A newborn baby's weight loss is often used to determine how well a baby is breastfeeding, and concern about a baby which loses too much weight may result in supplementing breastfeeding with formula. However, many women receive IV fluids during labor, and new research published in BMC's open access journal International Breastfeeding Journal shows that some of a newborn's initial weight loss may be due to the infant regulating its hydration and not related to a lack of breast milk.
A group of Canadian researchers looked at relationships among the IV fluids a mother received during labor (or prior to her caesarean section), neonatal output (measured by diaper weight), and newborn weight loss. They found that during the first 24 hours following birth there was a positive association both between the IV fluids given to mothers before birth and neonatal output, and between the neonatal output and newborn weight loss. At 60 hours post birth, the time of the average lowest weight, there was a positive relationship between maternal IV fluids and newborn weight loss.
"Nurses, midwives, lactation consultants, and doctors have long wondered why some babies lose substantially more weight than others even though all babies get small amounts to eat in the beginning," said principal investigator Prof Joy Noel-Weiss from the School of Nursing at the University of Ottawa's Faculty of Health Sciences. "It appears neonates exposed to increased fluids before birth might be born overhydrated, requiring the baby to regulate his or her fluid levels during the first 24 hours after birth."
Prof Noel-Weiss added, "We should reconsider the practice of using birth weight as the baseline when calculating newborn weight loss in the first few days following birth. For mothers and their breastfed babies, accurate assessment of weight loss is important. Although more research is needed, based on our findings, we would recommend using weight measured at 24 hours post birth as a baseline."
Alongside this article, the researchers have provided a standardized method for clinicians to collect and analyze data about newborn weight loss in their own maternity site, in the hope that this protocol will help them to make informed decisions when assessing newborn weight changes.
Monday, August 15, 2011
Stem Cells Central to Pathogenesis of Mature Lymphoid Tumors
New research suggests that blood stem cells can be involved in the generation of leukemia, even when the leukemia is caused by the abnormal proliferation of mature cells. The study, published by Cell Press in the August 16th issue of the journal Cancer Cell, may guide future strategies aimed at identifying therapeutic targets for chronic lymphocytic leukemia (CLL).
CLL is a cancer of a type of mature white blood cell called a B lymphocyte. "Most human CLL cases have a precursor phase, called monoclonal B lymphocytosis (MBL), that is an asymptomatic proliferation of B cells," explains senior study author Dr. Koichi Akashi from Kyushu University Graduate School of Medical Sciences in Japan. "Our question was, if progression from MBL to CLL reflects stepwise proliferation of aberrant cells, at what stage does the first cancer-causing event occur?"
To look for the cell population with cancer-initiating activity in human CLL, Dr. Akashi and colleagues tried to find the specific developmental stage where abnormal clonal B cells first appear. They began at the beginning, with hematopoietic stem cells (HSCs). HSCs are blood stem cells that can give rise to any type of blood cell. The researchers purified HSCs from healthy individuals or HSCs from CLL patients and transplanted them into mice with a deficient immune system. In contrast to the normal HSCs, the CLL HSCs gave rise to B cells similar to those seen in MBL. Interestingly, the CLL HSCs did not have chromosomal abnormalities common to CLL, suggesting that acquisition of chromosomal abnormalities that transform MBL into CLL are secondary events.
Taken together, the findings suggest that HSCs are involved in the pathogenesis of CLL, even though CLL is a malignancy of a mature cell type. "Our data suggest that the propensity to progress to CLL is already acquired at the HSC stage," concludes Dr. Akashi. "Identification of the intrinsic abnormality of HSCs in patients with CLL should be the key to finding the ultimate therapeutic target in human CLL."
CLL is a cancer of a type of mature white blood cell called a B lymphocyte. "Most human CLL cases have a precursor phase, called monoclonal B lymphocytosis (MBL), that is an asymptomatic proliferation of B cells," explains senior study author Dr. Koichi Akashi from Kyushu University Graduate School of Medical Sciences in Japan. "Our question was, if progression from MBL to CLL reflects stepwise proliferation of aberrant cells, at what stage does the first cancer-causing event occur?"
To look for the cell population with cancer-initiating activity in human CLL, Dr. Akashi and colleagues tried to find the specific developmental stage where abnormal clonal B cells first appear. They began at the beginning, with hematopoietic stem cells (HSCs). HSCs are blood stem cells that can give rise to any type of blood cell. The researchers purified HSCs from healthy individuals or HSCs from CLL patients and transplanted them into mice with a deficient immune system. In contrast to the normal HSCs, the CLL HSCs gave rise to B cells similar to those seen in MBL. Interestingly, the CLL HSCs did not have chromosomal abnormalities common to CLL, suggesting that acquisition of chromosomal abnormalities that transform MBL into CLL are secondary events.
Taken together, the findings suggest that HSCs are involved in the pathogenesis of CLL, even though CLL is a malignancy of a mature cell type. "Our data suggest that the propensity to progress to CLL is already acquired at the HSC stage," concludes Dr. Akashi. "Identification of the intrinsic abnormality of HSCs in patients with CLL should be the key to finding the ultimate therapeutic target in human CLL."
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