Nomograms for monitoring nutritional status

Nomograms based on National Child Health Surveys (NCHS) data are presented for the easy assessment of nutritional status

Infant feeding, growth and mortality: a 20-year study of an Australian aboriginal community

Data are presented on infant mortality, growth and feeding for an Australian Aboriginal Settlement over 20 years from 1953 to 1972. During this period the infant mortality rate fell from about 280/1000 to about 40/1000 although the growth, infant feeding and health facilities remained almost the same. It is proposed, as a hypothesis worthy of further exploration, that major factors leading to improvement in infant mortality have been a changed attitude to small infants and an ability to use health services appropriately. These factors may be important in all developing communities

EVOLUTION AND INFANT FEEDING

The darwinian theory of evolution has been used to justify the statement that breast-milk is ideal for infants. However, a broader interpretation of the theory suggests that the mother-child dyad is the evolutionary unit. For the survival of the species, both mother and child should benefit. Simple arithmetic shows that where there is a conflict of interests, the welfare of the mother outweighs that of the infant. The dyad hypothesis suggests that the maximum evolutionary gain is obtained when protein and energy levels in breast-milk are just high enough to prevent prohibitive infant mortality rates, but low enough to spare the mother. The anti-infective constituents of breast-milk are very small in bulk, so they place a minimum metabolic load on the mother but have a large benefit for the child. The contraceptive effect of breast feeding is pronounced only when the mother is malnourished. A separation of the nutritive from the anti-infective properties of breast-milk suggests that a rational method of infantfeeding for many mothers is to breast-feed for several months to reduce the morbidity rate in the infant, but to give supplementary milks, formulae, and foods when needed to promote the baby's nutritional status

Fascial planes within subcutaneous fat in humans

We have used B-mode (brightness-mode) ultrasound to investigate the fascial planes within subcutaneous fat at the triceps and abdominal sites in a group of 17 women attending a weight control group over a 12 month period. In most subjects there was a single intralipid fascial plane at each site. As the thickness of adipose tissue increased, most of the change at the abdominal site was in the deep rather than the superficial layer of fat. At the triceps site both deep and superficial layers increased. Our findings confirm the presence of two different layers in human subcutaneous fat at the triceps and abdominal sites. These layers have been shown to be functionally different in animals and our study supports this in humans at the abdominal site

Factors influencing school achievement of children from low socioeconomic groups in Malaysia

A general model is proposed relating the social and nutritional factors involved in school performance of children from poor socio‐economic backgrounds. The model has been tested in a group of 263 primary school children who came from mainly lower‐class families in Malaysia. School performance was assessed by the mark in a national school examination; the factors considered were race, sex, type of school attended, nutritional status and score in the Goodenough‐Harris Draw‐a‐Man test, and also the family size, income and education of parents. Multiple linear regression and extended median test were used in the analysis. There were strong associations between poor school performance on the one hand and nutritional and socio‐economic conditions on the other. However, detailed analysis showed that, for most sub‐groups, nutritional status was not a direct causal factor in school performance. Both nutrition and school achievement reflected home circumstances, particularly family income. There were however significant differences among children of different races. Many of the pathways on the general model have been shown to be irrelevant in this group of children; those pathways which remain are likely to be causal. The Goodenough‐Harris test showed highly significant differences between children of different ethnic groups. The general model seems justified as a framework for investigating school performance. It has been shown that simple correlation between factors is not a good guide to cause‐and‐effect relationships. Each deprived group is likely to have its own significant pathways, so that each group should be analysed rather than applying generalisations derived from other populations

Ethnic differences in the Goodenough-Harris draw-a-man and draw-a-woman tests

The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 school-children in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. The standard scores of the Chinese children averaged 118 in the DAM and 112 in the DAW tests. These scores were significantly better than the American standards. Malay children scored significantly lower than Chinese, and Tamil children scored lower again. The nutritional status of the children had no influence on the scores. Chinese and Tamil children scored better in the DAM than the DAW, while in Malay boys the reverse was true. Malay children tended to emphasise clothing in the DAM, but Chinese and Tamil children scored better on items relating to facial features and body proportions. The Goodenough-Harris draw-a-person tests are obviously not culture-free, but the causes of ethnic differences have not been elucidated

Food avoidance by breast feeding mothers in south east queensland

A group of 123 lactating mothers have been studied in Southeast Queensland, Australia. Seventy-three percent eliminated some foods from their own diets either to prevent problems or to treat existing conditions in their infants. The commonest food to be excluded was cabbage, followed by chocolate, other vegetables and fruit. A few mothers stopped taking cow’s milk or cow’s milk products. The mothers obtained this information from many sources including family, friends, books as well as health professionals. Avoidance of certain foods during lactation is a common practice. Mothers who avoided some foods had significantly greater weight loss between one and three months after delivery than those who ate a free diet, but maternal food restrictions had no significant effect on the weight gains of their infants

Influence of families on the growth of children in an Aboriginal community

Some Aboriginal children have poor growth while others grow according to international standards. This study was designed to find whether these differences were related to families. Data were obtained on 13 families at Cherbourg Aboriginal Community in Queensland. There were data on the growth and hospital admissions of children in these families for at least two generations. Data were taken from records of the Infant Health Clinic and Hospital on the Community. A total of 606 children were considered. The growth of a child during infancy is correlated with the growth of his/her mother in infancy, but not with the growth of the father. We have therefore defined families in the matrilineal line. There were marked and highly significant differences between the growth of children in the 13 families. The families with good growth in one generation were likely to have good growth of children in the next generation. In spite of the overall improvements in the growth of infants and children at Cherbourg, families tended to maintain their rankings from one generation to the next. It would be cost‐efficient to target health advice to those families who have, in the past, had poor growth among their children. Copyrigh