pediatrics 1954 nyhan 442 8

8/12/2019 Pediatrics 1954 NYHAN 442 8

1/9

1954;14;442Pediatrics

WILLIAM L. NYHAN and MORRIS A. WESSELDIFFERENT FEEDING REGIMENS

NEONATAL GROWTH IN WEIGHT OF NORMAL INFANTS ON FOUR

http://pediatrics.aappublications.org/content/14/5/442the World Wide Web at:

The online version of this article, along with updated information and services, is located on

ISSN: 0031-4005. Online ISSN: 1098-4275.

PrintIllinois, 60007. Copyright 1954 by the American Academy of Pediatrics. All rights reserved.by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village,it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarkedPEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication,

at Indonesia:AAP Sponsored on March 7, 2014pediatrics.aappublications.orgDownloaded from at Indonesia:AAP Sponsored on March 7, 2014pediatrics.aappublications.orgDownloaded from
http://pediatrics.aappublications.org/content/14/5/442http://pediatrics.aappublications.org/content/14/5/442http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/content/14/5/442


2/9

N E O N A T A L G R O W T H IN W E IG H T O F N O R M A L IN F A N T SON FOUR IFF R NT F ING R GIM NS

B y W LL M L . N Y H A N , M .D . ,#{176}A N D M O R R IS A . W E S S E L , M . D .N ew H av en Co nn ectic ut

44 2

T HE w eigh t o f in fan ts du ring the neo-na ta l pe r iod has been the su b jec t o f

ex ten sive stud y , an d de tailed ana lyse s o fsuch s tu d ies have been ava ilab le in thelite ra tu re fo r som e tim e . 2 T here is , h ow -ev er , a pauc ity o f m a te ria l invo lv ing con -cu rren t com p ar ison of sim ila r g roups of in -fan ts o n d ifferen t feed ing reg im ens w h icha ffo rd conc lus ions as to the e ffects o f d iffe r-en t ap proaches to feed in g du ring th is pe -n od . F abe r and S u tton 3 in 19 30 repo rtedsuch a s tudy of b reast and bo ttle fed bab ie s11 1 w hich it w as fou nd tha t d u rin g the firs t12 w eeks of life the average w eek ly ga in ofth e b reast fed in fan ts w as sign if ican tlyg rea te r than tha t o f th e bo ttle fed in fan ts .Q uite recen tly P a iva ,4 in a repo rt o f a studyo f a g ro up o f b reas t fed in fan ts , com -m en ted th a t th e pa ttern o f g row th of thesein fan ts d id no t d iffer sign if ican tly fro ms tan da rd Iow a grow th curves w h ich a reb ased on d a ta from b ab ies p red om in an tlya r tific ia lly fed . W ith rega rd to th e m an ne ro f feed in g , m u ch has been sa id re ferab le toth e theo ry of se lf-dem and feed ing 6#{ 176 } and toself-d em and feed in g behav io r.b0 13 L ittle ,h ow eve r, ha s b een p re sen ted to docum en tth e ph ysio lo g ical e ffec ts o f th is approachto in fan t feed ing .

T he p re sen t stu dy has inv o lved an an a ly -s is o f the w eig h t changes o f norm a l new -b orn in fan tsf on fou r d iffe ren t feed in g reg i-

F rom the Y ale R oom ing -In Pro jec t, D epartm en to f P ed ia tric s , Y a le U nivers ity S choo l o f M ed ic ine ,N ew H av en , C o nn .

T h is P ro jec t has been supp orted b y gran ts -in -a idf r o m : (1 ) M ead Johnson an d C om pany ; (2 ) T heG eorg e D av is B iv in F oun da tio n , Inc .; (3 ) T heF ie ld Fo unda tion , Inc ., and (4 ) N ationa l Institu teo f M e nta l H ea lth , o f the N a tio nal Inst itu tes o fH eal th , P u blic H e alth S erv ice .

(R ece ived fo r p ub lication A p ril 20 , 1954 .)* Address: 78 9 H ow ard A v en ue, N e w H av en ,

C onnec t icu t . O n the M atern ity D iv is ion of the G race-N ew

H av en C om m un ity H osp i ta l U n ive rs ity S e rv ice .

m en s in ord er to asce rta in if the re w erean y observ ab le d iffe rences th at cou ld be re -la ted to these d iffe ren t m e thod s o f feed ing .

M AT E RIA L S AND M E T H O DS

T he w eigh t changes o f 40 0 in fan ts dur in gthe first si x to e igh t w eeks of life w ere ana lyzed .T h e group in gs w ere as fo llow s: 1 00 b reas t-fedo n a flex ib le sched u le in ro om ing-in ;14 1 00b o ttle -fed on a flex ib le schedu le in room ing-in ;10 0 breast-fed in th e nurse ry o n a 4-ho ur sched-u le ; 10 0 bo ttlefed in the nu rse ry on a 4-h ourschedu le . M etho d of and crite ria fo r se lec tion ,and the m ilk m ix tu re rece ived by the b o ttle -fedin fan ts du ring the first w eek have been de-sc ribed .15 F o llow in g d isch arge from th e hosp i-ta l, these in fan ts receiv ed a m ix tu re o f evapo -rated m ilk and w ate r w ith 5% added carbohy -d ra te . T h ose in fan ts selec ted h ad re tu rn ed fo rthe pos tna ta l check-up be tw een 4 2 and 54 dayso f age .

W eigh ings w ere perfo rm ed in all cases bythe regu la r nurs ing s ta ff u tiliz ing stand ardnurse ry b alance sca les . In th e n ursery , w e igh -ing s w ere p erfo rm ed just p rio r to the firs t m o rning feed in g at 7 :0 0 a .m . In the room ing- inunits th e tim e of w eigh in g ten ded to be m oreflex ib le , w a itin g upo n the baby s tim e o f spon-taneous w ak i n g . H ow ev er here , too , bab iesw ere w eig hed just p rio r to feed ing and the tim eso f m orn ing feed in g w ere genera lly s im ila r. Ina ll cases the bab ies w ere w eig hed nu de andfo llo w ing brie f c leansing procedures . S ince a llw e igh ings w ere perfo rm ed in th e m o rn ing thefirst w e igh t period rep resen ted a partia l day . T hed a ta fo r a ll su bsequ en t period s rep resen t fu ll24 -h our in terv a ls .

R E S U L T ST he m ean d aily w e igh ts d u rin g the pe -I T h e m ilk m ix tu re g iv en in the h om e to in fan ts

a rtific ia lly fed w as a m ix tu re o f evap ora ted m ilkand w ate r in the prop ortions of 1 :1 .5 to w h ich 5%carb ohydrate w as add ed in the fo rm of corn sy rup .In th is m ilk m ix tu re appro x im ate ly 1 6% o f th e to ta lca lo ries is in p ro te in , 45 % in carbohyd ra te and 39%in fat. T he calo r ic v alu e is ap prox im ate ly 0 .7C al / cc .

at Indonesia:AAP Sponsored on March 7, 2014pediatrics.aappublications.orgDownloaded from
http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/


3/9

B OIIIe fed R oom Ing In{149} Breost fed R o o m In g I n {149 }Bo IIIe fed Nu rsery.B reosI fed Nut n ery

BI RTH 2 3 4D A Y

5 6

O RIG IN AL A RTIC LES 443

C H A R T I

TA BL E IM E A N W E IG H T VA RIA T IO NS G M 5. Fao B I RT H 1 IG H T A N D M A X I M A L Loss G M S .

FR O M BIR T H W E IG H T O F 4 G R O U P S OF 100 B A BIE S E M II O N4 DIF FE RE N T FE E D IN G R E G IM E N S

D ay I aXirn / 6

Losi II Is

Br e a s t f e d _ 1 5 0 . 8 2 2 3 . 2 2 1 5 . 9 1 7 0 . 2 1 2 1 . 7 8 4 .8 -256 .7 1650n u r s e r y 8 5 . 9 t 8 9 . 2 1 1 0 . 4 1 1 1 . 9 1 2 7 . 4 1 2 6 . 1 9 8 . 2 4 1 6

Br e a s t f e d 1 1 0 . 0 1 8 6 . 2 1 2 4 . 1 8 9 . 8 5 5 . 0 1 5 . 0 1 7 3 . 5 1 5 2 9r o o mi n g i n 7 5 . 8 8 0 . 8 1 0 6 . 9 1 1 9 . 9 1 4 0 . 9 1 5 1 . 9 8 8 . 2 4 9 6

Bo t t l e f e d 1 0 0 . 1 1 2 9 . 0 1 0 2 . 7 6 3 . 7 3 1 . 2 2 . 2 1 5 3 . 4 1 5 0 1n u r s e r y 68 7 72 8 89 9 97 1 114 9 119 4 75 9 45

Bo t t l e f e d 8 8 . 6 1 0 4 . 4 7 5 . 1 -57.7 -23.3 -11.5 -131.4 1529room ing-in 67.2 77.7 88.2 9 6 . 4 1 0 8 . 3 1 0 4 . 2 7 1 . 9 3 9 1

M ean. S tan dard d ev iatio n.

nod the period of hospitalization of the fourgroups of babies studied are presented inC hart I. It m ay be seen that the pattern ofw eight variation am ong the four groups w asquite sim ilar. The curves tended to besm ooth for all four groups.

B efore further statistical study the groupsw ere tested for com parability w ith regardto birth w eight. The standard deviations foreach mean birth weight were calculated andan analysis of mean difference (t test) per-form ed. There w ere no significant differ-ences am ong the various groups.

For each infant the changes in w eightN EAN DAI LY WEI GHTS OF FO U R G R O U P S O F 00 B A B IE S

EACH ON F OUR DI FF ERENT FEEDI NG REGI MENS

xCD

from birth w eight w ere determ ined. Tilem eans of these variations from birth w eightand their standard deviations w ere calcu-lated and analyzed statistically (t test).These data are presented in Tables I and II.

The first tw o com parisons in Table II,represent an estim ation of the differencesthat m ight be attributable to tile use ofhum an or cow s m ilk. A m ong the nurserybabies the breast-fed babies had signifi-cantly greater losses than the bottle-fedbabies on each day of the first w eek (0.1%level of confidence). Tile m axim al loss w aslikew ise significantly greater am ong thebreast-fed babies. A m ong the room ing-inbabies differences w ere in the sam e direc-tion but of som ew hat lesser m agnitude.D ifferences through day five w ere signifi-cant at the 1% or 5% levels of confidence.O n days six and seven the losses did notd if fe r s ig ni fi ca nt ly D if fe re nc es i n m ax im alloss w ere again highly significant statistic-ally (0 .1% level of confidence).

The last tw o lines of this table involvean estim ation of those differences that m ightb e a tt ri but ab le t o fl ex ib le schedule feedingas opposed to strict schedule feeding. Inboth com parisons the ad lib-fed babiestended to lose less during the hospital pe-riod than the schedule-fed babies. A m ong



4/9

T A B L E I ISI G NI F I C AN T I )I F FE I I E N C ES t \A L UE S ) IN A V E R A G E W E I G I I T C h A N G E A N D M A X I M A L

Loss F U 0 M B I R T h W E I G I I T A M O N G 4 ; I O I P S O F B A B I E S O N4 1 )I F F E R E N T F E E D I N G R E G I M E N S

Maxima l 6D ay Loss H ks.B r e a st - fe d n u r ser yBottle- fed nursery

4.56p< .001)

8 .20 8.00 p < .001 ) p < .00 1)

7.20p < .001 )

5.27p < .0 01)

5.00p < .00 1)

8.32 p < .001)

2.43 p< .0 2)

Breas t- fed r o O I I I i I l g - i I I 2 .10 2.8 1 3.55 2.06 3.60B ott le - f e d roohnillg- in p< .05 p< .01 p< .01 p< .05 p< .001

B reast- f ed nursery 3 .56 7.44 5.99 5.20 3.50 3.52 6. 32Breast-fed rooming- in p< . 001) p < .001 p< .001 p< .001 p< .001 p< .001 p< .001

Bo t t le - fed n u r se r y 2 .2 8 2 .2 0Bot t le- fed roolni l lg- i l l p < .05 ) p < .05

I n e a ch co m p a r iso n th e fig u r e s are p re se nt ed oppos i te

2.11p< .05

L ow day occurred s ign if icantly later in th e f i r s tgroup than in the last two groups: t=2.8 p


5/9

S ex olo r tern l Pari ty

M ale F em ale W hite N eg ro P rim ip ara Mul l i para

O RIG IN A L A RTIC LES 4 4 5TA BL E IV

CO M PO SIT IO N O F T H E G RO U PS W IT H RE G AR D T O SE X , C O L O R AN D M A TE R NA L PAR IT Y

B ottle-fed nurseryB reast-fed n urseryBo t t l e f ed r oom n g i nB reast-fed ro om in g-in

52 4848 5256 4452 48

75 2565 3 587 1393 7

9 83 694 4 5 66 6 34

not significant statistically.Three factors w hich m ight influence

w eight could not be controlled by prior se-lection because of the nature of the variouspopulations involved. These w ere color, sexof the baby and parity of the m other. Thebreakdow n of the four groups w ith relationto these three factors is presented in TableIV . W hen analyzed statistically it w as seenthat differences am ong the various groupsreferable to sex of the baby w ere not sig-nificant (X 1.3). W ith regard to colorthere w ere significantly m ore N egroes in thenursery groups than in the tw o room ing-ingroups X 2 = 25 (p.


6/9

44 6 N Y H A N -N E O N A T A L G R O W T Hstric tly schedu le -fed d uring th e firs t m on thsof life a t ho m e . T he se c on side ra tio ns in allprobab ility accoun t fo r the pauc ity o f sig -n if ican t d iffe ren ces a t th is tim e . C e rtain lyit is ev iden t tha t the re w ere few d iffe rencesat th is tim e w hich on e cou ld lik e ly rela teto the type of fo od in gested . P o ssib ly theph ilo sop hy of flex ib le feed in g sch ed u le sm igh t ha ve be en pa rtic u larly a pp ea lin g tothe n u rs in g m oth ers . C e rta in ly u nd er a nytype o f sch ed u le it is re la tive ly easy to regu-la te th e am oun t o f fo od a b o ttle -fed rece ivesa t a fee d in g w hile th is is m u ch m o re d iffi-cu lt in th e case o f a b reast-fed baby . I t m aybe tha t the se fa cto rs a c co un t fo r the fa cttha t the b re as t-fe d n u rse ry ba b ies ga ine dsig n if ican tly m ore than the ir bo ttle -fedse ry coun te rpa rts . P rec ise ana lysis o f the sela tte r fa cto rs w a s im p oss ib le b ec a use o f th en atu re o f th e da ta av a ila b le . T h e m o st strik -ing asp ec t o f th e ana lyses o f these neon ata lg ain s w as the c lose s im ila rity am on g theva rious g rou ps at the tim e of the s ix w eekc he ck u p . It is e v id en t tha t b y th is tim e theend resu lts o f d ifferen t feed ing reg im en s asm easured b y w eigh t g ain are rea lly verylittle d iffe ren t even th oug h th e d iffe ren cesno ted in the firs t w ee k of life a re qu item ar k ed .

T he p oss ib i lity tha t fa cto rs o the r tha n th ed iffe rences in feed ing reg im en m igh t h av ein f luenced these n eo na tal w e igh ts in theva rious d irec tio ns observed w as con side red .T he adv erse e ffec ts o f illn ess on w eig h t g ainw ere con tro lled by se lec tion of the pa tien tsstu d ied . T he re w ere no sig n ifican t d iffe r-ences am ong the g ro ups w ith reg a rd tob irth w e igh t o r sex of the bab y . I t is o f in -te res t w ith reg a rd to th e fo rm er th at theb reast-fed nu rse ry g rou p w hich had thelo w est b ir th w e igh t h ad , n ev erthe le ss , theg reate st lo sse s du ring the firs t w eek o f life .P o stna ta l w e igh t lo sse s h av e un ifo rm ly b eenfou nd to be grea te r in in fan ts heavy a t b irthth an in tho se w ith sm a ll b irth w e igh ts .2 18It w a s no ted th at th ere w e re m o re N e g ro e sin the nu rse ry groups than in the ro om -in g-in group s. In the earlie r litcra tu re l, 16 itis s ta ted tha t N egro in fan ts ga in w eig h tm ore s low ly than do w hite in fan ts . M o re re -

cen tly , B akw in and P atr ick l? fo und n o sig -n if ican t d iffe rences in th e w e igh t ga in o fN egro in fan ts as co m pared w ith w hite in -fan ts . It app ea rs like ly tha t th e obse rvedd iffe rences in th e p re sen t stu dy w ere no t re -la ted to co lo r d iffe rences am o ng the g rou pss tud ied .

W ith re ga rd to m a tern al pa rity , the rew e re m ore p rim ip ara e a m on g th e roo m in g -in g ro ups th an am o ng the nu rse ry g rou ps .A lso the re w e re m ore p rn rnp ara e a m o ngthe roo m ing -in m othe rs w ho fed the irbab ies a t b reast th an am on g tho se w h oused bo ttle feed ings . A m ong th e nurse rybab ies the b reast-fed g rou p d id no t d iffe rfrom th e bo ttle -fe d g ro up w ith reg ard tom a te rn al pa rity . In th e o lde r litera tu rew hich has been rev iew ed by G riffith an dG ittings1 8 an d in the ir o w n se ries on th esub jec t, in fan ts o f p rim ipa ro us m othe rs havebeen no ted to lose m ore w e igh t in itially an dla ter to ga in m ore slow ly than in fan ts o fm u ltip a rae . M ered ith s2 m ore recen t o bse r-va tion s on the e ffec t o f b ir th o rde r on neo-na ta l w eig h t chang es sho w ed a le ss co nsis-ten t tre nd . In th e p re se n t serie s the ro om -ing -in g ro up s , th oug h c on ta in in g a g rea te rnu m ber o f p rim ipa rae than the n urse ryg roup s, had th e sm alle r lo sse s. A s th is tren dis in th e o pp os ite d irec tio n to the ex pe c tedeffec ts o f d ifferences in pa rity , it is un -lik ely tha t th e obse rve d d iffe ren c es c ou ldbe re la te d to th is d isp a rity in th e co m posi-tion o f th e grou ps. A m o ng the roo m ing -inbab ie s th e g rea ter lo sses in th e b reast-fedg rou p th an in th e b o ttle -fe d g rou p w e re inthe d ire c tion on e w o u ld e xpe c t fro m theo bse rv ed d iffe ren ces in pa rity be tw een thetw o g rou ps . H o w ev er, th e fac t tha t sign ifi-can t d ifferences be tw een these tw o gro up soccurred on ly during the firs t few days o flife w ou ld seem to ind ica te tha t d ifferencesin foo d in tak e w ere op era tin g .

S U M M A R YN e on ata l w eig h t ch an ge s o f 40 0 n o r m a l

in fan ts w ere stud ied sta tis tic ally . T he se riesw as com p osed o f 200 in fan ts fed o n a flex i-b le sch edu le o f w h ich 100 w ere breas t- fedand 100 w ere bo ttle -fed ; and 20 0 in fan ts fed



7/9

O R IG IN A L A R T IC L E S 44 7o n the co nven tio na l fo u r-ho ur schedu le , o fw hich 1 00 w ere b reas t-fed and 1 00 w ereb o ttle -fed . D urin g the firs t w eek of life thead lib -fed bab ie s h ad sm alle r w e igh t lo s sesth an the schedu le-fed bab ie s and the b o ttle -fed b ab ies h ad sm alle r lo sse s than th eb reast-fed bab ies . T he du ra tion of w e igh tlo s s w as lo nge r in th e b reas t-fed bab ie s . B ythe tim e o f the six w eek pos tna tal c lin icv is it, the group th at h ad b een breas t-fedin the n ursery h ad ga ined sign ifican tly m o rethan th e g ro up th at had b een b o ttle -fed inth e n ursery . T h ere w ere o the rw ise am ongth e fo u r g roup s n o sign ifican t d iffe ren ces inw e igh t ga in d uring th is pe riod . It w as fe lttha t th e observed d iffe ren ces am on g thefou r g rou ps pa ralle lled the expec ted differ-ences in food in tak e .

R E F E R E N C E S1 . B a ldw in , B . T .: P hys ica l g row th of ch ild ren

from birth to m atu rity . U n iversity o fIow a S tud ies in C hild W elfa re , 1 :34 -51 ,1921 .

2 . M ered ith , H . V . an d B row n, A . W .:G ro w th in bo dy w eig h t du rin g th e firs tten days of po stna ta l life . H um an B io l.,11 :2 4 , 1939 .

3 . F aber, H . K . and S u tton , T . L .: A s ta tisti-ca l com parison of b reast fed an d bo ttlefed b ab ies dur in g the firs t yea r. A m . J.D is. C h ild ., 40 :116 3 , 193 0 .

4 . Pa iva , S . I.: Pa ttern of g row th o f selec tedg ro ups o f breast fed in fan ts in Io w a C ity .PED IATR ICS 11 :38 , 1953 .

5 . Jackson , R . L . and K elly , H . C .: G row thcharts fo r use in ped ia tric p ractice . J.P ed ia t., 27 :215 , 194 5 .

6 . G ese ll, A . and Ilg , F rances L .: F eed in gB ehav io r o f In fan ts . Ph ilade lph ia , J. B .L ipp in co tt C om pan y , 193 7 .

7. A ldrich , C . A . and A ldrich , M ary M .:Feed ing O ur O ld -Fash ioned C hild ren .N ew Y ork , T he M acm illan C om pany ,1941 .

8 . S en n , M . J. E . an d N ew ill, P hy llis K .: A llA bo u t F eed ing C hild ren . N ew Y ork ,D ou b led ay & C om p an y , Inc ., 194 4 .

9 . W ein feld , G . F .: Se lf-d em an d feed in g andin du lgence in early in fancy . J . Ped iat . ,31 :203 , 194 7 .

10 . O lm s ted , R . W . and Jackson , E d ith B .:S elf-dem and feed in g in th e first w eekof life. PEDIATR ICS 6 :3 96 , 195 0 .

11 . S im sarian , F ran ces P . and M cL en don , P .A .: Feed ing b eha v io r o f an infa n t dur ing

the f irs t tw elv e w eeks o f life o n a se lf-dem an d sch ed u le . J. P ed ia t., 2 0 :93 ,1942 .

12 . T rainh am , G en ev iev e, P ila fian , G race J.and K ra ft, R u th M . : A case h isto ry o ftwins b reas t fed on a self-dem andr eg i m e . J. P ed iat., 27 : 1 09 , 194 5 .13 . S im sa rian , F ran ces P . and M cL end on , P .A . : F urthe r reco rd s o f the se lf-dem an dschedu le in in fan t feed in g . J . Ped iat . ,27:109 1945.

1 4 . Jackso n , E d ith B ., e t a l.: H osp ital room ing-in un it fo r fou r n ew b orn in fan ts an dtheir mothers . P E D I A T R I C S , 1 :28 , 1 948 .

15 . N y han , W . L . : S to o l freq uency o f norm alin fan ts in the firs t w eek of life . P E D IA TRICS 1 0 :41 4 , 195 2 .

16 . D o dge , C . T . J. : W eigh t o f co lo red in fan ts .A m . J. Ph ys. A nth rop o l., 10 :336 , 19 27 .

17 . B akw in , H . and P a trick , T . W . : W eig h t o fnegro in fan ts . J. P ed ia t., 24 :405 , 19 44 .

18 . G riff ith , J. P . C . and G itting s, J . C . : T hew e igh t o f b reast fed in fan ts du ring th efirst tw o w eeks o f life . A rch . P ed ia t.,24:241 1907.

SPA N ISH A B ST R A C T

A u m ento de P eso d el R ecl# {23 3}n N ac ido conC ua tro R egIm enes de A lim en tac i#{ 243 }n

D iferentesL os au to res p resen tan sus ob servac iones

sobre el peso de 400 reci# {2 33 }n n acidos n orm alessu je tos a 4 regIm enes d ife ren tes de a lim en ta -c i#{243}n . l e stu d io se rea liz# {2 43 } co n e l fin de v er s i sepresen taban d iferen cias achacab les a ta lesreg Im en es y se basa en los da tos ob ten ido sdu ran te las p rim eras 6 a 8 sem anas de v ida .L os ni# {2 41} os se a gru paron de la sigu ien te m an era :1 00 a lim en tado s a l pecho y 1 00 ar tific ia lm en teba jo un reg im en de au to -d em and a y de roo m -ing-in ; 1 00 n if lo s a lim en tados a pecho y 100ar tific ia lm en te ba jo un reg im en fijo con in te r-va lo s de 4 horas . E n una pu b licas i#{24 3}n prev ia (15)lo s au to res d ie ro n a cono cer Ia fo rm ula l#{22 5}c teaem p lead , as I com o el m #{ 233} todo y crite rio deseiecci#{243}n d e los reci#{ 233} nnac idos . L o s flifiOS ali-m en tados artificia lm en te rec ib ie ron en sudom ic ilio una m ezc la de leche evaporad a yagua re lac iO n de 1 :1 .5 , ad ic ionada d e 5% d em iel de m aIz .

L as curvas de variac io nes en peso de lo scua tro grupo s fueron m uy s im ila res , segO n se yeen la tab la nO m ero 1 . D u ran te Ia p rim erasem ana los n i#{ 241} os lim en tado s por au to dem andapresen ta ro n m enor p#{ 233} rd idas d e peso que lo s a li-



8/9

44 8 N Y H A N -N E O N A T A L G R O W T Hmentados co n horar io fijo ; en e l m ism o gru pod e au todem and a, los a lim en tad os artific ia lm en tep resen ta ron ann m enores p#{ 233} rd idas de peso quelo s a lim en tados a seno ; en #{23 3}s tos,adem #{22 5}s , lap #{2 33}rd ida de peso ob servada tuvo una durac iO nm ayo r. Pu d ie ra se r que estas d ife renc ias de lap r im era sem ana se relac ionaran a h ech o deq ue los a lim en tados artific ialm en te rec ib ie rona lim en to desde e l p rim er d ia d e v ida , en tan toque lo s a lim en tados a pecho tu v ieron queespera r e l pe rIodo d e ins talac iO n d e Ia lactac iO npara rec ib ir una inges ta ca lO r ica su fic ien te .U na v ez que hu b ieron sa lid o de l hosp ita l ya lcanzado la ed ed de 6 sem anas d e v ida , los

n inos a lim en tados a pecho con hora rio fijoh ab lan au m en tado d e p eso con c ifras fran ca -m en te supe rio res al de l g rup o alim en tad o co nh orar io fijo y artific ia lm en te . F u era d e esta sd iferenc ias n o se observ aro n otros es tad Istica-m ente sign ifica tiv as en tre los cua tro grupo s deniflo s, a m en os d ura n te el p er Iodo de o bserv a-c iO n , d esde e l p un to de v is ta de raza y sexo d elo s n i# { 24 1 }o s , n i de l nn m ero de em barazo de Iamadre .

L as d ife renc ia s en peso de es tos cua trogrup os d e n iflos fuero n para le las a las d ife r-enc ias esperadas de acu erdo co n la ing estiO nnu tr icional .



9/9

1954;14;442PediatricsWILLIAM L. NYHAN and MORRIS A. WESSEL

DIFFERENT FEEDING REGIMENSNEONATAL GROWTH IN WEIGHT OF NORMAL INFANTS ON FOUR

ServicesUpdated Information &

http://pediatrics.aappublications.org/content/14/5/442including high resolution figures, can be found at:

Permissions & Licensing

http://pediatrics.aappublications.org/site/misc/Permissions.xhtmlor in its entirety can be found online at:Information about reproducing this article in parts (figures, tables)

Reprintshttp://pediatrics.aappublications.org/site/misc/reprints.xhtml

Information about ordering reprints can be found online:

Online ISSN: 1098-4275.Copyright 1954 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005.American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007.has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by thePEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it

http://pediatrics.aappublications.org/content/14/5/442http://pediatrics.aappublications.org/content/14/5/442http://pediatrics.aappublications.org/content/14/5/442http://pediatrics.aappublications.org/site/misc/Permissions.xhtmlhttp://pediatrics.aappublications.org/site/misc/Permissions.xhtmlhttp://pediatrics.aappublications.org/site/misc/Permissions.xhtmlhttp://pediatrics.aappublications.org/site/misc/reprints.xhtmlhttp://pediatrics.aappublications.org/site/misc/reprints.xhtmlhttp://pediatrics.aappublications.org/site/misc/reprints.xhtmlhttp://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/http://pediatrics.aappublications.org/site/misc/reprints.xhtmlhttp://pediatrics.aappublications.org/site/misc/Permissions.xhtmlhttp://pediatrics.aappublications.org/content/14/5/442

pediatrics 1954 nyhan 442 8

Documents