cm, respectively. After 11 months of treatment, cranial and spinal MRI showed a decrease in size of the suprasellar mass and no detectable tumor seeding at the cerebrospinal fluid (CSF) pathway. Patient 2

Physical Growth of Infant in Hiroshima Prefecture

Physical Growth of Infant in Hiroshima Prefecture

Sleep and physical growth in infants during the first 6 months

The aim of this study was to explore the relationships between infant sleep patterns and infant physical growth (weight for length ratio) using both objective and subjective sleep measures. Ninety-six first-born, healthy 6-month-old infants and their parents participated in the study. Infant sleep was assessed by actigraphy for four consecutive nights and by the Brief Infant Sleep Questionnaire (BISQ). In addition, parents were asked to complete background and developmental questionnaires. Questions about feeding methods were included in the developmental questionnaire. Infants' weight and length were assessed during a standard checkup at the infant-care clinic when the infants were 6 months old. Significant correlations were found between infant sleep and growth after controlling for potential infant and family confounding factors. Actigraphic sleep percentage and reported sleep duration were correlated negatively with the weight-to-length ratio measures. Sex-related differences in the associations between sleep and physical growth were found. Breast feeding at night was correlated with a more fragmented sleep, but not with physical growth. These findings suggest that sleep is related significantly to physical growth as early as in the first months of life. The study supports increasing evidence from recent studies demonstrating a link between short sleep duration and weight gain and obesity in young children.