• Proceedings of the Korean Society for Food Science of Animal Resources Conference
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• 2004.05a
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• pp.391-396
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• 2004

30명의 건강한 유아를 세 그룹으로 나누어 팔미틴산을 포함한 주요 지방산의 조성을 모유에 맞춘 조제분유 A, 팔미틴산의 비율을 모유의 1/3으로 조절한 조제분유 B, 그리고 모유와 조제분유 B를 약1:1 비율로 각각 1주일간 섭취하도록 하여 그들의 변을 수거, 분석을 하였다. 변의 농도, 횟수 및 변의 색에 있어서는 세 그룹 모두 유의할만한 차이를 관찰할 수 없었으나, 팔미틴산을 포함한 포화지방산과 칼슘, 마그네슘, 철분의 흡수는 혼합수유한 그룹이 가장 높았으며 조제분유 A를 섭취한 그룹에서 가장 낮았다. 또한 조제분유 B를 섭취한 그룹의 경우 혼합수유그룹에 비해 다소 낮은 흡수를 보이긴 하였으나 조제분유 A를 섭취한 그룹과는 현격한 차이를 보였다. 모유의 대표적인 포화지방산인 팔미틴산의 조성을 낮춘 조제분유를 수유할 경우 장내 지방산의 흡수를 개선하였으며 미네랄의 흡수도 효과적이었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.65-73
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• 1999

Purpose: Regurgitation, vomiting and feeding intolerance are frequent in the neonates. Esophageal function and gastric peristalsis are not fully developed in the neonates, so we should give attention to reduce the incidence of regurgitation and vomiting after feeding. It is necessary to shorten the gastric emptying by change of feeding types and postprandial postures. Gastric emptying time was measured by ultrasound in the neonates to evaluate the effect of feeding types and postprandial postures. Method: We measured gastric antral cross sectional area along the abdominal aorta at the level of the superior mesenteric artery in longitudinal section at NPO state (4 hours after feeding), 0 and every 30 min. after feeding until the value goes below or back to the NPO state. Fifteen neonates were examined in each breast-fed and formula-fed group in supine position. Eighteen and 15 neonates were examined in supine and prone posture after formula feeding, respectively. We used 5 MHz convex prove with Aloka Echo Camera SSD-650. Result: 1) Gastric emptying time of breast-fed infants was $76.0{\pm}20.02$ min. which was significantly shorter than $96.0{\pm}20.28$ min. of formula-fed infants. 2) Gastric emptying time on postprandial prone posture was $85.0{\pm}22.43$ min. which was not significantly different from $96.0{\pm}20.28$ min. on postprandial supine posture. Conclusion: Breast feeding is strongly recommended to the neonates to shorten gastric emptying time. So we can expect to reduce the incidence of regurgitation, vomiting and feeding intolerance. The postprandial posture depends on the traditional trend which is safe and comfortable to the mothers.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1166-1171
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• 2005

Purpose : The aim of this study was to evaluate whether breast milk feeding at infancy has the effect of a programming agent preventing school-age obesity, or whether formula milk feeding is the cause of elementary school-age obesity. Methods : We randomly selected 4 elementary school in Masan and Changwon city. We calculated the BMI and obesity degree from height and weight data on the school record of 1,275 children of first and second grade. The parents of 1,275 children were asked to a questionnaire about their birth history and feeding modality during infancy. Based on these data, we categorized them into 4- different groups : breast fed for less than 2 months; breast fed for 2-6 months; breast fed more than 6 months; mixed fed. We compared the mean BMI, obesity degree and prevalence rates of obesity of each groups. Results : There was no statistical difference on the prevalence rates of overweight and obesity, which was defined by BMI, according to the duration of breast feeding. The same was true for mild obesity and moderate obesity, which was defined by obesity degree. The mean BMIs and the mean obesity degree were not different among different feeding types. Conclusion : There seems to be no protective effect of breast feeding during infancy on reducing the prevalence rates of overweight and obesity. However, even wider and larger studies considering confounding factor might be needed to reach a definite conclusion in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.1-9
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• 2001

Purpose: Gastroesophgeal reflux (GER) is defined as involuntary movement of gastric contents into esophagus. Relaxation of lower esophageal sphincter caused by immature anatomical development in newborn and young infants produces GER frequently. We wanted to know whether the frequency of GER is influenced by feeding types and position or not. We studied in 16 subjects according to feeding types (breast feeding group: BFG-7, formula feeding group: FFG-9) who admitted to the Soonchunhyang university hospital for recurrent regurgitation with 24 hr esophageal pH monitoring from August 1996 to July 1999. Methods: We compared two groups by number of reflux episode, reflux rate, longest episode, numbers of episodes lasting >5 minutes, longest episode in upright position and longest episode in supine position. We used Mann-Whitney test for statistical analysis. Results: 1) The subjects were 7 infants in BFG and 9 infants in FFG, 16 in total, and mean age was 2.1, and 2.6 months for BFG and FFG, respectively. 2) The reflux numbers were $244{\pm}151/day$, $275{\pm}155/day$ for BFG and FFG, respectively. 3) The reflux rate was $14{\pm}15%$ for BFG and $28{\pm}22%$ for FFG. It was lower in BFG. 4) The longest episode was $20{\pm}28$ minutes for BFG and $58{\pm}66$ minutes for FFG. It was significantly longer in FFG. 5) The numbers of episodes lasting >5 minutes were $5{\pm}6$ for BFG and $9{\pm}3$ for FFG. 6) The longest episode in upright position was $10{\pm}8$ minutes for BFG and $40{\pm}47$ minutes for FFG. It was significantly shorter in BFG. 7) The longest episode in supine position was $18{\pm}29$ minutes for BFG and $52{\pm}66$ minutes for FFG. It was significantly shorter in BFG. Conclusion: Breast feeding is strongly recommended to reduce the regurgitation in infancy. It is an another benefit of breast feeding.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.454-458
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• 2003

Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide. The purpose of this study is to assess the difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomially-acquired rotaviral infection. Methods : The study was conducted on 348 babies who were delivered in Dongguk University Kyongju Hospital from Jan 1 to June 30 in 2001. Stool specimens were collected from clinically symptomatic neonates. We studied the rate of positive stool rotazyme ELISA tests and positive symptoms. We compared the frequency of clinical manifestations according to the feeding methods [breast feeding(BF) or formula feeding(FF)] and the delivery methods[normal vaginal delivery(NVD) or Cesarean section(C/sec)]. Results : Rotavirus was detected in 152 of 348 babies. The rate of positive rotazyme ELISA test was 43.7% in healthy full-term symptomatic neonates. The most common symptom of rotaviral enteritis was mild fever; the others were watery diarrhea, abdominal distension, vomiting, delayed weight gain, irritability, poor oral intake and dehydration. Compared with FF neonates, BF neonates have lower frequency of symptoms, especially watery diarrhea, delayed weight gain and poor oral intake. The symptomatic frequency was higher in FF and NVD neonates than BF and C/sec. Conclusion : The symptoms of rotaviral enteritis were less frequent in BF or C/sec delivered neonates. BF appeared to alleviate the rotaviral enteritis but further studies are needed. The cause of the lower frequency of symptoms in C/sec delivered neonates was unknown.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.151-158
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• 2010

The purpose of this study was to investigate the tooth surface caries patterns in the primary dentition according to breast or bottle feeding. The subjects of study were 815 children, 36 to 71 months old, in Iksan, Cheongju and Ulsan cities. The caregivers of the children were asked which they fed between the breast milk and the infant formula during the 1st year after birth and the duration of feeding. There was no significant difference in dmfs between the breast milk group and the infant formula group(significance level 0.05, same below). Tooth groups, tooth surface groups, teeth, and tooth surfaces which had significantly higher dmfs in the breast milk group than in the infant formula group were upper anterior teeth(tooth groups), upper incisors' buccal and proximal surfaces(tooth surface groups), upper incisors and upper second molars(teeth), upper central incisors' buccal and distal surfaces, upper lateral incisors' buccolingual and proximal surfaces, upper 2nd molars'lingual, proximal, and occlusal surfaces, and lower 2nd molars' buccal and distal surfaces. In the breast milk group, tooth groups, tooth surface groups, teeth, and tooth surfaces which dmfs significantly increased as the duration of the feeding increased were upper anterior teeth and upper molars(tooth groups), upper anterior teeth's proximal surfaces, upper molars' buccolingual, proximal, and occlusal surfaces, lower molars' proximal surfaces(tooth surface groups), upper anterior teeth, upper molars, lower 2nd molars(teeth), upper anterior teeth's proximal surfaces, upper 1st molars'buccolingual, proximal, and occlusal surfaces, upper 2nd molars' buccal surfaces, and lower 2nd molars'mesial surfaces(tooth surfaces). In the infant formula group, dmfs increased after 3 years of feeding, but the difference was not significant. Caries prevention is necessary in case of breastfeeding more than two years.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.704-712
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• 2008

Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.191-198
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• 2009

Purpose : Breastfeeding should be recommended for infants born to mothers with chronic hepatitis B Infection after postexposure prophylaxis. However, high proportion of these mothers are reluctant to engage in breastfeeding in Korea. This survey was taken to identify the cause of that reluctance. Method : Questionnaires were given to mothers with chronic hepatitis B infection who were registered at the 'Hepatitis B Perinatal Transmission Prevention Program' operated by Korea Center for Disease Control and Prevention. They visited a community health center for blood sample collection and signed a consent paper. The questionnaires were sent to the mothers. Result : Among 839 mailed questionnaires, 114 were returned marked 'address unknown'. The overall reply rate was 17% (n=125). Among responders, 52% (n=62) were breastfeeding and 48% (n=60) were formula-feeding. The most influential factor for breastfeeding was the mother's own decision (75%) and the obstetrician's recommendation (17%). For formulafeeding mothers, their decisions were influenced by obstetricians (57%), and by their own thinking (28%). The relationship between breastfeeding and perinatal prophylaxis failure was recognized as 45% 'related' and 50% 'not-related'. A total of 91% of breastfeeding mothers replied that they will breast-feed again. Among formula-feeding mothers, 78% answered that they will breast-feed if they were known that 'there is no direct relationship between breastfeeding and perinatal prophylaxis failure'. Conclusion : Despite the fact that there is no direct relationship between breastfeeding and perinatal prophylaxis failure, many were reluctant to breast-feed. Healthcare professionals have influence over the mothers for decision making. It will be necessary to educate healthcare personnel so that they can make a conceptual change as well as to promote the fact to the general public.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1055-1060
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• 2005

Purpose : The purpose of this study is to compare the growth pattern of breast fed and formula fed infants in the first 1 year of life. Methods : Anthropometric data(weight, length, head circumference) of at birth, 1, 3, 6, 9 and 12 months were collected by chart review and characteristics of subjects were collected by questionnaires. Among 358 infants, breast fed infants were 161(84 males, 77 females) and formula fed infants were 90(42 males, 48 females). Neither group was given solid foods before 4 months. The weight for age, length for age and head circumference for age were calculated. Breast fed infants were separated into 2 groups(breast fed for 4-11 months and breast fed for more than 12 months). Results : Characteristics of infants and mothers were similar in both groups except for maternal age. Mean weight of breast fed group was lower than that of formula fed group at 12 months of age(male : P=0.004, female : P=0.004). However, mean weight of 12 months breast fed group was below formula fed groups weight at 9 and 12 months(P<0.05). Mean length and head circumference were similar between groups. Conclusion : The growth indices of breast fed and formula fed infants are similar at birth, but weight curves of two groups differ in the first 1 year.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.875-880
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• 2009

Purpose : Iron-deficiency anemia remains the most common nutritional deficiency in young infants. This study aimed to survey the actual condition of feeding patterns and weaning diet and to study the association between these factors and the prevalence of anemia in infants aged over 9 months. Methods : We studied 171 infants aged 9-24 months who were hospitalized in the general ward with mild to moderate acute illnesses. The mothers answered a questionnaire about the feeding patterns and the status of the weaning diet of their infants. The infants were divided into three groups: infants who were exclusively breast-fed, those who had been given mixed feeding, and artificial milk feeders. Results : The incidence of anemia was significantly higher in exclusively breast-fed infants (23/68, 33.8%) than in the infants with mixed feeding (11/62, 17.7%) and artificial milk feeders (5/41, 12.1%). The mothers' awareness about the state of their infants󰡑 weaning diet was not related to the presence of anemia in the exclusively breast-fed infants. About 70% of the infants had started the weaning diet before age 6 months in all three groups, without any difference according to feeding patterns. Conclusion : The incidence of anemia was significantly higher in the breast-fed group than in the other infants. Many mothers of breast-fed infants with anemia also believed that their infants were taking sufficient weaning foods. Therefore, further education of the mothers about iron-rich weaning foods and the importance of iron intake during infancy is needed to prevent anemia, especially in breast-fed infants.