This document summarizes a study that investigated the relationship between the timing of breastfeeding initiation and neonatal mortality in Ghana. The study found that initiating breastfeeding within the first day of life reduced the risk of neonatal death, with even earlier initiation (within the first hour) further reducing risk. Delaying breastfeeding initiation beyond 1 day increased the risk of neonatal death. The study suggests that promoting early breastfeeding initiation could significantly reduce neonatal mortality rates in sub-Saharan Africa.
The Effects Of Early Pacifier Use On Breastfeeding DurationBiblioteca Virtual
This study examined the effects of pacifier use on breastfeeding duration in a cohort of 265 breastfeeding mother-infant dyads in the United States. The researchers found that:
1) Pacifier introduction by 6 weeks was associated with a 53% increased risk of shortened duration of full breastfeeding and a 61% increased risk of shortened overall breastfeeding duration.
2) Mothers who introduced pacifiers tended to breastfeed less frequently, with statistically significant differences at 2 and 12 weeks.
3) At 12 weeks, mothers using pacifiers were more likely to report breastfeeding being inconvenient and having insufficient milk supply.
4) Pacifier use begun before 2 weeks or 6 weeks was not significantly associated
This study analyzed data from over 15,000 infants in the UK Millennium Cohort Study to examine the relationship between breastfeeding and hospitalization for diarrhea and respiratory infections in the first 8 months of life. The results showed that exclusive breastfeeding, compared to no breastfeeding, was associated with a lower risk of hospitalization for both diarrhea and respiratory infections after adjusting for various confounding factors. Partial breastfeeding also showed a protective effect, but it was weaker than exclusive breastfeeding. The protective effects of breastfeeding decreased after breastfeeding cessation. The study suggests that increased rates of exclusive and prolonged breastfeeding could significantly reduce hospitalizations in the UK.
Breastfeeding Patterns In Relation To Thumb Sucking And Pacifier UseBiblioteca Virtual
This document describes a study examining the relationship between breastfeeding patterns, thumb sucking, and pacifier use in 506 mother-infant pairs in Sweden. The study found that pacifier use was associated with fewer breastfeeds per 24 hours, shorter suckling duration, shorter exclusive breastfeeding duration, and shorter total breastfeeding duration compared to no pacifier use. These associations were not found for thumb sucking. The negative effects of pacifiers on breastfeeding seemed related to frequency of pacifier use.
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.
The Timing And Predictors Of The Early Termination Of BreastfeedingBiblioteca Virtual
This study examined the early termination of breastfeeding among low-income mothers enrolled in the Women, Infants, and Children (WIC) program. The researchers found that over 70% of mothers stopped breastfeeding within the first 2 months. Through interviews, the researchers identified a lack of confidence in continuing to breastfeed at 2 months and a belief that the baby prefers formula as predictors of stopping breastfeeding within the first 2 weeks. The results suggest interventions should focus on boosting mothers' confidence in breastfeeding rather than only providing information.
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 study examined predictors of breastfeeding duration in Australia by following 587 women from hospital discharge through 52 weeks postpartum. The researchers found that less than half of infants were receiving any breast milk at 6 months, and only 12% were exclusively breastfed. By 12 months, only 19.2% received any breast milk. Factors positively associated with longer breastfeeding duration included higher maternal infant feeding attitudes and negatively associated factors included breastfeeding difficulties in the first 4 weeks, maternal smoking, early pacifier introduction, and early return to work. Relatively few women achieved international breastfeeding recommendations.
Professor Sharon Ricardo of Monash University is researching a novel therapy using colony stimulating factor 1 (CSF-1) to promote organ growth and maturation in premature infants and those with intrauterine growth restriction. Her research was inspired by findings that CSF-1 can promote postnatal organ development. She plans to test CSF-1's effects on lung development and maturation using a newborn lamb model of intrauterine growth restriction that mimics the underdeveloped lungs seen in similarly growth-restricted human infants. If results are positive, she hopes to advance the therapy to clinical trials as CSF-1 has shown safety in previous adult trials. The research aims to develop a treatment for the health complications commonly experienced by premature infants.
The Effects Of Early Pacifier Use On Breastfeeding DurationBiblioteca Virtual
This study examined the effects of pacifier use on breastfeeding duration in a cohort of 265 breastfeeding mother-infant dyads in the United States. The researchers found that:
1) Pacifier introduction by 6 weeks was associated with a 53% increased risk of shortened duration of full breastfeeding and a 61% increased risk of shortened overall breastfeeding duration.
2) Mothers who introduced pacifiers tended to breastfeed less frequently, with statistically significant differences at 2 and 12 weeks.
3) At 12 weeks, mothers using pacifiers were more likely to report breastfeeding being inconvenient and having insufficient milk supply.
4) Pacifier use begun before 2 weeks or 6 weeks was not significantly associated
This study analyzed data from over 15,000 infants in the UK Millennium Cohort Study to examine the relationship between breastfeeding and hospitalization for diarrhea and respiratory infections in the first 8 months of life. The results showed that exclusive breastfeeding, compared to no breastfeeding, was associated with a lower risk of hospitalization for both diarrhea and respiratory infections after adjusting for various confounding factors. Partial breastfeeding also showed a protective effect, but it was weaker than exclusive breastfeeding. The protective effects of breastfeeding decreased after breastfeeding cessation. The study suggests that increased rates of exclusive and prolonged breastfeeding could significantly reduce hospitalizations in the UK.
Breastfeeding Patterns In Relation To Thumb Sucking And Pacifier UseBiblioteca Virtual
This document describes a study examining the relationship between breastfeeding patterns, thumb sucking, and pacifier use in 506 mother-infant pairs in Sweden. The study found that pacifier use was associated with fewer breastfeeds per 24 hours, shorter suckling duration, shorter exclusive breastfeeding duration, and shorter total breastfeeding duration compared to no pacifier use. These associations were not found for thumb sucking. The negative effects of pacifiers on breastfeeding seemed related to frequency of pacifier use.
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.
The Timing And Predictors Of The Early Termination Of BreastfeedingBiblioteca Virtual
This study examined the early termination of breastfeeding among low-income mothers enrolled in the Women, Infants, and Children (WIC) program. The researchers found that over 70% of mothers stopped breastfeeding within the first 2 months. Through interviews, the researchers identified a lack of confidence in continuing to breastfeed at 2 months and a belief that the baby prefers formula as predictors of stopping breastfeeding within the first 2 weeks. The results suggest interventions should focus on boosting mothers' confidence in breastfeeding rather than only providing information.
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 study examined predictors of breastfeeding duration in Australia by following 587 women from hospital discharge through 52 weeks postpartum. The researchers found that less than half of infants were receiving any breast milk at 6 months, and only 12% were exclusively breastfed. By 12 months, only 19.2% received any breast milk. Factors positively associated with longer breastfeeding duration included higher maternal infant feeding attitudes and negatively associated factors included breastfeeding difficulties in the first 4 weeks, maternal smoking, early pacifier introduction, and early return to work. Relatively few women achieved international breastfeeding recommendations.
Professor Sharon Ricardo of Monash University is researching a novel therapy using colony stimulating factor 1 (CSF-1) to promote organ growth and maturation in premature infants and those with intrauterine growth restriction. Her research was inspired by findings that CSF-1 can promote postnatal organ development. She plans to test CSF-1's effects on lung development and maturation using a newborn lamb model of intrauterine growth restriction that mimics the underdeveloped lungs seen in similarly growth-restricted human infants. If results are positive, she hopes to advance the therapy to clinical trials as CSF-1 has shown safety in previous adult trials. The research aims to develop a treatment for the health complications commonly experienced by premature infants.
Isotretinoin is a novel treatment for severe, recalcitrant nodular acne sold under the brand names Accutane®, Amnesteem®, Claravis®, and Sotret®. It is the most widely used teratogenic drug in the United States. From a population based perspective, women and men use the drug in near equal proportions but the risks are exponentially greater for women of childbearing years. Serious developmental abnormalities have displayed a high tendency to occur in clusters in fetuses exposed to isotretinoin. This review of medical literature focuses on the public health implications of isotretinoin use and develops a case for continued risk management. Reduction of fetal isotretinoin exposure is contingent upon effective programming and continued adherence to strict standards.
1) In vitro fertilisation (IVF) is a technique where eggs are fertilised by sperm outside the body in a laboratory. Since the first successful IVF in 1978, millions of babies have been born through IVF worldwide.
2) Advances in IVF include techniques like gamete intrafallopian transfer and polar body diagnosis. Researchers are also exploring in vitro gametogenesis to produce gametes from stem cells for infertility treatment or same-sex couples.
3) While IVF has helped many couples conceive, it also carries risks like multiple births, preterm delivery, and ovarian hyperstimulation syndrome. Success rates have improved over time but depend on factors like a woman's age and the clinic's
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
Oral probiotics reduce the incidence and severity of necrotizingmarlonluisf
This study evaluated the effectiveness of probiotics in reducing necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. 367 VLBW infants were randomly assigned to receive breast milk with the probiotics Lactobacillus acidophilus and Bifidobacterium infantis or breast milk alone. The probiotic group had a significantly lower incidence of NEC and death compared to the control group. No adverse effects from the probiotics were observed. The probiotics were effective in reducing the incidence and severity of NEC in VLBW infants when administered with breast milk.
Newborn survival and perinatal health in resource-constrained settings in Asia and the Pacific: Applying Global Evidence to Priorities Beyond 2015
12 April 2013
WOMEN AND IMMUNISATION PROMOTING ADOLESCENT / ADULT WOMEN IMMUNIZATION DR....Lifecare Centre
This document discusses promoting immunization for women and adolescent/adult women. It notes that missed opportunities to vaccinate occur in an estimated 30% of children and women globally. For vaccinating women, emphasis should be placed on health worker knowledge, access and availability of vaccine services, cost and service quality, and using all opportunities. Guidelines are provided for vaccinating pregnant women and breastfeeding women against various diseases. Specific vaccines discussed include chickenpox, MMR, and HPV vaccines. Recommendations are given for vaccination schedules and the importance of immunizing women is emphasized.
Phenobarbital uses in a Maternal-fetal infections : A case reportAxlerJEANPAUL
Maternal-fetal infections (MFIs) are important causes of morbi-mortality in neonatal units. According to the French Society of Neonatology in the 2017 version of its recommendations the care should be provided by a complete physical examination; and probabilistic antibiotic therapy with beta-lactam antibiotics and aminoglycosides, but never Phenobarbital.During our pediatric internship at the State University Hospital of Haiti (HUEH), we have noticed Phenobarbital is administered to newborns suspected with MFIs; we aim to draw attention to the indications of Phenobarbital in newborns through this case report and review literature study realize at the neonatal unit of the pediatric department of the State University Hospital of Haiti.
This document discusses post-term pregnancy, which is defined as a pregnancy exceeding 294 days or 42 weeks. The risks of post-term pregnancy include increased perinatal mortality and morbidity. Specifically, studies have shown that the risks of stillbirth, neonatal death, and postneonatal death increase starting at 41-42 weeks gestation. Additional risks include longer labor, increased need for interventions like forceps delivery or C-section, and birth injuries. While the risks are small, prolonged pregnancy beyond 42 weeks requires careful surveillance due to the established fetal risks.
Do Baby Friendly Hospitals Influence Breastfeeding Duration On ABiblioteca Virtual
This study examined the influence of Baby-Friendly Hospital Initiative (BFHI) compliance on breastfeeding rates and duration in Switzerland. The authors conducted a national survey in 2003 of over 2800 mothers who had given birth in the previous 9 months. They collected data on breastfeeding practices and the hospital of delivery. They found that infants born in hospitals with high BFHI compliance had significantly longer durations of exclusive, full, and any breastfeeding compared to other hospitals, even after controlling for other factors. This supports the hypothesis that increased BFHI implementation in Switzerland has contributed to improved national breastfeeding outcomes since 1994. However, the authors note mothers choosing BFHI hospitals may also breastfeed longer regardless of the hospital practices.
Impact of neonatal nurses’ guidelines on improving their knowledgeAlexander Decker
The document discusses a study that evaluated the impact of guidelines on neonatal nurses' knowledge, attitudes, and practices regarding kangaroo mother care. The study found that the guidelines improved nurses' knowledge and practices in supporting kangaroo mother care, which facilitates parent-infant bonding. Kangaroo mother care involves skin-to-skin contact between a parent and premature infant and provides physiological and developmental benefits. While nurses saw benefits, some had concerns about safety and workload that could influence implementation of kangaroo mother care practices. Education is important for nurses to gain knowledge and skills in facilitating kangaroo mother care, but changing attitudes is also important for improving adoption of related practices.
Breastfeeding in Women with Covid19 infection-Expert group meeting for develo...Niranjan Chavan
Breastfeeding in Women with Covid19 infection-Expert group meeting for development of standard treatment protocols for clinical management of covid- 19 complicating pregnancy at New Delhi 8th December 2021
Safety issues in assisted reproduction technology Safety issues in assisted...MedicineAndHealth14
The document discusses safety issues related to assisted reproduction technologies (ARTs) such as in vitro fertilization (IVF). It finds that both multiple pregnancies and singleton pregnancies resulting from ARTs are associated with increased health risks for children compared to naturally conceived pregnancies. Multiple pregnancies face risks such as prematurity, growth restriction, and low birth weight. Singleton pregnancies from ARTs also show increased risks of cerebral palsy, preterm birth, and low birth weight compared to singletons conceived without ARTs. The causes of safety issues in both multiple and singleton pregnancies resulting from ARTs require further study. Medical guidelines recommend aiming to minimize health risks by promoting singleton pregnancies through practices like elective single embryo transfer
This document summarizes a study from the 1940s-1950s that investigated the use of diethylstilbestrol (DES) to prevent miscarriages and complications in pregnancy. The study was conducted at Harvard, Tulane, and the University of Chicago and was found to be unethical as it did not obtain informed consent from participants, exposed women to unnecessary harm, and violated principles of voluntary participation and self-determination. While the data should be used cautiously, the study overall should not have been conducted due to the ethical violations and long term health risks it posed.
This study compared the effectiveness of rectal enemas versus high doses of oral polyethylene glycol (PEG) for treating rectal fecal impaction in children with constipation. Ninety children were randomly assigned to receive either daily enemas or 1.5 g/kg per day of PEG for 6 days. Both treatments were equally effective in removing the fecal impaction, with success rates of 80% for enemas and 68% for PEG. However, PEG caused more frequent fecal incontinence and watery stools compared to enemas. The treatments improved colonic transit time equally and had comparable effects on behavior. The study concluded that enemas and PEG can be considered equally
This study compared the effectiveness of three umbilical cord care regimens (alcohol, natural drying, and salicylic sugar powder) on 143 neonates in Taiwan. They found that the salicylic sugar powder group had the lowest rates of umbilical cord colonization by bacteria and the shortest cord separation time, averaging 6.8 days, compared to the natural drying and alcohol groups. No cases of omphalitis (umbilical cord infection) occurred with any of the three regimens. The study suggests that natural drying and salicylic sugar powder are safe and effective options for umbilical cord care in high-humidity regions like Taiwan.
Safety Of the Influenza vaccine In pregnancy Lifecare Centre
Dr. Sharda jain,Life care centre
Safety of Inactivated Influenza Vaccines – WHO –SAGE position paper ,
The study found no evidence of increased RR or HR for
Major birth defects,
spontaneous abortion, or
Small for gestational age infants in pregnant women vaccinated with trivalent or monovalent influenza vaccine .
Dr. Sunita Chandra, Chairperson & Director-Rajendra Nagar Hospital & IVF Centre and Mopheus Lucknow Fertility Centre gave the talk on IVF PREGNANCY at webinar on March 27,2021
Influence Of Sorne Food Additives On Igg Plasma Concentrations In Newborn Cal...Biblioteca Virtual
This document describes a study that tested the influence of three food additives on the absorption of immunoglobulins extracted from colostrum by newborn calves. Fifty calves were divided into five groups, with one group receiving colostrum and the other four receiving an immunoglobulin solution extracted from colostrum, with or without additives. The additives tested were isobutyric acid, caseino-macropeptide, and a freeze dried colostrum extract. The study found that immunoglobulins extracted from colostrum were poorly absorbed compared to the control group that received colostrum. The additives were also unable to improve absorption of the immunoglobulins from the extracted
Danielle receives a call from her brother Oliver who has gotten himself into trouble. He has fathered 14 children with 12 different women from his time in college. Danielle goes to Oliver's house and counts the many children running around. She learns that the mothers have all dropped the children off to live with Oliver so that he has to pay $3,500 a week in child support. Danielle tells Oliver he needs to get a better job to support his large family.
Isotretinoin is a novel treatment for severe, recalcitrant nodular acne sold under the brand names Accutane®, Amnesteem®, Claravis®, and Sotret®. It is the most widely used teratogenic drug in the United States. From a population based perspective, women and men use the drug in near equal proportions but the risks are exponentially greater for women of childbearing years. Serious developmental abnormalities have displayed a high tendency to occur in clusters in fetuses exposed to isotretinoin. This review of medical literature focuses on the public health implications of isotretinoin use and develops a case for continued risk management. Reduction of fetal isotretinoin exposure is contingent upon effective programming and continued adherence to strict standards.
1) In vitro fertilisation (IVF) is a technique where eggs are fertilised by sperm outside the body in a laboratory. Since the first successful IVF in 1978, millions of babies have been born through IVF worldwide.
2) Advances in IVF include techniques like gamete intrafallopian transfer and polar body diagnosis. Researchers are also exploring in vitro gametogenesis to produce gametes from stem cells for infertility treatment or same-sex couples.
3) While IVF has helped many couples conceive, it also carries risks like multiple births, preterm delivery, and ovarian hyperstimulation syndrome. Success rates have improved over time but depend on factors like a woman's age and the clinic's
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
Oral probiotics reduce the incidence and severity of necrotizingmarlonluisf
This study evaluated the effectiveness of probiotics in reducing necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. 367 VLBW infants were randomly assigned to receive breast milk with the probiotics Lactobacillus acidophilus and Bifidobacterium infantis or breast milk alone. The probiotic group had a significantly lower incidence of NEC and death compared to the control group. No adverse effects from the probiotics were observed. The probiotics were effective in reducing the incidence and severity of NEC in VLBW infants when administered with breast milk.
Newborn survival and perinatal health in resource-constrained settings in Asia and the Pacific: Applying Global Evidence to Priorities Beyond 2015
12 April 2013
WOMEN AND IMMUNISATION PROMOTING ADOLESCENT / ADULT WOMEN IMMUNIZATION DR....Lifecare Centre
This document discusses promoting immunization for women and adolescent/adult women. It notes that missed opportunities to vaccinate occur in an estimated 30% of children and women globally. For vaccinating women, emphasis should be placed on health worker knowledge, access and availability of vaccine services, cost and service quality, and using all opportunities. Guidelines are provided for vaccinating pregnant women and breastfeeding women against various diseases. Specific vaccines discussed include chickenpox, MMR, and HPV vaccines. Recommendations are given for vaccination schedules and the importance of immunizing women is emphasized.
Phenobarbital uses in a Maternal-fetal infections : A case reportAxlerJEANPAUL
Maternal-fetal infections (MFIs) are important causes of morbi-mortality in neonatal units. According to the French Society of Neonatology in the 2017 version of its recommendations the care should be provided by a complete physical examination; and probabilistic antibiotic therapy with beta-lactam antibiotics and aminoglycosides, but never Phenobarbital.During our pediatric internship at the State University Hospital of Haiti (HUEH), we have noticed Phenobarbital is administered to newborns suspected with MFIs; we aim to draw attention to the indications of Phenobarbital in newborns through this case report and review literature study realize at the neonatal unit of the pediatric department of the State University Hospital of Haiti.
This document discusses post-term pregnancy, which is defined as a pregnancy exceeding 294 days or 42 weeks. The risks of post-term pregnancy include increased perinatal mortality and morbidity. Specifically, studies have shown that the risks of stillbirth, neonatal death, and postneonatal death increase starting at 41-42 weeks gestation. Additional risks include longer labor, increased need for interventions like forceps delivery or C-section, and birth injuries. While the risks are small, prolonged pregnancy beyond 42 weeks requires careful surveillance due to the established fetal risks.
Do Baby Friendly Hospitals Influence Breastfeeding Duration On ABiblioteca Virtual
This study examined the influence of Baby-Friendly Hospital Initiative (BFHI) compliance on breastfeeding rates and duration in Switzerland. The authors conducted a national survey in 2003 of over 2800 mothers who had given birth in the previous 9 months. They collected data on breastfeeding practices and the hospital of delivery. They found that infants born in hospitals with high BFHI compliance had significantly longer durations of exclusive, full, and any breastfeeding compared to other hospitals, even after controlling for other factors. This supports the hypothesis that increased BFHI implementation in Switzerland has contributed to improved national breastfeeding outcomes since 1994. However, the authors note mothers choosing BFHI hospitals may also breastfeed longer regardless of the hospital practices.
Impact of neonatal nurses’ guidelines on improving their knowledgeAlexander Decker
The document discusses a study that evaluated the impact of guidelines on neonatal nurses' knowledge, attitudes, and practices regarding kangaroo mother care. The study found that the guidelines improved nurses' knowledge and practices in supporting kangaroo mother care, which facilitates parent-infant bonding. Kangaroo mother care involves skin-to-skin contact between a parent and premature infant and provides physiological and developmental benefits. While nurses saw benefits, some had concerns about safety and workload that could influence implementation of kangaroo mother care practices. Education is important for nurses to gain knowledge and skills in facilitating kangaroo mother care, but changing attitudes is also important for improving adoption of related practices.
Breastfeeding in Women with Covid19 infection-Expert group meeting for develo...Niranjan Chavan
Breastfeeding in Women with Covid19 infection-Expert group meeting for development of standard treatment protocols for clinical management of covid- 19 complicating pregnancy at New Delhi 8th December 2021
Safety issues in assisted reproduction technology Safety issues in assisted...MedicineAndHealth14
The document discusses safety issues related to assisted reproduction technologies (ARTs) such as in vitro fertilization (IVF). It finds that both multiple pregnancies and singleton pregnancies resulting from ARTs are associated with increased health risks for children compared to naturally conceived pregnancies. Multiple pregnancies face risks such as prematurity, growth restriction, and low birth weight. Singleton pregnancies from ARTs also show increased risks of cerebral palsy, preterm birth, and low birth weight compared to singletons conceived without ARTs. The causes of safety issues in both multiple and singleton pregnancies resulting from ARTs require further study. Medical guidelines recommend aiming to minimize health risks by promoting singleton pregnancies through practices like elective single embryo transfer
This document summarizes a study from the 1940s-1950s that investigated the use of diethylstilbestrol (DES) to prevent miscarriages and complications in pregnancy. The study was conducted at Harvard, Tulane, and the University of Chicago and was found to be unethical as it did not obtain informed consent from participants, exposed women to unnecessary harm, and violated principles of voluntary participation and self-determination. While the data should be used cautiously, the study overall should not have been conducted due to the ethical violations and long term health risks it posed.
This study compared the effectiveness of rectal enemas versus high doses of oral polyethylene glycol (PEG) for treating rectal fecal impaction in children with constipation. Ninety children were randomly assigned to receive either daily enemas or 1.5 g/kg per day of PEG for 6 days. Both treatments were equally effective in removing the fecal impaction, with success rates of 80% for enemas and 68% for PEG. However, PEG caused more frequent fecal incontinence and watery stools compared to enemas. The treatments improved colonic transit time equally and had comparable effects on behavior. The study concluded that enemas and PEG can be considered equally
This study compared the effectiveness of three umbilical cord care regimens (alcohol, natural drying, and salicylic sugar powder) on 143 neonates in Taiwan. They found that the salicylic sugar powder group had the lowest rates of umbilical cord colonization by bacteria and the shortest cord separation time, averaging 6.8 days, compared to the natural drying and alcohol groups. No cases of omphalitis (umbilical cord infection) occurred with any of the three regimens. The study suggests that natural drying and salicylic sugar powder are safe and effective options for umbilical cord care in high-humidity regions like Taiwan.
Safety Of the Influenza vaccine In pregnancy Lifecare Centre
Dr. Sharda jain,Life care centre
Safety of Inactivated Influenza Vaccines – WHO –SAGE position paper ,
The study found no evidence of increased RR or HR for
Major birth defects,
spontaneous abortion, or
Small for gestational age infants in pregnant women vaccinated with trivalent or monovalent influenza vaccine .
Dr. Sunita Chandra, Chairperson & Director-Rajendra Nagar Hospital & IVF Centre and Mopheus Lucknow Fertility Centre gave the talk on IVF PREGNANCY at webinar on March 27,2021
Influence Of Sorne Food Additives On Igg Plasma Concentrations In Newborn Cal...Biblioteca Virtual
This document describes a study that tested the influence of three food additives on the absorption of immunoglobulins extracted from colostrum by newborn calves. Fifty calves were divided into five groups, with one group receiving colostrum and the other four receiving an immunoglobulin solution extracted from colostrum, with or without additives. The additives tested were isobutyric acid, caseino-macropeptide, and a freeze dried colostrum extract. The study found that immunoglobulins extracted from colostrum were poorly absorbed compared to the control group that received colostrum. The additives were also unable to improve absorption of the immunoglobulins from the extracted
Danielle receives a call from her brother Oliver who has gotten himself into trouble. He has fathered 14 children with 12 different women from his time in college. Danielle goes to Oliver's house and counts the many children running around. She learns that the mothers have all dropped the children off to live with Oliver so that he has to pay $3,500 a week in child support. Danielle tells Oliver he needs to get a better job to support his large family.
This document introduces the 5 Strands + 1 Model for modeling ICHK students. The 5 strands are: Mindset, Learning Zone, Psychosocial Development, Cognitive Disposition, and Interpersonal Relationships. Each strand draws from theories in educational psychology. Mindset refers to Carol Dweck's theory of fixed vs. growth mindsets. Learning Zone draws on Vygotsky's zone of proximal development. Psychosocial Development relates to Erik Erikson's stages of development. Cognitive Disposition comes from Egan's zones of understanding. Interpersonal Relationships is informed by Berne's PAC model and scripts. The model aims to provide a holistic understanding of students by considering their development across these interconnected dimensions.
This document provides background on the Azure legacy and updates on recent events. The legacy is based on Native American traditions, specifically the Blackfoot tribe. The last chapter revealed that Siksika Azure had disappeared without telling her family where she was going. Her younger sister Jacy-Nova is now the heir. Jacy calls a family meeting to share that Siksika's friend Koko reveals Siksika has gone traveling alone and will return at some point. Meanwhile, Koko gives birth to a daughter.
This document summarizes an article about Ray Gendron, who passed away after battling cancer. It discusses how Ray Gendron was instrumental in founding BICSI Cares, an organization that raises money for children's charities. It describes how Ray worked tirelessly at BICSI conferences to encourage donations, often making up challenges to inspire competitive spirits. While he knew thousands at conferences, he always took the time to greet people by name. Ray leaves behind a legacy of helping thousands of children through the money raised for charities due in large part to his efforts.
San Martín de los Andes is a tourist city located in Neuquén Province, Argentina that experiences temperatures between 10 and 0 degrees Celsius. It offers many outdoor recreational activities like kayaking, climbing, trekking, mountain biking, horseback riding, rafting, canoeing, hang gliding, snowshoeing, snowboarding, fishing, and hunting. Tourists can also visit nearby hot springs, volcanoes, lakes, villages, and rock art sites by booking tours in the area.
Rome has changed significantly over time in terms of transportation, government, and technology. In ancient Rome, transportation included walking or riding horses, while emperors rode in carriages. The government transitioned from kings to a republic to an empire. Technology and engineering advanced structures like aqueducts and baths. Modern Rome utilizes buses, trains, and automobiles, has a prime minister and elected officials, and widespread use of modern conveniences like cell phones. Roman influence also extended to other places through trade, military expansion, and the adoption of Roman gods by neighboring cultures.
Breastfeeding Rates In The United States By Characteristics Of The Child,Biblioteca Virtual
This study analyzed breastfeeding rates in the United States using data from the 2002 National Immunization Survey. It found that over two-thirds of infants were ever breastfed, but rates of exclusive and continued breastfeeding dropped significantly by 6 and 12 months. Certain groups had lower rates, including non-Hispanic black children, those in daycare, enrolled in WIC, from lower socioeconomic status families, or younger or less educated mothers. The results suggest more efforts are needed to improve and support breastfeeding, especially among disadvantaged populations.
Nutritional Factors In Milk From Brazilian Mothers Delivering Small For Gesta...Biblioteca Virtual
This study analyzed the composition of breast milk from Brazilian mothers who delivered small-for-gestational-age (SGA) term infants, preterm appropriate-for-gestational-age infants, and term appropriate-for-gestational-age infants. Milk samples were collected from mothers in each group 48 hours and 7, 15, 30, and 60 days after delivery and analyzed for osmolarity, proteins, fat, sodium, potassium, calcium, and magnesium. Osmolarity, proteins, fat, calcium, potassium, and magnesium did not significantly differ between groups over time. Sodium levels were higher in milk from mothers of SGA infants and preterm infants on days 7, 15, and 30 compared
Aiyana tells her children Pocahontas and Powhatan about their Lenmana Indian heritage and legacy. Aimee, the wolf who raised Aiyana, revealed that a prophecy said the firstborn daughter of each generation would help revive the lost Lenmana tribe. Pocahontas is the current heiress responsible for continuing the family's traditions into the next generation. Powhatan had felt jealous that Pocahontas was always first, but Bono assured him he would have his time to shine as well.
The document discusses social network analysis and influence identification. It provides examples of social networks and social graphs. It explains that a social graph diagrams the relationships between entities in a social network. It also defines social network analysis as the construction and analysis of social graphs to gain insights from network metrics. The document discusses factors that determine influence, like domain expertise and relevance/timing of information. It provides an example influence graph and explains the importance of relevance and timing of information for influence.
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.
Pooled Analysis Of Antidepressant Levels In Lactating Mothers, Breast Milk, A...Biblioteca Virtual
This document summarizes a pooled analysis of published studies on antidepressant levels in breastfeeding mothers, breast milk, and nursing infants. 57 studies were identified that measured antidepressant levels in these groups. The analysis found that on average, infants exposed to certain antidepressants (nortriptyline, paroxetine, sertraline) tended to have undetectable drug levels, while exposure to fluoxetine was more likely to produce higher infant drug levels above 10% of the mother's level. The analysis also found a relationship between the drug's protein binding in milk and the amount transferred to the infant. The authors conclude that nortriptyline, paroxetine, and sertraline may be preferable antidepressant choices for breastfeeding
Breastfeeding Status On Us Birth Certificates Where Do We Go From HereBiblioteca Virtual
This document discusses collecting breastfeeding data on US birth certificates. It finds that while most states now collect or will soon collect this data, the questions used are not standardized. It recommends that future revisions to the standard birth certificate assess breastfeeding exclusivity. Revisions should include feedback from health professionals, pretesting, and training to improve data quality.
This document summarizes a study on bacterial contamination found in powdered infant formula. The key points are:
- Testing found that over 50% of powdered formula samples from 35 countries were contaminated with Enterobacteria bacteria.
- Several outbreaks of illness in neonatal intensive care units were linked to formula contaminated with Salmonella or Enterobacter sakazakii bacteria before the formula was opened.
- In response, some formula brands recalled batches and health authorities issued safety warnings, but more needs to be done to inform consumers directly of the risks and encourage stricter manufacturing practices.
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.
This study examines labor patterns in over 26,000 women using data from the National Collaborative Perinatal Project collected between 1959-1966. The researchers found that the median time to progress from one centimeter of cervical dilation to the next decreased as labor advanced. Nulliparous women had the longest labor curves, while multiparous women had similar curves. The study suggests that the active phase of labor may not start until 5 cm of dilation in nulliparas and that a graduated approach based on cervical dilation is needed to properly diagnose abnormal labor progression.
Recent Advances in of BREAST FEEDING : Dr Sharda Jain Lifecare Centre
This document discusses the importance of breastfeeding and providing human milk to newborns within the first hour after birth, known as the "Golden Hour." It recommends exclusively breastfeeding or providing pasteurized donor human milk during this critical period, as formula feeds are not recommended. Initiating feeding within the Golden Hour provides significant health benefits and can reduce neonatal mortality rates. Challenges to early feeding include caesarean deliveries and ensuring babies receive an adequate volume of milk. New products like NeoLact 70 Prime aim to provide short term human milk-based nutrition for all newborns during the Golden Hour to promote gut health and a smooth transition to breastfeeding.
Role baby friendly hospital initiative on KAP of nursing mothersAnjum Hashmi MPH
The document summarizes a study on the role of the Baby Friendly Hospital Initiative (BFHI) on the knowledge and practices of nursing mothers regarding infant feeding. The study compared mothers who delivered at a Baby Friendly Hospital (BFH) versus a non-BFH. It found that some feeding practices were better in the BFH group, such as a lower rate of pre-lacteal feeding and longer duration of exclusive breastfeeding. However, the non-BFH group had a higher rate of initiating breastfeeding within the first hour. The BFHI was found to have a beneficial impact on certain infant feeding practices and the duration of exclusive breastfeeding.
1) ART pregnancies have some differences from natural pregnancies that require special care and monitoring, such as progesterone and estrogen supplementation due to the absence of a corpus luteum in some cases.
2) Multiple pregnancies are a major risk factor for ART pregnancies and require close monitoring due to higher risks of preterm birth and low birth weight.
3) While antenatal care is largely the same for ART and natural pregnancies, ART pregnancies have slightly higher risks of complications like preterm birth and birth defects, so careful screening and management is important.
Pediatric Nurses’ Knowledge and Practices Regarding Nursing Management of Pre...paperpublications3
Abstract: Prematurity used to be a major cause of infant deaths. The premature babies need improved medical and nursing techniques by highly competence nursing team.
Material and Methods: This descriptive hospital based study was conducted at Soba university hospital, Khartoum state in the period from January to March 2014. The study aimed at assessing the knowledge and practices of pediatric nurses in neonatal intensive care unit concerning nursing management of preterm babies. The sample size compromised of 50 nurses that constituted the total coverage of study population during the period of the study. Data were collected using structured interview questionnaire and observation check list designed f or the study. The data was analyzed using statistical package for social sciences (SPSS). Results:The results obtained that the majority of nurses were knowledgeable about the characteristics of preterm babies, causes of prematurity, immediate nursing care of preterm, signs of hypothermia were adequate (100%, 92%, 100%,100% respectively). Half of them (50%) identify the breathing pattern of preterm baby. The nurses clinical performance were inadequate where 70% of them recorded pulse rate only when recorded the baby pulse.100% did not wear mask, 80% find a difficulty on selecting appropriate vein for sampling . Also 48% of nurses gave feeding incorrect and 60% of them did not aspirate gastric contents before feeding.
Conclusion: The study concluded that the majority of pediatric nurses had adequate knowledge about prematurity, but they were lacking in their clinical skills to manage the preterm baby. So the study recommended continuous training programs for the nurses to refresh their knowledge and practices towards management of preterm babies to ideal standards.Keywords: Pediatric Nurses’ Knowledge, Practices Regarding Nursing Management, Premature Babies.
Title: Pediatric Nurses’ Knowledge and Practices Regarding Nursing Management of Premature Babies in Neonatal Intensive Care Unit at Soba University Hospital, Khartoum State, Sudan
Author: Widad Ibrahim A/gadir A/moula, Ietimad Ibrahim Abd Elrahman kambal
ISSN 2349-7823
International Journal of Recent Research in Life Sciences (IJRRLS)
Paper Publications
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.
Neonatal and Obstetric Risk Assessment (NORA) Pregnancy Cohort Study in Singa...Premier Publishers
The Neonatal and Obstetric Risk Assessment (NORA) pregnancy cohort study was set up to assess clinical, biochemical and biophysical markers for risk assessment and prediction of the outcomes early in pregnancy. A total of 3271 patients who were in KK Women’s and Children’s Hospital between September 2010 and October 2014 were screened and 1013 patients consented to participate in the study. Women were followed at 18 to 22 weeks, 28 to 32 weeks and 34 weeks and above, till their postnatal discharge from the hospital. Finally, 926 patients remained for studying the outcome. In NORA study, we established locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters. Higher serum progesterone levels at 28–32 weeks of pregnancy were observed in women who had preterm deliveries compared with women with term deliveries in the cohort. We also found that extracellular vesicle (EV) biomarkers enhanced the predictive robustness of an existing pre-eclampsia (PE) biomarker sufficiently to justify PE screening in a low-risk general obstetric population. We plan to further conduct a range of serial assessments from the biosamples which will provide a comprehensive and valuable information of the dynamics of maternal conditions and fetal development during pregnancy.
Perinatal magnesium administration and the prevention of periventricular leuk...Ross Finesmith M.D.
This study examined the effect of magnesium sulfate (MgSO4) on the development of cystic periventricular leukomalacia (cPVL) in preterm infants. The researchers conducted a retrospective case-control study of 492 preterm infants born between 1992-1994 weighing less than 1750g who survived at least 7 days. They found infants exposed to MgSO4 in utero were less likely to develop cPVL. Specifically, 2 of 18 infants with cPVL were exposed to MgSO4 compared to 14 of 36 controls, indicating MgSO4 exposure is associated with a reduced risk of cPVL. Further analysis confirmed the groups were similar in other variables and preeclampsia alone did
Why Do Women Stop Breastfeeding Findings From The Pregnancy RiskBiblioteca Virtual
This study examined breastfeeding behaviors using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) from 2000-2001. The authors found that 32% of women did not initiate breastfeeding, 4% stopped within the first week, 13% stopped within the first month, and 51% continued for over 4 weeks. Younger women and those with limited socioeconomic resources were more likely to stop breastfeeding early. Common reasons for stopping included sore nipples, perceived inadequate milk supply, and difficulties with breastfeeding. Women's predelivery intentions impacted their likelihood of initiating and continuing breastfeeding.
Magnesium Prevents the Cerebral Palsy Precursor in Premature InfantsRoss Finesmith M.D.
To determine if magnesium sulfate has an effect on the development of cystic
periventricular leukomalacia in preterm infants, this retrospective case control study
was conducted. There were 23,382 infants born at three teaching hospitals in the metropolitan New York area from January 1992 to December 1994. Four hundred ninety-two infants met our entrance criteria. Criteria included a birth weight less than 750 g, survival to at least 7 days of life and at least one cranial ultrasound after 7 days of life.
Infants exposed to magnesium sulfate in utero were less likely to develop periventricular
leukomalacia. Two of 18 (11%) infants with periventricular leukomalacia were
exposed to magnesium sulfate in-utero compared to 14 of 36 controls (39%) (p =
0.035) (OR = 0.196, 95% Cl = 0.039-0.988). Pre-eclampsia as an independent factor
was not associated with a reduced risk (p = 0.251) (OR = 0.294, 95% Cl =
0.033-2.65). Preterm infants exposed to antenatal magnesium sulfate were found to
have a reduced risk of developing cystic periventricular leukomalacia.
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.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
This document discusses innovations and breakthroughs in in vitro fertilization (IVF). It covers the following topics in 3 sentences or less:
Genetic screening techniques like preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) are discussed to select embryos without genetic disorders or the highest chance of implantation. Time-lapse monitoring is presented as a way to continuously monitor embryo development in real-time without disruptions. Stem cell therapy and its potential role in inducing ovarian regeneration and sustained ovarian function is briefly covered.
This study assessed the incidence of uterine rupture in the Netherlands using a nationwide population-based cohort of 371,021 deliveries between 2004-2006. The incidence of uterine rupture was 5.9 per 10,000 deliveries, with 183 cases (87.1%) occurring in women with a previous uterine scar. No maternal deaths occurred due to uterine rupture, but 18 cases of perinatal death (8.7%) were reported. Risk factors associated with uterine rupture included prior cesarean delivery, induction of labor, post-term or pre-term delivery, overweight, non-Western ethnicity, and advanced maternal age.
This document discusses strategies for preventing fetal macrosomia. It begins by defining fetal macrosomia as a birth weight over 4000g or above the 90th percentile for gestational age. Factors that can cause macrosomia include maternal diabetes, obesity, excessive weight gain, and diets high in calories, sugar, or glycemic index. Macrosomia poses risks for prolonged labor, maternal and neonatal injuries, and cesarean section. The document reviews studies on using low glycemic index diets and extracts from alligator pepper to reduce weight gain and blood sugar levels in pregnant women at risk of macrosomia. It suggests further research is needed to validate prevention strategies and develop targeted protections.
Peripartum Breastfeeding Management For The Healthy Mother And Infant At Term...Biblioteca Virtual
This document provides guidelines for peripartum breastfeeding management for healthy mothers and infants. It recommends:
1) Prenatal breastfeeding education and support.
2) Skin-to-skin contact immediately after birth and rooming-in to facilitate breastfeeding.
3) Assessment and support for breastfeeding mothers to ensure effective latching and milk transfer.
4) Avoidance of supplemental feedings unless medically necessary to avoid breastfeeding difficulties.
Effect Of An Educational Intervention About Breastfeeding On The Knowledge,Biblioteca Virtual
This study evaluated the impact of an educational intervention on pediatric residents' knowledge, confidence, and clinical behaviors regarding breastfeeding. The residents completed pre- and post-intervention questionnaires to assess knowledge and confidence. Telephone interviews with breastfeeding mothers after clinic visits evaluated residents' clinical behaviors. The results showed that residents' knowledge scores increased significantly after the intervention. Their clinical behaviors when interacting with breastfeeding mothers also improved substantially. The educational intervention was effective in enhancing residents' support of breastfeeding patients.
perineal outcome after restrictive use of episiotomyarbin joshi
This study evaluated perineal outcomes in primi-gravidas after restrictive use of episiotomy in Nepal. The episiotomy rate was 22% and the majority (43.2%) experienced first degree tears. Only one woman (1.4%) experienced a third degree tear, with no long-term complications. Having a baby weighing 2.5kg or more significantly increased mean tear length and nearly doubled the risk of a second or third degree tear. The restrictive episiotomy protocol was successfully implemented with no significant complications observed.
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
Similar to Delayed Breastfeeding Initiation Increases Risk Of Neonatal Mortality (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.
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.
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.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
3. A LTHOUGH THE CHILD survival revolution of the
1980s led to dramatic reductions in overall child
mortality, it had little impact on neonatal mortality.1,2 In
trial to assess the impact of weekly vitamin A supple-
mentation on maternal mortality. It involves all women
of childbearing age who live in 4 rural contiguous dis-
2002, 4 million infants died during the first month of tricts (Kintampo, Wenchi, Techiman, and Nkoranza) in
life, and neonatal deaths now account for 36% of deaths the forest-savanna transitional ecological zone in the
among children 5 years of age.1,2 Tackling neonatal Brong Ahafo region of central Ghana. It covers 12 000
mortality is essential if the millennium development km2, and 80% of the study population live in remote
goal for child mortality is to be met.3,4 Sub-Saharan and rural villages.
Africa contributes a high proportion of neonatal deaths, All of the singleton infants born to mothers in the
yet its progress has been the slowest of any region in the ObaapaVitA trial between July 1, 2003, and June 30,
world.2,3,5 Because the majority of neonatal deaths occur 2004, who initiated breastfeeding, survived to day 2, and
at home,1 feasible interventions for home-based imple- whose mothers were visited in the neonatal period were
mentation are needed urgently. included in the present study. Both the ObaapaVitA trial
The promotion of breastfeeding is a key component of and this nested study were approved by the ethics com-
child survival strategies.3 Furthermore, the recent Lancet mittees of Ghana Health Service and London School of
neonatal survival series included breastfeeding in its rec- Hygiene and Tropical Medicine.
ommended package of interventions to reduce neonatal
mortality.6 International policy places emphasis on ex- Data Collection
clusive breastfeeding during the first 6 months of life, Women were visited once every 4 weeks by a network of
with some groups promoting early initiation of breast- trained village-based fieldworkers to distribute vitamin
feeding within 1 hour of birth.7,8 Although there is an A capsules and collect data on morbidity and mortality.
extensive scientific basis for the impact of breastfeeding When a birth was reported, the fieldworker adminis-
on postneonatal mortality,3,9,10 evidence is sparse for its tered a “birth” questionnaire, which included birth out-
impact on neonatal mortality1,6 and, to our knowledge, come, birth weight (if taken within 48 hours of birth at
nonexistent for the contribution of the timing of initia- a health facility), gestational age, details of the delivery,
tion to any mortality impact. health care during pregnancy, health of the mother,
Maternal colostrum, produced during the first days socioeconomic and environmental characteristics, and
after delivery, has long been thought to confer additional home-based neonatal care practices, including early
protection because of its immune and nonimmune prop- breastfeeding practices. The mother was asked when she
erties.11 However, epidemiologic data indicate that a initiated breastfeeding and was prompted for the exact
high proportion of neonatal deaths are a result of ob- timing (within 1 hour, after 1 hour but first day, day 2,
stetric complications,1,12 and these are unlikely to be day 3, day 4 –7, or after day 7). She was then asked what
affected by colostrum, transitional breast milk, or mature she offered her child to eat or drink in the 24 hours
breast milk. Elucidating the role of timing of initiation of before the interview. After noting the unprompted re-
breastfeeding is particularly relevant for sub-Saharan sponse, the mother was asked if she offered her own
Africa, where neonatal and infant mortality rates are breast milk, breast milk from a wet nurse, animal milk,
high but most women already exclusively or predomi- infant formula, milk-based fluids, water-based fluids, or
nantly breastfeed their infants.2 solid foods. The mother was also asked about the infant’s
A surveillance system from a large trial in rural Ghana health on the day of birth and in the previous 24 hours.
of the impact of weekly vitamin A supplementation to At the next 4-week visit, an “infant” questionnaire was
women of childbearing age on maternal and infant mor- administered to obtain additional outcome data (infant
tality (ObaapaVitA trial) afforded the opportunity to morbidity and mortality) and information about infant
evaluate the association between early breastfeeding feeding practices. Infants were followed up at subse-
practices and deaths in breastfed neonates. Our primary quent visits every 4 weeks until they reached 12 months
objective was to evaluate the association between the of age.
timing of initiation of breastfeeding and neonatal mor-
tality. The secondary objective was to assess whether the Study Definitions and Statistical Analysis
different types of breastfeeding (exclusive, predominant, An infant was considered to be breastfed if breast milk
and partial breastfeeding) were associated with substan- constituted any portion of their diet. Infants were clas-
tially different risks of neonatal death. sified according to the timing of breastfeeding initiation
(first hour, after first hour but day 1, day 2, day 3, and
after day 3). “Early initiation” of breastfeeding referred
METHODS
to breastfeeding that started on the first day of life. “Late
Setting and Participants initiation” indicated breastfeeding that began after the
The ObaapaVitA trial is an ongoing community-based, first day of life. “Established breastfeeding” referred to
cluster-randomized, double-blind, placebo-controlled the reported breastfeeding pattern in the 24 hours before
PEDIATRICS Volume 117, Number 3, March 2006 e381
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4. the first interview (median: 14 days postpartum; inter- as “very tiny” or “smaller than average” gave a sensitiv-
quartile range: 7–21 days). “Exclusive breastfeeding” ity of 80% and specificity of 95% in detecting a birth
was defined as feeding of only breast milk and nothing weight of 2.0 kg (Table 1). Thus, the mother’s percep-
else, not even water, with the exception of vitamin tion of birth size was used in the logistic-regression
supplements and prescribed medicines. “Predominant models as a proxy for birth weight.
breastfeeding” was defined as feeding of breast milk To further reduce problems with reverse causality,
along with other nonmilk fluids. Infants who were of- analyses were repeated excluding infants at high risk of
fered breast milk and animal milk, infant formula, or death and ill health (congenital anomalies, premature,
solids were considered to be “partially breastfed.” These unwell on the day of birth, and unwell at the time of
definitions are consistent with the current World Health interview) and early neonatal deaths. All of the analyses
Organization definitions for breastfeeding patterns.8 were conducted in Stata 8.2 (Stata Corp, College Station,
The primary comparisons were made between early TX). aORs and 95% confidence intervals (CIs) are pre-
and late initiation of breastfeeding and between the sented. Because neonatal mortality is a relatively rare
types of established breastfeeding patterns (exclusive, event, these ORs closely approximate relative risks and
predominant, and partial). To reduce problems with re- are referred to as such in the text. To elucidate the public
verse causality (ie, the possibility of the breastfeeding health importance of improving early breastfeeding pat-
pattern being affected by serious illnesses that lead to terns, the proportions of all neonatal deaths that would
death), only infants who survived to day 2 and who be avoided if all infants initiated breastfeeding during the
were breastfed successfully were included in the primary first hour or during the first day of life (the population-
analyses. Multiple births, noninitiators, and those who attributable fractions [PAFs]) were calculated also.
were interviewed outside the neonatal period were also
excluded. The primary outcome variable was calculated RESULTS
as the number of breastfed singleton infants who died There were 14 403 live births in the ObaapaVitA trial
during ages 2 to 28 days per 1000 singleton births sur- area from July 1, 2003, to June 30, 2004, and 433
viving to day 2. Early neonatal deaths were infants who neonatal deaths, giving a neonatal mortality rate of 30.1
died from days 2 to 7, and late neonatal deaths were per 1000 live births. Data were captured for 11 316
infants who died from 8 to 28 days of age. (82%) of the 13 860 singleton births within 28 days of
Logistic regression was used to calculate crude and delivery (median: 14 days postpartum; interquartile
adjusted odds ratios (aORs) for mortality associated with range: 7–21 days). This included 268 neonatal deaths,
the breastfeeding-exposure variables. Potential con- 109 (41%) of which occurred within the first day of
founders relating to the mother (health, parity, age, birth. We excluded 106 (0.9%) of the day-2 singleton
educational level, and cash income), household (water survivors who either did not initiate breastfeeding or
supply and place of defecation), health system (number started then stopped, plus 154 (1.4%) whose mothers
of antenatal visits, place of birth, and birth attendant), moved out of the study area before the second infant
and the infant (gender, birth size, gestational age, pres- interview. This analysis is based on the remaining
ence of a congenital anomaly, health on the day of birth, 10 947 infants, among whom there were 145 neonatal
and health at the time of interview) were included a deaths from days 2 to 28.
priori in the models. ObaapaVitA trial group (maternal
vitamin A supplementation or placebo) was not includ- Breastfeeding Patterns and All-Cause Neonatal Mortality
ed; it was not a confounder, because it was not associ- Breastfeeding was initiated within the first day of birth
ated with infant feeding patterns. in 71% of the infants and by the end of day 3 in all but
Only 3264 infants had their weight measured within 1.3% of them (Table 2); 70% of the infants were exclu-
48 hours of birth, but perceived birth size was available sively breastfed during the neonatal period (Table 3).
from all of the mothers. Mothers’ perception of an infant There was a marked dose response of increasing risk of
TABLE 1 Validation of Mother’s Perception of Birth Size
Perception of Birth Weight, kga Total, N Mean (SD)
Birth Size Birthweight, kg
2.00 2.00–2.49 2.50–3.49 3.50
Very tiny 8 (35) 6 (26) 8 (35) 1 (4.4) 23 2.23 (0.70)
Smaller than average 10 (6.0) 57 (34) 97 (58) 3 (1.8) 167 2.50 (0.45)
Average size 5 (0.3) 134 (7.5) 1389 (78) 261 (15) 1789 2.95 (0.43)
Larger than average 0 21 (3.2) 388 (59) 248 (38) 657 3.30 (0.46)
Very big baby 0 0 326 (52) 302 (48) 628 3.45 (0.46)
Total 23 (0.7) 218 (6.7) 2208 (68) 815 (25) 3264 3.09 (0.51)
a Values are n (%).
e382 EDMOND, et al
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5. TABLE 2 Risks of Neonatal Mortality According to Timing of Initiation of Breastfeeding in Singletons
Who Initiated Breastfeeding and Survived to Day 2
Initiation of Breastfeeding No. (%) of Infants No. of Deaths (% risk)a aOR 1 (95% CI)b aOR 2 (95% CI)c
Within 1 h 4763 (43) 34 (0.7) 1 1
From 1 h to end of day 1 3105 (28) 36 (1.2) 1.45 (0.90 to 2.35) 1.43 (0.88 to 2.31)
Day 2 2138 (20) 48 (2.3) 2.70 (1.70 to 4.30) 2.52 (1.58 to 4.02)d
Day 3 797 (7.3) 21 (2.6) 3.01 (1.70 to 5.38) 2.84 (1.59 to 5.06)d
After day 3 144 (1.3) 6 (4.2) 4.42 (1.76 to 11.09) 3.64 (1.43 to 9.30)d
Total 10 947 (100) 145 (1.3)
P LRT .0001 P LRT .0001
P trend .0001 P trend .0001
LRT indicates likelihood ratio test.
a % risk no. of deaths/no. of infants in exposure category.
b Adjusted for gender, birth size, gestational age, presence of a congenital anomaly, health on the day of birth, health at the time of interview,
mother’s health at the time of delivery, age of mother, parity, educational level of mother, mother having cash income, household water supply,
place of defecation, number of antenatal visits, place of birth, and birth attendant.
c Adjusted for all factors mentioned previously plus established breastfeeding pattern.
d The combined aOR for initiation of breastfeeding after 1 d was 2.88 (95% CI: 1.87 to 4.42).
TABLE 3 Risks of Neonatal Mortality According to Established Breastfeeding Pattern in Singletons Who
Initiated Breastfeeding and Survived to Day 2
Established Neonatal No. (%) of Infants No. of Deaths aOR 1 (95% CI)b aOR 2 (95% CI)c
Breastfeeding Pattern (% risk)a
Exclusive 7680 (70) 84 (1.1) 1 1
Predominant 3034 (27) 48 (1.6) 1.41 (0.97 to 2.03) 1.30 (0.90 to 1.87)
Partial 233 (2.1) 13 (5.6) 4.51 (2.38 to 8.55) 3.82 (1.99 to 7.34)
Total 10 947 (100) 145 (1.3)
P LRT .0001 P LRT .0001
P trend .0001 P trend .0001
Median age of ascertainment of established breastfeeding patterns was 14 days (interquartile age, 7–21 days). LRT indicates likelihood ratio test.
a % risk no. of deaths/no. of infants in exposure category.
b Adjusted for gender, birth size, gestational age, presence of a congenital anomaly, health on the day of birth, health at the time of interview,
mother’s health at the time of delivery, age of mother, parity, educational level of mother, mother having cash income, household water supply,
place of defecation, number of antenatal visits, place of birth, and birth attendant.
c Adjusted for all factors mentioned previously plus timing of initiation of breastfeeding.
neonatal mortality with increasing delay in initiation of 1.44 to 3.87]; P .001). Furthermore, the trend with
breastfeeding from 1 hour to day 7 (Table 2); overall late late initiation was still significant after adjusting for the
initiation (after day 1) was associated with a 2.4-fold type of breastfeeding (Table 2), and the increased risk
increase in the risk of neonatal mortality (Table 4). associated with late initiation was similar within each
The size of this effect was similar (aOR: 2.44; 95% CI: breastfeeding category (Table 4). Infants who were given
1.60 to 3.74; P .0001) when the model was refitted to prelacteal feeds (any food or fluids before breastfeeding
exclude infants at high risk of death (unwell on the day was established) on day 1 also had a high neonatal
of birth, congenital abnormalities, premature, and un- mortality risk (aOR: 1.63; 95% CI: 1.09 to 2.45; P
well at the time of interview) or when deaths during the .017).
first week (days 2–7) were excluded (aOR: 2.36; 95% CI: The type of breastfeeding was also found to be asso-
TABLE 4 Neonatal Mortality Risk by Time of Initiation of Breastfeeding and Established Diet
Established Neonatal Initiation of Breastfeeding Late vs Early Initiation
Breastfeeding Pattern
Early (first day) Late (After 1 d) aOR (95% CI)b P
No. of Deaths (% risk)a No. of Deaths (% risk)a
Exclusive 48/5767 (0.8) 36/1913 (1.9) 2.19 (1.38 to 3.49) .001
Predominant 18/1968 (0.9) 30/1066 (2.8) 2.55 (1.38 to 4.71) .003
Partial 4/133 (3.0) 9/100 (9.0) 2.63 (0.60 to 11.63) .202
Overall 70/7868 (0.9) 75/3079 (2.4) 2.40 (1.69 to 3.40) .0001
a% risk no. of deaths/no. of infants in exposure category.
b Late vs early initiation, adjusted for gender, birth size, gestational age, presence of a congenital anomaly, health on the day of birth, health at the
time of interview, mother’s health at the time of delivery, age of mother, parity, educational level of mother, mother having cash income,
household water supply, place of defecation, number of antenatal visits, place of birth, and birth attendant.
PEDIATRICS Volume 117, Number 3, March 2006 e383
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6. ciated with mortality risk. Both predominantly (aOR: breastfeeding and neonatal mortality risk was demon-
1.41; 95% CI: 0.97 to 2.03) and partially (aOR, 4.51; strated after controlling for factors that are known to be
95% CI, 2.38 to 8.55) breastfed infants had higher risks associated with earlier onset of breastfeeding,13,14 lower
of neonatal death than exclusively breastfed infants, al- rates of perinatal and infant mortality,3,6 and established
though the risk was much higher and only statistically breastfeeding practices.15,16 The prevalence of HIV infec-
significant in the partially breastfed group (Table 3). The tion is relatively low in the Brong Ahafo region of Ghana
pattern was unchanged after adjustment for timing of (4% prevalence in women of reproductive age)17,18 and,
initiation of breastfeeding; the size of the ORs was only thus, is unlikely to have influenced the promotion of
slightly reduced (Table 3). breastfeeding by health care providers in the region.
These findings indicate that both timing of initiation To our knowledge, this is the first study that has
and type of breastfeeding pattern exert independent in- examined the impact of initiation of breastfeeding on
fluences on neonatal mortality. Furthermore, there was mortality during the neonatal period. A Guinea-Bissau
no evidence of any interaction between the sizes of these study found no effect of early initiation (day 1) on
effects and birth weight or gestational age. postneonatal mortality (in infants aged 29 days to 3
years).19 However, the World Health Organization Col-
PAFs laborative Study Team10 reported a higher protective
The percentage of neonatal deaths from 2 to 28 days of effect against mortality of any breastfeeding in the first 2
life that could be prevented if all of the infants in the months compared with later ages, and 3 studies found
study population initiated breastfeeding in the first hour early initiation of breastfeeding (days 1–3) to be sugges-
of life was 41.3% (Table 5, PAF). This is equivalent to tively20 or significantly13,21 associated with a lower rate of
preventing 22.3% of all neonatal deaths if it is assumed diarrhea during infancy. Two of these studies adjusted
that breastfeeding has no impact on deaths during the for confounding factors,13,20 but only 1 adjusted for later
first day of life. The equivalent PAFs associated with breastfeeding patterns.13
initiating breastfeeding on the first day (rather than the Data showing the impact of postinitiation breastfeed-
first hour) are 30.2% of neonatal deaths saved from days ing patterns on neonatal mortality are also sparse. The
2 to 28 or 16.3% of all neonatal deaths. only study identified examined infants in Bangladesh
and reported no significant differences between exclu-
DISCUSSION sive and predominant breastfeeding on neonatal or post-
neonatal mortality (excluding infants who died within
Statement of Principal Findings
3 days) after adjusting for confounding factors.15 This
Interventions to improve early infant feeding practices
study grouped together partially breastfed and non-
can result in considerable reductions in neonatal mor-
breastfed neonates and presented a combined hazard
tality. All-cause neonatal mortality could be reduced by
ratio of 1.17 (95% CI: 0.26 to 5.38) for not exclusively
16.3% if all infants initiated breastfeeding on day 1 of
breastfeeding.
life and by 22.3% if initiation took place within the first
hour. The risk of neonatal death is increased approxi-
mately fourfold if milk-based fluids or solids are pro- Potential Limitations
vided to breastfed neonates. Observational studies of breastfeeding and infant health
may be affected by a number of methodologic problems
Strengths and Relation to Other Studies including self-selection, reverse causality, confounding,
This article presents the risks of neonatal mortality that and misclassification.22–24 However, we analyzed data for
are associated with early breastfeeding practices from a the entire study population of singleton births and ad-
large cohort study of 10 000 infants in rural Ghana. dressed reverse causality by excluding all deaths before
The protective relationship between early initiation of day 2, excluding infants who either did not start or
TABLE 5 PAFs for Initiation of Breastfeeding in Breastfed Singletons Who Survived to Day 2
No. (%) of Deaths aORa (95% CI) PAF,b % (95% CI)
Within 1 h 34 (23.4) 1 —
After 1 h to end of day 1 36 (24.8) 1.45 (0.90 to 2.35) 7.7 ( 2.8 to 13)
Day 2 48 (33.1) 2.70 (1.70 to 4.30) 20.8 (10 to 19)
Day 3 21 (14.4) 3.01 (1.70 to 5.38) 9.6 (5.9 to 12)
After day 3 6 (4.1) 4.42 (1.76 to 11.09) 3.2 (1.8 to 3.7)
Total 145 (100) 41.3
a Adjusted for gender, birth size, gestational age, presence of a congenital anomaly, health on the day of birth, health at the time of interview,
mother’s health at the time of delivery, age of mother, parity, educational level of mother, mother having cash income, household water supply,
place of defecation, number of antenatal visits, place of birth, and birth attendant.
b PAF indicates proportion of deaths exposed (aOR 1)/aOR.
e384 EDMOND, et al
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7. started and stopped breastfeeding, controlling for high- ACKNOWLEDGMENTS
risk infants, and repeating analyses excluding all deaths This work was supported by the United Kingdom De-
before day 8 and high-risk infants (which did not alter partment for International Development, US Agency for
effect estimates). We also adjusted for many potential International Development, Ghana Health Service, Lon-
confounding variables, although residual confounding don School of Hygiene and Tropical Medicine, and the
cannot be discounted. Finally, any differential misclassi- United Kingdom National Perinatal Epidemiology Unit.
fication of type of breastfeeding would have tended to We thank the mothers and children who participated
underestimate rather than overestimate effect sizes. in this study for their cooperation and patience, the field
and computer center staff at Kintampo Health Research
Potential Mechanisms Centre (KHRC) for their dedication and attention to
Early initiation of breastfeeding could affect neonatal detail, and the ObaapaVitA trial steering committee for
mortality risk by 4 mechanisms. First, the lower rate of their support and encouragement. Finally, we dedicate
mortality in early initiators may have occurred because this article to the late Dr Paul Arthur, the founding
mothers who suckle their offspring shortly after birth director of the KHRC, whose vision, guidance, and in-
have a greater chance of successfully establishing and spiration enabled the neonatal program of work at
sustaining breastfeeding throughout infancy25 and be- KHRC to become a reality.
cause breastfeeding during infancy is related protectively
to mortality.10 However, the effect of early initiation
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9. Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality
Karen M. Edmond, Charles Zandoh, Maria A. Quigley, Seeba Amenga-Etego, Seth
Owusu-Agyei and Betty R. Kirkwood
Pediatrics 2006;117;e380-e386
DOI: 10.1542/peds.2005-1496
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