Children with smoking parents have a higher airway resistance measured by the interruption technique

Children exposed to environmental tobacco smoke, during or after pregnancy, are known to have decreased lung function. So far this has been measured using spirometry in schoolchildren and invasive techniques in newborns. The interruption technique (Rint) is a noninvasive technique to measure airway resistance in preschool children. Our aim in this study was to investigate the effect of passive smoke exposure on Rint values in preschool and school-aged children. Rint values were obtained from 557 children in two nursery and two primary schools in the north of the Netherlands. Besides information on parental smoking habits, we collected data on characteristics that might affect airway resistance (respiratory symptoms, atopy, and family history for asthma), using a short questionnaire. Multiple linear regression was used to estimate the associations of these characteristics with Rint, for the whole group as well as for the preschool group separately. Atopy or a positive family history for asthma did not affect Rint values in the total group of 4-12-year-olds. However, as may be expected, height, age, weight, and having respiratory symptoms were associated with Rint. Moreover, Rint was significantly increased if parents smoked three or more cigarettes a day in the presence of their child. This result remained after subgroup analysis in the preschool children (4-6 years old). We conclude that passive smoke exposure is associated with a significantly higher airway resistance in preschool and school-aged children measured by Rint. (C) 2004 Wiley-Liss, Inc

Effect of Donor Milk on Severe Infections and Mortality in Very Low-Birth-Weight Infants The Early Nutrition Study Randomized Clinical Trial

Item does not contain fulltextIMPORTANCE: Infections and necrotizing enterocolitis, major causes of mortality and morbidity in preterm infants, are reduced in infants fed their own mother's milk when compared with formula. When own mother's milk is not available, human donor milk is considered a good alternative, albeit an expensive one. However, most infants at modern neonatal intensive care units are predominantly fed with own mother's milk. The benefits of add-on donor milk over formula are not clear. OBJECTIVE: To determine whether providing donor milk instead of formula as supplemental feeding whenever own mother's milk is insufficiently available during the first 10 days of life reduces the incidence of serious infection, necrotizing enterocolitis, and mortality. DESIGN, SETTINGS, AND PARTICIPANTS: The Early Nutrition Study was a multicenter, double-blind randomized clinical trial in very low-birth-weight infants (birth weight <1500 g) admitted to 1 of 6 neonatal intensive care units in the Netherlands from March 30, 2012, through August 17, 2014. Intent-to-treat analysis was performed. INTERVENTIONS: Infants received pasteurized donor milk or preterm formula during the first 10 days of life if own mother's milk was not (sufficiently) available. MAIN OUTCOMES AND MEASURES: The primary end point was cumulative occurrence of serious infection (sepsis or meningitis), necrotizing enterocolitis, or mortality during the first 60 days of life. RESULTS: A total of 930 infants were screened for inclusion; 557 were excluded, resulting in 373 infants (183 receiving donor milk and 190 receiving formula) who were evaluated by intent-to-treat analysis (median birth weight, 1066 g; mean gestational age, 28.4 weeks). Own mother's milk comprised 89.1% and 84.5% of total mean intake during the intervention period for the donor milk and formula groups, respectively. The incidence of the combined outcome was not different (85 [44.7%] [formula] vs 77 [42.1%] [donor milk]; mean difference, 2.6%; 95% CI, -12.7% to 7.4%). The adjusted hazard ratio was 0.87 (95% CI, 0.63-1.19; P = .37). CONCLUSIONS AND RELEVANCE: In the current study, pasteurized donor milk and preterm formula as supplemental feeding during the first 10 days of life yielded similar short-term outcomes in very low-birth-weight infants regarding safety and efficacy when own mother's milk availability was insufficient. Future studies investigating longer duration of use of human donor milk on short-term and long-term outcomes are necessary. TRIAL REGISTRATION: trialregister.nl Identifier: NTR3225