Goat's milk and infant feeding

LOS Clear plastic soft Yes 98% 100% face-seal cushion Ohio Clear plastic hard Yes 10% 100% face-seal but some difficulty Vital Signs Clear plastic soft Yes97% 100% face seal CIG Clear plastic soft/firm No 98% 100% face-seal Concord Clear plastic soft/firm No 98% 100% face-seal Laerdahl Clear plastic collapsible No 25% 100% pocket mask around the world the incidence of NEC has risen to 2%-6 % of babies and this dramatic increase is now being seen in Australia. ' Fresh raw milk (cow's and goat's) contains 20-25 mg of vitamin C per litre about half as much as breast milk. Pasteurization destroys half this vitamin C content, 25% of the vitamin B1 content of milk and 9%-16% of the iodine content. Calcium composition is also changed so that 6% less is available for absorption," These losses may be critical for infants who derive most or all their nutrition from milk. The table in Coveney and Darnton-Hill's paper that compares the vitamin content of goat's and human breast milk, contradicts the work of Dr H.P. Maree in South Africa who has shown that goat's milk has the same folic acid level as does human milk. Coveney and Darnton-Hill's warning about toxoplasmosis from unpasteurized goat's milk is unsubstantiated. Dubey has inoculated mice with milk from goats which were artificially and naturally infected with toxoplasmosis. He concluded "the chance of T. gondiibeing in the milk of naturally infected goats is very small and, as the stage likely to be present would be tachyzoite which is destroyed by gastric juice, the risk of human infection would seem to be infinitesimal". 6 The paper neglected to mention that the survey that showed unsatisfactory microbiological standards with raw goat's milk was of unregistered dairies with no milk production and handling regulations. Registered dairies operate under stringent health regulations. Soya bean juice which Coveney and Darnton-Hillrecommended is even less suitable than is goat's or cow's milk. The Chief of the WA Department of Agriculture's Division of Dairying and Food Technology, Mr Morris, has warned that soya bean "milk" is devoid of vitamins B12 and D and has about 20% less Bcomplex vitamins than, and other deficiencies compared with, real milk. Infants have been so sensitized to cow's milk that they cannot tolerate the beef proteins that are being passed through their mothers' milk. If the mothers substitute goat's milk and dairy products for the bovine equivalents, breastfeeding problems usually end? Raelene Heston Federal Publicity Officer Dairy Goat Society of Australia RMB 3 Nummerak Close Radcliffe, Queanbeyan, NSW 2620 I. Coveney J, Damton-HiI1 I. Goat's milk andinfantfeeding. Med J Aust 1985; 143: 508-510. 2. Gerrard JW, MacKeD2ie JW, Goluboss N, et aI. Cow's milk allergy: prevaIence and manifestations in an unselected series of newborns. Acta PaedScand 1973;234 (suppl): 1-21. 3. Gross JD, Douglas RM, Cameron S. Cow's milk and symptoms in the first year of life. Ausl rom Phys 1<n7; 6: 802-811. 4. Cummins G. Necrotizing enterocolitis. MedJ Aust 1<n7; I: 376-378. 5. Dashington ffi. Why milk pasteurization sowing the seeds of fear. Milwaukee, WISCOnsin: Lee Foundation ror Nutritional Research. Reprint no. 286. Dubey JP. Persistence of encysted Toxoplasma gondiiin caprine livers and public health significance Of toxoplasmosis in goats. J Am u,tMed Assoc 1980; 177: 1203-1207. 7. Gerrard JW. Allergy in breast fed babies to ingredients in breast milk. Ann Allergy 1979; 42: 61-72. was used. The same masks were also used by anaesthetists and were attached by means of a Bain circuit to an anaesthetic machine to ventilate anaesthetized and paralysed patients. The results are shown in the Table. The current price for the disposable facemasks is less than $10 each. In choosing a disposable mask the ability to practise ventilation on a manikin is important. In initial in-hospital cardiopulmonary resuscitation the need for addtional oxygen is arguable. Nevertheless, the Concord and the Laerdahl pocket mask have oxygen ports; however, all masks with soft face-seal cushions could accept standard diameter oxygen tubing that is interposed between the patient's face and the mask. A small T piece attachment for additional oxygen is also available to be usedin conjunction with the VentEasy valve. After the above trials, it was decided to introduce the Vital Signs face-mask together with the VentEasy valve to all resuscitation trolleys at this hospital, with the recommendation that this be the prime form of ventilation while equipment for endotracheal intubation was being assembled and until someone competent in the technique of endotracheal intubation was present. Roger Goucke, FFARACS Department of Anaesthesia Royal Perth Hospital Box X2213, GPO Perth, WA 6001 I. Lawrence PJ, Sivaneswaran N. Ventilation during cardiopulmonary resuscitation; which method? MedJ Ausl 1985; 143: 443-446. experience, should become a part of public health, and, ultimately, preventive medicine. A keen medical field worker, say on the staff of each State Health Department, who could respond to calls from medical practitioners who are seeing a particular infectious disease syndrome in their practices, is needed to facilitate this kind of active monitoring of the community, and to keep clincians informed as to the organisms that are currently in circulation. C.R. Boughton, MD Department of Infectious Diseases The Prince Henry Hospital Little Bay, NSW 2036