BACKGROUND: Breast milk (BM) is the main nutritional source for newborns before they are capable to eat and consume other foods. BM has carbohydrates, lipids, complex proteins, and other biologically active components which have a direct effect on infant growth. AIM: The aim of the study was to correlate anthropometric data of the infant to macronutrients in BM (fat, protein, and carbohydrates) and to find some modifiable issues affecting macronutrient contents of BM for the benefits of upcoming infants. METHODS: One hundred breastfeeding mothers participated in the study, they were recruited from the outpatient clinic, El Demerdash Hospital, Ain Shams University, from September 2019, to December 2019. BM was expressed by an electric pump, macronutrient content was assessed. Anthropometric data of the babies and mothers were obtained, gestational age, parity, age of the women, and the route of birth were recorded. RESULTS: For the macronutrients content of milk, a positive significant correlation was observed between BM fat, protein, and lactose. Infants’ body mass index (BMI) was negatively related to the fat content of BM, while no relation was found between BMI and protein or lactose content of the milk. BM fat content was negatively correlated with gestational age and maternal age. Positive correlations were found between BMI and protein, lactose and infant age. Protein content was negatively correlated with parity. No impact of infant’s sex on BM composition and as regards maternal diet, high protein consumption leading to increase BM protein content. CONCLUSIONS: The current study confirms that BM macronutrient composition has a wide variability; this variability is associated with each macronutrient, respectively. To improve BM composition, one could aim for improving the nutritional balance in lactating women, especially for protein intake. More well-designed longitudinal studies about factors that influence human milk compositions are warranted.

Background: Early childhood frequent exposure to toxic stress such as abuse or neglect, parental substance abuse or parental mental illness, and violence can have a cumulative impact on the child's mental health. Therefore, the study aimed to assess the association between frequent exposures to family-related adverse experiences and the development of behavioral and cognitive impairment in a random sample of Egyptian primary school children. Results: Witnessing household member treated violently was the most prevalent adversity in 90.4% of the studied students, followed by emotional neglect in 88.6%. The highly exposed children were more likely to have below-average performance IQ, 2.5 times more than the exposed group (P = 0.03) [IQ score is considered average if it ranged 90-110 and below average if it ranged 70-89]. They were nearly 3 times at risk to develop behavioral problems (P = 0.003), 2.5 times more likely to develop attention deficit (P = 0.02), and nearly 5 times more likely to develop externalizing behavior (P < 0.001) than their peers. Conclusion: Early exposure to adverse experiences increases the child's vulnerability to attention deficit and externalizing behavior with negative impact on IQ scores especially performance IQ.

BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

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Cognitive impairment, growth faltering and stunting are pervasive in many countries. mostly causes are unknown. Role of intestinal inflammation in such cases should be minded especially in low- and middle-income countries. We assessed serum markers of inflammation, fecal markers of intestinal inflammation and serum micronutrients in cases with aged 1 to 10 years who suffer from moderate or severe malnutrition “weight-for-age z-score and height-for-age z- Score (WAZ or HAZ) less than -2 SD”. Cognitive abilities were assessed using Wechsler intelligence scale for preschool and school children, Bayley scale III. 55.6% of preschool cases were below average or had mild or moderate intelligence retardation while 24.5% of school cases and 5% of children below 2 years were below average regarding cognitive functions. Cases showed statistically significant reduction of vitamin D, zinc and iron as compared to control. Serum markers of inflammation (alpha 1- glycoprotein (a1-AGP), endotoxin core protein (EndoCAB)) and fecal markers of intestinal inflammation (alpha 1 antitrypsin (AAT) and neopterin (NEOP)) were significant higher in cases than controls. School children showed negative correlation between processing functions and( a1-AGP), positive correlation between perceptual reasoning and serum vitamin A. Children below 2 years, showed negative correlations between motor function and (AAT), (a1-AGP), tumor necrosis factor- alpha (TNF-a) and (EndoCAB), positive correlation between language and serum zinc. In conclusion, our study showed impaired neurocognitive and psychomotor functions in malnourished stunted children. Also, vitamins and minerals deficiency and increased markers of intestinal inflammation were observed in cases compared to healthy control.