• Title/Summary/Keyword: infant feeding.

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Development of a Nutrition Questionnaire and Guidelines for the Korea National Health Screening Program for Infants and Children (영유아 건강검진 영양 문진 및 지침 개발)

  • Moon, Jin-Soo;Kim, Jae-Young;Chang, Soo-Hee;Choi, Kwang-Hae;Yang, Hye-Ran;Seo, Jeong-Kee;Ko, Jae-Sung;Choi, Kyung-Dan;Seo, Jeong-Wan;Chung, Hee-Jung;Eun, Baik-Lin;Hwang, Seung-Sik;Seo, Soon-Ryu;Kim, Han-Suk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.42-55
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    • 2008
  • Purpose: A new health policy, referred to as the National Health Screening Program for Infants and Children, was launched in November 2007 by the Ministry of Health and Welfare and National Health Insurance Corporation in Korea. We have developed a nutrition-counseling program that was incorporated into this project. Methods: We reviewed the nutritional guidelines published by The Korean Pediatric Society and internationally well-known screening programs such as Bright Future in the United States. We also reviewed the recent Korean national surveys on nutritional issues, including the Korea National Health and Nutrition Examination Survey (KNHANES) and the 2005 National Survey of Physical Body and Blood Pressure in Children and Adolescents. The development of questions, pamphlets, computer programs, and manuals for doctors was carried out after several meetings of researchers and governmental officers. Results: We summarized the key nutritional issues according to age, including breastfeeding in infants, healthier complementary feeding, and prevention of iron deficiency anemia, establishment of healthier diets, as well as dietary prevention of overweight children with an emphasis on physical exercise. We have constructed a new Korean nutrition questionnaire and an anticipatory guidance program based on the primary care schedule of visits at 4, 9, 18, 30, and 60 months of age. Five to eight questions were asked at each visit and age-matched pamphlets for parents and guidelines for doctors were provided. Conclusion: We developed a nutrition-counseling program based on recent scientific evidence for Korean infants and children. Further research on this national program for screening the nutritional problems in detail and setting the therapeutic approaches may help identify areas of success as well as those that need further attention.

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Short-term clinical outcomes of late preterm infants (후기 조산아들의 단기 임상적 결과)

  • Na, Ji Youn;Park, Narimi;Kim, Eun Sun;Lee, Hyun Ju;Shim, Gyu Hong;Lee, Jin-A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.303-309
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    • 2009
  • Purpose : To identify the short-term clinical outcomes of late preterm infants and to test the hypothesis that late preterm infants have more clinical problems during the early postnatal period than term infants. Methods : One hundred late preterm infants [gestational age (GA) $34^{+0}$-$36^{+6}$ weeks] and the same number of term infants (GA $37^{+0}$-$41^{+6}$ weeks) were randomly selected from 289 late preterm infants and 825 term infants born in the Seoul National University Bundang Hospital between January 2007 and December 2007, and their electronic medical records were reviewed and analyzed. Results : Compared to term infants, late preterm infants had significantly more medical problems such as temperature instability (odds ratio [OR] 8.7), hypoglycemia (OR 17.5), intravenous fluid infusion (OR 10.2), evaluation for sepsis (OR 9.4), respiratory problems (OR 7.5), apnea and bradycardia (OR 8.6), phototherapy for jaundice (OR 3.6), and feeding intolerance (OR 10.0). Hospital stay was also significantly longer in late preterm infants. Conclusion : Late preterm infants had significantly more medical problems and increased length of hospital stay compared to term infants. More attention should be given to caring for these late preterm infants in newborn nursery during the early postnatal period.

Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants (미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험)

  • Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1216-1220
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    • 2009
  • Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

Factors Related to Poor School Performance of Elementary School Children (국민학교아동의 학습부진에 관련된 요인)

  • Park, Jung-Han;Kim, Gui-Yeon;Her, Kyu-Sook;Lee, Ju-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4
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    • pp.628-649
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    • 1993
  • This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

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Immunogenicity and Safety of a Haemophilus influenzae Type b Polysaccharide-Tetanus Toxoid Conjugate Vaccine (PRP-T: HiberixTM) in Korean Infants (우리나라 영아에서 PRP-T(HiberixTM)백신의 면역원성 및 안전성에 대한 연구)

  • Chung, Eun Hee;Kim, Yae Jean;Kim, Yun Kyung;Kim, Dong Ho;Seo, Jeong Wan;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.71-80
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    • 2003
  • Purpose : Four kinds of Haemophilus influenzae type b protein conjugate vaccines, PRPD, PRP-T, PRP-OMP and PRP-CRM197, have been developed, and PRP-T vaccines are currently produced by two manufacturer, $ActHib^{(R)}$ by Aventis and $Hiberix^{TM}$ by GlaxoSmith-Kline Biologicals. The purpose of this study is to evaluate the immunogenicity and safety of $Hiberix^{TM}$ in Korean infants. Methods : Seventy-three healthy infants(43 male infants) were recruited for this study after parental informed consent was obtained. Each infant was vaccinated at 2, 4 and 6 months of age with the study vaccine. At each visit, infants were also immunized with DTaP, trivalent oral polio vaccine and hepatitis B vaccine when indicated. The serum anti-PRP antibody was measured at prevaccination, 2 month later after the 2nd dose, and 1 month later after the 3rd dose by the ELISA method. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Immunogenicity of vaccine was evaluated in infants who received all the scheduled immunization and the adverse reactions were evaluated for infants who received at least one dose of the study vaccine. Results : Among seventy three infants, enrolled in this study; sixty three(37 male infants) completed all the scheduled immunizations. The geometric mean titer(GMT) of anti-PRP antibodies at prevaccination was 0.17 ${\mu}g/mL$(95% confidence interval[CI]; 0.13~0.22). The GMT of anti-PRP antibodies increased to 4.14 ${\mu}g/mL$(95% CI; 2.65~6.48) at 2 month later after the 2nd dose of PRP-T and 14.65 ${\mu}g/mL$(95% CI; 10.83~19.81) at 1 month later after the 3rd dose. Anti-PRP antibody ${\geq}0.15$ ${\mu}g/mL$, was observed in 98.4%(95% CI; 91.8~100) after 2 doses and 100%(95% CI; 100~100) after 3 doses. Anti-PRP antibody ${\geq}1.0$ ${\mu}g/mL$, was obtained in 77.8%(95% CI; 67.5~88.0) after 2 doses, and 98.4%(95% CI; 95.3~100) after 3 doses. Most of the adverse reaction after vaccination were mild. Irritability, the most common systemic reaction, was observed in 45.5%, followed by drowsiness(30.5%), poor feeding(26.7%) and fever(5.6%). Among the local reactions tenderness was observed in 7.9%, redness(${\geq}5$ mm) in 2.8% and swelling(${\geq}5$ mm) in 1.8%. Conclusion : The PRP-T vaccine used in this study was highly immunogenic and safe in Korean young infants. The finding that high GMT and high frequency of infants with a protective titer achieved after 2 doses is consistent with the previous studies which were done with a PRP-T vaccine of other manufacturer. This study suggests that the immunization schedule of PRP-T vaccine for Korean infants may need re-evaluation.

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