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Newborn

Newborn

The word infant derives from the Latin in-fans, meaning unable to speak. It is commonly used as a slightly more formal word for baby (the youngest category of child). The term infant is also used as formal/legal term for minor; that is, a child in general. A newborn infant is known as a neonate (neonatal, neonatus) after the final stage of gestation. Newborn infants are born with their skin coated with a white substance known as vernix caseosa, which is hypothesized to act as an antibacterial barrier. Newborns look physically different from prototypical older infants. They typically suffered minor trauma during birth resulting in a misshapen skull (compressed and pointed), puffy eyes, various discharges, blotchy and wrinkled skin. The Apgar score is a measure of a newborn's health. Infant mortality is the death of infants in the first year of life. Infant mortality can be subdivided into neonatal death, referring to deaths in the first 27 days of life, and post-neonatal death, referring to deaths after 28 days of life. Major causes of infant mortality include dehydration, infection, congenital malformation, and SIDS. This epidemiological indicator is recognised as a very important measure of the level of healthcare in a country because it is directly linked with the health status of infants, children, and pregnant women as well as access to medical care, socio-economic conditions, and public health practices. Feeding is done by breastfeeding or with special industrial milk, "infant formula". As infants age, and their appetites grow, many parents choose from a variety of baby foods to feed the child. Infants have a sucking instinct allowing them to extract the milk from the nipples of the breasts or the nipple of the baby bottle. If the mother is unable to breast feed, or does not want to, infant formula is used in Western countries. Sometimes a wet nurse is hired to feed the infant. wet nurse Breastfeeding provides infants with many natural immune substances and isolates the infant from most bacteria or other contaminations in the local water supply. Infant formula does not provide these immune substances and in places with poor quality water supply, subjects the infant to an increased risk of disease. Infants are incontinent, therefore diapers are generally used in industrialized countries, while methods similar to elimination communication[http://groups.yahoo.com/group/eliminationcommunication/] are common in third world countries. These techniques assert babies can control their bodily functions at the age of six months and they are aware when they are urinating at even earlier age. Babies can learn to signal to the parents when it is time to urinate or defecate by turning or making some noises. Parents have to pay attention to the baby's action so they can learn the signals. third world Babies cannot walk, although more mature infants may crawl; baby transport may be by perambulator (stroller or buggy) or on the back or in front of an adult in a special bag, cloth or cradle board. Infants cry as a form of basic instinctive communication to their parents when in need of feeding or when in discomfort. As is the case with most other young children, infants are usually treated as special persons. Their social presence is different from that of adults, and they may be the focus of attention. Fees for transportation and entrance fees at locations such as amusement parks or museums are often waived.

External links

- [http://dmoz.org/Home/Family/Babies/ Baby Links] Parenting and Information sites from the Open Directory Project
- [http://www.pregnancybirthandbaby.co.uk Pregnancy, birth and baby] Parenting site including the Parenting wiki
- [http://www.cia.gov/cia/publications/factbook/fields/2091.html CIA FactBook] — Infant mortality rates in different countries and other health indicators
- [http://www.babymilkaction.org Baby Milk Action] — "aims to save lives and to end the avoidable suffering caused by inappropriate infant feeding"
- [http://www.who.int/whr/2005/en/ The World Health Report 2005 – Make Every Mother and Child]
- [http://www.babycentre.co.uk BabyCentre] — "A fantastic resource for parents from preconception to baby, to toddler" Category:Infancy simple:Baby

Latin

Latin is an ancient Indo-European language originally spoken in the region around Rome called Latium. It gained great importance as the formal language of the Roman Empire. All Romance languages, those being most notably Spanish, French, Portuguese, Italian, and Romanian, are descended from Latin, and many words based on Latin are found in other modern languages such as English. The Latin alphabet, derived from the Greek, remains the most widely-used alphabet in the world. It is said that 80 percent of scholarly English words are derived from Latin (in a large number of cases by way of French). Moreover, in the Western world, Latin was a lingua franca, the learned language for scientific and political affairs, for more than a thousand years, being eventually replaced by French in the 18th century and English in the late 19th. Ecclesiastical Latin remains the formal language of the Roman Catholic Church to this day, and thus the official national language of the Vatican. The Church used Latin as its primary liturgical language until the Second Vatican Council in the 1960s. Latin is also still used (drawing heavily on Greek roots) to furnish the names used in the scientific classification of living things. The modern study of Latin, along with Greek, is known as Classics.

Main features

Latin is a synthetic inflectional language: affixes (which usually encode more than one grammatical category) are attached to fixed stems to express gender, number, and case in adjectives, nouns, and pronouns, which is called declension; and person, number, tense, voice, mood, and aspect in verbs, which is called conjugation. There are five declensions (declinationes) of nouns and four conjugations of verbs. There are six noun cases: #nominative (used as the subject of the verb or the predicate nominative), #genitive (used to indicate relation or possession, often represented by the English of or the addition of s to a noun), #dative (used of the indirect object of the verb, often represented by the English to or for), #accusative (used of the direct object of the verb, or object of the preposition in some cases), #ablative (separation, source, cause, or instrument, often represented by the English by, with, from), #vocative (used of the person or thing being addressed). In addition, some nouns have a locative case used to express location (otherwise expressed by the ablative with a preposition such as in), but this survival from Proto-Indo-European is found only in the names of lakes, cities, towns, small islands, and a few other words related to locations, such as "house", "ground", and "countryside". Latin itself, being a very old language, is far closer to Proto-Indo-European than are most modern Western European languages; it has, in fact, about the same relationship with PIE as modern Italian or French has to Latin. There are six general tenses in Latin (technically they are tense/aspect/mood complexes). The indicative mood can be used with all of them. The subjunctive mood, however, has only present, imperfect, perfect, and pluperfect tenses. These tenses in the subjunctive mood do not completely correlate in meaning to the tenses in the indicative. The following examples are of the first conjugation verb "laudare" ("to praise") in the indicative mood and the active voice:
Primary sequence tenses
# present (laudo, "I praise") # imperfect (laudabam, "I was praising") # future (laudabo, "I shall praise," "I will praise")
Secondary sequence tenses
# perfect (laudavi, "I praised", "I have praised") # pluperfect (laudaveram, "I had praised") # future perfect (laudavero, "I shall have praised," "I will have praised") The future perfect tense can also imply a normal future idea (like in "When I will have run...") and so may also sometimes be included in the primary sequence.
Latin and Romance
After the collapse of the Roman Empire, Latin evolved into the various Romance languages. These were for many centuries only spoken languages, Latin still being used for writing. For example, Latin was the official language of Portugal until 1296 when it was replaced by Portuguese. The Romance languages evolved from Vulgar Latin, the spoken language of common usage, which in turn evolved from an older speech which also produced the formal classical standard. Latin and Romance differ (for example) in that Romance had distinctive stress, whereas Latin had distinctive length of vowels. In Italian and Sardo logudorese, there is distinctive length of consonants and stress, in Spanish only distinctive stress, and in French even stress is no longer distinctive. Another major distinction between Romance and Latin is that all Romance languages, excluding Romanian, have lost their case endings in most words except for some pronouns. Romanian retains a direct case (nominative/accusative), an indirect case (dative/genitive), and vocative. In Italy, Latin is still compulsory in secondary schools as Liceo Classico and Liceo Scientifico which are usually attended by people who aim to the highest level of education. In Liceo Classico Ancient Greek is a compulsory subject.
Latin and English
See Latin influence in English for a more complete exposition. English grammar is independent of Latin grammar, though prescriptive grammarians in English have been heavily influenced by Latin. Attempts to make English grammar follow Latin rules — such as the prohibition against the split infinitive — have not worked successfully in regular usage. However, as many as half the words in English were derived from Latin, including many words of Greek origin first adopted by the Romans, not to mention the thousands of French, hundreds of Spanish, Portuguese and Italian words of Latin origin that have also enriched English. During the 16th and on through the 18th century English writers created huge numbers of new words from Latin and Greek roots. These words were dubbed "inkhorn" or "inkpot" words (as if they had spilled from a pot of ink). Many of these words were used once by the author and then forgotten, but some remain. Imbibe, extrapolate, dormant and inebriation are all inkhorn terms carved from Latin words. In fact, the word etymology is derived from the Greek word etymologia, meaning "true sense of the word." Latin was once taught in many of the schools in Britain with academic leanings - perhaps 25% of the total [http://www.channel4.com/history/microsites/T/teachem2/thennow/]. However, the requirement for it was gradually abandoned in the professions such as the law and medicine, and then, from around the late 1960s, for admission to university. After the introduction of the Modern Language GCSE in the 1980s, it was gradually replaced by other languages, although it is now being taught by more schools along with other classical languages.
Latin education
The linguistic element of Latin courses offered in high schools or secondary schools, and in universities, is primarily geared toward an ability to translate Latin texts into modern languages, rather than using it in oral communication. As such, the skill of reading is heavily emphasized, whereas speaking and listening skills are barely touched upon. However, there is a growing movement, sometimes known as the Living Latin movement, whose supporters believe that Latin can, or should, be taught in the same way that modern "living" languages are taught, that is, as a means of both spoken and written communication. One of the most interesting aspects of such an approach is that it assists speculative insight into how many of the ancient authors spoke and incorporated sounds of the language stylistically; without understanding how the language is meant to be heard it is very difficult to identify patterns in Latin poetry. Institutions offering Living Latin instruction include the Vatican and the University of Kentucky. In Britain the Classical Association encourages this approach, and there has been something of a vogue for books describing the adventures of a mouse called Minimus. In the United States there is a thriving competitive organization for high school Latin students, the National Junior Classical League (the second-largest youth organization in the world after the Boy Scouts), backed up by the Senior Classical League for college students. Many would-be international auxiliary languages have been heavily influenced by Latin, and the moderately successful Interlingua considers itself to be the modernized and simplified version of the language (le latino moderne international e simplificate). Latin translations of modern literature such as Paddington Bear, Winnie the Pooh, Harry Potter and the Philosopher's Stone, Le Petit Prince, Max und Moritz, and The Cat in the Hat have also helped boost interest in the language.
See also

About the Latin language

- Latin grammar
- Latin spelling and pronunciation
- Latin declension
- Latin conjugation
- Latin alphabet
- List of Latin words with English derivatives
- Latin verbs with English derivatives
- Latin nouns with English derivatives
- ablative absolute
- Word order in Latin
About the Latin literary heritage

- Latin literature
- Romance languages
- Loeb Classical Library
- List of Latin phrases
- List of Latin proverbs
- Brocard
- List of Latin and Greek words commonly used in systematic names
- List of Latin place names in Europe
- Carmen Possum
Other related topics

- Roman Empire
- Internationalism
References

- Bennett, Charles E. Latin Grammar (Allyn and Bacon, Chicago, 1908)
- N. Vincent: "Latin", in The Romance Languages, M. Harris and N. Vincent, eds., (Oxford Univ. Press. 1990), ISBN 0195208293
- Waquet, Françoise, Latin, or the Empire of a Sign: From the Sixteenth to the Twentieth Centuries (Verso, 2003) ISBN 1859844022; translated from the French by John Howe.
- Wheelock, Frederic. Latin: An Introduction (Collins, 6th ed., 2005) ISBN 0060784237
External links

- [http://www.jambell.com/latin.html Latin Phrases for after dinner conversation (Thanks to Elaine Poole)]
- [http://www.ethnologue.com/show_language.asp?code=lat Ethnologue report for Latin]
- [http://forumromanum.org/literature/index.html Corpus Scriptorum Latinorum] is a comprehensive webography of Latin texts and their translations.
- [http://www.perseus.tufts.edu/ The Perseus Project] has many useful pages for the study of classical languages and literatures, including [http://www.perseus.tufts.edu/cgi-bin/resolveform?lang=Latin an interactive Latin dictionary].
- [http://lysy2.archives.nd.edu/cgi-bin/words.exe words by William whitaker] is a dictionary program online capable of looking up various word forms.
- [http://retiarius.org/ Retiarius.Org] includes a Latin text search engine.
- [http://www.nd.edu/~archives/latgramm.htm Latin-English dictionary and Latin grammar from U of Notre Dame]
- [http://latin-language.co.uk/ Latin language] History of Latin language, Latin texts with English translation and a collection of dictionaries.
- [http://augustinus.eresmas.net/scl/ Societas Circulorum Latinorum] gathers together Latin Circles all over the world.
- [http://www.learnlatin.tk LearnLatin.tk] - Free online course in Latin
- [http://www.latintests.net/ LatinTests.net] - Lets Latin learners test their grammar and vocabulary with self-checking quizzes.
- [http://thelatinlibrary.com/ The Latin Library] contains many Latin etexts
- [http://www.textkit.com/ Textkit] has Latin textbooks and etexts.
- [http://www.websters-online-dictionary.org/definition/Latin-english/ Latin–English Dictionary]: from Webster's Rosetta Edition.
- [http://www.language-reference.com/ Language reference] Cross-foreign-language lexicon powered by its own search engine. All cross combinations between Latin and French, German, Italian, Spanish.
- [http://comp.uark.edu/~mreynold/rhetor.html Rhetor by Gabriel Harvey] was originally published in 1577 and never again reprinted.
- [http://freewebs.com/omniamundamundis omniamundamundis] Latin hypertexts from fourteen ancient Roman authors.
- [http://www.saltspring.com/capewest/pron.htm Pronunciation of Biological Latin, Including Taxonomic Names of Plants and Animals]
- [http://www.yleradio1.fi/nuntii Nuntii Latini (News in Latin)], written and spoken (RealAudio) news in latin. Weekly review of world news in Classical Latin, the only international broadcast of its kind in the world, produced by YLE, the Finnish Broadcasting Company.
- [http://www.tranexp.com:2000/InterTran?url=http%3A%2F%2F&type=text&text=Replace%20Me&from=eng&to=ltt InterTran Latin], Translate from Latin to ENGLISH or vice versa.
- [http://www.latinvulgate.com Latin Vulgate] The Latin and English of the Old & New Testaments in parallel, along with the Complete Sayings of Jesus in parallel Latin and English. Category:Classical languages Category:Ancient languages Category:Fusional languages Category:Languages of Italy Category:Languages of Vatican City als:Latein zh-min-nan:Latin-gí ko:라틴어 ja:ラテン語 simple:Latin language th:ภาษาละติน

Vernix caseosa

:For the town in France, see Vernix, Manche. Vernix, also known as Vernix caseosa, is the "waxy" or "cheesy" white substance found coating the skin of newborn humans. It is secreted by the fetus's sebaceous glands in utero, and is hypothesized to have antibacterial properties. The word "smegma" is occasionally used to describe vernix. Vernix is composed of sebum (the oil of the skin) and cells that have sloughed off the fetus' skin.

External link

- [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Vernix+Caseosa PubMed articles on Vernix caseosa] Category:Integumentary system Category:Immune system Category:Pediatrics

Apgar score

The Apgar score was devised in 1952 by Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after childbirth. The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two and summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The test is generally done at one and five minutes after birth, and may be repeated later if the score is, and remains, low. Scores below 3 are generally regarded as critically low, with 4 to 7 fairly low and over 7 generally normal. Low scores at the one minute test may require medical attention, but are not an indication of longer term problems, particularly if there is an improvement by the stage of the five minute test. If the Apgar score remains below 3 at later times such as 10, 15, or 30 minutes, there is a risk that the child will suffer longer term neurological damage. There is also a small but significant increase in the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long-term predictions on a child's health. Some ten years after the initial publication, the acronym APGAR was coined in the US as a mnemonic learning aid: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. The mnemonic was introduced in 1963 by the pediatrician Dr. Joseph Butterfield. The same acronym is used in German (Atmung, Puls, Grundtonus, Aussehen, Reflexe), although the letters have different meanings. Another such backformation attempting to make Apgar an acronym is American Pediatric Gross Assessment Record. The test, however, is named for Dr. Apgar.

Literature

- Apgar, Virginia. [http://apgar.net/virginia/Apgar_Paper.html A proposal for a new method of evaluation of the newborn infant], Curr. Res. Anesth. Analg. 1953;32, pp. 260–267

Infection

An infection is the detrimental colonization of a host organism by a foreign species. In infection, the infecting organism seeks to utilize the host's resources in order to multiply at the expense of the host. The infecting organism, or pathogen, interferes with the normal functioning of the host and can lead to chronic wounds, gangrene, loss of an infected limb, and even death. The host's response to infection is inflammation. Colloquially, a pathogen is usually considered a microscopic organism though the definition is broader, including bacteria, parasites, fungi, viruses, prions, and viroids. The branch of medicine that focuses on infections and pathogens is infectious disease.

Colonization

Wound colonization refers to nonreplicating microorganisms within the wound, while in infected wounds replicating organisms exist and tissue is injured. All multicellular organisms are colonized to some degree by extrinsic organisms, and the vast majority of these exist in either a symbiotic or commensal relationship with the host. An example of the former would be the anaerobic bacteria species which colonize the mammalian colon, and an example of the latter would be the various species of staphylococcus which exist on human skin. Neither of these colonizations would be considered infections. The difference between an infection and a colonization is often only a matter of circumstance. Organisms which are normally non-pathogenic can become pathogenic under the right conditions, and even the most virulent organism requires certain circumstances to cause a compromising infection. Some colonizing bacteria, such as Corynebacteria sp. and viridians streptococci, prevent the adhesion and colonization of pathogenic bacteria and thus have a symbiotic relationship with the host, preventing infection and speeding wound healing. The variables involved in the outcome of a host becoming inoculated by a pathogen and the ultimate outcome include:
- the route of entry of the pathogen and the access to host regions that it gains
- the intrinsic virulence of the particular organism
- the quantity or load of the initial inoculant
- the immune status of the host being colonized As an example, the staphylococcus species present on skin remain harmless on the skin, but, when present in a normally sterile space, such as in the capsule of a joint or the peritoneum, will multiply without resistance and create a huge burden on the host.

SIDS

Sudden infant death syndrome (SIDS) is any sudden and unexplained death of an apparently healthy infant aged one month to one year. The term cot death is sometimes used in the United Kingdom, and crib death in the United States.

Diagnosis

SIDS is a definition of exclusion and only applies to an infant whose death remains unexplained after the performance of an adequate postmortem investigation including (1) an autopsy, (2) investigation of the scene and circumstances of the death and (3) exploration of the medical history of the infant and family. Generally, but not always, the infant is found dead after having been put to sleep and exhibits no signs of having suffered. The inexplicability of the death often leaves parents with a deep sense of guilt in addition to their grief.

Statistics

SIDS is responsible for roughly 50 deaths per 100,000 births in the US. It is responsible for far fewer deaths than congenital disorders and disorders related to short gestation; though it becomes the leading cause of death in otherwise healthy babies after one month of age. The frequency of SIDS appears to be a strong function of the age, race, education, and socio-economic status of the parents.

Risk factors

Very little is known about the possible causes of SIDS; there is no method for absolute prevention. However, several risk factors are associated with increased probability of the syndrome.

Prenatal risks

- inadequate prenatal care
- inadequate prenatal nutrition
- tobacco smoking
- use of cocaine or heroin
- teenage pregnancy
- less than a one year interval between subsequent births

Post-natal risks

- low birth weight (especially less than 1.5 kg)
- exposure to tobacco smoke
- laying an infant to sleep on his or her stomach (see positional plagiocephaly)
- failure to breastfeed
- excess clothing and overheating
- excess bedding, soft sleep surface and stuffed animals
- sex (60% of deaths occur in males)
- age (incidence is higher between 2-4 months) In addition, research indicates a reduced risk of SIDS in conjunction with a safe co-sleeping arrangement. Though findings are still preliminary, the proximity of a parent's respiration is thought to stimulate proper respiratory development in the infant. (The use of baby monitors, particularly those with motion sensors, can allow the parents to remotely keep track of their child.)

SIDS and child abuse

Controversial British pediatrician Roy Meadow believes that many cases diagnosed as SIDS are really the result of child abuse on the part of a parent suffering from Munchausen Syndrome by Proxy (a condition which he himself identified). During the 1990's and early 2000's, a great many mothers of multiple apparent SIDS victims were convicted of murder on the basis of Meadow's opinion. However, in 2003 a number of high-profile acquittals brought Sir Roy's theories into disrepute, and many now doubt their credibility. Several hundred murder convictions are now under review. On the other hand, in a 6 March 2004 incident, a father is being accused of the murders of four of his children, one of which had been ruled a case of SIDS[http://www.cnn.com/2004/US/Northeast/03/06/tracking.child.abuse.ap/index.html], and the [http://nccanch.acf.hhs.gov/ National Clearinghouse on Child Abuse and Neglect Information] indicates more than half of child abuse cases may be unreported or described as SIDS.

Possible nitrogen dioxide link

A recent study by researchers at the University of California, San Diego suggests a link between nitrogen dioxide (NO₂) levels and SIDS [http://abcnews.go.com/Health/wireStory?id=970339].

Conditions that may mimic SIDS

Medium Chain Acyl Dehydrogenase (MCAD) deficiency.

Prevention

Though SIDS cannot be prevented absolutely, parents of infants are encouraged by pediatricians and popular parenting books to take several precautions in order to reduce the likelihood of SIDS. Place the infant on its back to sleep. Among the theories supporting this habit is the idea that the small infants with little or no control of their heads may smother themselves on their bedding. Another theory states that babies sleep more soundly when placed on their stomachs, and are unable to rouse themselves when have an incidence of sleep apnea (which is thought to be common in infants). Only use a firm mattress with well fitted (tight) sheets in a crib or bassinet. No pillows, stuffed animals, or fluffy bedding should be used or placed in a crib. In cold weather dress the infant warmly in well fitted clothing. Wearable blankets are prefferable over loose blankets. These directions also stem from the belief that small babies with little or no control of their bodies may inadvertently smother themselves in their sleep. Parents are also encouraged to sleep near their babies. 'Near' is generally understood to mean in the same room, but not in the same bed. Adult bedding often does not follow the 'no pillows, no fluffy blankets and firm mattresses only' instuctions mentioned before. Keeping the baby in the same room as the parent is thought to allow the parent to be wakened by a baby in distress even if the child is unable to cry. A 2005 study in the British Medical Journal indicated that use of a pacifier is associated with a 90% reduction in the risk of SIDS[http://bmj.bmjjournals.com/cgi/gca?gca=bmj%3Bbmj.38671.640475.55v1], confirming earlier research[http://edition.cnn.com/HEALTH/9905/10/sids.pacifier/].

External links

- [http://www.cdc.gov/reproductivehealth/SIDS/ US Center for Disease Control SIDS page, with links to a variety of information and statistics]
- [http://www.sidsfamilies.com/ SIDS Families]
- [http://bmj.bmjjournals.com/cgi/gca?gca=bmj%3Bbmj.38671.640475.55v1 British Medical Journal pacifier study (abstract)] Category:Pediatrics Category:Infancy ja:乳幼児突然死症候群

Health

:For the science of human and animal health, see Health science. Defined negatively, health is the absence of illness, functionally, as the ability to cope with everyday activities, or positively, as fitness and well-being. In any organism, health is a form of homeostasis. This is a state of balance, with inputs and outputs of energy and matter in equilibrium (allowing for growth). Health also implies good prospects for continued survival. In sentient creatures such as humans, health is a broader concept. Many definitions of health have been offered from time to time. Webster's Dictionary defines health as "the condition of being sound in body, mind or spirit, especially freedom from physical disease or pain". The Oxford English Dictionary defines health as "soundness of body or mind; that condition in which its functions are duly and efficiently discharged". Dubos (1968) defined health as " a modus vivendi enabling imperfect men to achieve a rewarding and not-too-painful existance while they cope with an imperfect world". However, the most widely accepted definition is that of the World Health Organization Constitution. It states that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization, 1946). In more recent years, this statement has been amplified to include the ability to lead a "socially and economically productive life". The WHO definition is not without criticism, mainly that it is too broad. Some argue that health cannot be defined as a state at all, but must be seen as a process of continuous adjustment to the changing demands of living and of the changing meanings we give to life. It is a dynamic concept. the WHO definition is therefore considered by many as an idealistic goal rather than a realistic proposition. Using the WHO definition classifies 70-95% of people as unhealthy. In spite of the above limitations, the concept of health as defined by WHO is broad and positive in its implications. It sets out a high standard for positive health. It represents the overall goal that nations should strive to reach. The most solid aspects of wellness that fit firmly in the realm of medicine are the environmental health, nutrition, disease prevention, and public health matters that can be investigated and assist in measuring well-being.

Notes and references

- World Health Organization, Constitution, World Health Organization, Geneva, 1946. Available online at [http://w3.whosea.org/aboutsearo/pdf/const.pdf http://w3.whosea.org/Accessed October 24, 2005.
- WHO (1979)Health for All, Sr. Nos. 1, 2

External links

- [http://www.sensemassage.co.uk/news The Latest Health News from Around the World]
- [http://www.christianopendirectory.com/Christian-Health/ The World Health Directory]
- [http://edgelife.net/glossary/health.htm The Evolving Concept of Health]
- [http://www.cdc.gov/nchs/ National Center for Health Statistics] (USA)
- [http://www.nih.gov National Institute of Health] (USA)
- [http://www.cdc.gov Centers for Disease Control and Prevention] (USA)
- [http://www.code-interactive.com/evolution-diet/healthprofile.html Personalized Online Health Profile]
- [http://www.who.int/en/ World Health Organization]
- [http://www.eldis.org/health/ HRC/Eldis Health Resource Guide] - new research and other resources on health in developing countries
- [http://www.wikimd.org WikiMD]
- [http://medical-info.blogspot.com Medical Info.]
- [http://www.best-home-remedies.com Home remedies for health]
- [http://www.herhealthplan.com Women's Health Care]
- [http://www.nahanniriverherbs.com/ Health, nutrition and herbal news and resources.]
- Category:Personal life Category:School subjects ms:kesihatan ja:健康 nb:Helse simple:Health

Feeding

Feeding is the process by which organisms, typically animals, obtain food. There are many types of feeding that animals exhibit, including:
- filter feeding - obtaining food suspended in the water column
- deposit feeding - obtaining food particles in soil
- fluid feeding - obtaining food by consuming other organisms fluids
- food-mass feeding - obtaining food by eating pieces of other organisms Another classification refers to the food groups some animals specialize in, such as:
- Carnivore - meat
- Detritivore - decomposing material
- Folivore - leaves
- Frugivore - fruits
- Granivore - seeds
- Herbivore - plants
- Insectivore - insects
- Nectarivore - nectar
- Mucivore - plant juices
- Mycovore - fungi
- Omnivore - plants and meat
- Piscivore - fishes
- Sanguinivore - blood
- Saprovore - dead matter
- Etc. There are also several food sources which have caused the development of specialized feeding behaviors, such as:
- Ophiophagy: feeding on snakes
- Hematophagy: feeding on blood
- Coprophagy: feeding on faeces
- Mucophagy: feeding on mucus
- Cannibalism: feeding on members of the same species
- Trophallaxis: regurgitation of food to another animal
- Etc. In many instances, the specialization of organisms in a specific type of food source has been one of the major causes of evolution of form and function, such as: evolution
- mouth parts and teeth, such as in whales, vampire bats, leeches, mosquitos, predatory animals such as felines and fishes, etc
- distinct forms of beaks in birds, such as in hawks, woodpeckers, pelicans, hummingbirds, parrots, kingfishers, etc.
- specialized claws and other appendages, for apprehending or killing (including fingers in primates
- changes in body colour for facilitating camouflage, disguise, setting up traps for preys, etc.
- changes in the digestive system, such as the system of stomaches of herbivores, comensalism and symbiosis

Milk

:For other senses of this word, see milk (disambiguation). milk (disambiguation) Milk most often means the nutrient fluid produced by the mammary glands of female mammals. It provides the primary source of nutrition for newborns before they are able to digest more diverse foods. It is also processed into dairy products such as cream, butter, yoghurt, ice-cream, gelato, cheese, casein, whey protein, lactose, condensed milk, powdered milk, and many other food-additive and industrial products. It can also be used to mean
- the white juice and the processed meat of the coconut in, more or less, liquid form, used especially in Thai, Indian (Kerala), and Polynesian cuisine.
- a non-animal substitute such as soya milk, rice milk, and almond milk. Human milk is fed to infants through breastfeeding, either directly or by the female expressing her milk to be saved and fed later. The early lactation milk is known as colostrum, and carries the mother's antibodies to the baby. It can reduce the risk of many diseases in both mother and baby.

Composition and nutrition

The composition of milk differs widely from species to species and a little within species. Factors such as the lactose content, the proportion of and size of the butterfat globule, and the strength of the curd (formed by the human enzymes digesting the milk) can differ from breed to breed and mammal to mammal. For example:
- Human breast milk is thin and high in lactose, its primary sugar.
- Cow's milk is lower in sugar and higher in protein, and is composed of about 3.5% to 6.5% milkfat, 4% to 8.5% milk solids and about 88% water. Its main protein (80%) is casein, while whey proteins make up most of the rest. The nutritional makeup of cow's milk is much different from human milk. One cup of human milk has 70% less protein, 38% more fat, and 47% more carbohydrates than cow's milk. Vitamin C, folic acid, sodium, iron and calcium levels also differ significantly. Lactose in milk is digested with the help of the enzyme lactase produced by the bodies of infants. In humans, production of lactase falls off towards adulthood, leading to an inability to digest milk; this is known as lactose intolerance. Some human populations (most notably Europeans) retain the ability to digest lactose into adulthood. Whole cow's milk has approximately 634 Calories (2650kJ) per litre.

Cow's milk

In the western world cow's milk is most often extracted on an industrial scale for human consumption and industrial uses. It is the most commonly consumed form of milk. Dairy farming has become such a large business that in many countries the process is highly automated; with farmers using machines that attach directly to the teats of the cow's udder to speed milking, and breeds of cattle, such as Holstein, specially bred for increased milk production.

Commercial processing of milk

Holstein In North America a dairy facility processes milk and products obtained from milk (dairy products), such as cream, butter, cheese, and so on. Most dairies are local companies, as opposed to large or nationwide companies found in the southern hemisphere. Upon standing, fresh milk has a tendency to separate into a high-fat cream layer on top of a larger, skim-milk layer. The cream is often sold as a separate product with its own uses. In the United States, a blended mixture of half cream and half milk is often sold in smaller quantities and is called half and half. Half and half is used for creaming coffee and similar uses. Milk produced for commercial consumption usually undergoes several processes. Pasteurization kills many harmful micro-organisms by heating the milk for a short time and then cooling it for storage and transportation. Pasteurized milk is still perishable and must be stored cold by both suppliers and consumers. Dairies print expiration dates on each container, after which stores will remove any unsold milk from their shelves. In many countries it is illegal to sell milk that is not pasteurized. A complementary process for commercial milk is homogenization, which produces milk in a single phase (or layer). This is accomplished by mechanically reducing the fat globules to a size that stabilizes them in solution. Milk, sold commercially in countries where the cattle (and often the people) live indoors, commonly has vitamin D added to it to make up for lack of exposure to UVB radiation. Milk often has flavoring added to it for better taste or as a means of improving sales. Chocolate-flavored milk has been sold for many years, followed recently by other flavors of milk and cream. South Australia has the highest consumption of flavoured milk per person, where Farmers Union Iced Coffee outsells Coca-Cola, a success shared only by Inca Kola in Peru and Irn-Bru in Scotland.

Support

Cow's milk is a generally healthy source of protein and calcium in human diets. It is also a good source of a number of vitamins. A serving (1 cup or 250 ml) of 2%-fat milk contains 285 mg of calcium, which represents 22% to 29% of the daily recommended intake (DRI) of calcium for an adult, depending on the age, 8 grams of protein, and a number of other nutrients (either naturally or through fortification):
- Vitamins D and K - essential for bone health
- Iodine - a mineral essential for thyroid function
- Vitamin B12 and Riboflavin - necessary for cardiovascular health and energy production
- Biotin and Pantothenic Acid - B vitamins important for energy production
- Vitamin A - critical for immune function
- Potassium and Magnesium - for cardiovascular health
- Selenium - cancer-preventive trace mineral
- Thiamin - B-vitamin important for cognitive function, especially memory
- Conjugated Linoleic Acid - beneficial fatty acid that inhibits several types of cancer in mice, has been shown to kill human skin cancer, colorectal cancer and breast cancer cells in in vitro studies, and may help lower cholesterol and prevent atherosclerosis; only available in milk from grass-fed cows Milk supporters point out that studies show possible links between low-fat milk consumption and reduced risk of arterial hypertension, coronary heart disease, and obesity. Overweight individuals who drink milk may benefit from decreased risk of insulin resistance and type 2 diabetes. [http://www.nationaldairycouncil.org/NationalDairyCouncil/Nutrition/Reducing/DairysRoleManagingBP.htm]

Criticism

Cow's milk is also argued to be unhealthy primarily due to its fat and cholesterol content, as well as the toxicity of its protein. The following studies are used to support this position:
- The pasteurization process for raw milk kills most, if not all, resident micro-organisms (including beneficial ones that aid in its digestion and metabolization) and many nutritional constituents. The resulting pasteurized product causes digestive problems, is less nutritional and turns rancid (as opposed to souring) when aging. [http://www.realmilk.com/rawvpasteur.html Raw Milk Versus Pasteurized Milk]
- Some milk is rich in saturated fat, which studies have linked to increased risk of atherosclerosis and coronary heart disease. Low-fat and non-fat forms of milk may mitigate any such risk.
- Up to 70% of humans have an incomplete ability to digest milk, lactose intolerance. For those individuals, milk may induce symptoms such as cramping, bloating, gas, and diarrhoea. Certain ethnic groups may be more susceptible to these effects.
- Critics dispute the claim that drinking large amounts of milk can reduce the risk of bone fractures, especially in the elderly. Studies have failed to associate high calcium intakes with lower risk of hip and forearm fractures in men[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9278560] or women[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9224182].
- Critics of milk claim that plant-based sources of calcium are preferable, on the grounds that animal proteins in milk causes leaching or excretion of calcium from bones.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8198060] Such critics refute the claim that milk prevents osteoporosis and make the counterclaim that milk, in fact, contributes to that disease.
- A study published in June 2005 suggests that consumption of milk by 9- to 14-year-old children is associated with weight gain, although the researchers identify that excessive calorie intake is the cause rather than dairy specific factors. Researchers were surprised by their conclusion that weight gain was associated with dietary calcium and low-fat or skim milk, but not dairy fat.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15939853]
- A February 2005 study found a positive association between acne and the consumption of whole milk, skim milk, and other dairy products in high-school-age women.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15692464].
- Critics also make the claim that the protein content of cow’s milk can act to block the absorption of calcium and cause the human body to produce antibodies that are believed to damage the pancreas, leading to the development of type 1 diabetes.
- In children, cow’s milk consumption has allegedly been linked to anemia, colic, allergies, and asthma. In adults, cow's milk consumption has been related to breast cancer.
- Two studies show a correlation between high galactose consumption, and high rates of ovarian cancer. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2510499][http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2567871]
- A study suggests a correlation between high calcium intake and prostate cancer.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9458087]. There is no evidence that any such problem is specific to milk. A review published by the World Cancer Research Fund and the American Institute for Cancer Research states that at least 11 human population studies have linked dairy product consumption and prostate cancer.
- Scientific evidence has also been unable to support the claim that the consumption of cow’s milk as a source of calcium reduces the risk of osteoporosis. On the contrary, epidemiological research has linked the countries with the highest dairy consumption rates (for example, the United States, Sweden and Finland) to the incidence of osteoporosis. But no studies have shown the same in New Zealand, which has the highest per capita consumption.
- The A1 β-casein in cow's milk has been reportedly linked to ischaemic heart disease, type I diabetes, and to a lesser extent, schizophrenia and autism. Some milk contains higher levels of the A2 β-casein, which has been claimed to not lead to these diseases. Milk with the "A2 milk" trademark has been tested to be high in the A2 β-casein.

Distribution

A2 milk A2 milk milk]] Because of the perishable nature of milk, expeditious distribution is desirable. Milk used to be delivered to households daily, but this is no longer economically feasible. People buy it chilled at grocery or convenience stores or similar retail outlets. Prior to the widespread use of plastics, milk was often distributed to consumers in glass bottles, and before that in bulk that was ladled into the customer's container. In the UK, milk can be delivered daily by a milk man who travels his local milk round (route) using a battery-powered milk float, although this is becoming less popular as a result of supermarkets selling milk at cheaper prices. New Zealand was possibly the last country to distribute milk in glass bottles. As of November 30, 2005, New Zealand Dairy Foods will cease to produce bottled milk at their Christchurch factory. In the United States bottles were replaced with milk cartons, tall boxes with a square cross-section and a peaked top that can folded outward upon opening to form a spout. Now milk is increasingly sold in plastic bottles. First the gallon and half-gallon sizes were sold in plastic jugs while the smaller sizes were sold in milk cartons. Recently milk has been sold in smaller bottles made to fit in automobile cup holders. The half-pint milk carton is the traditional unit as a component of school lunches. Pictures of missing children were printed on milk cartons as a public service until it was determined that this was disturbing children. Milk preserved by the UHT process is sold in boxes often called a "brick" that lack the peak of the traditional milk carton. Glass containers are rare these days. Most people purchase milk in plastic jugs or bags or in waxed-paper cartons. Ultraviolet light from fluorescent lighting can destroy some of the proteins in milk so many companies, that once distributed milk in transparent or highly translucent containers, are using thicker materials that block the harmful rays. Many people feel that such "UV protected" milk tastes better. In the United States, milk is commonly sold in gallon, half-gallon and quart containers (U.S. customary units) of rigid plastic or waxed cardboard. The US single-serving size is usually the half-pint (about 500 ml). In Canada, a 1 1/3 litre plastic bag (sold as 4 litres in 3 bags) is the most common, while 2 litre, 1 litre, 500 millilitre, and 250 millilitre cartons are also available. In Europe, sizes of 500 millilitres, 1 litre (the most common), 2 litres and 3 litres are commonplace (in the UK, some stores still stock the equivalents of old Imperial sizes: 568 ml (1 pint), 1.136 l (2 pints), 2.273 l (4 pints) or, rarely, a combination including both metric and imperial sizes). In Australia and New Zealand a 250 ml cardboard container of flavoured milk is marketed as a common breakfast meal. For refrigerator use milk comes in 1, 2 and 3 litre plastic screw-top bottles. Most UHT-milk is packed in 1 litre paper containers with a sealed plastic spout. Condensed milk is distributed in metal cans, 250 and 125 ml paper containers and 100 and 200 ml squeeze tubes, and powdered milk (skim and whole) is distributed in boxes or bags.

Varieties and brands

Cow's milk is generally available in several varieties. In some countries these are:
- full cream (or "whole" in North America, about 3.25% fat)
- semi-skimmed ("reduced fat" or "low fat", about 1.5-1.8% fat)
- skimmed (about 0.1% fat) Milk in the U.S. and Canada is sold as
- "whole" varieties
- "2 percent" (reduced fat)
- "1 percent" (low fat)
- "1/2 percent" (low fat)
- "skim" (very low fat) Note: In Canada "whole" milk refers to unhomogenized milk. "Homogenized" milk (or "Homo milk" in short) refers to milk which is 3.25% butterfat. Generally all store-bought milk in Canada has been homogenized, yet the term is also used as a name to describe butterfat content for a specific variety of milk. Modern commercial dairy processing techniques involve first removing all of the butterfat, and then adding back the appropriate amount depending on which product is being produced on that particular line. In Britain, it is possible to get Channel Island milk, which is 5.5% fat. In the United States, skim milk is also known as "fat free" milk, due to USDA regulations stating that any food with less than 1/2 gram of fat per serving can be labeled "fat free". Full cream, or whole milk, has the full milk fat content (about 3-4% if Friesian- or Holstein-breed are the source). For skimmed or semi-skimmed milk, all of the fat content is removed and then some (in the case of semi-skimmed milk) is returned. The best-selling variety of milk is semi-skimmed; in some countries full-cream (whole) milk is generally seen as less healthy and skimmed milk is often thought to lack taste. Whole milk is recommended to provide sufficient fat for developing toddlers who have graduated from breast milk or infant formula.

Other milk animals

In addition to cows, the following animals provide milk for dairy products:
- Humans
- Sheep
- Goats
- Horses
- Donkeys
- Camels (Including the South American camelids)
- Yaks
- Water buffalo
- Reindeer In Russia and Sweden, small moose dairies also exist [http://www.cnn.com/2004/WORLD/europe/06/23/sweden.moosecheese.ap/index.html]. Donkey and horse milk have the lowest fat content, while the milk of seals contains more than 50% fat. [http://www.havemilk.com/article.asp?id=1485#contentbyspecies]

Curdling

When raw milk is left standing for a while, it turns sour. This is the result of fermentation: lactic acid bacteria turning the milk sugar into lactic acid. This fermentation process is exploited in the production of various dairy products such as cheese and yogurt. Pasteurized cow's milk, on the other hand, spoils in a way that makes it unsuitable for consumption, causing it to assume an unpleasant odor and pose a high danger of food poisoning if ingested. The naturally-occurring lactic acid bacteria in raw milk, under suitable conditions, quickly produce large amounts of lactic acid. The ensuing acidity in turn prevents other germs from growing, or slows their growth significantly. Through pasteurization, however, these lactic acid bacteria are mostly destroyed, which means that other germs can grow unfettered and thus cause decomposition. In order to prevent spoilage, milk can be kept refrigerated and stored between 1 and 4 degrees Celsius. Most milk is Pasteurized by heating briefly and then refrigerated to allow transport from factory farms to local markets. The spoilage of milk can be forestalled by using ultra-high temperature (UHT) treatment; milk so treated can be stored unrefrigerated for several months until opened. Sterilized milk, which is heated for a much longer period of time, will last even longer, but also lose more nutrients and assume a still different taste. Condensed Milk, made by removing most of the water, can be stored for many months, unrefrigerated. The most durable form of milk is milk powder which is produced from milk by removing almost all water.

External links

- [http://www.pukeariki.com/en/stories/farming/milkingintheearlydays.asp Milking in the early days]
- [http://www.pukeariki.com/en/stories/farming/elthamfirsts.asp Advances in processing milk]
- [http://www.attra.org/attra-pub/gbdairy.html Year-round grazing of dairy cows in the United States]
- [http://www.milkismilk.com Milk is Milk Web site and blog]
- [http://www.ars.usda.gov/is/AR/archive/mar03/osteo0303.htm Boning Up on Osteoporosis]
- [http://www.drafthorsejournal.com/features/horsemilk/horsemilk.htm Horse milk]
- [http://www.hsph.harvard.edu/nutritionsource/calcium.html Harvard School of Public Health: Calcium and Milk]: describes claims of milk supporters and critics
- [http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtrank/sr17w301.pdf USDA National Nutrient Database, Calcium contents of selected foods]
- [http://www.iom.edu/Object.File/Master/7/294/0.pdf USDA Dietary Reference Intakes: Elements]
- [http://www.straightdope.com/columns/030321.html Is cow's milk "the worst beverage on earth?"] - straightdope.com response to anti-milk websites.
- [http://beauty.about.com/od/bathmilk/ Bath Milk] (About.com), milk used for bathing
- [http://www.milksucks.com MilkSucks.Com] - a site run by PETA extolling the benefits of going Dairy-free Category:Beverages Category:Non-alcoholic drink Category:Dairy products
- Category:Materials involved in Hinduism ko:우유 ia:Lacte] [[id:Susu]] [[io:Lakto ja:乳 simple:Milk th:นม

Baby food

Baby food is any food that is made specifically for infants, roughly between the ages of six months to two years. The food comes in many varieties, with different manufacturers and tastes. A common trait of the many different baby foods is that they are designed for ease of eating; either a soft, liquidy paste or an easily chewed food. This is due to the fact that infants lack teeth and experience in eating. Note that many commercial baby foods, particularly meats, are largely filler material like cornstarch. Each baby is different, some may need food other than breast milk or infant formula sooner than others, and as there is no Baby Food Pyramid it is hard to tell the nutritional requirements of a baby. Babies typically move to consuming baby food once nursing or formula is not sufficient for the child's appetite. A baby usually starts to eat solid food once the child has enough teeth to adequately chew. It is often recommended to give a baby food at around 6 months of age, but babies differ greatly. Signs of readiness include the ability to sit without help and the display of active interest in food that others are eating. A baby may be started directly on normal family food if attention is given to choking hazards. Because breastmilk takes on the flavor of foods eaten by the mother, these foods are especially good choices. One may wish to introduce only one new food at a time, leaving a few days in between to notice any reactions that would indicate a food allergy or sensitivity. This way if a baby is unable to tolerate a certain food then it can be determined which food is causing the reaction.

Suck

Suck could refer to the following:
- See suction for the meaning of sucking (e.g. drinks through a straw, or a vacuum cleaner sucking up dust).
- See Wiktionary:sucks for a sometimes vulgar term expressing inferiority or dislike.
- See Suck.com for the early satire and editorial web site.
- "The Suck" is a slang term for the United States Marine Corps

Nipple

right Nipple is, generally, the name given to the mammalian nipple. In its most general form, a nipple is an appurtenance from which a fluid emanates, in this instance breast milk, to nurture a mother's young.

Anatomy

In the anatomy of mammals, a nipple or mammary papilla is a small projection of skin containing the outlets for 15-20 lactiferous ducts arranged cylindrically around the tip. The physiological purpose of nipples is to deliver milk produced in the female mammary glands during lactation to the infant. In the male, nipples are often not considered functional with regard to breastfeeding, although male lactation is possible. Mammalian infants have a rooting instinct for seeking the nipple, and a sucking instinct for extracting milk. suck Mammals typically have an even number of nipples arranged bilaterally. Rarely, as in the platypus, the mammary glands empty onto the skin without a nipple. In human anatomy, the two nipples are located near the center of the breasts, surrounded by an area of sensitive, pigmented skin known as the areola. The nipple and areola can be erotic receptors, or considered sex organs, of males and females. Stimulation or sexual arousal can cause the nipples to become erect. Breastfeeding or exposure to cold temperatures often have this effect as well. Pregnancy and nursing tend to increase nipple size somewhat, and this increase may remain permanently thereafter. Small non-striated myocytes (muscle cells) arranged cylindrically within the nipple are responsible for this erection of the nipples. Embryologically, nipples develop along the 'milk lines' which in humans extend from the axilla (armpit) down to the pubis (groin) on both sides. Other mammals such as cats and dogs develop more nipples along the milk lines, in number generally approximating the average litter size for that species, rounded up to an even number. Most people develop two nipples (one on each breast) but some have supernumerary nipples. Occasionally, these have lactiferous glands attached. Sometimes, babies (male or female) are born producing milk. This, called "witches' milk", is caused by maternal estrogens acting on the baby and is quite normal. Witches' milk disappears after several days.

Baby bottle

A baby bottle is a bottle with a teat to drink directly from. It is typically used if someone can not (as conveniently) drink from a cup, for feeding oneself or being fed. In particular it is used to feed an infant with infant formula, expressed breast milk or pediatric electrolyte solution.

Dimensions and design

A large-sized bottle typically holds 270 ml; the small size 150 ml. It is composed of a bottle itself, a teat (or nipple), a ring to seal the teat to the bottle, a cap to cover the teat and optionally a disposable liner. The height-to-width ratio of bottles is high (relative to adult cups) because it is needed to ensure the contents flood the teat when used at normal angles; otherwise the baby will drink air. However, if the bottle is too tall, it easily tips. There are asymmetric bottles that ensure the contents flood the teat if the bottle is held at a certain direction.

Teats (or nipples)

The teat itself is typically slimmer and more flexible than the mother's nipple. Babies can find feeding from the bottle easier than breastfeeding. Specialized teats that mimic the shape of the breast exist to allow babies to switch back and forth between bottle feeding and breast feeding for cases where "teat confusion" occurs. Teats come in a selection of flow rates. Different flow rate teats either have more holes or larger holes. The correct flow rate needs to selected based on the age of the infant. Variable flow rate teats are available for older infants. The hole is asymmetric so that by turning the bottle/teat, different flows can occur. Specialized teats are available for infants with cleft palate (see also Haberman feed).

Vented bottles

"Vented" bottles allow air to enter the bottle while the baby is drinking without the need to break the baby's suction during feeding. Alternatively a bottle liner can be used to enclose the formula instead of directly in the bottle. The liner collapses as the formula is drained. Vented bottles work by allowing air to enter while preventing the liquid inside from escaping. Avent is the most popular brand in this category. It works by an "anti-vacuum skirt" built right into the base of the teat where it forms a seal with the bottle. The skirt acts as a one way valve, allowing air to enter the bottle but not liquids to leave. If the sealing ring is tightened too much, the skirt is compressed too tightly to allow it to open and the bottle will not vent. If the sealing ring is too loose, liquid leaks from the bottle.

Patents

There are multiple patents for technologies in this area. Initial designs called for a complex spring and valve system that was impossible to clean and sterilize. Current research is in specialized materials with microscopic pores that allow the entry of air without the escape of liquids. This avoids the caregiver having to get the sealing ring tension just right. It remains to be seen whether these materials can withstand the rigours of daily cleaning and sterilization. Another competitor, Dr Brown's offers a system whereby the vented air is conducted through a tube to the bottom of the bottle where the airspace is when the bottle is in use. This avoids the vented air from bubbling through the liquid and unnecessarily aerating the liquid.

Variations and accessories

Bottles may be designed to attach directly to a breast pump for a complete "feeding system" that maximizes the reuse of the components. Such systems include a variety of drinking spouts for when the child is older. This converts the bottle into a sippy cup, a cut with lid and spout, for toddles that is intermediate between a baby bottle and an open top cup. Bottles that are part of a feeding system may include handles that can be attached. The ring and teat may be replaced by a storage lid. Accessories for bottles include cleaning brushes and drying racks. Brushes may be specially designed for a specific manufacturer's bottles and teats. Bottle warmers warm previously made and refrigerated formula. Cooler designed to fit a specific manufacturer's bottles are available to keep refrigerated forumula cold. Special formula powder containers are available to store premeasured amounts of formula so that caregivers can prefill bottles with sterile water and mix in the powder easily. The containers are typically designed to stack together so that multiple premeasured amounts of formula powder may be transported as a unit. Specialty, "designer" bottles are now quite common as novelty gifts for parents or just something interesting for the child. They either have special logos or are of special shapes (e.g. animals). Some even have a hole in the middle. Depending on the shape, these bottles can be quite difficult to clean. Another speciality bottle is made from heat sensitive materials that act as a built-in thermometer. If the contents are too hot, the bottle changes colour. Institutions can purchase ready-to-feed formula in containers that can be used as baby bottles. The lid screws off and is replaced by a disposable teat when the forumla is ready to be used. This avoids storing the formula with the teat and possibly clogging the teat holes when formula is splashed within the bottle and dries.

Sterilization

Bottles should be sterilized for babies under six months. Bottles can be sterilized by boiling in hot water, in a specialized bottle sterilization appliance (which typically uses steam) or in a specialized sterlization container that is microwaved. Modern bottles are difficult to sterilize in boiling water because they tend to float. Bottles were originally composed of glass which was dangerous when babies learned to feed themselves and hold the bottle. Modern bottles are unbreakable plastic. Since bottles have to be sterilized the plastic are automatically dishwasher-safe.

Regulation

While infant formula is highly regulated, baby bottles are not. Only the materials of the teat and bottle itself are specifically regulated in some countries (e.g. British Standards BS 7368:1990 "Specification for babies' elastomeric feeding bottle teats" [http://bsonline.techindex.co.uk/BSI2/protected/SitePage.asp?LS=&PgID=0003&LR=&LD=&Src=&Dest=&Last=&SessID=QGL0BA3DRQ358HUX82N5CV5B237V06N2&MSCSID=&ErrID=&SessStat=&Parent=&Child=&PCount=0&LogStat=&URLData=&EndPage=20&SEARCH_ID=D97L82VQJKEX9PBXUNGQS9RET0SU9LUB&StartRecord=1&ITEM_UPI=223922&SEARCH_TYPE=SRCH%5FTYP%5FQCK&StartPage=1]). In the USA, the FDA also regulates teats[http://www.fda.gov/fdac/features/095_quiz.html] and the bottle materials. In 1985 it tightened allowable levels of nitrosamines released from bottle teats[http://www.fda.gov/ora/compliance_ref/cpg/cpgfod/cpg500-450.html]. A 1999 Consumer Reports study suggesting that plastic bottles release unsafe amounts of bisphenol A was denounced as sensationalism because of the unreasonable conditions the bottles were subject to[http://www.fumento.com/babybottle.html][http://www.plasticsinfo.org/babybottles/index.html].

History

Bottles with hard spouts go back to prehistory[http://www.acif.org/past.html]. Soft teats of various materials were tried but were very difficult to clean. The invention of vulcanized rubber provided a material that was soft and could withstand the heat of sterilization. Elijah Pratt of New York patented the first rubber teat in 1845 [http://www.babybottle-museum.co.uk/teats%20through%20the%20ages.htm]. It took until the 1900s before the technology was perfected for a pratical soft teat such that the baby bottle could become a practical and safe alternative to breastfeeding.

External links

- [http://www.babybottle-museum.co.uk/ History of the feeding bottle]
- [http://cleftclub.com/modules.php?name=Forums&file=viewforum&f=30 CleftClub.com's Personal Experience Database - Bottle Feeding] – Personal stories of babies who were born with cleft lip and/or palate and were bottle fed
- [http://www.aventbaby.com/ Avent]
- [http://www.handi-craft.com Dr. Browns] Category:Infant feeding

Immune system

The immune system is the system of specialised cells and organs that protect an organism from outside biological influences. In a broad sense, almost every organ has a protective function (e.g., the skin). When the immune system is functioning properly, it protects the body against bacteria and viral infections, destroying cancer cells and foreign substances. If the immune system weakens, its ability to defend the body also weakens, allowing pathogens, including viruses that cause common colds and flu, to grow and flourish in the body. The immune system also performs surveillance of tumor cells, and immune suppression has been reported to increase the risk of certain types of cancer. The immune system is often divided into two sections:
- Innate Immunity: Comprised of germ-line encoded components that provide an immediate "first-line" of defense to continuously ward off noxious influences (pathogens);
- Adaptive Immunity: The provision of long lasting and specific protection against formerly encountered pathogens, which takes days to develop, achieving specificity through somatic recombination and selection of pathogen (antigen) receptors

Structure

Most multicellular organisms possess an "innate immune system", generally comprising a set of germ-line encoded receptors to pathogens, that does not change during the lifetime of the organism. Adaptive immunity, in which the responses to pathogens change and develop during the lifetime of an individual, seems to have appeared somewhat abruptly in evolutionary time, with the appearance of chondrichthyes (cartilaginous or jawed fish). Organisms that possess an adaptive immunity also possess an innate immunity, and with many of the mechanisms between the systems being common, it is not always possible to draw a hard and fast boundary between the individual components involved in each, despite the clear difference in operation. Higher vertebrates and all mammals have both an innate and an adaptive immune system.

Innate immune system

The adaptive immune system may take days or weeks, after an initial infection, to have an effect. However, most organisms are under constant assault from pathogens, which must be kept in check by the faster-acting innate immune system. Innate immunity defends against pathogens by rapid responses coordinated through "innate" receptors that recognize a wide spectrum of conserved pathogenic components. Plants and many lower animals do not possess an adaptive immune system, and rely instead on their innate immunity. The study of the innate immune system has recently flourished. Earlier studies of innate immunity utilized model organisms that lack adaptive immunity, such as the plant Arabidopsis thaliana, the fly Drosophila melanogaster, and the worm Caenorhabditis elegans. Recent advances have been made in the field of innate immunology with the discovery of toll-like receptors (TLRs) and the intracellular nucleotide-binding site leucine-rich repeat proteins (NODs), which are receptors in mammal cells that are responsible for a large proportion of the innate immune recognition of pathogens. In 1989, prior to the discovery of mammalian TLRs, Charles Janeway conceptualized and proposed that evolutionarily conserved features of infectious organisms were detected by the immune system through a set of specialized receptors, which he termed pathogen-associated molecular patterns (PAMPs) and pattern recognition receptors (PRRs), respectively. This was a remarkable insight at the time but was only fully appreciated after the discovery of TLRs. The TLRs now comprise the largest family of innate immune receptors (or PRRs). Janeway’s hypothesis has come to be known as the ‘stranger model’ and substantial debate in the field persists to this day as to whether or not the concept of PAMPs and PRRs, as described by Janeway, is truly suitable to describe the mechanisms of innate immunity. The competing ‘danger model’ was proposed in 1994 by Polly Matzinger and argues against the focus of the stranger model on microbial derived signals, suggesting instead that endogenous danger/alarm signals from distressed tissues serve as the principle purveyors of innate immune responses. Both models are supported in the current literature, with discoveries that substances of both microbial and non-microbial sources are able to stimulate innate immune responses, which has led to increasing awareness that perhaps a blend of the two models would best serve to describe the currently known mechanisms governing innate immunity.

First-line defense: Physical barrier

The first-line defense includes barriers to infection, such as skin and mucus coating of the gut and airways, physically preventing the interaction between the host and the pathogen. Pathogens, which penetrate these barriers, encounter constitutively-expressed anti-microbial molecules (eg. lysozyme) that restrict the infection.

Second-line defense: Phagocytic cells

The second-line defense includes phagocytic cells (macrophages and neutrophil granulocytes) that can engulf (phagocytose) foreign substances. Macrophages are thought to mature continuously from circulating monocytes. Phagocytosis involves chemotaxis, where phagocytic cells are attracted to microorganisms by means of chemotactic chemicals such as microbial products, complement, damaged cells and white blood cell fragments. Chemotaxis is followed by adhesion, where the phagocyte sticks to the microorganism. Adhesion is enhanced by opsonization, where proteins like opsonins are coated on the surface of the bacterium. This is followed by ingestion, in which the phagocyte extends projections, forming pseudopods that engulf the foreign organism. Finally, the bacterium is digested by the enzymes in the lysosome, involving reactive oxygen species and proteases.

Anti-microbial proteins

In addition, anti-microbial proteins may be activated if a pathogen passes through the barrier offered by skin. There are several classes of antimicrobial proteins, such as acute phase proteins (C-reactive protein, for example, enhances phagocytosis and activates complement when it binds itself to the C-protein of S. pneumoniae ), lysozyme, and the complement system. The complement system is a very complex group of serum proteins which is activated in a cascade fashion. Three different pathways are involved in complement activation:
- classical pathway: recognizes antigen-antibody complexes;
- alternative pathway: spontaneously activates on contact with pathogenic cell surfaces; and
- mannose-binding lectin pathway: recognizes mannose sugars, which tend to appear only on pathogenic cell surfaces. A cascade of protein activity follows complement activation; this cascade can result in a variety of effects, including opsonization of the pathogen, destruction of the pathogen by the formation and activation of the membrane attack complex, and inflammation.

Adaptive immune system

The adaptive immune system, also called the "acquired immune system", ensures that most mammals that survive an initial infection by a pathogen are generally immune to further illness, caused by that same pathogen. The adaptive immune system is based on dedicated immune cells termed leukocytes (white blood cells) that are produced by stem cells in the bone marrow, and mature in the thymus and/or lymph nodes. In many species, including mammals, the adaptive immune system can be divided into two major sections:
- Humoral immune system: It acts against bacteria and viruses in the body liquids (eg. blood) by means of proteins, called immunoglobulins (also known as antibodies), which are produced by B cells.
- Cellular immune system: It destroys virus-infected cells (among other duties) with T cells (also called "T lymphocytes"; "T" means they develop in the thymus). There are two major types of T cells:
- Cytotoxic T cells (T_C cells): These cells recognize infected cells by using T cell receptors to probe cell surfaces. If they recognize an infected cell, they release granzymes to trigger that cell to become apoptotic ("commit suicide"), thus killing that cell and any viruses that it is in the process of creating.
- Helper T cells (T_H cells): These cells activate macrophages (cells that ingest dangerous material), and also produce cytokines (interleukins) that induce the proliferation of B and T cells. In addition, there are regulatory T cells (T_reg cells) which are important in regulating cell-mediated immunity.

Intersections between systems

Splitting the innate and adaptive immunity has served to simplify discussions of immunology. However, the systems are quite intertwined in a number of important respects. One of the most important examples are the mechanisms of 'antigen presentation'. After they leave the thymus, T cells require activation to proliferate and differentiate into cytotoxic ("killer") T cells (CTLs). Activation is provided by antigen-presenting cells (APCs), a major category of which are the dendritic cells. These cells are part of the innate immune system. Activation occurs when a dendritic cell simultaneously binds itself to a T "helper" cell's antigen receptor and to its CD28 receptor, which provides the "second signal" needed for DC activation. This signal is a means by which the dendritic cell conveys that the antigen is indeed dangerous, and that the next encountered T "killer" cells need to be activated. This mechanism is based on antigen-danger evaluation by the T cells that belong to the adaptive immune system. But the dendritic cells are often directly activated by engaging their toll-like receptors, getting their "second signal" directly from the antigen. In this way, they actually recognize in "first person" the danger, and direct the T killer attack. In this respect, the innate immune system therefore plays a critical role in the activation of the adaptive immune system. Adjuvants, or chemicals that stimulate an immune response, provide artificially this "second signal" in procedures when an antigen, that would not normally raise an immune response, is artificially introduced into a host. With the adjuvant, the response is much more robust. Historically, a commonly-used formula is Freund's Complete Adjuvant, an emulsion of oil and mycobacterium. It was later discovered that toll-like receptors, expressed on innate immune cells, are critical in the activation of adaptive immunity.

Disorders of the human immune system

The most important function of the human immune system occurs at the cellular level of the blood and tissues. The lymphatic and blood circulation systems are highways for specialized white blood cells to travel round the body. White blood cells include B cells, T cells, natural killer cells, and macrophages. Each has a different responsibility, but all function together with the primary objective of recognizing, attacking and destroying bacteria, viruses, cancer cells, and all substances seen as foreign. Without this coordinated effort, a person would not be able to survive more than a few days, before succumbing to overwhelming infection. Infections set off an alarm that alerts the immune system to bring out its defensive weapons. Natural killer cells and macrophages rush to the scene to gobble up and digest infected cells. If the first line of defense fails to control the threat, antibodies, produced by the B cells, upon the order of T helper cells, are custom-designed to hone in on the invader. Many disorders of the human immune system fall into two broad categories that are characterized by:
- Attenuated immune response: There are 'congenital' (inborn) and 'acquired' forms of immunodeficiency, characterized by an attenuated response. Chronic granulomatous disease, in which phagocytes have trouble destroying pathogens, is an example of the former, while AIDS ("Acquired Immune Deficiency Syndrome"), an infectious disease caused by the HIV virus that destroys CD4⁺ T cells, is an example of the latter. Immunosuppressive med