This document summarizes evidence linking breastfeeding to prevention of childhood obesity and discusses biological mechanisms that may explain this link. It reviews 11 studies that found breastfeeding was associated with reduced risk of childhood obesity. It also discusses how breastfeeding promotes appetite regulation and leads to slower weight gain in infants. While more research is still needed, the evidence suggests breastfeeding has potential as a cost-effective way to address the childhood obesity epidemic.
Final research paper written for Introduction to Child Development in fall 2019. This paper discusses the benefits of breastfeeding for the child and the mother.
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
This document discusses the growing pediatric obesity epidemic and its associated health risks and anesthetic implications. Some key points:
- Up to 30% of children in some countries are now obese, representing a pandemic. Girls and certain ethnic groups have higher rates.
- Obese children often become obese adults and are at risk for conditions like asthma, sleep apnea, diabetes, and cardiovascular disease.
- Both genetic and environmental factors like diet, activity levels, and sleep contribute to pediatric obesity.
- Anesthetizing obese children requires attention to airway management, positioning, oxygenation, and appropriate dosing of drugs based on ideal rather than total body weight. Emergence and postoperative monitoring may also need
Exclusive Breastfeeding Reduces Acute Respiratory Infection And DiarrheaBiblioteca Virtual
This study examined the relationship between breastfeeding practices and infant mortality in Dhaka, Bangladesh. The researchers followed over 1600 infants from birth to 12 months. They found that exclusive breastfeeding declined from 53% at 1 month to 5% at 6 months. Partial or no breastfeeding was associated with a 2-3 times higher risk of infant death from all causes, acute respiratory infection (ARI), and diarrhea compared to exclusive breastfeeding. The study suggests that exclusive breastfeeding in early infancy reduces infant mortality, particularly from ARI and diarrhea.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
This document discusses the importance of breastfeeding for infant health and development. It reviews several studies that show breastfeeding reduces the risk of morbidity and mortality from various infectious diseases like diarrhea, otitis media, neonatal sepsis, and respiratory infections. However, in many societies false beliefs interfere with breastfeeding and infants are commonly given prelacteal feeds or mixed feeding instead of being exclusively breastfed. The purpose of the study described is to examine the patterns of infectious diseases in non-breastfed infants compared to breastfed infants admitted to the hospital.
Professor Forsyth studied the health outcomes of 543 children from lower and higher socioeconomic groups. He found that (1) in the lower socioeconomic group, breastfed children had similar or significantly better health outcomes than formula-fed children, even compared to formula-fed children in the higher socioeconomic group. Subsequent studies discussed in the document found that (2) exclusive breastfeeding for at least 15 weeks reduced respiratory illness and that (3) one month of exclusive breastfeeding conferred protection against allergies and respiratory issues into childhood and adolescence. Overall, the document reviews extensive evidence that breastfeeding leads to improved health outcomes related to infectious disease, cognitive development, cardiovascular risk factors, obesity, and diabetes among others.
This study aims to determine the role of nature vs nurture in obesity through an experiment using 50 sets of identical twins aged 6-11. The twins will be given different calorie diets for 3 months - one twin receiving a high calorie diet and the other the daily recommended intake. Measurements of weight, BMI and body composition will be taken before and after to analyze the effects of the different diets while controlling for genetic factors. However, concerns are raised about the ethics of the varying diets and whether 3 months is sufficient time to see changes in such a complex issue.
Final research paper written for Introduction to Child Development in fall 2019. This paper discusses the benefits of breastfeeding for the child and the mother.
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
This document discusses the growing pediatric obesity epidemic and its associated health risks and anesthetic implications. Some key points:
- Up to 30% of children in some countries are now obese, representing a pandemic. Girls and certain ethnic groups have higher rates.
- Obese children often become obese adults and are at risk for conditions like asthma, sleep apnea, diabetes, and cardiovascular disease.
- Both genetic and environmental factors like diet, activity levels, and sleep contribute to pediatric obesity.
- Anesthetizing obese children requires attention to airway management, positioning, oxygenation, and appropriate dosing of drugs based on ideal rather than total body weight. Emergence and postoperative monitoring may also need
Exclusive Breastfeeding Reduces Acute Respiratory Infection And DiarrheaBiblioteca Virtual
This study examined the relationship between breastfeeding practices and infant mortality in Dhaka, Bangladesh. The researchers followed over 1600 infants from birth to 12 months. They found that exclusive breastfeeding declined from 53% at 1 month to 5% at 6 months. Partial or no breastfeeding was associated with a 2-3 times higher risk of infant death from all causes, acute respiratory infection (ARI), and diarrhea compared to exclusive breastfeeding. The study suggests that exclusive breastfeeding in early infancy reduces infant mortality, particularly from ARI and diarrhea.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
This document discusses the importance of breastfeeding for infant health and development. It reviews several studies that show breastfeeding reduces the risk of morbidity and mortality from various infectious diseases like diarrhea, otitis media, neonatal sepsis, and respiratory infections. However, in many societies false beliefs interfere with breastfeeding and infants are commonly given prelacteal feeds or mixed feeding instead of being exclusively breastfed. The purpose of the study described is to examine the patterns of infectious diseases in non-breastfed infants compared to breastfed infants admitted to the hospital.
Professor Forsyth studied the health outcomes of 543 children from lower and higher socioeconomic groups. He found that (1) in the lower socioeconomic group, breastfed children had similar or significantly better health outcomes than formula-fed children, even compared to formula-fed children in the higher socioeconomic group. Subsequent studies discussed in the document found that (2) exclusive breastfeeding for at least 15 weeks reduced respiratory illness and that (3) one month of exclusive breastfeeding conferred protection against allergies and respiratory issues into childhood and adolescence. Overall, the document reviews extensive evidence that breastfeeding leads to improved health outcomes related to infectious disease, cognitive development, cardiovascular risk factors, obesity, and diabetes among others.
This study aims to determine the role of nature vs nurture in obesity through an experiment using 50 sets of identical twins aged 6-11. The twins will be given different calorie diets for 3 months - one twin receiving a high calorie diet and the other the daily recommended intake. Measurements of weight, BMI and body composition will be taken before and after to analyze the effects of the different diets while controlling for genetic factors. However, concerns are raised about the ethics of the varying diets and whether 3 months is sufficient time to see changes in such a complex issue.
Comparison of prolonged low volume milk and routine volume milk onamir mohammad Armanian
This study compared outcomes for very low birth weight neonates who were fed using either a prolonged low volume milk strategy (20 mL/kg/day for 7 days before increasing) or a routine advancing volume strategy (increasing volumes by 20 mL/kg/day). The study found that the incidence of necrotizing enterocolitis was significantly lower in infants fed with the prolonged low volume strategy compared to those fed with advancing volumes. However, infants fed with advancing volumes reached full enteral feeding volumes sooner. Overall hospital stay times and weight gain at 30 days were similar between the two groups. The study suggests prolonged low volume feeding may help reduce NEC risk in very low birth weight neonates.
Constraints of exclusive breastfeeding practice among breastfeeding mothers i...Oba Adeboye
Exclusive breastfeeding is recommended for the first six months of life as the best way of feeding an infant. The result of this study will increase the knowledge and encourage mothers on exclusive breastfeeding in Alimosho General Hospital, Igando and also show them the dangers of not practicing exclusive breastfeeding. It will also help the Nurse to debunk myths about exclusive breastfeeding. Using a concurrent mixed method approach, a structured questionnaire was administered to 100 breastfeeding mothers. Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. The research however reveals larger percentage of the respondents are between 25-35 years in the study
This document discusses various factors associated with childhood overweight and obesity, including sleep habits, academic performance, activity levels, eating rates, and cognitive function. Shorter sleep duration and later bedtimes are linked to higher BMI in children. Overweight children often have poorer math performance and interpersonal skills. Higher infant motor activity predicts lower body size, while rapid infant weight gain is tied to later childhood overweight. Faster eating rates are seen in overweight preschoolers. Certain breakfast foods may positively impact cognition more than others. Maternal influences like postpartum depression and lifestyle can also impact childhood weight.
This document discusses risk factors for early childhood obesity from a prenatal care perspective. It identifies several risk factors that occur before or immediately after birth, including maternal obesity, excessive weight gain during pregnancy, smoking during pregnancy, and bottle feeding rather than breastfeeding. The document provides evidence from multiple studies on how each of these factors increases the risk of a child being overweight or obese. It emphasizes that prenatal care provides an opportunity for healthcare providers to educate mothers on these risks and support behaviors like maintaining a healthy weight, smoking cessation, limiting weight gain during pregnancy, and breastfeeding to help decrease the likelihood of early childhood obesity.
Breastfeeding Practice and Breastfeeding Self-efficacy Among first time Nepal...Ambika Rai
This document outlines a proposed study on breastfeeding practices among adolescent mothers in Nepal. The study aims to describe breastfeeding rates at 6 weeks postpartum and compare breastfeeding self-efficacy among mothers with exclusive, partial, or no breastfeeding. The conceptual framework is based on self-efficacy theory. The methodology describes a descriptive comparative design using surveys of 110 adolescent mothers attending a well-baby clinic. Data will be analyzed to classify breastfeeding practices and compare self-efficacy scores. The results could inform policies to improve breastfeeding among adolescent mothers in Nepal.
The document summarizes a presentation on infant growth given by medical students. It includes definitions of growth, phases of infant growth, and factors that can affect growth. It also discusses techniques for measuring infant growth, interpreting growth charts, and examples of abnormal growth patterns. The presentation is divided into two parts: an overview of infant growth and statistics from a patient care project analyzing whether mode of feeding, delivery, or gestational age at birth influence initial growth rates of newborns. The data analysis found no significant associations or differences in growth rates based on these factors.
Bedsharing And Maternal Smoking In A Population Based Survey Of New MothersBiblioteca Virtual
This study examined the relationship between maternal smoking and bedsharing using data from the Oregon Pregnancy Risk Assessment Monitoring System survey of 1867 new mothers. The study found that bedsharing was common in Oregon, with 35.2% of mothers reporting frequent bedsharing and an additional 41.4% sometimes bedsharing. There was no significant association found between smoking (either prenatal or postnatal) and bedsharing for any racial/ethnic group. Both smoking and nonsmoking mothers were equally likely to bedshare. The results suggest the message that smoking mothers should avoid bedsharing is not being effectively communicated. More effort is needed to inform smoking mothers of the risks of mixing bedsharing and smoking.
Genetics of Obesity: The thrifty gene hypothesisStephen Magness
Early humans faced regular cycles of feast and famine that promoted the evolution and selection of "thrifty genes" that increased the body's ability to efficiently store and utilize fuels like fat and glucose. While these genes provided an evolutionary advantage in the past by helping humans survive periods of starvation, they predispose modern humans to obesity and related diseases due to our current environment of abundant food and low physical activity levels. The "thrifty genotype" hypothesis has been expanded to include the concept of a "thrifty epigenome," where environmental factors like famine experienced by pregnant mothers can epigenetically influence gene expression and metabolic function in offspring in ways that increase disease risk in a modern context of plentiful food.
This randomized controlled trial found that advising mothers to avoid pacifier use did not reduce the risk of breastfeeding cessation before 3 months or affect infant crying behavior. Mothers who were advised against pacifier use were less likely to report using one but showed no differences in breastfeeding duration or infant fussing compared to the control group. While pacifier use has been linked to early weaning in observational studies, this trial did not find evidence that pacifiers directly increase weaning risk or that advising against their use provides benefits.
Annals of Nutritional Disorders & Therapy is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients leading to various Nutritional diseases including obesity, eating disorders, malnutrition, developmental abnormalities that could be prevented by diet, hereditary metabolic disorders that retort to dietary treatment, food allergies and intolerances, and potential hazards in the food supply. It also focuses upon the chronic diseases caused due to improper nutrition such as cardiovascular disease, hypertension, cancer, and diabetes mellitus.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Annals of Nutritional Disorders & Therapy journal accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients.
Food and Nutrition across the Lifespan Case StudyElizaPaknya
Used both critical thinking and writing skills in order to complete a thoughtful case study that used course material regarding nutrition, lactation, pregnancy, diet, etc.
This document discusses shoulder dystocia, which occurs in approximately 1% of vaginal births and complicates delivery. Fetal macrosomia and maternal diabetes are known risk factors, but shoulder dystocia remains largely unpredictable. While the risk increases with higher birthweights, especially over 4500g, ultrasound and clinical estimates of fetal weight are inaccurate in predicting macrosomia. A history of prior shoulder dystocia or maternal diabetes also increase the risk of recurrence. However, due to the inability to reliably predict shoulder dystocia, preventative cesarean sections are not recommended. Patients with risk factors require careful management and counseling regarding delivery.
1. Nutritional programming theories suggest that the prenatal and early life nutritional environment can influence long-term health by permanently programming physiological functions and disease risk.
2. Animal studies demonstrate a direct link between nutrient imbalance during fetal development and later diseases like hypertension, diabetes, and heart disease, independent of growth rates.
3. Exposure to glucocorticoids and alterations in gene expression from nutrient imbalance in early life are thought to be important mechanisms influencing tissue development and function long-term.
An investigation-of-fetal-growth-in-relation-to-pregnancy-characteristicsDr Max Mongelli
A PDF copy of the DM thesis "An Investigation of Fetal Growth in Relation to Maternal Characteristics", based on research carried out at the Perinatal Research and Monitoring Unit at the Queens' Medical Centre in Nottingham, UK. Some of this material formed the basis for the development of the customised fetal growth charts.
1. The study found that exclusive breastfeeding provided strong protection against infant death in Ghana, India, and Peru, where infant mortality from infectious disease is high. However, the risks of death or hospitalization for infants who were predominantly breastfed were not significantly different than for those who were exclusively breastfed.
2. Some experts were concerned that this finding could undermine promotion of exclusive breastfeeding, as the benefits of exclusive breastfeeding over predominant breastfeeding may be greatest in the first months of life when the study's sample sizes were smaller.
3. It was also noted that the study only looked at infants older than 6-10 weeks, so the findings may not apply to younger infants, for whom the differences between
This article challenges the hypothesis that the modern genetic predisposition to obesity has arisen through random genetic drift following predation release. The authors present evidence to support the hypothesis that famines and seasonal food shortages in the post-agricultural era have exerted natural selection favoring fat storage, mediated through fertility selection. The authors conclude that genetic and bioinformatic methods will soon provide a definitive resolution to the long-standing debate over the "thrifty gene" theory of obesity.
Admission Criteria in PICU for Children having COVID 19 & general care of a ...Vivek Maheshwari
The document discusses criteria for admission to the pediatric intensive care unit (PICU) for children with COVID-19 and the general care of children in the PICU. Children may be admitted to the PICU if they require mechanical ventilation, have shock requiring vasopressors, worsening mental status, or multi-organ dysfunction. Once admitted, the focus is on supportive care including feeding, analgesia, sedation, glucose control, and pressure sore prevention to restore the child's health and provide family support.
This study examined the relationship between sleep duration, sleep regularity, body weight, and metabolic homeostasis in 308 community children ages 4-10. The researchers found that obese children had more variable sleep durations, especially on weekends when their sleep was shorter. Higher variability in sleep duration on school nights was correlated with higher triglyceride levels in obese children. Overall, the study suggests that maintaining longer and more stable sleep is important for metabolic health in children, and irregular or shorter sleep may contribute to obesity and metabolic issues.
The Potential Role Of Breast Feeding And Other Factors In Helping To Reduce E...Biblioteca Virtual
This study examined the relationship between breastfeeding and early childhood caries (ECC) in 175 children aged 1 to 5 receiving dental care. The researchers found:
1) Children who were exclusively bottle fed for at least 1.5 years had more decayed or filled tooth surfaces than children who were breastfed for some time but less than a year.
2) Children who did not receive bottles at night or juice at irregular times, whose mothers brushed their teeth, and whose mothers had adequate dental care themselves had lower rates of ECC.
3) Too few children were exclusively breastfed to adequately study the relationship between exclusive breastfeeding and ECC. However, the results suggest measures like avoiding nighttime bottles and frequent
Comparison of prolonged low volume milk and routine volume milk onamir mohammad Armanian
This study compared outcomes for very low birth weight neonates who were fed using either a prolonged low volume milk strategy (20 mL/kg/day for 7 days before increasing) or a routine advancing volume strategy (increasing volumes by 20 mL/kg/day). The study found that the incidence of necrotizing enterocolitis was significantly lower in infants fed with the prolonged low volume strategy compared to those fed with advancing volumes. However, infants fed with advancing volumes reached full enteral feeding volumes sooner. Overall hospital stay times and weight gain at 30 days were similar between the two groups. The study suggests prolonged low volume feeding may help reduce NEC risk in very low birth weight neonates.
Constraints of exclusive breastfeeding practice among breastfeeding mothers i...Oba Adeboye
Exclusive breastfeeding is recommended for the first six months of life as the best way of feeding an infant. The result of this study will increase the knowledge and encourage mothers on exclusive breastfeeding in Alimosho General Hospital, Igando and also show them the dangers of not practicing exclusive breastfeeding. It will also help the Nurse to debunk myths about exclusive breastfeeding. Using a concurrent mixed method approach, a structured questionnaire was administered to 100 breastfeeding mothers. Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. The research however reveals larger percentage of the respondents are between 25-35 years in the study
This document discusses various factors associated with childhood overweight and obesity, including sleep habits, academic performance, activity levels, eating rates, and cognitive function. Shorter sleep duration and later bedtimes are linked to higher BMI in children. Overweight children often have poorer math performance and interpersonal skills. Higher infant motor activity predicts lower body size, while rapid infant weight gain is tied to later childhood overweight. Faster eating rates are seen in overweight preschoolers. Certain breakfast foods may positively impact cognition more than others. Maternal influences like postpartum depression and lifestyle can also impact childhood weight.
This document discusses risk factors for early childhood obesity from a prenatal care perspective. It identifies several risk factors that occur before or immediately after birth, including maternal obesity, excessive weight gain during pregnancy, smoking during pregnancy, and bottle feeding rather than breastfeeding. The document provides evidence from multiple studies on how each of these factors increases the risk of a child being overweight or obese. It emphasizes that prenatal care provides an opportunity for healthcare providers to educate mothers on these risks and support behaviors like maintaining a healthy weight, smoking cessation, limiting weight gain during pregnancy, and breastfeeding to help decrease the likelihood of early childhood obesity.
Breastfeeding Practice and Breastfeeding Self-efficacy Among first time Nepal...Ambika Rai
This document outlines a proposed study on breastfeeding practices among adolescent mothers in Nepal. The study aims to describe breastfeeding rates at 6 weeks postpartum and compare breastfeeding self-efficacy among mothers with exclusive, partial, or no breastfeeding. The conceptual framework is based on self-efficacy theory. The methodology describes a descriptive comparative design using surveys of 110 adolescent mothers attending a well-baby clinic. Data will be analyzed to classify breastfeeding practices and compare self-efficacy scores. The results could inform policies to improve breastfeeding among adolescent mothers in Nepal.
The document summarizes a presentation on infant growth given by medical students. It includes definitions of growth, phases of infant growth, and factors that can affect growth. It also discusses techniques for measuring infant growth, interpreting growth charts, and examples of abnormal growth patterns. The presentation is divided into two parts: an overview of infant growth and statistics from a patient care project analyzing whether mode of feeding, delivery, or gestational age at birth influence initial growth rates of newborns. The data analysis found no significant associations or differences in growth rates based on these factors.
Bedsharing And Maternal Smoking In A Population Based Survey Of New MothersBiblioteca Virtual
This study examined the relationship between maternal smoking and bedsharing using data from the Oregon Pregnancy Risk Assessment Monitoring System survey of 1867 new mothers. The study found that bedsharing was common in Oregon, with 35.2% of mothers reporting frequent bedsharing and an additional 41.4% sometimes bedsharing. There was no significant association found between smoking (either prenatal or postnatal) and bedsharing for any racial/ethnic group. Both smoking and nonsmoking mothers were equally likely to bedshare. The results suggest the message that smoking mothers should avoid bedsharing is not being effectively communicated. More effort is needed to inform smoking mothers of the risks of mixing bedsharing and smoking.
Genetics of Obesity: The thrifty gene hypothesisStephen Magness
Early humans faced regular cycles of feast and famine that promoted the evolution and selection of "thrifty genes" that increased the body's ability to efficiently store and utilize fuels like fat and glucose. While these genes provided an evolutionary advantage in the past by helping humans survive periods of starvation, they predispose modern humans to obesity and related diseases due to our current environment of abundant food and low physical activity levels. The "thrifty genotype" hypothesis has been expanded to include the concept of a "thrifty epigenome," where environmental factors like famine experienced by pregnant mothers can epigenetically influence gene expression and metabolic function in offspring in ways that increase disease risk in a modern context of plentiful food.
This randomized controlled trial found that advising mothers to avoid pacifier use did not reduce the risk of breastfeeding cessation before 3 months or affect infant crying behavior. Mothers who were advised against pacifier use were less likely to report using one but showed no differences in breastfeeding duration or infant fussing compared to the control group. While pacifier use has been linked to early weaning in observational studies, this trial did not find evidence that pacifiers directly increase weaning risk or that advising against their use provides benefits.
Annals of Nutritional Disorders & Therapy is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients leading to various Nutritional diseases including obesity, eating disorders, malnutrition, developmental abnormalities that could be prevented by diet, hereditary metabolic disorders that retort to dietary treatment, food allergies and intolerances, and potential hazards in the food supply. It also focuses upon the chronic diseases caused due to improper nutrition such as cardiovascular disease, hypertension, cancer, and diabetes mellitus.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Annals of Nutritional Disorders & Therapy journal accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients.
Food and Nutrition across the Lifespan Case StudyElizaPaknya
Used both critical thinking and writing skills in order to complete a thoughtful case study that used course material regarding nutrition, lactation, pregnancy, diet, etc.
This document discusses shoulder dystocia, which occurs in approximately 1% of vaginal births and complicates delivery. Fetal macrosomia and maternal diabetes are known risk factors, but shoulder dystocia remains largely unpredictable. While the risk increases with higher birthweights, especially over 4500g, ultrasound and clinical estimates of fetal weight are inaccurate in predicting macrosomia. A history of prior shoulder dystocia or maternal diabetes also increase the risk of recurrence. However, due to the inability to reliably predict shoulder dystocia, preventative cesarean sections are not recommended. Patients with risk factors require careful management and counseling regarding delivery.
1. Nutritional programming theories suggest that the prenatal and early life nutritional environment can influence long-term health by permanently programming physiological functions and disease risk.
2. Animal studies demonstrate a direct link between nutrient imbalance during fetal development and later diseases like hypertension, diabetes, and heart disease, independent of growth rates.
3. Exposure to glucocorticoids and alterations in gene expression from nutrient imbalance in early life are thought to be important mechanisms influencing tissue development and function long-term.
An investigation-of-fetal-growth-in-relation-to-pregnancy-characteristicsDr Max Mongelli
A PDF copy of the DM thesis "An Investigation of Fetal Growth in Relation to Maternal Characteristics", based on research carried out at the Perinatal Research and Monitoring Unit at the Queens' Medical Centre in Nottingham, UK. Some of this material formed the basis for the development of the customised fetal growth charts.
1. The study found that exclusive breastfeeding provided strong protection against infant death in Ghana, India, and Peru, where infant mortality from infectious disease is high. However, the risks of death or hospitalization for infants who were predominantly breastfed were not significantly different than for those who were exclusively breastfed.
2. Some experts were concerned that this finding could undermine promotion of exclusive breastfeeding, as the benefits of exclusive breastfeeding over predominant breastfeeding may be greatest in the first months of life when the study's sample sizes were smaller.
3. It was also noted that the study only looked at infants older than 6-10 weeks, so the findings may not apply to younger infants, for whom the differences between
This article challenges the hypothesis that the modern genetic predisposition to obesity has arisen through random genetic drift following predation release. The authors present evidence to support the hypothesis that famines and seasonal food shortages in the post-agricultural era have exerted natural selection favoring fat storage, mediated through fertility selection. The authors conclude that genetic and bioinformatic methods will soon provide a definitive resolution to the long-standing debate over the "thrifty gene" theory of obesity.
Admission Criteria in PICU for Children having COVID 19 & general care of a ...Vivek Maheshwari
The document discusses criteria for admission to the pediatric intensive care unit (PICU) for children with COVID-19 and the general care of children in the PICU. Children may be admitted to the PICU if they require mechanical ventilation, have shock requiring vasopressors, worsening mental status, or multi-organ dysfunction. Once admitted, the focus is on supportive care including feeding, analgesia, sedation, glucose control, and pressure sore prevention to restore the child's health and provide family support.
This study examined the relationship between sleep duration, sleep regularity, body weight, and metabolic homeostasis in 308 community children ages 4-10. The researchers found that obese children had more variable sleep durations, especially on weekends when their sleep was shorter. Higher variability in sleep duration on school nights was correlated with higher triglyceride levels in obese children. Overall, the study suggests that maintaining longer and more stable sleep is important for metabolic health in children, and irregular or shorter sleep may contribute to obesity and metabolic issues.
The Potential Role Of Breast Feeding And Other Factors In Helping To Reduce E...Biblioteca Virtual
This study examined the relationship between breastfeeding and early childhood caries (ECC) in 175 children aged 1 to 5 receiving dental care. The researchers found:
1) Children who were exclusively bottle fed for at least 1.5 years had more decayed or filled tooth surfaces than children who were breastfed for some time but less than a year.
2) Children who did not receive bottles at night or juice at irregular times, whose mothers brushed their teeth, and whose mothers had adequate dental care themselves had lower rates of ECC.
3) Too few children were exclusively breastfed to adequately study the relationship between exclusive breastfeeding and ECC. However, the results suggest measures like avoiding nighttime bottles and frequent
The document provides instructions for arranging a tour of important landmarks in Argentina for an international band visiting the country for the first time. It asks the reader to design a tour guide leaflet selecting relevant places to visit, describing activities and transportation, and including all required information. The best leaflet will be chosen to guide the band's tour and win prizes for the designer.
This summary provides an overview of activities during a 3-day trip to Puerto Madryn, Argentina. On the first day, guests arrive at the Dawn on Holidays hotel and can relax in luxurious rooms with views of the beach, city, or countryside. The next day includes a city tour of Rawson in the morning and a play in the evening, with sandwiches and juice for lunch. In between, guests go whale watching and see penguins and dolphins by ship. The third day is not described.
The Internet of Things is here, and buildings are becoming smart, so we must rethink our relationships with objects. Connected devices are cool, but they aren't a strategy. You must consider your users, their goals, what you're going to do with the data, who's going to own the data, and have expertise with connected device trends.
This talk was given at the AGC IT Forum 2015 on July 30th at the Loews Hotel in Chicago, IL.
http://www.fdivoicebusiness.com877-257-6390
This is a presentation of the FDI business opportunity. For more info visit Facebook and search for FDI - A Better Way
The document discusses a relationship where one person has been unhappy and lonely recently. The writer explains they cannot stay by the person's side, and that everything between them has already ended. They do not want to be bound or suffer anymore, and believe the next relationship will be better. While they care about the person and want to hug them, the writer feels they cannot fully give the person what they want in a relationship, and that the two people are not truly compatible.
Breastfeeding And The Risk Of Postneonatal Death In The United StatesBiblioteca Virtual
This study examined the association between breastfeeding and postneonatal mortality in the United States using data from the 1988 National Maternal and Infant Health Survey. The study found that children who were ever breastfed had a 21% lower risk of postneonatal death compared to children who were never breastfed. Longer durations of breastfeeding were associated with even lower risk. The protective effect of breastfeeding was seen across different causes of postneonatal death, including infections, injuries, and sudden infant death syndrome.
This document promotes a wellness party that includes various activities and products. The party will include cleansing rituals, chair massage therapy, cooking classes, and a purse fashion show. A variety of purses will be displayed in different colors and materials like denim, alligator, and crocodile prints. The party aims to help attendees feel purified and rejuvenated through these wellness activities. Contact information is provided to book the wellness party.
HTML5 is the new standard for HTML that supports rich multimedia content like video and audio with tags like <video> and <audio>. It also improves the semantic structure of documents. Currently, browsers like Firefox, Chrome, and Safari support HTML5 to varying degrees, while Internet Explorer 9 will provide support later in 2011. HTML5 can be used for rich websites, web apps, and many mobile apps on devices that support it like iPhone, iPad, and Android phones. While HTML5 has benefits for eLearning like mobile learning and interactive content, tools are still needed to easily create HTML5 content and many eLearning courses will continue to use Flash for now due to its current dominance and expertise with Flash developers.
The author attends Normal School, which has been located on Av. Roca street for 100 years. It has two floors with many classrooms, a small playground, assembly hall, science lab, public library and computer room. Students must wear a uniform and have three breaks per day. Subjects taught include math, science, history, English, and physical education either in the morning or evening. Teachers evaluate students with a final test at the end of the year.
1) The document describes an experiment to use a null 0 interface to avoid a routing loop.
2) The network diagram shows routers R1, R2, and R3 connected, where R3 is an ISP backbone router, R1 is an ISP router, and R2 is a customer router using addresses from the 192.168.0.0/24 block.
3) When pinging an unused address on the 192.168.0.0/24 block from R3, a timeout occurs due to a loop between R1 and R2.
The document provides information on eleven artworks by Henry Bismuth that are being shown or represented by the Chisholm Gallery, including the titles, materials, dimensions, dates and prices for each piece. Contact information is also provided for the Chisholm Gallery.
El documento lista 12 nombres de estudiantes seguidos por su clase o grado escolar. Los nombres parecen ser de estudiantes en el quinto grado o curso de la escuela y no proporcionan más información sobre ellos.
Success story: IFS CRM helped Damen Shipyards realize its visionIFS
This document discusses IFS CRM software and its benefits for customer relationship management. It describes IFS CRM's capabilities for managing the customer lifecycle and its integration with other IFS applications. The presentation then highlights new features in IFS Applications 8 like the Sales Companion app and configuration tools. It concludes with a customer story about Damen Shipyards Group which implemented IFS CRM to improve sales effectiveness and create a single customer database across its global operations.
The document discusses the challenges of sustaining long-form content businesses in the digital age. Traditional print magazines and books are struggling as readers increasingly consume short-form, free content online from amateurs and enthusiasts. While platforms like Twitter and blogs have lower costs, they also bring in less revenue from advertising and must rely on volunteers instead of paid professionals.
На вопрос "Что такое "Конвергентные ИТ" в октябрьском номере журнала "CIO / Руководитель информационной службы " ответили представители ведущих международных поставщиков.
Contribution Of Environmental Factors To The Risk Of Male InfertilityBiblioteca Virtual
This study investigated the relationship between environmental exposures and male infertility in 225 men seeking infertility treatment in Argentina. The men were grouped based on reported exposures to pesticides, solvents, heat, or a mixture. Semen analysis and hormone levels were compared between exposure groups. Results showed that exposure to pesticides was associated with lower sperm counts and higher estrogen levels, while solvent exposure was linked to lower LH levels, with effects being more pronounced in men with primary infertility. The study suggests environmental factors contribute to male infertility severity and may worsen genetic or medical risk factors.
Association Of Breastfeeding Intensity And Bottle Emptying Behaviors At Early...Biblioteca Virtual
This study examined the relationship between breastfeeding intensity, bottle emptying behaviors, and risk of excess weight in infants. The study found:
1) Infants who were breastfed at low (20% of milk feeds) or medium (20-80% of milk feeds) intensities in early infancy were over twice as likely to have excess weight in late infancy compared to infants breastfed at high (80% of milk feeds) intensities.
2) Infants who often emptied bottles in early infancy were 69% more likely to have excess weight in late infancy than infants who rarely emptied bottles.
3) Mothers' encouragement of bottle emptying was negatively associated with infants' risk of
Making it Easier for Women to Work & Breastfeed: The Working Parent Support C...Leith Greenslade
Several leading US companies, universities, medical and media associations are joining forces to offer more support to working women so they can exercise a real choice to breastfeed.
at SciVerse ScienceDirectSocial Science & Medicine 75 (201.docxikirkton
at SciVerse ScienceDirect
Social Science & Medicine 75 (2012) 323e330
Contents lists available
Social Science & Medicine
journal homepage: www.elsevier.com/locate/socscimed
Breastfeeding and risk of overweight and obesity at nine-years of age
Cathal McCrory*, Richard Layte 1
The Economic and Social Research Institute, Whitaker Square, Sir John Rogerson’s Quay, Dublin 2, Ireland
a r t i c l e i n f o
Article history:
Available online 17 April 2012
Keywords:
Ireland
Breastfeeding
Children
Overweight
Obesity
Body mass index (BMI)
Cohort study
* Corresponding author. Tel.: þ353 1 8632027; fax:
E-mail address: [email protected] (C. McCror
1 Tel.: þ353 1 8632027; fax: þ353 1 8632100.
0277-9536/$ e see front matter � 2012 Elsevier Ltd.
doi:10.1016/j.socscimed.2012.02.048
a b s t r a c t
Whether breastfeeding is protective against the development of childhood overweight and obesity
remains the subject of considerable debate. Although a number of meta-analyses and syntheses of the
literature have concluded that the greater preponderance of evidence indicates that breastfeeding
reduces the risk of obesity, these findings are by no means conclusive. The present study used data from
the Growing Up in Ireland study to examine the relationship between retrospectively recalled breast-
feeding data and contemporaneously measured weight status for 7798 children at nine-years of age
controlling for a wide range of variables including; socio-demographic factors, the child’s own lifestyle-
related behaviours, and parental BMI. The results of the multivariable analysis indicated that being
breastfed for between 13 and 25 weeks was associated with a 38 percent (p < 0.05) reduction in the risk
of obesity at nine-years of age, while being breastfed for 26 weeks or more was associated with a 51
percent (p < 0.01) reduction in the risk of obesity at nine-years of age. Moreover, results pointed towards
a doseeresponse patterning in the data for those breastfed in excess of 4 weeks. Possible mechanisms
conveying this health benefit include slower patterns of growth among breastfed children, which it is
believed, are largely attributable to differences in the composition of human breast milk compared with
synthesised formula. The suggestion that the choice of infant feeding method has important implications
for health and development is tantalising as it identifies a modifiable health behaviour that is amenable
to intervention in primary health care settings and has the potential to improve the health of the
population.
� 2012 Elsevier Ltd. All rights reserved.
Introduction
The belief that breastfeeding during infancy affords protection
against a number of diseases features prominently in the epide-
miological literature; there is considerable evidence to support this
assertion. Breastfeeding is associated with reduced risk for
a number of neonatal infections including gastro-intestinal infec-
tions, diarrhoeal infections, and types of extra-intestinal infecti ...
A Systematic Review Of Maternal Obesity And Breastfeeding Intention, Initiati...Biblioteca Virtual
This document summarizes a systematic review examining the relationship between maternal overweight/obesity and breastfeeding intention, initiation and duration. The review identified 27 studies on this topic. The studies generally found that obese women had shorter intended and actual breastfeeding duration compared to normal weight women. Specifically, obese women were less likely to intend to or initiate breastfeeding, and breastfed for shorter durations even after adjusting for confounding factors. The relationship between maternal obesity and delayed onset of lactation was also observed. However, the reasons for these relationships are not fully understood and require further qualitative research.
The 25 Th Anniversary Of The Surgeon General’S Workshop On Breastfeeding And ...Biblioteca Virtual
The document summarizes the key findings and recommendations from the 25th anniversary of the Surgeon General's Workshop on Breastfeeding and Human Lactation. It discusses the benefits of breastfeeding for both infant and maternal health. While breastfeeding rates have increased since 1984, gaps remain between current practices and recommendations such as exclusively breastfeeding for 6 months. Efforts are needed to support breastfeeding at hospitals, workplaces, and in the community to improve rates and reduce disparities.
This annotated bibliography provides summaries for two sources about childhood and adult obesity. The first source is a scholarly article that analyzes childhood obesity trends in the US and finds inconsistencies in predicting future rates due to diversity in demographics. It addresses causes and risk factors of childhood obesity but does not deeply examine perceptions of it. The second source is an article that finds women who experienced childhood maltreatment were more likely to perceive weight discrimination and have smaller increases in BMI. It demonstrates how childhood experiences can trigger adult obesity but does not analyze differences in perceiving childhood versus adult obesity. Both sources will aid the student's research on perceptions of childhood versus adult obesity, though the second source fails to critically compare the two perceptions.
1) Childhood obesity has more than doubled in the past few decades and poses significant health risks.
2) Early identification of excessive weight gain is important through tracking BMI percentiles over time.
3) Pediatricians should discuss healthy eating and physical activity with families during routine visits to promote prevention and early recognition of obesity issues.
This document summarizes evidence that breastfeeding can help combat childhood obesity. It finds that exclusive breastfeeding for at least one year is associated with lower rates of childhood obesity compared to formula feeding. This is because breastmilk regulates appetite and promotes healthy weight through hormones. While breastfeeding rates have increased in the US, rates of exclusive breastfeeding at 6 and 12 months have remained low. Increasing exclusive breastfeeding could help address the epidemic of childhood obesity and subsequent risks of adult obesity and related diseases.
A "Academy of Breastfeeding Medicine" é uma organização mundial de médicos dedicados à promoção, proteção, e apoio da amamentação e lactação humana.
Nossa missão é unir em uma associação membros das várias especialidades médicas com este propósito comum.
Gostaria que a SBP - Sociedade Brasileira de Pediatria firma-se um MANIFESTO com esse mesmo conteúdo, principalmente em relação ao conflito de interesses.
Prof. Marcus Renato de Carvalho, IBCLC
Characteristics Of Breastfeeding Practices Among Us MothersBiblioteca Virtual
1) More than half of breastfeeding mothers exclusively breastfed (breast milk only) until 4 months of age, after which exclusive breastfeeding declined sharply. Formula supplementation peaked at 42% at 1 month and declined to 15% at 1 year.
2) Around 6% of mothers reported exclusively pumping breast milk rather than directly breastfeeding.
3) Maternal reports showed considerable variation in behaviors related to common breastfeeding advice on frequency, duration, and intervals of feedings over the infant's first year.
Breastfeeding for 4 months or less does not significantly increase the risk of asthma in children at 14 years according to a study of 4964 children. The study found similar rates of asthma whether children were breastfed for 4 months or less or not breastfed after controlling for potential confounding factors like maternal asthma. There was no association found between duration of breastfeeding and reported asthma symptoms, medication use, school days missed, or hospital admissions related to asthma. The study provides evidence that breastfeeding does not impact the prevalence of asthma in late childhood.
This document examines the Gomez classification of malnutrition, which categorizes children's nutritional status based on their weight as a percentage of theoretical average weight for their age. While the Gomez classification has been widely used, it has several drawbacks like arbitrary cut-off points and not distinguishing between acute and chronic malnutrition. The document proposes using the WHO growth charts and defining the lower limit of normality as two standard deviations below the mean weight-for-age. It also recommends measuring both weight and height to differentiate between acute and chronic malnutrition for individual children, and using weight-for-age screening followed by weight-for-height assessment for populations.
The document discusses the growing epidemic of childhood overweight and obesity in the United States. Some key points:
- The percentage of overweight children has more than doubled from the late 1970s to 2000, and tripled for adolescents. Close to 1 in 5 children are now overweight or obese.
- This increase in overweight is associated with significant health impacts, including increased risk for conditions like hypertension, diabetes, and heart disease. Medical costs of obesity are substantial.
- Factors contributing to the rise in childhood overweight include decreases in physical activity and increases in caloric intake from foods like snacks, soft drinks and fast food. Children on average spend much more time engaged in sedentary activities now compared to the past.
This document reviews literature on childhood obesity. It discusses how the rate of childhood obesity has significantly increased over the past 30 years. Obesity in children can lead to both short-term and long-term health impacts. Common causes of childhood obesity include increased calorie intake, lack of exercise, and consumption of sugary drinks. Addressing childhood obesity is important as obese children are more likely to be obese adults and develop related health conditions like diabetes if obesity continues into adulthood.
The surgeon general's call to action to support breastfeeding.Sarah Ali Farooq
This document summarizes the health benefits of breastfeeding for both infants and mothers. It finds that breastfeeding is uniquely suited to infant nutrition and protects against illnesses. Not breastfeeding is associated with increased risks of diseases like diabetes and obesity. The document also discusses the psychosocial benefits of breastfeeding for bonding, and the economic benefits at both the family and national levels from reduced healthcare costs. Breastfeeding has environmental benefits from reduced waste compared to formula packaging. Major health organizations recommend exclusive breastfeeding for six months due to these benefits.
This document from the American Academy of Pediatrics outlines their policy statement on breastfeeding and the use of human milk. The key points are:
1) Extensive research has demonstrated significant health benefits for infants and mothers from breastfeeding, including reduced risk of infectious diseases, sudden infant death syndrome, diabetes, obesity, and improved cognitive development.
2) The policy statement provides recommendations for pediatricians and healthcare professionals to promote, protect, and support breastfeeding through individual practice, hospitals, medical schools, and communities.
3) Certain infectious diseases like HIV may preclude breastfeeding in some situations, but exclusive breastfeeding for the first 6 months does not increase HIV transmission risk according to some studies in developing countries.
Campus How Does Breast Feeding Compared to Bottle Feeding.pdfbkbk37
The document discusses breastfeeding versus bottle feeding and a case study of an infant experiencing failure to thrive while being exclusively breastfed. The case involves a 6-month-old infant who was breastfed but lost weight and showed signs of failure to thrive. The infant was taken to the hospital and monitored, with initial tests and observations not revealing any organic causes. Supplemental formula feedings were provided while more assessment was conducted.
The document summarizes evidence on childhood obesity from various studies and reviews. Key findings include:
1) The prevalence of childhood overweight and obesity is increasing globally, with psychological and current and future health risks for affected children.
2) Family-based programs that focus on behavior modification, improved diet, and increased physical activity can help reduce weight in obese pre-adolescent children, though effects are modest.
3) School-based programs show potential for obesity prevention by decreasing sedentary behaviors and improving diet, but schools are not well-suited for treatment due to stigma. Overall the evidence indicates multicomponent lifestyle interventions tailored to individual families are most effective for managing childhood obesity.
Infant Feeding And Feeding Transitions During The First Year Of LifeBiblioteca Virtual
This document summarizes infant feeding patterns during the first year of life based on data from the Infant Feeding Practices Study II. Key findings include:
1) While 83% of infants were breastfed in the hospital, 42% of these infants also received formula supplementation. By 3 months, 61% of infants received formula.
2) Solid foods were introduced earlier than recommended, with 40% of infants consuming cereal and 17% consuming fruits/vegetables by 4 months of age.
3) Early introduction of solids was associated with discontinuing breastfeeding earlier and consuming more fatty/sugary foods by 12 months.
This article discusses the increasing prevalence of type 2 diabetes in adolescents and the role of sleep. It notes that while genetics play a role, lifestyle changes like decreased sleep have contributed to rising obesity and diabetes rates. Sleep is influenced by biological and social factors in adolescents. Short sleep duration is linked to increased insulin resistance and BMI. The article reviews studies showing that sleep education and advice programs can improve sleep habits and duration in teens, with some evidence they may also positively impact metabolic health and weight. Larger and longer trials are still needed.
Similar to Breastfeeding, Childhood Obesity And The Prevention Of Chronic Diseases (20)
Este documento fornece informações sobre a anatomia e fisiologia da glândula mamária. Resume que a mama é composta de tecido glandular, gordura e tecido conjuntivo, e descreve o desenvolvimento da mama desde a embriogênese até a puberdade. Também aborda a anatomia da mama adulta e a fisiologia da produção de leite, incluindo os hormônios envolvidos.
The 2008 IBLCE examination saw the largest candidate population in its history with 3,323 candidates taking the exam across 37 countries and territories. The exam was administered in 13 languages and saw continued growth in candidates from outside the United States, Canada, and Australia. Analysis of exam results found a pass rate of 93.56% with a mean score of 77.87% and standard deviation of 8.21%.
This document provides an overview of the Third Edition (Revised) of the Wellstart International Lactation Management Self-Study Modules, Level I. It was developed by Wellstart International, a nonprofit organization focused on educating healthcare providers about optimal infant and young child feeding. The Third Edition was reviewed by 30 volunteer experts from around the world and updated to ensure the information is current and internationally relevant. It is intended to be available at low or no cost globally to support breastfeeding education.
AvaliaçãO Do Impacto De Um Programa De Puericultura Na PromoçãO Da Amamentaçã...Biblioteca Virtual
1) O estudo avaliou o impacto de um programa de puericultura na promoção da amamentação exclusiva em uma coorte de 112 crianças no Sul do Brasil.
2) A prevalência de amamentação exclusiva no primeiro mês foi de 95%, caindo progressivamente para 81%, 64%, 53%, 39% e 35% nos meses seguintes.
3) A mediana da duração da amamentação exclusiva foi de 4 meses, maior do que as taxas nacionais brasileiras, indicando a eficácia do programa.
AnáLise Da Efetividade De Um Programa De Incentivo Ao Aleitamento Materno Exc...Biblioteca Virtual
O documento analisa a efetividade de um programa de incentivo ao aleitamento materno exclusivo em uma comunidade carente de São Paulo. Os principais resultados são: 100% das mulheres eram desempregadas, 51,8% aderiram ao programa mas 48,2% abandonaram por motivos desconhecidos, e no momento da alta apenas 17,3% relataram aleitamento exclusivo até os seis meses.
The 2008 IBLCE examination saw the largest candidate population in its history with 3,323 candidates taking the exam across 37 countries and territories. The exam was administered in 13 languages and saw continued growth in candidates from outside the United States, Canada, and Australia. Analysis of exam results found a pass rate of 93.56% with a mean score of 77.87% and standard deviation of 8.21%.
The document summarizes monitoring results from the Baby Feeding Law Group (BFLG) project on marketing practices of baby formula companies in the UK. It finds that Danone, maker of Aptamil and Cow & Gate formulas, continues advertising claims promoting follow-on formulas and undermining breastfeeding, despite rulings against such claims from the Advertising Standards Authority. The report provides examples of non-compliant magazine and television ads, and calls on Trading Standards offices to take action against illegal marketing practices.
The document summarizes statistics from the 2008 IBLCE lactation consultant examination. It reported that:
- 3,323 candidates took the exam across 37 countries, representing the largest candidate population in the exam's history.
- Less than half of candidates were from the US, with over 30% from other countries, indicating the credential has become a global standard.
- The exam was administered in 13 languages across 5 continents, and was taken online or on paper.
- 771 candidates took the exam for recertification purposes after 5 years of practice.
PromoçãO, ProtecçãO E Apoio. Apoio RepresentaçõEs Sociais Em Aleitamento MaternoBiblioteca Virtual
Este documento resume uma dissertação de mestrado sobre representações sociais em aleitamento materno. O trabalho analisou as percepções de profissionais de saúde e puérperas de dois hospitais sobre o aleitamento materno, comparando um hospital credenciado pela Iniciativa Hospital Amigo da Criança e outro não credenciado. Entre os principais achados, destacam-se a culpabilização da mulher no desmame, os efeitos das rotinas médicas no aleitamento e diferenças nas percepções entre os profissionais dos dois hosp
O Ensino De Aleitamento Materno Na GraduaçãO Em Medicina Um Estudo De CasoBiblioteca Virtual
Este documento descreve uma dissertação de mestrado sobre o ensino de aleitamento materno na graduação em medicina da Universidade Federal de Juiz de Fora. O estudo avaliou o nível de formação teórica e prática dos alunos, sua confiança em lidar com o tema e em transmitir informações às futuras mães. Os resultados sugerem que é necessária uma reavaliação do ensino teórico com foco prático para preparar melhor os médicos.
No Seio Da FamíLia AmamentaçãO E PromoçãO Da SaúDe No Programa De SaúDe Da ...Biblioteca Virtual
Este documento apresenta os resultados de uma pesquisa sobre a implementação da promoção da saúde no Programa de Saúde da Família em cinco municípios brasileiros. A pesquisa avaliou os conhecimentos e atividades de profissionais de saúde em relação à promoção do aleitamento materno, e entrevistou mães sobre sua experiência com o programa. Os resultados mostraram que os programas capacitaram bem suas equipes, que demonstraram conhecimentos acima da média sobre aleitamento materno. No entanto, as at
This document is the third edition of Wellstart International's self-study modules on lactation management at level 1. It contains pre-tests and post-tests, 3 modules that cover the basics of breastfeeding and common problems, and annexes with additional resources. The modules are designed to teach health care providers about promoting and supporting breastfeeding.
AnáLise Da Efetividade De Um Programa De Incentivo Ao Aleitamento Materno Exc...Biblioteca Virtual
O documento analisa a efetividade de um programa de incentivo ao aleitamento materno exclusivo em uma comunidade carente de São Paulo. Os principais resultados foram: 100% das mulheres eram desempregadas, 51,8% aderiram ao programa mas 48,2% abandonaram por motivos desconhecidos, e no momento da alta apenas 17,3% relataram aleitamento exclusivo até os seis meses.
AvaliaçãO Do Impacto De Um Programa De Puericultura Na PromoçãO Da Amamentaçã...Biblioteca Virtual
1) O estudo avaliou o impacto de um programa de puericultura na promoção da amamentação exclusiva em uma coorte de 112 crianças acompanhadas desde o nascimento.
2) A prevalência de amamentação exclusiva no primeiro mês foi de 95%, caindo progressivamente para 81%, 64%, 53%, 39% e 35% nos meses seguintes.
3) A mediana da duração da amamentação exclusiva foi de 4 meses, maior do que as taxas nacionais brasileiras, indicando a eficácia do programa.
Iblce Regional Office In Europe Candidate Information GuideBiblioteca Virtual
This document provides information for candidates applying to take the International Board Certified Lactation Consultant (IBCLC) certification exam. It outlines the eligibility requirements including the necessary educational background, clinical experience providing breastfeeding counseling, and professional lactation education. Candidates must meet the eligibility criteria for one of several pathways that differ in their required hours of clinical experience depending on a candidate's educational background and profession. The document reviews the application process and provides sample exam questions to help candidates prepare for the rigorous international certification exam.
A ImportâNcia Da AmamentaçãO Para A SaúDe Da Mulher Que AmamentaBiblioteca Virtual
O documento discute os benefícios da amamentação para a saúde da mulher, incluindo proteção contra câncer de mama e ovário, recuperação pós-parto mais rápida, e prevenção de osteoporose. A amamentação também ajuda no controle de natalidade através da produção de hormônios que inibem a ovulação.
AmamentaçãO E Uso De AntiinflamatóRios NãO EsteróIdes Pela Nutriz InformaçõEs...Biblioteca Virtual
1) O documento analisa as informações contidas nas bulas de medicamentos antiinflamatórios não esteróides em comparação com as evidências científicas sobre seu uso durante a amamentação.
2) Foi encontrada referência à segurança de uso durante a amamentação em apenas 14 de 27 medicamentos, e 9 de 10 medicamentos considerados seguros aconselhavam evitar o uso ou suspender a amamentação.
3) As bulas são discordantes das evidências científicas sobre a compatibilidade desses medicamentos com a amamentação, sendo necess
Este documento descreve a anatomia e fisiologia da amamentação. Resume a estrutura da mama, incluindo lobos, alvéolos e ductos, e explica os processos de mamogénese, mastogénese e lactogénese, que envolvem o desenvolvimento da mama durante a puberdade, gravidez e após o parto.
This document provides information on contraindications and conditions where breastfeeding may or may not be advised. It lists situations where breastfeeding is not recommended, such as if the baby has galactosemia or the mother has active untreated tuberculosis. It also outlines conditions where the benefits of breastfeeding outweigh the risks, such as if the mother is a hepatitis B carrier or smokes, as long as she takes certain precautions. The document is intended as a factsheet for GPs and pharmacists on breastfeeding recommendations.
This document provides information and advice for GPs and pharmacists on contraception options for breastfeeding women. It outlines that breastfeeding delays ovulation, so all contraceptives are less likely to fail if used consistently. It recommends immediate use of the lactational amenorrhoea method, IUDs, condoms, or female sterilization. Under 4 weeks, it recommends the progestogen-only pill, implant, or emergency contraception. From 4 weeks, it recommends IUDs or the LNG-IUS. From 6 weeks, it recommends the progestogen-only injectable, combined oral contraception, or diaphragms. It also discusses the lactational amenorrhoea method and progesterone-
Breastfeeding, Childhood Obesity And The Prevention Of Chronic Diseases
1. Breastfeeding Briefs
No. 38, 2004
Breastfeeding, Childhood Obesity and the Prevention of Chronic Diseases
After carefully reviewing the scientific evidence, the USA Centre for Disease Control and Prevention (CDC) con-
cluded that there are only two potential, cost-effective interventions that can be put into place immediately to deal
with the childhood obesity1 epidemic: decreased television viewing and breastfeeding promotion2. The purpose of
this editorial is to summarize the evidence linking breastfeeding with the prevention of childhood and adolescent
obesity, but first, it is important to say a few words about the relevance of breastfeeding promotion for the area of
chronic diseases in general.
Obesity has become a global pandemic and is a major risk factor for hypertension, heart disease, type 2 diabetes,
and several types of cancer. Thus, this condition is decimating the health care budgets of countries worldwide. In
the USA, the direct and indirect costs of obesity are estimated to be over US$100 billion per year as a result of
direct medical expenditures and lost productivity caused by chronic diseases. In Brazil, the prevalence of over-
weight in children increased from 4.1% to 13.9%3. If breastfeeding can really make a difference, the recent longer
duration (median around 10 months) found in Brazil4 might represent hope for a lower incidence of obesity. The
reason why it is crucial for obesity prevention interventions to start early on in life is that once a child becomes
obese, it is quite likely that s/he will remain obese as an adult.
Thus, breastfeeding represents a potentially ideal window of opportunity for obesity prevention. Dewey5 has recently
reviewed the literature on this topic and concluded that breastfeeding is likely to be associated with a reduction in
the risk of child obesity to a moderate extent. Dewey reviewed eleven observational studies with adequate sample
sizes and with children’s obesity data beyond 3 years of age. Only one of the studies was longitudinal and all were
conducted in industrialized nations in North America, Europe, Australia and New Zealand. Of these eleven studies,
eight showed an inverse relationship between breastfeeding and child obesity after controlling for potential con-
founders. The three studies where such an association was not documented lacked data as to the exclusivity of
breastfeeding. Since Dewey’s review was published, two additional studies have been printed with somewhat con-
tradictory results6, 7, but here again both studies lack a clear definition of what is considered to be exclusive breast-
feeding. These two studies highlight the need for doing more research in developing country populations and
among ethnic minorities in developed countries. Although much work remains to be done in this area, particularly in
regard to the need for well-designed, longitudinal studies that allow for a clear description of different breastfeeding
modalities, the preponderance of the epidemiological evidence strongly suggests a link between breastfeeding and
the prevention of obesity in the childhood and adolescent period.
However, because association does not prove causation, it is important to discuss the biological plausibility of these
findings. First, individuals who were breastfed have a leptin profile that may favour adequate appetite regulation and
less fat deposition. With regards to appetite regulation, Pérez-Escamilla et al.8 showed that Honduran babies ad-
justed their milk intake volume in an inverse proportion to the energy density of their mother’s breastmilk. It has also
been proposed that the reason that the milk fat content toward the end of the feeding episode (i.e.“hind milk”) is
higher than at the start of the episode (“fore milk”) is that it signals the baby that the feeding episode is coming to an
end. Obviously, formula-fed babies are not exposed to such “physiological signalling” as the fat concentration in for-
mula remains constant throughout the feeding episode. A corollary of this is that among formula-fed babies it is the
caretaker and not the infant who controls the child’s caloric intake. Second, breastfed babies gain less weight than
formula-fed infants during the first year of life. Third, formula-fed babies have higher insulin levels circulating in their
blood stream, as a result of the higher protein content in infant formula, which in turn may stimulate a higher deposi-
tion of fat stores. Fourth, it is possible that breastmilk influences the development of a taste receptors profile that
can foster a preference for lower energy diets later on in life.
1 Because of the psychosocial implications for children, some researchers in the USA use the term “overweight” instead of
“obesity” when referring to children. For the purpose of consistency and clarity, the term obesity is used throughout this edit-
orial. Usually, overweight and obesity are defined based on the BMI (Body Mass Index), calculated by dividing weight in kilo-
grammes by the square of height in metres. There is overweight when the BMI is between 25 and 29.9, obesity when it is 30
and over.
2
Dietz WH. Breastfeeding may help prevent childhood overweight. JAMA. 2001; 285:2506-7.
3
Wang, Y, Monteiro, C, Popkin, BM. Trends of obesity and underweight in older children and adolescents in the United States,
Brazil, China and Russia. AM J Clin Nutr 2002; 75:971-7.
4
Rea, MF. Reflexões sobre a amamentação no Brasil: de como passamos a 10 meses de duração. Cadernos de Saúde
Pública, R. Janeiro, 2003; 19:109-118.
5
Dewey KG. Is breastfeeding protective against child obesity? J Hum Lact. 2003;19:9-18.
6
Grummer-Strawn LM, Mei Z. Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the
Centres for Disease Control and Prevention Paediatric Nutrition Surveillance System. Pediatrics. 2004;113:e81-6.
7
Victora CG, Barros FC, Lima RC, Horta BL, Wells J. Anthropometry and body composition of 18-year-old men according to
duration of breastfeeding: a birth cohort study from Brazil. BMJ 2003:327:901-4.
8
Perez-Escamilla R, Cohen RJ, Brown KH, Rivera LL, Canahuati J, Dewey KG. Maternal anthropometrical status and lactation
performance in a low-income Honduran population: evidence for the role of infants. Am J Clin Nutr. 1995 61:528-34.
2. We are still far from having conclusive evidence regarding the biological mechanism(s) that may explain a link
between breastfeeding and the prevention of obesity. However, the high biological plausibility for this link
coupled with the preponderance of the epidemiological evidence gives us a lot of room for optimism that putting
resources into breastfeeding promotion indeed represents a major investment in the prevention of serious and
costly chronic diseases later on in life. Considering all these arguments, it is important to support implementation
of a strong WHO Global Strategy on Diet, Physical Activity and Health which puts public health rather than
profits in the centre-stage.
Breastfeeding why...
Obesity fed between 3 to 5 months, which is difficult to ex-
plain. The authors speculate about whether truly ex-
clusive breastfeeding would have resulted in a
Toschke AM, et al. Overweight and obesity in 6- to 14-
clearer pattern of association with obesity.
year-old Czech children in 1991: protective effect of breast-
feeding. J Pediatr 2002;141:764-9
Frye C, Heinrich J. Trends and predictors of overweight
In 1991, more than 33,000 Czech children aged and obesity in East German children. Int J Obes Relat Me-
6-14 years were studied in a cross sectional survey tab Disord 2003;27:963-9
to assess the impact of breastfeeding on childhood
overweight and obesity; 9.3% of them were never In three consecutive surveys performed in Eastern
breastfed. Among these, 12.4% were overweight Germany (1992-3; 1995-6 and 1998-9) with 5- to
and 4.4% obese, compared to 9.3% and 3.2% 14-year-old school children, more than 7,000 were
among the 30,641 ever breastfed. Longer duration assessed in order to analyze the trends in over-
of breastfeeding was associated with a significantly weight and obesity, according to selected factors. A
lower prevalence of overweight, but no effect was significant increase was shown for 11-14 y and for
seen for obesity. The fact that the baby’s intake var- 8-10 y, but not for the school entrants aged 5-7 y.
ies at each feed during breastfeeding, a lower en- Low-birth weight and higher parental education were
ergy density of human milk compared with formula protective factors against overweight and obesity,
milk, and thus a better self-control of food consump- while breastfeeding was protective only with regard
tion in breastfed children, are possible explanations to obesity. This effect was stronger if the children
for the observed effect of breastfeeding. were exclusively breastfed.
Parsons TJ, Power C, Manor O. Infant feeding and obesity
Grummer-Strawn LM, Mei Z. Does breastfeeding protect
through the lifecourse. Arch Dis Child 2003;88:793-4
against pediatric overweight? Analysis of longitudinal data
from the Centers for Diseases Control and Prevention Pe-
In another study all children born in England, Wales
diatric Nutrition Surveillance System. Pediatrics 2004;13:
and Scotland in 1958 were studied, with the result
e81-6
that, differently from the above article on Czech chil-
dren, no relationship was found between breastfeed-
Among a huge sample of children (177,304 up to 60
ing and BMI. Data were obtained for 98% of 17,733
months of age), the authors of this study examined
births. BMI was calculated from heights and weights,
whether increased duration of breastfeeding is
at 7, 11, 16 and 33 years. Breastfeeding was
associated with a lower risk of obesity in a low-
protective against increased BMI in females at ages
income American population. A statistical analysis
16 and 33 years, and in males at 33 years, but this
was performed controlling for gender, ethnicity, and
effect was reduced and no longer significant after
birth weight. For 12,587 children, data from
adjustment for confounding factors.
pregnancy were available also. The longer the
duration of breastfeeding beyond 6 months, the
Li L, Parsons TJ, Power C. Breastfeeding and obesity in higher the protective effect and the lower the risk of
childhood: cross-sectional study. BMJ 2003:327:904-5 overweight among non-Hispanic whites, but not
among Blacks or Hispanics. Breastfeeding for any
In a British study of 2,631 children - offspring born duration was also protective against underweight.
from the 1958 cohort described above - no protect-
ive effect of breastfeeding on obesity was found.
Adjustments for confounding factors - birth weight, Butte NF. The role of breastfeeding in obesity. Pediatr Clin
mother's smoking during pregnancy - did not alter North Amer 2001;48:189-98
these findings.
In a review of 18 studies, this author concludes that
the protective effect of breastfeeding on later obesity
Victora CG et al. Anthropometry and body composition of remains controversial. 12 studies found a non
18-year-old men according to duration of breastfeeding: a significant effect, while only 4 showed a protective
birth cohort study from Brazil. BMJ 2003;327:901-4 effect. Parental obesity continues to be the strongest
determinant for childhood obesity; this may be partly
2,250 18-year-old men of a relatively affluent Brazil– due to genetic factors (studies on twins and adopted
ian city were studied to look at the effect of breast- children had already provided estimates of genetic
feeding on several measures of adiposity, including contribution) and partly to shared dietary habits. This
BMI. They had been enrolled at birth in a large co- review confirms that childhood obesity is caused by
hort study. Neither the duration of total breastfeeding several factors; disentangling the effect of breast-
nor that of predominant breastfeeding showed signif- feeding is difficult and requires control of many
icant association with BMI. However, a significant confounding variables on which information is not
reduction in obesity was found among those breast- always available or complete.
3. Dewey KG. Is breastfeeding protective against child were never breastfed, after controlling for age, sex,
obesity? J Human Lact 2003;19:9-18 room temperature and field observer. Overall, there
was a 0.2 mm Hg reduction in systolic blood
The author reviews the different studies published pressure for each 3 months of any breastfeeding.
up to 2003 that investigate childhood obesity and The importance of this study is that it took place
breastfeeding. She concludes that to understand the during the 1990s, when infant formula contained
relationship, it is necessary to know how to control less salt than formula manufactured earlier. Even so,
as many confounding variables as possible; but calls children fed infant formula compared to those
attention on the difficulty to control: 1) child-feeding breastfed presented higher blood pressure. One
practices and parental control over feeding, and 2) explanation is the higher sodium content of infant
physical activity. Breastfeeding might reduce child formula. The authors also discuss the implications of
overweight by metabolic programming in early life, this small reduction: lower systolic pressure in 1% of
but this has to be studied in more depth. the population is associated with approximately
1.5% reduction in all-cause mortality.
High blood pressure
Cholesterol
Owen CG, Whincup PH, Gilg JA, Cook DG. Effect of breast
feeding in infancy on blood pressure in later life: systematic Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG. Infant
review and meta-analysis. BMJ 2003;327:1189-95 feeding and blood cholesterol: a study in adolescents and a
systematic review. Pediatrics 2002;110:597-608
The association between infant feeding and blood
pressure in later life is controversial. A systematic The authors examined the influence of infant feeding
review of 25 studies concludes that the selective methods on total serum cholesterol (TC) and low-
publication of small studies with positive findings density lipoprotein (LDL) cholesterol, both associat-
may have exaggerated claims that breastfeeding in ed with high incidence of coronary heart disease and
infancy reduces blood pressure in later life. The re- arteriosclerosis. They conducted a cross-sectional
sults of larger studies suggest that feeding in infancy study of 13-to 16-year-olds and reviewed a number
has, at most, a modest effect on systolic blood pres- of observational studies on the effects of infant feed-
sure, of limited clinical or public health importance, ing on cholesterol in infancy (<1 year), childhood/
and no effect on diastolic blood pressure. adolescence (1-16 years), and adulthood (17 years
or over). 1,532 individuals (92% white; 55% male;
mean age: 15.1 years) in ten British towns were
Singhal A, Cole TJ, Lucas A. Early nutrition in pre-term examined; and 37 studies with 52 observations on
infants and later blood pressure: two cohorts after TC/LDL (26/7 in infancy, 17/4 in childhood or
randomised trials. Lancet 2001;357:413-9 adolescence, and 9/6 in adulthood) were reviewed.
The results show that breastfeeding is associated
Consumption of human milk has been shown to with increased mean TC and LDL levels in infancy,
have many benefits for infants - both pre-term and but lower levels in adulthood. These results suggest
full term - including a reduced risk of necrotizing en- that breastfeeding may have long-term benefits for
terocolitis, atopy, infections and improved later cardiovascular health.
cognitive development. The hypothesis that
consumption of human milk also may lower blood
pressure is supported by this randomised trial and Singhal A, Cole TJ, Fewtrell M, Lucas A. Breastmilk feed-
by two other studies. Both mean and diastolic blood ing and lipoprotein profile in adolescents born pre-term:
pressures were lower comparing infants fed donated follow-up of a prospective randomised study. Lancet
human milk with those fed pre-term formula. Even 2004;363:1571-8
among those babies whose mothers decided to pro-
vide breastmilk in addition to the assigned formula Breastfeeding is associated with reduced cholesterol
diet, diastolic, systolic and mean blood pressure concentration later in life, but previous studies have
were lower. Further investigation may elucidate not used random assignment of infant diet with pro-
mechanisms for early life nutritional programming spective follow-up. This study did so in 926 infants
leading to low or high blood pressure. born pre-term and randomly assigned to receive do-
nated banked breastmilk or pre-term formula in one
trial, or standard term formula or pre-term formula in
Martin RM, Ness AR, Gunnell D, Emmett P, Smith GD. a second trial, as sole diet or as supplement to
Does breastfeeding in infancy lower blood pressure in mother's milk in both trials. 216 participants were
childhood? The Avon Longitudinal study of parents and followed up to age 13-16 years. Adolescents who
children (ALSPAC). Circulation 2004;109:1259-66 had been randomised to banked breastmilk had a
lower C-reactive protein (CRP, a measure of the
Breastfeeding was associated with lower systolic inflammatory process associated with arteriosclero-
blood pressure at 7 years in a study done with more sis) and LDL to HDL (high density lipoprotein,
than 7,000 UK children. Of all mothers, 83% report- associated with a lower risk of heart disease) ratio
ed having ever breastfed and 34% reported exclus- than those given pre-term formula. A greater propor-
ive breastfeeding beyond 2 months (although some tion of human milk intake in infancy was associated
water might be included in this definition, it was res- with lower ratios of LDL to HDL and of other lipopro-
trictive for all other liquids besides breastmilk). Of teins associated with heart disease, independent of
those who breastfed, 49% did so for 6 months. The gestation and potential confounding factors. The
systolic and diastolic blood pressures of breastfed authors conclude that their data provide experiment-
children were 1.2 mm Hg lower and 0.9 mm Hg al evidence for the long-term benefits of breastmilk
lower, respectively, compared with children who feeding on the risk of arteriosclerosis.
4. Diabetes city of Embu, near São Paulo. Constipation was
found in 25% of them; the prevalence was higher
Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E. between 6 and 24 months (39%) than in the first 6
Early infant feeding and risk of developing type 1 diabetes- months (15%). The statistical analysis demonstrated
associated autoantibodies. JAMA 2003;290:1721-8 that formula-fed infants were 4.5 times more liable to
develop constipation than infants who were predom-
To determine whether breastfeeding duration, food inantly breastfed. The daily dietary fiber intake was
supplementation, or age at introduction of gluten- similar among the constipated and non-constipated
containing foods influence the risk of developing infants. Constipation was defined by the elimination
auto-antibodies against islet (the insulin-producing of hard stool associated with one of the following:
tissue of the pancreas), a study of 1,610 children painful or difficult defecation, hard or round cracked
was conducted from 1989 to 2003 in inpatient/ stools and less than three defecations a week.
outpatient clinics in Germany. Blood samples were
obtained at birth, age 9 months, 2, 5, and 8 years.
Dropout rate was 14.4% by the age of 5 years. Andiran F, Dayi S, Mete E. Cows milk consumption in
Breastfeeding data were obtained by questionnaires, constipation and anal fissure in infants and young children.
and food supplementation data by family interview. J Paediatr Child Health 2003;39:329-31
Life-table islet auto-antibody frequency was 5.8% by
the age of 5. Reduced total or exclusive breastfeed- This study confirms the above findings using a
ing duration did not significantly increase the risk of different research design. 30 infants and young
developing islet auto-antibodies. Food supplementa- children aged 4 months to 3 years with chronic
tion with gluten-containing foods before the age of 3 constipation and anal fissure (surgical causes were
months, however, was associated with a significant, excluded) were compared with 30 children in the
four-fold increase in islet auto-antibody risk. Children same age range with normal bowel habits. The
who first received gluten-containing foods after the mean daily consumption of cow’s milk was signif-
age of 6 months did not have increased risks for islet icantly higher in the former (756 ml, range 200-1500)
or celiac disease (a severe lifelong disease due to than in the latter group (253 ml, range 0-1000).
gluten intolerance) auto-antibodies. The authors Children with chronic constipation and anal fissure
conclude that ensuring compliance to WHO infant were breastfed for a significantly shorter period (5.8
feeding guidelines is a possible way to reduce the months, range 0-18) than the other children (10.1
risk of developing type 1 diabetes auto-antibodies. months, range 2-24).
Sadauskaite-Kuehne V, et al. Longer breastfeeding is an Breastfeeding how
independent protective factor against development of type
1 diabetes mellitus in childhood. Diabetes Metab Res Rev Rea MF. Rethinking breastfeeding in Brazil: how we have
2004;20:150-7 reached 10 months of duration. Cad Saúde Pública
Is early nutrition a risk factor for diabetes? A case- 2003;19 suppl.1:37-45
control study was carried out in Sweden on 517
children and in Lithuania on 286 children 0 to 15 In 1975, only one out of two Brazilian women breast-
years old with newly diagnosed type 1 diabetes fed until the 2nd or 3rd month; however, in 1999, a
mellitus, a type of that starts in childhood. The study survey indicated that one out of two Brazilian moth-
included three age- and sex-matched health con- ers breastfed for 10 months. This increase over the
trols. In Sweden, exclusive breastfeeding longer course of 25 years can be viewed as a success.
than 5 months (longer than 2 months in Lithuania), However, many activities could be better organized,
total breastfeeding longer than 7 or 9 months, and coordinated and corrected when errors occur. Var-
breastfeeding substitution later than the 3rd month ious relevant decisions have been made by internat-
were shown to be protective against diabetes when ional health agencies during this period, in addition
adjusted for all other factors. The authors advise that to studies on breastfeeding that have reoriented
postponing introduction of breast-milk substitutes practice. The study reviews the history of the Brazil-
might protect children from type 1 diabetes. ian national programme to promote breastfeeding,
focusing on an analysis of the influence of internat-
ional policies during four periods: 1975-1981 (when
Constipation little was done), 1981-1986 (media campaigns),
1986-1996 (breastfeeding-friendly policies), and
Aguirre AN, Vitolo MR, Puccini RF, de Morais MB. Constip- 1996-2002 (planning and human resources training
ation in infants: influence of type of feeding and dietary activities backed by policies to protect breastfeed-
fiber intake. J Pediatr (Rio J) 2002;78:202-8 ing). One challenge for the future is to continue to
promote exclusive breastfeeding for 6 months, tak-
Breastfeeding may be a protective factor against ing specific population groups into account. Another
constipation in the first 6 months of life. This is the challenge is to prevent future deaths from both infect-
conclusion drawn after a study of 275 infants conse- ious diseases and non-communicable diseases by
cutively enrolled in two primary care clinics in the further improving breastfeeding rates and duration.
Prepared by the Geneva Infant Feeding Association (GIFA), a member of the
International Baby Food Action Network (IBFAN).
Editors: Marina Ferreira Rea, Adriano Cattaneo. Robert Peck and Elaine Petitat-Côté revised and edited the text. Editorial:
Rafael Perez-Escamilla. For copies of Breastfeeding Briefs please make request to GIFA, Av. de la Paix 11, 1202 Geneva,
Switzerland. Fax: +41-22-798 44 43, e-mail: info@gifa.org, or to UNICEF country offices. Available also in French, Spanish,
Portuguese and Arabic. A contribution of CHF 20.-- for a subscription to organisations in industrialised countries
is gratefully accepted and can be sent by international postal order to account no. 12-17653-5