Tor Lindberg

Cow's milk as a cause of infantile colic in breast-fed infants.

18 mothers of 19 breast-fed infants with infantile colic were put on a diet free of cows-milk protein. The colic disappeared promptly from 13; in 12, it reappeared on at least two further indirect challenges (in the form of a diet containing cows milk to the mother). Most infants became symptom-free at age 2 to 4 months; at 4 months, only 4 reacted with colic when the mother took cows milk. 5 infants were directly challenged with cows milk; 4 reacted promptly with colic. Other signs of intolerance to cows-milk protein developed in 3 infants during weaning. The treatment of infantile colic in breast-fed infants by a diet free of cows milk for the mother appears worthwhile.

Bovine β-Lactoglobulin in the Human Milk

ABSTRACT. Human milk samples (n=232) collected during the whole lactation period from 25 healthy, Swedish mothers were analyzed by radioimmunologic method for content of bovine β‐lacto‐globulin. Detectable amounts (5‐800 μ/1) were found in 93 of 232 milk samples (40%). Six mothers had no detectable β‐lactoglobulin in their breast milk on any occasion. Two mothers had measurable /Mactoglobulin in all their milk samples. No correlation was found between daily cows milk intake and concentration of β‐lactoglobulin in the milk samples. Six mothers with allergic symptoms such as asthma, hay‐fever, eczema all had detectable amounts of β‐lactoglobulin in their milk. Of 19 mothers without allergy, 13 had detectable amounts. This difference did not show statistical significance. The presence of symptoms in the infant such as diarrhoea, vomiting, colic, exanthema was significantly correlated to high levels of β‐lactoglobulin in the milk. Bovine β‐lactoglobulin was also detected in 7 of 13 serum samples. The two mothers with detectable β‐lactoglobulin in all milk samples had the highest serum values, and their infants suffered from gastro‐intestinal symptoms, weight decline and exanthema.

Dietary Bovine β Mactoglobulin is Transferred to Human Milk

ABSTRACT. Human milk from 38 mothers was analysed by radioimmunological method for content of bovine (5‐Iactoglobulin. Detectable amounts (5‐33 μg/1) of immunoactive β‐lactoglobulin were found in 18 human milk samples. Milk from 3 mothers, whose infants suffered from infantile colic contained high amounts of fi‐lactoglobulin (32, 18 and 14 μg/1 respectively). With the mothers on a cows milk free diet the contents fell to non‐detectable amounts in two mothers and to 6 μg/1 in the third. All three infants became free from colic,

Intestinal dipeptidases I. Spectrophotometric determination and characterization of dipeptidase activity in pig intestinal mucosa

Summary 1. A new simple and rapid spectrophotometric assay for dipeptidase (dipeptide hydrolase, EC class 3.4.3) activity is described. The method is based upon the decrease of absorption at 220 μ m as peptide bonds are hydrolyzed. By using ethanol as a precipitating reagent, the method is suitable for the study of peptidase activity in crude tissue extracts or partially purified preparations. The accuracy is about ± 1%, and the sensitivity is greatly increased as compared with procedures commonly used hitherto. 2. The method has been employed for the determination and characterization of L -alanyl- L -glutamic acid, glycylglycine, glycyl- L -leucine and glycyl- L -valine hydrolysing activities of pig intestinal mucosa. 3. The results suggest that the four different activities are related to four separate enzymes. 4. The relation of our findings to previous knowledge of the properties of the dipeptidases has been discussed.

Motilin, vasoactive intestinal peptide and gastrin in infantile colic.

ABSTRACT. Intestinal hyperperistalsis is one part of the clinical picture in infantile colic. Three gut hormones involved in the regulation of gut motility; motilin, vasoactive intestinal peptide (VIP) and gastrin, were measured with the RIA method in: 40 infants with infantile colic, (age 2–22 weeks), 42 healthy age‐matched infants, 11 children (age 3–36 months) with gastrointestinal disorders, and 20 children (age 3–36 months) with non‐gastrointestinal disorder. Basal s‐motilin levels were raised in infants with infantile colic (p<0.01) and in children with other gastrointestinal disorders (p<0.001). Formula‐fed infants had higher basal s‐motilin levels than the breast‐fed infants (p<0.05). P‐VIP and s‐gastrin levels were raised in children with other gastrointestinal disorders (p<0.05), but not in infantile colic. Formula‐fed colicky infants had higher s‐gastrin levels than the breast‐fed colicky infants (p<0.05). We suggest that the increased s‐motilin level in infantile colic might account in part for the clinical picture of this disorder.

α-FOETOPROTEIN, ALBUMIN AND TOTAL PROTEIN IN SERUM FROM PRETERM AND TERM INFANTS AND SMALL FOR GESTATIONAL AGE INFANTS

Blood serum levels of fetoprotein albumin and total protein were measured for infants of various gestational ages and with various birth weights. Laboratory assays used electrophoresis in agarose gel containing specific antibodies. The alpha fetoprotein levels for boys were numerically higher than for girls; these differences did not show up for either albumin or total protein. Results of the study show alpha fetoprotein levels to be a good indicator of gestational age. This is true because the levels did not differ between groups of infants of the same gestational age but different body weights; the levels did differ for groups of infants with the same birth weight but different gestational ages. In this study alpha fetoprotein levels were higher in preterm than in term infants. Albumin and total protein levels varied according to weight rather than gestational age.

Infantile colic and small intestinal function: a nutritional problem?

Approximately 25% of infants with moderate or severe colic (crying > 3 h d−1) have a cows milk‐dependent colic. The author recommends a strict cows milk‐free diet for the mother (with an extra supplement of calcium) in breastfed infants and a casein‐hydrolysate formula for formula‐fed infants. With this dietary regimen, there will be no nutritional problems. Later in infancy a relatively high proportion of the infants will continue to show an adverse reaction to cows milk and will also develop allergies to other foods. Several signs (e.g. increased macromolecular absorption, increased motilin levels in serum, increased breath hydrogen excretion, decreased gallbladder contractility) indicate an abnormal intestinal function in colicky infants. The nature of this abnormality is still unknown.

In vitro digestion of cow's milk proteins by duodenal juice from infants with various gastrointestinal disorders.

The hydrolysis of bovine α-lactalbumin, β-lactoglobulin, and casein by duodenal juice from 20 infants (18 with normal exocrine pancreatic function, 2 with pancreatic insufficiency), aged 3–19 months was studied in vitro with the aid of electroimmunoassay and sodium dodecyl sulfate–poly-acrylamide gel electrophoresis. The results from the two methods were almost identical. Duodenal juice from infants with cows milk protein intolerance (7), celiac disease (5), and unclassified gastrointestinal disorder (6) had the same capacity to hydrolyze the milk proteins. No hydrolysis occurred in the two patients with pancreatic insufficiency. The hydrolyzing capacity was not correlated with age in the actual age group. The hydrolysis of the milk proteins occurred at a considerably slower rate when the proteins were crude, as in cows milk, adapted, or unadapted formula, than when they were in a purified form. About 1 mg of purified α-lactalbumin or β-lactoglobulin, and about 30 mg of purified casein could be hydrolyzed per milliliter duodenal juice per minute. Corresponding figures for the hydrolysis of the various proteins in cows milk were 0.03, 0.12, and 16.1 mg/ml duodenal juice/min. Preincubation (60 min) with gastric aspirate after adjusting pH to 4–5 did not change the results. In conclusion, the duodenal juice from infants with normal exocrine pancreatic function has a great ability to hydrolyze casein. Corresponding hydrolytic capacity for α-lactalbumin or β-lactoglobulin is considerably lower.

INCIDENCE OF COELIAC DISEASE AND TRANSIENT GLUTEN INTOLERANCE IN CHILDREN IN A SWEDISH URBAN COMMUNITY

Abstract. The incidence of coeliac disease in children in the city of Malmö, South Sweden, was 1: 982 during 1966 to 1975. The diagnostic criteria were: flat intestinal mucosa on gluten‐containing diet, free of symptoms, and improvement in mucosal morphology on gluten‐free diet, and morphological and/or evident clinical relapse (three times) on gluten challenge. 6 (12 %) of 49 children with initially a flat mucosa still had a normal mucosa on a gluten‐containing diet for two years or longer, having so‐called transient gluten intolerance.

POSTNATAL CHANGES OF ALPHA-FOETOPROTEIN, ALBUMIN AND TOTAL PROTEIN IN HUMAN SERUM

Alpha fetoprotein albumin and total protein levels were determined in 330 infants whose gestational age was 25-44 weeks. The relationship of these levels to gestational age was examined in a subgroup of 171 newborns and postnatal changes were studied in the remaining 159. Infants with 25-30 weeks gestational age had high alpha fetoprotein levels and these levels decreased successively in infants with increasing gestational age until they were 8 times lower at term than 25-30 weeks gestation. Albumin and total protein levels on the other hand increased with gestational age until term when they were double those at 25-30 weeks. Albumin and total protein levels were lower in infants delivered at 43 weeks than in term infants whereas alpha fetoprotein levels were the same. Postnatal alpha fetoprotein levels decreased from .10-.02 ng/ml in the 1st 20 hours after birth remained constant for 24 days and then decreased to .0006 ng/ml at 2 weeks. Albumin decreased from 50-30 ng/ml and total protein from 70-50 ng/ml in the 1st 5 days postpartum and remained constant for 40-150 days. Alpha fetoprotein was shown to have a higher coefficient or correlation with gestational age than did birth weight or albumin and total rotein levels but there was a high correlation between albumin and total protein.