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  • Title: Feeding studies in Ceylonese babies.
    Author: Jayasuriya D, Soysa P.
    Journal: J Trop Pediatr Environ Child Health; 1974 Dec; 20(6):275-97. PubMed ID: 4499504.
    Abstract:
    A study of the effects of 4 milk preparations on the early growth of low birth-weight newborns in Ceylon is reported. The following parameters were studied: mortality; weight gain; tolerance, as indicated by the incidence of diarrhea and the presence of sugar in the stools; blood glucose levels; and blood urea and serum sodium levels. A powdered and partially skimmed cow's milk, Nestogen, was used as it is available in the government hospitals throughout the island. 2 strengths constituted Formulas 1 and 2, and by addition of sucrose to the latter, a 3rd of higher calorie value was prepared. The 4th formula was breast milk. The study population from 3 nurseries consisted of 112 babies between 1250 and 2057 grams birth-weight, those of lighter weight being excluded as many required intravenous therapy initially. Weights were checked daily, and as soon as babies were able to suck adequately, they were allowed home. Mean blood glucose levels were within the normal range in babies appropriate and small for gestational age on all 4 milks. There was a high incidence of diarrhea among babies on all 3 Nestogen formulas. On Formulas 1 and 2, diarrhea occurred between the 4th and 12th day, and, in all cases, preceded weight loss and dehydration. Babies with diarrhea on Formula 3 showed symptoms between the 3rd and 5th days, and in each case lethargy, weight loss, dehydration, and in some, fever, were followed by diarrhea. Blood urea nitrogen levels increased with the protein content of the diet and may have reflected a diminished extra cellular fluid volume due to extra renal fluid losses. Mortality rates were similar in the Nestogen fed babies; no breast fed babies died. In sum, the comparison showed breast milk to be overall superior for those who could suck. A higher protein feed was associated with more rapid weight gain but addition of sucrose produced intolerance. Higher strengths of Nestogen which obligate greater urinary fluid are probably unsafe in a hot climate which induces considerable insensible losses of water.
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