Effect of Early Breast Milk Nutrition on Serum Insulin-Like Growth Factor-1 in Preterm Infants

BACKGROUND: Insulin-like growth factor 1 (IGF-1) is one of the essential intrauterine hormonal mediators of growth, and its serum values are often low after preterm delivery. AIM: To evaluate the influence of immediate breast milk feeding on serum IGF-1 in preterm newborns. SUBJECTS AND METHODS: This prospective, observational cohort study included 60 premature infants born < 32 weeks of gestation, divided into group A and B regarding breastfeeding or formula feeding. Growth measurements were taken at birth. The standard deviation of each measurement was calculated. Serum IGF-I was measured one day postnatal and at a time equivalent to 40 weeks of gestation. RESULTS: Significant higher level of mean serum IGF-1 was detected in group A than B at postnatal age equivalent to 40 weeks of gestation. In group A, the higher significant level was detected in mean serum IGF-1 at an age equivalent to 40 weeks of gestation than at birth (25.21 ± 6.69 and 20.13 ± 5.46 p < 0.05). Multiple linear regression analysis showed that high birth weight, increased age of gestation and breastfeeding were correlated to the elevated serum level of IGF-1 at a postnatal age corresponding to 40 weeks gestational age. CONCLUSION: Immediate breast milk feeding was accompanied by elevated IGF-1 in the serum of preterm infants

Adaptive Functioning and Psychosocial Problems in Children with Beta Thalassemia Major

BACKGROUND: Beta thalassemia major is considered one of the serious health problems and the commonest hemoglobinopathy in Egypt that creates a burden not only on health system but also on the affected families and children who become vulnerable to emotional, social, psychological and behavioural problems. AIM: This study was designed to assess the psychosocial burden and the adaptive functioning in children with beta-thalassemia major. SUBJECTS AND METHODS: A group of 50 children with thalassemia major and 50 normal children matched for age and sex were included in a case-control study. Vineland Adaptive Functioning Scale was used to assess the adaptive functions; while the Pediatric Symptom Checklist (PSCL) was used to assess psychosocial morbidity. RESULTS: A group of 50 children aged 5-17 years old with thalassemia major, their mean age was 11.05 ± 3.8, showed a statistically significant lower total adaptive behaviour score and communication subscale score. All the mean values of adaptive behaviour for cases and controls were within the average values. Results from the PSCL revealed no significant difference between mean scores of children with thalassemia and controls. A score of attention domain was markedly higher in children with thalassemia. Internalising behaviour was the most dominant as it was detected in 10% of the patient group. CONCLUSION: Thalassemic patients had a relatively mild affection for adaptive and psychosocial functioning that can be explained by social and medical support they receive, which may increase their competence and psychological wellbeing

Neurocognitive Function and Its Related Potentials in Children with Beta Thalassemia Major: An Egyptian Study

BACKGROUND: Repeated blood transfusions and hemolysis in β-Thalassemia major children lead to iron overload in various organs, including the brain which may cause neurodegeneration. AIM: To evaluate intelligence quotient in children with β-thalassemia major and healthy counterparts and to assess risk factors that cause cognitive problems. SUBJECTS AND METHODS: This case-control study was performed on 50 children aged 6-16 years old with β-thalassemia major as patients group and compared with 50 healthy children as a control group of matched age, sex, and social class. Cognitive functions were evaluated by using the Wechsler Intelligence Scale for Children. Serum ferritin and iron were measured by ELISA. RESULTS: There were significantly lower mean performance and full-scale IQ scores of patients group in comparison with controls, whereas no significant differences between both groups as regards to a verbal IQ score. In thalassemic children, block design, comprehension and arithmetic were negatively correlated with age of disease onset, duration of illness and onset of chelation therapy. Serum iron and ferritin were negatively correlated with similarities and digit span. Serum iron levels were negatively correlated with performance IQ score. CONCLUSION: Children with β-thalassemia major need to receive more academic attention and cognitive assessment to improve their IQ