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Fresh Goat's Milk for Infants: Myths and Realities-A Review

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Many infants are exclusively fed unmodified goat's milk as a result of cultural beliefs as well as exposure to false online information. Anecdotal reports have described a host of morbidities associated with that practice, including severe electrolyte abnormalities, metabolic acidosis, megaloblastic anemia, allergic reactions including life-threatening anaphylactic shock, hemolytic uremic syndrome, and infections. We describe here an infant who was fed raw goat's milk and sustained intracranial infarctions in the setting of severe azotemia and hypernatremia, and we provide a comprehensive review of the consequences associated with this dangerous practice.
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DOI: 10.1542/peds.2009-1906
; originally published online March 15, 2010; 2010;125;e973Pediatrics
Sangita Basnet, Michael Schneider, Avihu Gazit, Gurpreet Mander and Allan Doctor
A Review−−Fresh Goat's Milk for Infants: Myths and Realities
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Fresh Goat’s Milk for Infants: Myths and Realities—A
Review
abstract
Many infants are exclusively fed unmodified goat’s milk as a result of
cultural beliefs as well as exposure to false online information. Anec-
dotal reports have described a host of morbidities associated with that
practice, including severe electrolyte abnormalities, metabolic acido-
sis, megaloblastic anemia, allergic reactions including life-threatening
anaphylactic shock, hemolytic uremic syndrome, and infections. We
describe here an infant who was fed raw goat’s milk and sustained
intracranial infarctions in the setting of severe azotemia and hyper-
natremia, and we provide a comprehensive review of the conse-
quences associated with this dangerous practice. Pediatrics 2010;125:
e973–e977
AUTHORS: Sangita Basnet, MD, FAAP,
a
Michael Schneider,
MD,
a
Avihu Gazit, MD,
b
Gurpreet Mander, MD, FAAP,
a
and
Allan Doctor, MD
b
a
Department of Pediatrics, Southern Illinois University School of
Medicine, Springfield, Illinois; and
b
Department of Pediatrics,
Washington University School of Medicine, St Louis, Missouri
KEY WORDS
goat’s milk, infant feeding, hypernatremia
ABBREVIATION
G-tube— gastrostomy tube
www.pediatrics.org/cgi/doi/10.1542/peds.2009-1906
doi:10.1542/peds.2009-1906
Accepted for publication Dec 15, 2009
Address correspondence to Sangita Basnet, MD, FAAP, Southern
Illinois University School of Medicine, Department of Pediatrics,
Division of Pediatric Critical Care, PO Box 19676, Springfield, IL
62794-9676. E-mail: sbasnet@siumed.edu
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2010 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.
CASE REPORTS
PEDIATRICS Volume 125, Number 4, April 2010 e973
at Siu School Of Medicine on May 24, 2012pediatrics.aappublications.orgDownloaded from
The developed world does not lack nu-
tritious food; nevertheless, infants
may still suffer from inadequate and
inappropriate nutrition because of pa-
rental and cultural beliefs. Further-
more, easy access to the Internet ex-
poses women to false information in
regards to alternative foods for their
infants, such as raw goat’s milk, that
may cause severe morbidity and even
death. We describe here the case of an
infant with severe electrolyte imbal-
ance, renal dysfunction, and stroke as
a result of being fed goat’s milk.
CASE REPORT
A 5-month-old white boy with CHARGE
(coloboma, heart defect, atresia choa-
nae, retarded growth and develop-
ment, genital hypoplasia, ear anoma-
lies/deafness) association from an
Amish family was admitted to the PICU
from an outside emergency depart-
ment after presenting with respiratory
failure that required endotracheal
tube placement and mechanical venti-
lation. He had a 1-day history of in-
creased work of breathing and de-
pressed level of consciousness that
was preceded by a 4-day history of di-
arrhea. His past medical history was
significant for tracheoesophageal fis-
tula repair with gastrostomy tube (G-
tube) placement, multiple esophageal
dilatations, and repair of choanal atre-
sia. He also had a history of atrial and
ventricular septal defects. In the neo-
natal period, because of parental con-
sanguinity, testing for plasma amino
acids and urine organic acids and the
state-expanded tandem mass spec-
troscopy screen were performed; no
abnormalities were found. There had
been no previous episodes of acidosis
or hypernatremia.
The infant’s respiratory distress
seemed principally to be the result of
severe metabolic acidosis with respi-
ratory compensation. A comprehen-
sive metabolic panel revealed aci-
demia, severe hypernatremia, and
azotemia, with significant hyperosmo-
larity. He had hyperchloremia, hyper-
phosphatemia, hyperuricemia, and an
elevated creatinine kinase level. Re-
sults of lactic acid and liver function
tests were within normal limits. Urinal-
ysis was significant for proteinuria, he-
maturia, and glucosuria. A complete
blood count showed leukocytosis with
left shift but was otherwise unremark-
able. Abnormal initial serum labora-
tory values are shown in Table 1.
On arrival to the PICU, the infant was
pharmacologically sedated and on me-
chanical ventilation with a hemody-
namic profile that was normal for his
age. His respiratory rate was in the 80
breaths per minute range. His capil-
lary refill time was prolonged. Results
of his chest radiograph were normal
except for minimal right perihilar infil-
trates. An echocardiogram on admis-
sion revealed normal segmental anat-
omy and left ventricular systolic
function, a small patent foramen ovale,
and tiny atrial and ventricular septal
defects.
Nutritional history revealed that the in-
fant was initially fed breast milk
through a G-tube. However, for 3 to 4
weeks before admission, he had been
exclusively fed raw goat’s milk be-
cause his mother was unable to pump
sufficient volume.
The infant’s hypernatremia and dehy-
dration were corrected slowly over 96
hours to reduce the risk of cerebral
edema and central pontine or extra-
pontine myelinolysis, which can occur
rarely.1–3 He required substantial
amounts of intravenous bicarbonate
to correct the metabolic acidosis, with
his serum level normalizing after 4
days of replacement. He also required
intravenous boluses and intermittent
supplementation of calcium, magne-
sium, potassium, and albumin. He was
started on low-sodium, low-protein
formula through his G-tube on the sec-
ond hospital day. His serum amino ac-
ids, urine organic acids, carnitine pro-
file, ammonia levels, and lactate level
were not diagnostic of an inborn error
of intermediary metabolism; the acido-
sis quickly corrected and has not
recurred.
Renal ultrasound showed normal ar-
chitecture and anatomy and demon-
strated a normal Doppler flow signal in
the renal veins. A renal duplex scan
showed no evidence of renal artery oc-
clusive disease and normal intrarenal
vascular perfusion. The ongoing losses
of electrolytes and bicarbonate were
attributed to acute tubular necrosis.
The infant’s serum urea nitrogen and
creatinine slowly normalized.
MRI of his brain showed acute and sub-
acute infarcts within the left posterior
cerebral artery territory and right
temporo-occipital periventricular white
matter and chronic infarctions involv-
ing bilateral occipital lobes (Fig 1).
There was no history of seizures or
neurologic deficits, and there was no
seizure activity noted during hospital-
ization. A hypercoagulability workup,
including protein C, protein S, and an-
tithrombin levels, was normal. The
TABLE 1 Initial Serum Laboratory Values at
Presentation
Blood Test Result Reference
Range
pH (arterial) 6.90 7.35–7.45
PCO
2
, mm Hg 13 35–45
HCO
3
, mmol/L 3 18–23
Sodium, mmol/L 176 135–147
Chloride, mmol/L 154 96–107
Anion gap 18 4–16
Measured osmolarity,
mOsm/kg
384 262–286
Serum urea nitrogen,
mg/dL
112 10–25
Creatinine, mg/dL 2.1 0.7–1.3
Calcium, mg/dL 7.2 9–11
Ionized calcium,
mmol/L
1.35 1.10–1.30
Glucose, mg/dL 132 70–109
Uric acid, mg/dL 13.5 3.4–7.4
Creatinine kinase, U/L 1000 0–200
Phosphorus, mg/dL 9.6 3.5–6.7
e974 BASNET et al at Siu School Of Medicine on May 24, 2012pediatrics.aappublications.orgDownloaded from
strokes were attributed, therefore, to
severe hypernatremic dehydration.
The infant had severe respiratory dis-
tress on extubation, was diagnosed
with having severe tracheomalacia,
and underwent tracheostomy. Cardiac
angiography demonstrated a vascular
ring that was subsequently repaired.
The infant was discharged from the
hospital with a tracheostomy and me-
chanical ventilatory assistance. How-
ever, he is gaining weight on regular
infant formula, and his electrolyte lev-
els have normalized without the need
for supplementation.
DISCUSSION
The first case in the literature to report
concerns with goat’s milk feeding in
infants described a 7-month-old boy
who had been fed for 6 months on
goat’s milk, weighed only 4 lb, and was
thought to have died of malnutrition
because “goat’s milk is lighter than
skimmed milk.”4The author ridiculed
the physician who made the diagnosis
saying that after cow’s milk, “goat’s
milk closely approximates to that of a
woman.”
As a result of information technology,
it is very easy for parents to read and
be influenced by false and potentially
dangerous information. A Google
search of the terms “goat’s milk” and
“infant” and “benefits” yielded 9490
hits; these pages provide information
such as “[g]oat’s milk is the ideal food
for babies....Beneficial for the treat-
ment of asthma, eczema, migraines,
stomach ulcers, liver complaints and
chronic catarrh, goat’s milk also helps
babies with colic, habitual vomiting
and those not gaining weight.”5This
same site suggests that the first few
feeds be given at half strength, in-
creased to two thirds, then three quar-
ters, reaching full strength in 2 to 3
days’ time mixed with honey (another
concerning recommendation).
The infant in this report presented
with severe hypernatremia and
azotemia in addition to other electro-
lyte abnormalities. Goat’s milk con-
tains 50 mg of sodium and 3.56 g of
protein per 100 mL, approximately 3
times that in human milk (17 mg and
1.03 g per 100 mL, respectively).6The
estimated requirements of sodium
and protein for infants 6 months old
are 100 to 200 mg/day and 9 to 11
g/day, respectively.7The infant de-
scribed here was receiving 500 mg/
day of sodium and 30 g/day of protein,
with a total intake of 32 oz of goat’s
milk per day. The immature kidneys in
very young infants have difficulty han-
dling the byproducts of foods with a
high renal solute load.8Sodium excre-
tion capacity matures more slowly
than glomerular filtration rate and
does not attain full capacity until the
second year of life.9Therefore, infants
fed fresh goat’s milk are at substantive
risk for hypernatremia and azotemia,
particularly in the face of dehydration
(as in the case described here), which
may in turn result in major central ner-
vous system pathology, including dif-
fuse encephalopathy, intraparenchy-
mal hemorrhage, or thromboses10 as
manifested in our patient.
Metabolic acidosis has been described
in infants fed undiluted goat’s milk.11–13
Our patient presented with severe
metabolic acidosis with increased an-
ion gap, which seemed out of propor-
tion to the dehydration and hyperchlor-
emia alone. The high protein content of
goat’s milk may have contributed to
this problem. Excessive protein load-
ing may result in accumulation of non-
volatile acids and urea,14,15 and it has
been shown that the incidence of met-
abolic acidosis increases with in-
crease in dietary protein intake.16
The main benefit claimed by propo-
nents of fresh goat’s milk for infants is
that it is less allergenic than cow’s
milk and is a suitable substitute for in-
fants who are allergic to the latter.
However, evidence shows that most in-
fants who are allergic to cow’s milk
are also allergic to goat’s milk. In vitro
studies have shown that there is an
extensive cross-reactivity of sera from
individuals who are allergic to cow’s
milk with proteins found in goat’s
milk.17–19 In 1 study, 26 children with
immunoglobulin E–mediated cow’s
milk allergy also had positive skin test
responses to goat’s milk, and 24 of 26
had positive double-blind, placebo-
FIGURE 1
Acute stroke: restricted diffusion (bright-white signal) of the left occipital lobe (A) and the white
matter along the occipital horn of the right lateral ventricle (B).
CASE REPORTS
PEDIATRICS Volume 125, Number 4, April 2010 e975
at Siu School Of Medicine on May 24, 2012pediatrics.aappublications.orgDownloaded from
controlled, oral food challenges with
fresh goat’s milk.20 There have been
case reports of severe life-threatening
anaphylactic reactions after the inges-
tion of commercial goat’s milk prepa-
ration in infants with documented
cow’s milk protein allergy.21 Further-
more, infants and young children may
have signs, symptoms, and serology
positive for goat’s milk without being
allergic to cow’s milk.22–25 In a retro-
spective study, children presented
with severe allergic reactions, includ-
ing anaphylaxis, after consumption of
goat’s milk products but tolerated
cow’s milk products.26
Folate deficiency with anemia in in-
fants fed homemade formula based on
goat’s milk has been described.27,28 In
fact, “goat’s milk anemia” was the
name given to the macrocytic hyper-
chromic megaloblastic anemia ob-
served in infants fed goat’s milk in Eu-
rope during the 1920s and 1930s.29 The
anemia was thought to be more severe
than that associated with exclusive
cow’s milk feeding and was cured by
giving supplements of liver extracts.
The concentration of folate in goat’s
milk is 6
g/L in comparison to human
breast milk, which contains 50
g/L.30
Infants younger than 6 months of age
need 65
g/day of folate, and the rec-
ommended daily allowance increases
with age.30
There have been reports of infections
such as Q fever, toxoplasmosis, and
brucellosis associated with feeding
raw goat’s milk.31–33 Consumption of un-
pasteurized goat’s milk has also been
implicated in the development of Esch-
erichia coli O157:H7–associated hemo-
lytic uremic syndrome.34,35 Although
raw goat’s milk is a proven vehicle for
pathogen transmission, the belief per-
sists that raw dairy products are
healthier and that pasteurized prod-
ucts are less beneficial and even
harmful.5
Although infants should not be fed un-
modified, raw goat’s milk, goat’s milk
infant formula may be a suitable alter-
native to cow’s milk formula. A study
performed in New Zealand showed
that there was no difference in weight
gain between healthy neonates fed ei-
ther formulas.36 Sixty-two infants were
randomly assigned to either goat’s
milk formula or cow’s milk formula
from within 72 hours of birth until
168 days of age. There was no statisti-
cally significant difference in average
weight gain in the goat’s milk formula
group versus the cow’s milk formula
group (309 g [95% confidence interval:
49 to 668]). Furthermore, although
infants fed goat’s milk formula had
higher bowel motion frequency (2.4 vs
1.7 bowel motions per day), both for-
mulas resulted in similar bowel mo-
tion consistency and periods of crying
and were deemed safe and well toler-
ated. However, the authors cautioned
feeding it to infants with documented
allergy to cow’s milk infant formula.
CONCLUSIONS
An exclusive, unmodified goat’s milk
diet can cause significant morbidity
and even mortality in infants, including
electrolyte imbalances, metabolic aci-
dosis, folate deficiency, and species-
specific and nonspecific antigenicity.
Unpasteurized goat milk has its ad-
ditional infectious risks. However,
information supporting this practice
abounds on the Internet and in specific
cultures. Our case report and literature
review support the need to strongly ad-
vocate against this practice.
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CASE REPORTS
PEDIATRICS Volume 125, Number 4, April 2010 e977
at Siu School Of Medicine on May 24, 2012pediatrics.aappublications.orgDownloaded from
DOI: 10.1542/peds.2009-1906
; originally published online March 15, 2010; 2010;125;e973Pediatrics
Sangita Basnet, Michael Schneider, Avihu Gazit, Gurpreet Mander and Allan Doctor
A Review−−Fresh Goat's Milk for Infants: Myths and Realities
Services
Updated Information &
tml
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tml#ref-list-1
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... The study also stated that children who have cow's milk allergy have a higher risk of developing FPIES with goat's milk, too [4]. Another case report documented the severe presentation of FPIES as a result of goat's milk consumption in a 5-month-old child with respiratory failure requiring mechanical ventilation, severe metabolic acidosis, renal failure, and severe electrolyte derangements [5]. Cultural and parental beliefs can be significant contributors to the introduction of goat's milk in infants as well. ...
... The average composition per 100 g of milk for goat's milk includes 2.9 g of protein as compared to 1.1 g of protein in human milk [6]. Infants' digestive tracts and kidneys are immature and are not prepared for the digestion and processing of complex proteins [5,7]. The potentially harmful effects of goat's milk introduction in infants include but are not limited to electrolyte abnormalities, renal damage, and central nervous system pathologies [5]. ...
... Infants' digestive tracts and kidneys are immature and are not prepared for the digestion and processing of complex proteins [5,7]. The potentially harmful effects of goat's milk introduction in infants include but are not limited to electrolyte abnormalities, renal damage, and central nervous system pathologies [5]. Unpasteurized goat milk may also have serious infectious risks. ...
Article
The differential diagnosis for bilious emesis and hematochezia in newborns is broad and includes structural abnormalities (malrotation with volvulus, atresia, pyloric stenosis, intussusception), infectious colitis, necrotizing enterocolitis, milk protein intolerance, vascular malformations, and other bleeding disorders. Here we report a case of bilious emesis and hematochezia in an 8-day-old male infant who was ultimately found to have goat's milk protein intolerance after an extensive workup ruling out other pathology. There have been limited studies that examine goat's milk protein intolerance in pediatric patients, and to our knowledge, our paper presents the youngest patient presenting with bilious emesis related to goat's milk intake.
... Anti-carcinogenic properties of CLA have been reported against mammary and colon cancer in animal models, as well as in vitro models of human melanoma, colorectal and breast cancer (Palomboet al., 2002). 14 Basnet et al. (2010) reported an infant was exclusively fed goat milk, which led to azotemia (abnormally high levels of nitrogen compounds in the blood), hypernatremia (electrolyte imbalance caused by elevated sodium levels) and hemorrhages in the brain but when it gave malnourished children (1-5 years) goat or cow milk, weight gain and fat absorption were similar in both groups. 15 ...
... 14 Basnet et al. (2010) reported an infant was exclusively fed goat milk, which led to azotemia (abnormally high levels of nitrogen compounds in the blood), hypernatremia (electrolyte imbalance caused by elevated sodium levels) and hemorrhages in the brain but when it gave malnourished children (1-5 years) goat or cow milk, weight gain and fat absorption were similar in both groups. 15 ...
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Goat is known as poor man’s animal. The fat globules are smaller in goat milk, which makes it easily digestible. Polyunsaturated fatty acids in goat milk fat, is mainly responsible for anticancerous behavior of goat milk. Although protein is somewhat low in goat milk than cow milk, the digestibility of goat milk protein is higher compared to cow milk protein. Taurine present in goat milk is reported to have inhibitory action on cardiovascular disease leads to synthesis of essential amino acids. Goat’s milk contains less lactose than cow’s milk, which is beneficial to lactose intolerance patients. Higher selenium concentration in goat milk, results in platelet regeneration when suffering from dengue fever. Bioactive peptides released during fermentation and invitro digestion are reported to produce antioxidant and antimicrobial peptides. Sialic acid present in caprine milk is also reported to help fast brain development. As compared to milk of other milch animals, goat’s milk has great potential to prevent various diseases. Beside nutritional properties, goat milk possesses potent nutraceutical and Therapeutic properties making it most suitable for infants, older and convalescent people. In this review, strong nutraceutical power of caprine milk is briefly explored.
... Козье молоко как основа для производства молочной смеси содержит те же витамины и минералы, что и ко ровье молоко [42]; содержание витаминов A, D, PP в нем выше, чем в коровьем [41]; причем концентрация витамина А превышает таковую в коровьем молоке в 2 раза [89]. Однако козье молоко по сравнению с коровьим содержит меньше фолиевой кислоты и витамина В 12 , чем может быть обусловлен высокий риск развития анемии у детей, находящихся на вскармливании цельным козьим молоком [90]. Дополнительное обогащение смесей фолиевой кислотой помогает избежать природного дефицита этого нутриента в смесях. ...
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This review summarizes the benefits of goat’s milk as the basis to produce adapted milk formulas according to relevant infants feeding issues. The characteristics of main nutrients of modern goat’s milk formulas are presented. A balanced protein composition enriched with β-palmitate, presence of prebiotics-oligosaccharides, natural nucleotides and probiotics advances these formulas closer to breast milk and provide their multipotent sanogenetic effects. The unique composition of goat’s milk formulas allows to ensure normal physical growth of a baby, induces tissue and systemic immunity via adequate intestinal microbiota formation, maintains normal functioning of gut-brain axis, that promotes vegetative and visceral disorders (due to functional digestive disorders) correction. Thus, it is possible to recommend goat’s milk formulas in cases of forced mixed or formula feeding of healthy infants and children with functional digestive disorders.
... Toxoplasmosis is a serious public health concern that continues to be exacerbated by the presence of the parasite in goat milk, consumer demands for pathogen-free goods have focused government authorities and the food industry's attention on the need of having safe, high-quality products, raw milk is sold and distributed commercially in a variety of ways in different nations (Mancianti et al., 2013). Despite the fact that raw goat's milk has been proved to be a vector for disease transmission, unpasteurized dairy products have gained appeal among customers who believe raw milk improves the immune system and provides other health advantages (Basnet et al., 2010). Toxoplasmosis in humans can be spread vertically through the placenta or horizontally by the intake of foods contaminated with bradyzoites and tachyzoites, analogous as unpasteurized milk or cheese, undercooked meat, or ignoble fruits and vegetables (Tenter et al., 2000). ...
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This study concluded detection of Toxoplasma gondii in milk, immunologically by using Elisa and nested PCR)nPCR (based on B1 gene, also to investigate the effect of toxoplasmosis, parity, breed and flock on some milk composition in the Iraqi local and Shami goats in the middle of Iraq. A total of 80 milk samples of the lactating goats were collected. Results of this study showed the prevalence of Toxoplasmosis was 21.25% and 28.75% by Elisa and nPCR respectively without significant differences. The sensitivity of Elisa was a low (30.43%) whereas the specificity was a high (82.45%). The degree of agreement estimated by Kappa coefficient revealed a slight agreement (0.14) between two methods. The results indicated that goats infected with toxoplasmosis have significantly (P<0.05) higher in protein and lactose percentage whereas the effect was not significant for each of fat, SNF and pH. On the other hand, the effect of parity was significant (P<0.05) on fat, protein, lactose, solid nonfat and non-effect on PH. As well as effect of breed and flock was significant (P<0.05) on protein, lactose and solid nonfat without significant effect on fat and PH.
... The fact that goat milk was consumed in the study, even by children especially maternal orphan new-borns, mainly without any processing, represents a serious concern. According to Basnet et al. (2010), although goat milk is very nutritious and recommended for the growth of children, it should not be consumed in its unmodified form by children. These authors reported serious clinical cases associated with the consumption of raw goat milk by children. ...
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Goats, more popular than cattle in rural Benin, are mainly kept for meat production. Their milk is still unpopular but can provide the much-needed nutrients for children in food-insecure households. This study explored the socio-economic factors affecting the attitude of rural households in the Niger Valley of Benin toward goat milk consumption. Data were collected through individual face-to-face interviews of 721 heads of households or their representatives. Binary logistic regression analysis was carried out to test the association between socioeconomic variables and goat milk consumption. Goat milk and its products were consumed in 14.7% of the surveyed households and were not part of the traditional diets of remaining 81.8%. Their sensory qualities were further reasons reported by 18.4% of respondents for their non-consumption. A household's likelihood to consume goat milk or its derivatives was significantly influenced by the sociocultural background of its head and whether it kept goats or not. The odds of consuming goat milk and/or its derivatives were 2.285 and 2.017 times higher, respectively, for households from Dendi and Peulh socio-cultural groups. Despite the recorded cultural barriers, there is room for increasing goat milk consumption by rural households by increasing its availability and raising awareness of its nutritional and health benefits.
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Iron deficiency is the most commonly detected nutritional disorder in childhood and at the same time the most frequent cause of anaemia worldwide. In most cases it can go unnoticed, because it causes subtle symptoms and signs. Iron plays a key role in many biochemical processes, including neurological development, oxygen transport and energy metabolism. Proper nutrition from birth and any iron supplementation are in most cases sufficient to prevent iron deficiency anaemia. However, in rural or mountain areas, in cases of maternal hypogalease, boiled cow and/or goat milk are often preferred to formula milks, which are considered healthier. In many cases the intervention by the paediatrician allows families to be directed towards the correct management of the infant but in a context such as the pandemic one some situations may easily get out of control.
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Goat milk is considered as one of the most suitable substitute for human milk, especially for children, the aged and those with cow milk allergies. Consumption of raw or unpasteurized goat milk has been known to be a potential route of Toxoplasma gondii infection for human beings. However, no studies have been carried out to detect T. gondii in goat milk in China. Thus, this stuy was firstly carried out to detect T. gondii IgG antibody in domestic goat's serum and milk during lactation by a commercial validated ELISA kit in China. In total, 10.49% (66/629) serum samples and 9.70 (61/629) milk samples randomly collected for Shandong and Jilin provinces were seropositive for anti-T. gondii IgG, respectively. A high correlation of S/P% value was obtained between serum and milk samples (Spearman's coefficient = 0.891, p-value <0.001 and Kendall's tau = 0.724, p-value < 0.001). Statistical analysis showed that history of abortion, source of water and source of fodder were considered to be highly related to the T. gondii infection in the investigated domestic goats. The present results provide important information for the control and prevention of toxoplasmosis in goats and/or human beings in China.
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In October 1978, a large family cluster of acute toxoplasmosis was identified in northern California. Indirect fluorescent IgM antibody tests showed that ten of 24 members of an extended family had serological evidence of acute Toxoplasma infection. The index case had retinochoroiditis; the other nine persons had asymptomatic infections. All ten seropositive persons had recently consumed raw goat's milk from the family herd as compared with no consumption of raw milk by the 14 persons with negative results. No dietary item or other risk factors were as strongly associated with positive serological test results as raw milk consumption. Although ingestion of soil-transmitted oocysts could not be ruled out unequivocally as the source of infection, the data suggest that drinking raw milk from infected goats might be another possible vehicle for the transmission of toxoplasmosis.(JAMA 1982;248:1728-1732)
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The allergic potential of α-caseins from bovine, ovine, and goat's milk sharing more than 85% identical amino acids was compared. Caseins were purified by anion-exchange chromatography and used for a specific IgE and IgG ELISA with diluted human sera. Sera were from 17 children with immediate-type allergy to cow's milk, from 59 children with atopy but without food allergy, and from 27 healthy children without atopic disease. The sera of cow's milk-allergic children showed a significantly higher IgE and IgG binding to α-caseins from all three species than the sera of the other groups. All groups showed an increased antibody binding to bovine a-casein compared to the sheep and goat proteins, but the differences were significant only in the groups of atopic children and of healthy controls. Furthermore, inhibition of the IgE binding to bovine α-casein with α-casein from cow, goat, and sheep revealed that the a-caseins from these species are highly cross-reactive, on the basis of the small differences in their primary structure. In conclusion, the milk of goat and sheep harbor an allergic potential and is not suitable for the nutrition of milk-allergic patients.
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This study describes the development of renal control of salt and water homeostasis. Twenty-three infants aged 3 weeks to 13 months were studied with respect to glomerular filtration rate (GFR) using single injection technique, ability to excrete an oral salt load, ability to excrete water, and diluting capacity. GFR developed exponentially, salt excretion linearly, water excretion was unchanged and diluting capacity actually decreased. A hypothesis is presented for the theoretical basis of this functional development taking into account the interdependence of the functional parameters studied. This theory might well explain the high incidence of hypernatremic dehydration in infants.
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One-hundred-and-fifty-seven children admitted with brucellosis at Abha, Saudi Arabia, were studied prospectively. Ninety-two per cent gave a history of animal contact, usually with sheep or goats, or ingesting raw milk, milk products, or raw liver. Three-quarters of the patients had an acute or subacute presentation with diverse symptomatology: fever (100 per cent), malaise (91 per cent), anorexia (68 per cent), cough (20 per cent), abdominal symptoms (20 per cent), arthralgia (25 per cent). Hepatomegaly (31 per cent), splenomegaly (55 per cent), and lymphadenopathy (18 per cent) were common findings. Organ complications were rare except for arthritis (36 per cent) which usually presented as a peripheral oligoarthritis involving the hips and knees. All patients had significant agglutination titres; B. melitensis was grown from the blood in 7 of 16 (44 per cent) patients. Haematological variations were common, but non-specific: anaemia (64 per cent), thrombocytopenia (28 per cent), leucopenia (38 per cent), leucocytosis (12 per cent), and elevated erythrocyte sedimentation rate (81 per cent). Varying combinations of rifampicin, co-trimoxazole, tetracycline, and streptomycin resulted in a prompt pyrexial response (mean: 3.8 days), and a slower response in the arthropathy and hepatosplenomegaly. Relapses were related to poor compliance, use of a single drug or a shorter duration of chemotherapy. Brucellosis is a common childhood problem in southwestern Saudi Arabia as in other parts of the country and the Middle East. It should be considered in every child from an endemic area presenting with a febrile illness and a history of animal contact.
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Crossed radioimmunoelectrophoresis (CRIE) was used to study the presence of serum IgE against antigenic components of cow milk in 21 selected milk-allergic patients. The amount of each IgE specificity was estimated by a scoring system. The milk-allergic children had mainly IgE against alpha-lactalbumin, beta-lactoglobulin, albumin and immunoglobulin, the four major proteins of bovine whey, as well as IgE against three casein components. A serum pool from 1000 normal adults had IgE against the same whey protein, but in smaller amounts, and no IgE against the casein components. Eight cow milk-based formulae, commonly used for infant feeding, and goat milk were studied by the same method. It was found that six of the milk substitutes did not differ significantly from cow milk in antibody binding, but the two hydrolysed casein products, Nutramigen and Pregestimil, consisted of such small molecules that the rabbit antisera could not precipitate the hydrolysed proteins in the gels on the CRIE plates. It was therefore not possible to study their IgE binding, if any, by this method.
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In this investigation comprising 516 neonates the frequency of metabolic acidosis from day 5 to day 21 of postnatal life is reported. 334 term and 131 preterm appropriate-for-gestational age (AGA) infants and 51 small-for-gestational age (SGA) infants were studied. The incidence of metabolic acidosis occurring after the 5th day of postnatal life was in each group of infants 4.79%, 20.61% and 11.76% respectively. Furthermore, the infants were divided into three groups according to the amount of protein and solute content of the formula consumed. An increasing incidence of metabolic acidosis with increasing dietary protein intake was observed, especially among preterm infants. In the group of small-for-gestational age infants a similar increase with a higher protein and solute content of the formula was registered. However, this augmented incidence was related to the gestational age, rather than to birth weight.