1. Breastfeeding provides numerous health benefits for both infants and mothers. It reduces the risk of breast cancer in mothers and lowers the risk of HIV transmission from mother to child.
2. Exclusive breastfeeding for the first 3-6 months of life protects infants from common illnesses like diarrhea and pneumonia. It also supports optimal infant nutrition and development.
3. For HIV-positive mothers, exclusive breastfeeding or replacement feeding with formula can be appropriate depending on individual circumstances. Proper support is crucial to help mothers make informed choices about infant feeding.
Chatterjee (UNICEF) on HIV and Infant Feedingericpgreen
This document summarizes challenges around infant feeding for HIV-positive mothers in resource-limited settings. It discusses the risks of different feeding options like breastfeeding or replacement feeding. While exclusive breastfeeding carries lower HIV transmission risk, replacement feeding risks increased infant mortality from diseases like diarrhea if adequate water and sanitation are not available. Ensuring replacement feeding is acceptable, feasible, affordable, sustainable and safe (AFASS criteria) is difficult, and maintaining consistent formula supply over months is a challenge. Ongoing studies are exploring antiretroviral use by mothers and infants to reduce HIV transmission through breastfeeding. Public health recommendations depend on individual circumstances and support systems available.
This is a compilation of recommendations for feeding of HIV-exposed infants based on WHO-UNICEF and the DOH Administrative Order. Ideally, patient's choice should still be considered whether exclusively breastfeeding or exclusively replacement feeding.
This document summarizes an update published in 2007 on HIV transmission through breastfeeding. It reviews scientific evidence from 2001 to 2007 on the risk of HIV transmission through breastfeeding, the impact of different infant feeding options on child health outcomes, and strategies to reduce transmission through breastfeeding in developing countries. The update aims to inform public health recommendations around infant feeding by HIV-infected mothers.
This document provides guidance for breastfeeding mothers during the COVID-19 pandemic. It recommends that mothers continue breastfeeding and take precautions like wearing a mask, washing hands, and cleaning surfaces. If a mother has COVID-19, she can express milk and have another caregiver feed the infant. The document provides tips for proper hygiene during formula feeding as well. It emphasizes the importance of breastfeeding for infant health and immunity.
This document discusses COVID-19 and breastfeeding. It recommends that breastfeeding should continue as breast milk provides antibodies that strengthen infant immunity. It also outlines safety precautions for breastfeeding such as handwashing, wearing a mask, and cleaning pump/bottle parts thoroughly if expressing milk. For COVID-19 positive mothers, breastfeeding is still recommended while taking safety measures like washing breasts and wearing a mask.
The document discusses infant feeding and prevention of mother-to-child transmission (PMTCT) of HIV. It outlines national guidelines for HIV and infant feeding, including promoting exclusive breastfeeding for the first six months unless replacement feeding is acceptable, affordable, feasible, sustainable and safe. The risks and benefits of different infant feeding options like breastfeeding and replacement feeding are presented. Guidelines for counseling mothers on feeding choices and providing follow-up support are also described.
FEEDING OPTIONS IN THE CONTEXT OF HIV 22-6-12(2)WILLIAM DINDA
1. Martina tests HIV positive during her ANC visit at 21 weeks gestation. She does not want to disclose her status to her family.
2. Given her health status and CD4 count, the nutritionist would put Martina on lifelong antiretroviral therapy (ART) to benefit her own health and prevent transmission of HIV to her child.
3. Martina's feeding options include exclusive breastfeeding for 6 months while taking a long ARV regimen, then gradually weaning from breastmilk while continuing ARVs, as outlined in the 2010 WHO guidelines.
A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
Chatterjee (UNICEF) on HIV and Infant Feedingericpgreen
This document summarizes challenges around infant feeding for HIV-positive mothers in resource-limited settings. It discusses the risks of different feeding options like breastfeeding or replacement feeding. While exclusive breastfeeding carries lower HIV transmission risk, replacement feeding risks increased infant mortality from diseases like diarrhea if adequate water and sanitation are not available. Ensuring replacement feeding is acceptable, feasible, affordable, sustainable and safe (AFASS criteria) is difficult, and maintaining consistent formula supply over months is a challenge. Ongoing studies are exploring antiretroviral use by mothers and infants to reduce HIV transmission through breastfeeding. Public health recommendations depend on individual circumstances and support systems available.
This is a compilation of recommendations for feeding of HIV-exposed infants based on WHO-UNICEF and the DOH Administrative Order. Ideally, patient's choice should still be considered whether exclusively breastfeeding or exclusively replacement feeding.
This document summarizes an update published in 2007 on HIV transmission through breastfeeding. It reviews scientific evidence from 2001 to 2007 on the risk of HIV transmission through breastfeeding, the impact of different infant feeding options on child health outcomes, and strategies to reduce transmission through breastfeeding in developing countries. The update aims to inform public health recommendations around infant feeding by HIV-infected mothers.
This document provides guidance for breastfeeding mothers during the COVID-19 pandemic. It recommends that mothers continue breastfeeding and take precautions like wearing a mask, washing hands, and cleaning surfaces. If a mother has COVID-19, she can express milk and have another caregiver feed the infant. The document provides tips for proper hygiene during formula feeding as well. It emphasizes the importance of breastfeeding for infant health and immunity.
This document discusses COVID-19 and breastfeeding. It recommends that breastfeeding should continue as breast milk provides antibodies that strengthen infant immunity. It also outlines safety precautions for breastfeeding such as handwashing, wearing a mask, and cleaning pump/bottle parts thoroughly if expressing milk. For COVID-19 positive mothers, breastfeeding is still recommended while taking safety measures like washing breasts and wearing a mask.
The document discusses infant feeding and prevention of mother-to-child transmission (PMTCT) of HIV. It outlines national guidelines for HIV and infant feeding, including promoting exclusive breastfeeding for the first six months unless replacement feeding is acceptable, affordable, feasible, sustainable and safe. The risks and benefits of different infant feeding options like breastfeeding and replacement feeding are presented. Guidelines for counseling mothers on feeding choices and providing follow-up support are also described.
FEEDING OPTIONS IN THE CONTEXT OF HIV 22-6-12(2)WILLIAM DINDA
1. Martina tests HIV positive during her ANC visit at 21 weeks gestation. She does not want to disclose her status to her family.
2. Given her health status and CD4 count, the nutritionist would put Martina on lifelong antiretroviral therapy (ART) to benefit her own health and prevent transmission of HIV to her child.
3. Martina's feeding options include exclusive breastfeeding for 6 months while taking a long ARV regimen, then gradually weaning from breastmilk while continuing ARVs, as outlined in the 2010 WHO guidelines.
A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
The document discusses the revised training package for the Baby Friendly Hospital Initiative (BFHI). Some key points:
- The BFHI was launched in 1991 to promote breastfeeding. Over 15,000 facilities in 134 countries have achieved Baby-Friendly status.
- However, progress in designating new hospitals has slowed since 1996. On average, less than seven hospitals per country are designated each year.
- WHO and UNICEF have developed a revised 20-hour training course package to revitalize the BFHI both quantitatively and qualitatively.
- The package includes updates to certain steps and new/optional criteria on areas like HIV/AIDS, labor/childbirth care, and compliance with
This document summarizes a research article about the challenges faced by HIV-positive mothers in exclusively breastfeeding their infants for six months in sub-Saharan Africa. Some key points:
- Exclusive breastfeeding for six months is recommended to reduce HIV transmission risk, but formula feeding poses challenges in poor areas with limited access to clean water and healthcare.
- Mothers face socio-cultural barriers to adhering to recommendations, such as stigma, partner disapproval, and pressure to introduce other foods and water earlier. Health workers also lack training to adequately counsel and support mothers' choices.
- Access to antiretroviral treatment is limited, and high maternal viral loads increase infection risk, despite recommendations for
Many pregnant women visiting baby scan clinics in Leicester have expressed concerns about the impact of coronavirus on themselves and their babies as well. For more information visit: https://windowtothewomb.co.uk/find-a-clinic/leicester-baby-scan-clinic/
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.
The Baby-Friendly Hospital Initiative was launched globally in 1991 by WHO and UNICEF to promote breastfeeding and adopted 10 steps to support breastfeeding in hospitals, with over 152 countries now implementing the initiative. India established a national task force in 1992 to improve breastfeeding practices in hospitals and certify them as "Baby-Friendly" if they follow the 10 steps. The initiative has been shown to increase exclusive breastfeeding rates for the first six months.
Infant and young child feeding in emergenciesPrithwiGhosh1
This document provides guidance on infant and young child feeding in emergencies. It outlines key actions to protect, promote and support optimal infant and young child feeding practices during emergencies. Some of the main points covered include:
- The importance of emergency preparedness and having policies in place to guide responses. National governments should lead coordination of infant and young child feeding responses, with UNICEF or UNHCR providing support as needed.
- Multi-sector collaboration is essential, as is training emergency staff across sectors on infant and young child feeding issues. Needs assessments should inform context-specific responses.
- Immediate action is needed to protect recommended feeding practices and support higher risk groups. Donations of breast
Going Beyond Nutrition to Understand Child Growth and Development_Laura Smith...CORE Group
1) The document discusses environmental enteropathy (EE), a condition caused by ingesting fecal matter that damages the gut and stunts growth. EE is a major cause of stunting in children under 2 in developing countries.
2) A randomized trial in Zimbabwe will test if a water, sanitation, and hygiene (WASH) intervention can reduce EE and stunting by preventing infants from ingesting fecal matter. The intervention provides protected play areas, handwashing, and latrines.
3) The trial will also test if combining the WASH intervention with a nutrition intervention provides added benefits for stunting and anemia reduction beyond either alone. Outcomes will be measured on 4,800 infants to test
The document outlines the 10 steps of the WHO/UNICEF Baby-Friendly Hospital Initiative launched in 1991 to ensure hospitals, maternity facilities, and communities support breastfeeding. The 10 steps include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, and not providing breastfed infants with any food or drink other than breastmilk unless medically necessary. Implementing the 10 steps could save an estimated 1.5 million lives worldwide each year if every baby was exclusively breastfed for the first 6 months.
The document discusses breastfeeding policies and statistics globally and locally. It finds that [1] breastfed babies have lower rates of illnesses like gastrointestinal and respiratory infections, [2] most women in the UK stop breastfeeding before 6 weeks despite health benefits, and [3] policies aim to promote exclusive breastfeeding for 6 months but face challenges from formula marketing practices. The document calls for stronger implementation of the International Code on breastfeeding and marketing of breastmilk substitutes to better protect breastfeeding.
The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 by WHO and UNICEF to implement practices that protect, promote, and support breastfeeding globally. The aims of BFHI are to follow the Ten Steps to Successful Breastfeeding and end free distribution of breast milk substitutes in healthcare facilities. The Ten Steps include having a written breastfeeding policy, training staff, informing pregnant women about benefits of breastfeeding, helping mothers initiate breastfeeding within 30 minutes of birth, and fostering breastfeeding support groups.
Flash Heat Method for Breastfeeding Moms with HIVJenny
One of the most difficult decisions for HIV-positive women is whether to breastfeed or use formula. Breastfeeding carries a risk of transmitting HIV to the baby, but formula risks malnutrition and disease in areas without clean water or refrigeration. For mothers in low-resource areas who meet certain criteria, exclusive breastfeeding for 6 months or flash-heating expressed breast milk are recommended options that aim to balance the health risks.
The document summarizes the services provided at an under five clinic. The clinic provides preventative, curative, referral, and educational services to children under five years old under one roof. The overall goal is to provide comprehensive healthcare to young children in a specialized facility. The clinic treats acute and chronic illnesses, monitors growth through periodic weighing and measurement, provides immunizations and nutrition care, and educates mothers on childcare.
"Experiência de paíse com a IHAC = BFHI"
Baby-Friendly Hospital Initiative 2016
Experiência de 13 países são relatadas: Bolívia, Brasil, China, Gana, Irlanda, Quênia, Kuwait, Quirguistão, Nova Zelândia, Filipinas , Arábia Saudita, EUA e Vietname.
Demonstra que precisamos fortalecer e aprimorar esse programa mundial em defesa do estabelecimento da Amamentação nas Maternidades, Casas de Parto, Centros de Nascimento.
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
The document outlines Methodist Dallas Medical Center's plan to achieve Baby-Friendly designation by adopting several evidence-based practices. The plan includes having a neonatal admission nurse care for infants in the same location as mothers to promote skin-to-skin contact and rooming-in. Research shows these practices improve breastfeeding and maternal-infant bonding. The plan also delays unnecessary interventions like early infant bathing to prevent hypothermia and supports breastfeeding within one hour of birth.
Integrated management of Neonatal and Childhood illness among Infants of 0 to...Dhruvendra Pandey
Integrated management of Neonatal and Childhood illness among Infants of 0 to 2 months, Difference between IMCI and IMNCI, Objective, Elements, Management of Diarrhea, Bacterial Infections, Jaundice, Hypothermia, Feeding problem, counseling of mothers, followup
Evidence of 10 steps4,92 bfhi revised section2.4.a_slidesELCA Egypt
Step 1 informs all health care staff of the hospital's written breastfeeding policy.
Step 2 trains all health care staff in the skills needed to implement the breastfeeding policy.
Step 3 informs all pregnant women about the benefits of breastfeeding.
The document discusses the Baby Friendly Hospital Initiative (BFHI) which was launched in 1991 by WHO and UNICEF to promote breastfeeding. It was introduced in India in 1993. The BFHI aims to protect, promote and support breastfeeding practices through 10 steps that health facilities should implement. These include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, teaching positioning and latching, rooming-in, not providing supplements unless medically necessary, and fostering breastfeeding support groups. The BFHI helps encourage breastfeeding and address mothers' concerns. Its implementation can improve infant health and growth through breastfeeding.
This document discusses barriers to providing human milk feedings (HMF) to very low birth weight infants in the NICU. It identifies key barriers as financial constraints, physiological challenges for mothers of preterm infants, and hospital cultures that do not adequately support lactation. The role of nurses is emphasized in establishing and maintaining milk supply through early and frequent pumping and hand expression, education of mothers, and advocating for hospital policies that follow evidence-based practices to promote HMF. Adopting the Baby-Friendly Hospital Initiative is presented as a way to standardize high-quality lactation support.
In Search of Diablotín: One of the world's rarest birds and its unlikely stro...Julie Hart
Background on the biology of and threats to Diablotín/Black-capped Petrel and a presentation on my participation in searching for this rare species in Haiti in 2010.
Innovation webinar - Three ways erp will change - dan matthewsIFS
Compared to those used in the 90’s, today’s ERP systems have many things in common—but also significant differences. In this webinar you are welcome to listen to IFS Chief Technology Officer Dan Matthews talk about three ways in which ERP will change over the next 15 years.
The document discusses the revised training package for the Baby Friendly Hospital Initiative (BFHI). Some key points:
- The BFHI was launched in 1991 to promote breastfeeding. Over 15,000 facilities in 134 countries have achieved Baby-Friendly status.
- However, progress in designating new hospitals has slowed since 1996. On average, less than seven hospitals per country are designated each year.
- WHO and UNICEF have developed a revised 20-hour training course package to revitalize the BFHI both quantitatively and qualitatively.
- The package includes updates to certain steps and new/optional criteria on areas like HIV/AIDS, labor/childbirth care, and compliance with
This document summarizes a research article about the challenges faced by HIV-positive mothers in exclusively breastfeeding their infants for six months in sub-Saharan Africa. Some key points:
- Exclusive breastfeeding for six months is recommended to reduce HIV transmission risk, but formula feeding poses challenges in poor areas with limited access to clean water and healthcare.
- Mothers face socio-cultural barriers to adhering to recommendations, such as stigma, partner disapproval, and pressure to introduce other foods and water earlier. Health workers also lack training to adequately counsel and support mothers' choices.
- Access to antiretroviral treatment is limited, and high maternal viral loads increase infection risk, despite recommendations for
Many pregnant women visiting baby scan clinics in Leicester have expressed concerns about the impact of coronavirus on themselves and their babies as well. For more information visit: https://windowtothewomb.co.uk/find-a-clinic/leicester-baby-scan-clinic/
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.
The Baby-Friendly Hospital Initiative was launched globally in 1991 by WHO and UNICEF to promote breastfeeding and adopted 10 steps to support breastfeeding in hospitals, with over 152 countries now implementing the initiative. India established a national task force in 1992 to improve breastfeeding practices in hospitals and certify them as "Baby-Friendly" if they follow the 10 steps. The initiative has been shown to increase exclusive breastfeeding rates for the first six months.
Infant and young child feeding in emergenciesPrithwiGhosh1
This document provides guidance on infant and young child feeding in emergencies. It outlines key actions to protect, promote and support optimal infant and young child feeding practices during emergencies. Some of the main points covered include:
- The importance of emergency preparedness and having policies in place to guide responses. National governments should lead coordination of infant and young child feeding responses, with UNICEF or UNHCR providing support as needed.
- Multi-sector collaboration is essential, as is training emergency staff across sectors on infant and young child feeding issues. Needs assessments should inform context-specific responses.
- Immediate action is needed to protect recommended feeding practices and support higher risk groups. Donations of breast
Going Beyond Nutrition to Understand Child Growth and Development_Laura Smith...CORE Group
1) The document discusses environmental enteropathy (EE), a condition caused by ingesting fecal matter that damages the gut and stunts growth. EE is a major cause of stunting in children under 2 in developing countries.
2) A randomized trial in Zimbabwe will test if a water, sanitation, and hygiene (WASH) intervention can reduce EE and stunting by preventing infants from ingesting fecal matter. The intervention provides protected play areas, handwashing, and latrines.
3) The trial will also test if combining the WASH intervention with a nutrition intervention provides added benefits for stunting and anemia reduction beyond either alone. Outcomes will be measured on 4,800 infants to test
The document outlines the 10 steps of the WHO/UNICEF Baby-Friendly Hospital Initiative launched in 1991 to ensure hospitals, maternity facilities, and communities support breastfeeding. The 10 steps include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, and not providing breastfed infants with any food or drink other than breastmilk unless medically necessary. Implementing the 10 steps could save an estimated 1.5 million lives worldwide each year if every baby was exclusively breastfed for the first 6 months.
The document discusses breastfeeding policies and statistics globally and locally. It finds that [1] breastfed babies have lower rates of illnesses like gastrointestinal and respiratory infections, [2] most women in the UK stop breastfeeding before 6 weeks despite health benefits, and [3] policies aim to promote exclusive breastfeeding for 6 months but face challenges from formula marketing practices. The document calls for stronger implementation of the International Code on breastfeeding and marketing of breastmilk substitutes to better protect breastfeeding.
The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 by WHO and UNICEF to implement practices that protect, promote, and support breastfeeding globally. The aims of BFHI are to follow the Ten Steps to Successful Breastfeeding and end free distribution of breast milk substitutes in healthcare facilities. The Ten Steps include having a written breastfeeding policy, training staff, informing pregnant women about benefits of breastfeeding, helping mothers initiate breastfeeding within 30 minutes of birth, and fostering breastfeeding support groups.
Flash Heat Method for Breastfeeding Moms with HIVJenny
One of the most difficult decisions for HIV-positive women is whether to breastfeed or use formula. Breastfeeding carries a risk of transmitting HIV to the baby, but formula risks malnutrition and disease in areas without clean water or refrigeration. For mothers in low-resource areas who meet certain criteria, exclusive breastfeeding for 6 months or flash-heating expressed breast milk are recommended options that aim to balance the health risks.
The document summarizes the services provided at an under five clinic. The clinic provides preventative, curative, referral, and educational services to children under five years old under one roof. The overall goal is to provide comprehensive healthcare to young children in a specialized facility. The clinic treats acute and chronic illnesses, monitors growth through periodic weighing and measurement, provides immunizations and nutrition care, and educates mothers on childcare.
"Experiência de paíse com a IHAC = BFHI"
Baby-Friendly Hospital Initiative 2016
Experiência de 13 países são relatadas: Bolívia, Brasil, China, Gana, Irlanda, Quênia, Kuwait, Quirguistão, Nova Zelândia, Filipinas , Arábia Saudita, EUA e Vietname.
Demonstra que precisamos fortalecer e aprimorar esse programa mundial em defesa do estabelecimento da Amamentação nas Maternidades, Casas de Parto, Centros de Nascimento.
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
The document outlines Methodist Dallas Medical Center's plan to achieve Baby-Friendly designation by adopting several evidence-based practices. The plan includes having a neonatal admission nurse care for infants in the same location as mothers to promote skin-to-skin contact and rooming-in. Research shows these practices improve breastfeeding and maternal-infant bonding. The plan also delays unnecessary interventions like early infant bathing to prevent hypothermia and supports breastfeeding within one hour of birth.
Integrated management of Neonatal and Childhood illness among Infants of 0 to...Dhruvendra Pandey
Integrated management of Neonatal and Childhood illness among Infants of 0 to 2 months, Difference between IMCI and IMNCI, Objective, Elements, Management of Diarrhea, Bacterial Infections, Jaundice, Hypothermia, Feeding problem, counseling of mothers, followup
Evidence of 10 steps4,92 bfhi revised section2.4.a_slidesELCA Egypt
Step 1 informs all health care staff of the hospital's written breastfeeding policy.
Step 2 trains all health care staff in the skills needed to implement the breastfeeding policy.
Step 3 informs all pregnant women about the benefits of breastfeeding.
The document discusses the Baby Friendly Hospital Initiative (BFHI) which was launched in 1991 by WHO and UNICEF to promote breastfeeding. It was introduced in India in 1993. The BFHI aims to protect, promote and support breastfeeding practices through 10 steps that health facilities should implement. These include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, teaching positioning and latching, rooming-in, not providing supplements unless medically necessary, and fostering breastfeeding support groups. The BFHI helps encourage breastfeeding and address mothers' concerns. Its implementation can improve infant health and growth through breastfeeding.
This document discusses barriers to providing human milk feedings (HMF) to very low birth weight infants in the NICU. It identifies key barriers as financial constraints, physiological challenges for mothers of preterm infants, and hospital cultures that do not adequately support lactation. The role of nurses is emphasized in establishing and maintaining milk supply through early and frequent pumping and hand expression, education of mothers, and advocating for hospital policies that follow evidence-based practices to promote HMF. Adopting the Baby-Friendly Hospital Initiative is presented as a way to standardize high-quality lactation support.
In Search of Diablotín: One of the world's rarest birds and its unlikely stro...Julie Hart
Background on the biology of and threats to Diablotín/Black-capped Petrel and a presentation on my participation in searching for this rare species in Haiti in 2010.
Innovation webinar - Three ways erp will change - dan matthewsIFS
Compared to those used in the 90’s, today’s ERP systems have many things in common—but also significant differences. In this webinar you are welcome to listen to IFS Chief Technology Officer Dan Matthews talk about three ways in which ERP will change over the next 15 years.
This document provides information about tourism activities and destinations in Monte Hermoso and Ushuaia, Argentina. It promotes The Best Tourist agency by listing the various services and attractions they offer, including the best hotels, activities, restaurants, tours, shops, and staff. Specific attractions mentioned for Monte Hermoso include fishing, windsurfing, a small theme park, and nice beaches. For Ushuaia, activities listed include skiing, dog sledding, snow biking, forests, and scuba diving. Hotel and tour options are also summarized for both locations.
The document introduces PowerPoint toolbars and other essential concepts. It discusses the four main toolbars - Standard, Formatting, Drawing, and Common Tasks. It describes how to move, dock, add, and remove toolbars. Key terms like slide, presentation, object, and transition are defined. The document recommends teaching PowerPoint basics like toolbars and vocabulary to students in a systematic way before introducing more advanced features.
HTML5 is the new standard for HTML that supports rich multimedia content like video and audio with tags like <video> and <audio>. It also improves the semantic structure of documents. Currently, browsers like Firefox, Chrome, and Safari support HTML5 to varying degrees, while Internet Explorer 9 will provide support later in 2011. HTML5 can be used for rich websites, web apps, and many mobile apps on devices that support it like iPhone, iPad, and Android phones. While HTML5 has benefits for eLearning like mobile learning and interactive content, tools are still needed to easily create HTML5 content and many eLearning courses will continue to use Flash for now due to its current dominance and expertise with Flash developers.
Octopod Mobile Development Platform for rapid cross-platform Enterprise IT Mo...Michael Kozloff
Octopod is a mobile application development platform for independent software developers and enterprise IT departments striving to find a flexible, yet powerful way of «IT Mobilization» with fast time to market and low cost of ownership.
The document presents artwork by artist Noel Hoffmann depicting dogs in various settings and activities. It includes the titles, sizes, media, and prices for 15 pieces available for purchase at the Chisholm Gallery. Hoffmann's artist statement discusses his lifelong passion for drawing and painting dogs, and enjoying observing their behaviors in the woods near his Vermont home.
The document discusses a relationship where one person has been unhappy and lonely recently. The writer explains they cannot stay by the person's side, and that everything between them has already ended. They do not want to be bound or suffer anymore, and believe the next relationship will be better. While they care about the person and want to hug them, the writer feels they cannot fully give the person what they want in a relationship, and that the two people are not truly compatible.
Why It as a Service and new CIO's competences to survive?Michael Kozloff
Ситуация
- Бизнес-спонсоры считают, что ДИТ не понимает их ожиданий
Последствия
- Спонсоры считают, что ИТ это ширпотреб, оцениваемый по затратам
- Неохотно выделяют бюджеты на развитие ИТ
- Выбирают дешевый аутсорсинг в ущерб качеству
Решение для CIO: Управлять ИТ как услугами
- Понимать задачи, требования и ожидания спонсоров
- Уметь доказывать вклад ИТ в реализацию стратегии компании (ключевые показатели и приоритеты бизнеса)
- Предлагать ИТ решения и уметь считать затраты (TCO) и отдачу (ROI) от инвестиций в ИТ
The document provides guidance for breastfeeding mothers. It discusses how a mother's body prepares for breastfeeding during pregnancy. It emphasizes the importance of breastfeeding in the first few days to provide the baby with colostrum. The document provides tips on proper feeding positions and how to know when a baby is hungry or full. It addresses issues like engorgement, growth spurts, and taking care of oneself as a new mother.
Mark Robinson is a British artist born in Belfast in 1960 who specializes in golf portraits. He studied Fine Art in London during the 1970s and has exhibited internationally. The document provides biographical information about Robinson and notes that he focuses on portraits related to the sport of golf in his work.
This document summarizes research on the safety risks of infant formulas contaminated with Enterobacter sakazakii. Several studies found instances of E. sakazakii infection in neonates linked to consumption of contaminated powdered formula. One study detected E. sakazakii in a powdered formula after 2 years of storage at room temperature. Global health organizations responded by calling for revisions to food safety guidelines and recommending against powdered formulas for preterm infants when alternatives exist.
The document discusses three main types of production methods: batch production, flow production, and job production. Batch production involves making groups of similar products on the same line, while flow production makes identical products continuously on an assembly line. Job production makes unique custom products one at a time for specific customers. The key advantages and disadvantages of each method are outlined. The most suitable production method depends on various factors like workforce skills, available finance and technology, business size, product, and production quantities and quality standards needed.
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.
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
[[IAA JSR 10(1)49-60, 2023.Awareness and Practice of Breast Feeding among Mot...PUBLISHERJOURNAL
Breastfeeding is a key tool for nourishing a baby, preventing childhood illnesses like obesity, and hypertension later on in life. In addition, it reduces the cost to the family and the entire country. Uganda to some extent faces a great deal of challenges, particularly in the health sector. The aim of this study was to assess the knowledge, attitude and practices of exclusive breastfeeding in mothers with infants between 1 day to 2 years of age attending the immunization and the pediatric inpatient in Kiryandongo Hospital and to identify factors that affect exclusive breastfeeding (EBF). A cross-section descriptive survey design was used. 187 respondents were selected randomly. The data were collected using a questionnaire and the data was analyzed using descriptive statistics of frequency and percentages. The result of this study showed that 71.2 % knew the correct definition and duration of exclusive breastfeeding, 59.7% exclusively breastfeeds for the first six (6) months of life, 100% gave colostrum to their babies because they believed it provides nutrition and protection to their babies, 87% breastfed on demand. The result also showed that there is a positive attitude of mothers toward exclusive breastfeeding as 86.6% of them agreed that breast milk alone is sufficient to the baby during the first six (6) months of life as well as believed that EBF has benefits to both the infants and the mother. 51% of respondents weaned their babies between 15-18 months and 41% weaned between 19 months to 2 years. It was concluded that there was a high level of knowledge on breastfeeding among the respondents, more than half of the respondents practiced exclusive breastfeeding as recommended and relatively all the respondents had positive attitude toward exclusive breastfeeding.
Keywords: knowledge, attitude, practice, breastfeeding, mothers
A STUDY OF THE PERCEPTION ON EXCLUSIVE BREASTFEEDING AMONG POSTNATAL MOTHERS ...edianbiir
This document presents a study on the perception of exclusive breastfeeding among postnatal mothers at Legon Hospital in Ghana. It provides background information on the benefits of exclusive breastfeeding for six months and highlights breastfeeding rates in Ghana. While nearly all Ghanaian mothers initiate breastfeeding, exclusive breastfeeding rates drop significantly after the first few months. The study aims to address the lack of record keeping on exclusive breastfeeding and mother support groups at Legon Hospital.
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.
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.
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.
This document summarizes research on the optimal duration of exclusive breastfeeding. It discusses how the WHO recommendation had been 4-6 months but was changed to around 6 months in 2001 based on evidence from over 3,000 studies. The resolution passed by the World Health Assembly urges exclusive breastfeeding for six months as a global recommendation, taking into account the expert committee's findings that exclusive breastfeeding for six months does not harm growth and protects against infection.
Breastfeeding during pregnancy does not increase the risk of miscarriage or preterm birth according to a case-control study. The study compared 215 pregnant women who breastfed during pregnancy to 280 pregnant women who did not breastfeed. The frequency of miscarriage was significantly lower in those who breastfed, but there was no significant difference in rates of preterm birth or birth weight between the groups. The study concludes that breastfeeding during pregnancy does not pose additional risks for miscarriage, preterm birth, or neonatal birth weight.
Awareness of Exclusive Breastfeeding Practice Among Mothers’ In The Formal Se...QUESTJOURNAL
ABSTRACT: The study examined the practice of exclusive breastfeeding among working mothers in the formal sector. The objectives of the study were, to evaluate the extent of exclusive breastfeeding awareness; to ascertain how working mothers cope with exclusive breastfeeding. The study applied social action theory, quantitative and qualitative method of data collection was used. Two hundred questionnaires were administered to mothers’ attending university of Abuja teaching hospital (UATH), St Mary’s Private Hospital and Area Council Town Clinic. From the returned questionnaires, one hundred and eighty seven (187) of them were correctly answered. Also two rounds of In-depth interview was conducted, participants were paediatric doctors and nurses. Analysis was done using frequency counts and simple percentages, while chi-square (X2 ) was used in testing hypotheses. Findings showed that majority of the working mothers practice exclusive breastfeeding, but the practice is stressful. It was also observed that mothers with higher qualifications tend to practice exclusive breastfeeding because of its gains. Also work place lack facilities to cater for the needs of working mothers. The research is significant to government on policy issues and other related agencies for a productive workforce and a greater reduction in infant mortality. The study suggested among others that the policy for maternity leave should be reviewed upward. Again, work places should establish crèches for a productive workforce.
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
This study aimed to describe the risk of HIV transmission in pediatric patients breastfed by HIV-infected mothers in Haiti following the implementation of the 2010 WHO breastfeeding guidelines. The study analyzed data from over 1400 pediatric patients across four sites from 2008-2012. Only two cases of HIV transmission were observed, indicating a minimal risk of transmission for mothers compliant with antiretroviral therapy and exclusive breastfeeding. However, further research is still needed to conclusively determine the impact of the national breastfeeding recommendations on infant morbidity and mortality in Haiti.
Higher maternal educational attainment is associated with decreased exclusive breastfeeding and increased use of formula in both urban and rural Peru. Exclusive breastfeeding rates are significantly higher in rural versus urban mothers across all education levels. Urban mothers also report higher use of other fluids in addition to breastfeeding compared to rural mothers. Targeted breastfeeding campaigns should focus on mothers with higher education and those in urban areas to promote exclusive breastfeeding practices.
Teenage mothers care practices study in Sierra Leone.
The study examined care practices of 45 teenage mothers in Western Area, Koinadugu and Pujehun districts. It found teenage pregnancy leads to feelings of isolation, rejection and poverty. Most mothers dropped out of school and had complications during delivery due to their young age. Feeding practices like early initiation of breastfeeding and exclusive breastfeeding rates were low. Mothers had poor nutrition knowledge and children lacked balanced diets. Many mothers did not consistently seek healthcare for their children. Hygiene practices around water treatment and handwashing were inadequate. The study concluded teenage mothers would benefit from additional support and education on maternal and child healthcare.
This document summarizes a study that assessed the knowledge, attitudes, and practices of mothers in Jos North, Nigeria regarding childhood immunization. The study used a questionnaire to survey 232 mothers with children aged 0-1 years old. It found that while most mothers (89.6%) had good overall knowledge of vaccines, less than 60% reported vaccinating their children on schedule and less than 3% had negative attitudes towards immunization. Factors like education level, marital status, religion, and whether the mother was vaccinated as a child influenced mothers' knowledge. Records also showed only 23.4% of children completed their vaccination schedules, revealing poor practice. The study concluded health education and promotion efforts are needed to improve mothers' knowledge
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Rega...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Diabetes has become the fastest growing chronic disease in New Zealand and a major cause of death for Māori. A community-based program in the Waikato region aims to prevent diabetes through health education, screening, and lifestyle changes. Key interventions include raising awareness of diabetes risks and promoting screening to catch cases early. Evaluating the program through surveys before and after will assess if the goal of minimizing complications was achieved to guide future programs.
This document from the American Academy of Pediatrics outlines their policy statement on breastfeeding and the use of human milk. The key points are:
1) Extensive research has demonstrated significant health benefits for infants and mothers from breastfeeding, including reduced risk of infectious diseases, sudden infant death syndrome, diabetes, obesity, and improved cognitive development.
2) The policy statement provides recommendations for pediatricians and healthcare professionals to promote, protect, and support breastfeeding through individual practice, hospitals, medical schools, and communities.
3) Certain infectious diseases like HIV may preclude breastfeeding in some situations, but exclusive breastfeeding for the first 6 months does not increase HIV transmission risk according to some studies in developing countries.
This study evaluated the clinical and perinatal outcomes of 100 teenage pregnancies at a tertiary referral center in South India. The study found that teenage pregnancies had higher rates of complications like anemia (43%), preeclampsia (21%), preterm labor (21%), and emergency c-sections (33%) compared to adult pregnancies. Neonatal outcomes were also worse, with 38% of babies being low birth weight (<2.5 kg) and 21% being preterm. The study concluded that teenage pregnancy poses significant health risks to both mother and baby due to the biological immaturity of teenage mothers.
This document provides a summary of the under five children's health situation in Bangladesh. It discusses the leading causes of under five mortality, including preterm birth, pneumonia, and diarrhea. It also reviews vaccination rates, treatment of common childhood illnesses, breastfeeding practices, vitamin A supplementation, and childhood nutrition status. Several ongoing government and non-government programs aimed at improving child health in Bangladesh are also outlined, including the National Nutrition Services and Expanded Programme on Immunization. The document concludes by noting that Bangladesh has made progress in reducing under-five mortality but more efforts are still needed.
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Hiv, Infant Feeding, And Maternal And Child Health
1. Breastfeeding Briefs
June 2002
No. 34
HIV, infant feeding, and maternal and child health
In 1997 the UN Policy Statement highlighted that, as a general principle and in all populations, irrespective of
HIV infection rates, breastfeeding should be protected, promoted and supported. It also clearly emphasised that
HIV-positive mothers have to be empowered to make a fully informed choice about infant feeding and have to
be supported in implementing their decisions.
In October 2000, UNICEF, WHO and UNAIDS reviewed evidence that accumulated in the course of three
years. There were research findings that required specific attention. The results published by Coutsoudis et al.
(The Lancet, 1999) suggested benefits of exclusive breastfeeding over mixed feeding, with exclusive
breastfeeding carrying a similar risk of transmission compared to exclusive formula feeding (presented in BB
29). A follow up analysis of the data, published by Coutsoudis et al. In 2001 (BB 31-32), also concluded that
infants exclusively breastfed for 3 months or more had no excess risk of HIV infection over 6 months than those
never breastfed. After analysing the data the UN clearly reiterated the 1997 Policy on HIV and Infant Feeding
and specified in the recommendations that:
• When replacement feeding is acceptable, feasible, affordable, sustainable and safe, then avoidance of all
breastfeeding by the HIV positive mother is recommended.
• In the absence of any of these conditions, exclusive breastfeeding is recommended during the first months of
life.
Already at that time, the experts placed special emphasis on maternal health and recommended the inclusion of
family planning services and nutritional support for HIV positive women.
This recommendation was again reviewed by WHO in 2001 in the light of the findings of Nduati et al which
suggested that HIV positive mothers had higher mortality rates if they breastfed their infants. These results
conflicted with findings of a South African study that found no increase in death among HIV nursing mothers.
An editorial in the Lancet points out that these conflicting results must lead to further research, not to
recommendations. 1 On 7 June 2001,WHO issued a statement that warned against rushing to quick conclusions
leading to a shift in the policy.2 WHO stated that the limitations of the Nduati data call for a cautious
interpretation and reiterated again the importance of proper support, clinical as well as nutritional, to mothers
who are HIV infected.
HIV and the infant feeding component of programmes on prevention of mother-to-child transmission of HIV
has been most challenging. This is because research has not yet provided definite responses to issues such as the
effect of exclusive breastfeeding and the impact of anti-retroviral therapy during lactation on the transmission
rates. Much research that has looked at breastfeeding and HIV did not take into account the WHO 1991
definitions for individual infant feeding patterns (exclusive breastfeeding, predominant breastfeeding, partial
breastfeeding etc). It was thus impossible to separate the data in this respect and provide useful guidance for
programme managers. In 2001, WHO in collaboration with UNICEF and experts issued an assessment tool for
research to assist scientists in designing research protocols.
The 2000 recommendation about using replacement feeding only when it is acceptable, feasible, affordable,
sustainable and safe is certainly a step in the right direction. However, all these conditions are extremely
situation specific. Therefore it is crucial that a proper detailed situation analysis is performed so that the
counsellors for HIV positive mothers have a good understanding of the range of options and conditions and can
effectively assist mothers in making an informed choice. The experience for counselling of HIV positive
mothers in various parts of the world suggests that many counsellors are not fully equipped with knowledge and
skills and are often acting on the basis of prejudice, personal experience and under time pressure.
1 Newell ML. Does breastfeeding really affect mortality among HIV-1 infected women? Lancet 2001;357:1634
2 WHO. New data on the prevention of mother-to-child transmission of HIV and their policy and implications. WHO, Geneva, 7 June 2001
2. Highlights
1. Nduati R, John G, Mbori-Ngacha D, Richardson B, Overbaugh J, Mwatha A, Ndinya-Achola J, Bwayo J, Onyango FE, Hughes J,
Kreiss J. Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. JAMA 2000;283:1167-74
2. Nduati R, Richardson BA, John G, Mbori-Ngacha D, Mwatha A, Ndinya-Achola J, Bwayo J, Onyango FE, Kreiss J. Effect of
breastfeeding on mortality among HIV-1 infected women: a randomised trial. Lancet 2001;357:1651-5
3. Mbori-Ngacha D, Nduati R, John G, Reilly M, Richardson B, Mwatha A, Ndinya-Achola J, Bwayo J, Kreiss J. Morbidity and
mortality in breastfed and formula-fed infants of HIV-1-infected women: a randomized clinical trial. JAMA 2001;286:2413-20
OBJECTIVES. This study was conducted to determine the frequency of breast milk transmission of HIV-1, and to compare
morbidity, nutritional status, mortality and HIV-1-free survival in breastfed and formula-fed infants. The same data were
also used to examine the effect of breastfeeding on maternal death rates during two years after delivery.
METHODS. Four hundred and twenty five HIV-1-seropositive pregnant women never treated with antiretroviral drugs were
enrolled from November 1992 to July 1998 in antenatal clinics in Nairobi, Kenya. Of these, 212 were randomized to
breastfeeding (BF) and 213 to formula feeding (FF). Four hundred and one mother-infant pairs were followed-up for a
median period of 24 months and were included in the analysis for the first two papers, while 371 infants were included in
the analysis for the third paper.
RESULTS (1). Compliance with the assigned feeding mode was 96% in the BF arm and 70% in the FF arm (p<.001).
Median duration of breastfeeding was 17 months. The cumulative probability of HIV-1 infection at 24 months was 36.7%
in the BF arm and 20.5% in the FF arm (p=.001). The estimated rate of breast milk transmission was 16.2%, and 44% of
HIV-1 infection in the BF arm was attributable to breast milk. Most breast milk transmission occurred early, with 75% of
the risk difference between the two arms occurring by 6 months, although transmission continued throughout the duration
of exposure. The 2-year mortality rates in both arms were similar (BF 24.4% vs FF 20.0%; p=.30), even after adjusting for
HIV status. The rate of HIV-1-free survival at 2 years was significantly lower in the BF arm than in the FF arm (58.0% vs
70.0%, respectively; p=.02). The incidence of diarrhoea during the two years of follow-up was similar (155 vs 149
episodes per 100 person-years, respectively). The incidence of pneumonia was identical in the two groups (62 per 100
person-years), and there were no significant differences in incidence of other recorded illnesses. Infants in the BF arm
tended to have better nutritional status, significantly so during the first six months of life. Mortality among mothers was
higher in the BF than in the FF arm (18 vs 6 deaths, p=.009). The cumulative probability of maternal death at 24 months
after delivery was 10.5% in the BF and 3.8% in the FF arm (p=.02). BF mothers had a 3.2 times higher risk of death
compared to FF mothers; the estimated proportion of deaths due to breastfeeding among BF mothers was 69%. There was
an association between maternal death and subsequent infant death, even after infant HIV-1 infection status was controlled
for.
DISCUSSION. Infants assigned to FF or BF had similar mortality rates and incidence of diarrhoea and pneumonia during the
first two years of life. However, HIV-free survival at two years was significantly higher in the FF arm. According to the
authors, with appropriate education and access to clean water, formula feeding can be a safe alternative to breastfeeding for
infants of HIV-infected mothers in a resource-poor setting.
4. Coutsoudis A, Coovadia H, Pillay K, Kuhn L. Are HIV-infected women who breastfeed at increased risk of mortality? AIDS
2001;15:653-655
For the objectives and methods of this study, see summary in BB 29 and BB 31-32. A total of 566 HIV positive mothers
were followed after delivery for 10.4 months among those who ever breastfed (n = 410) and for 10.6 months in those who
never breastfed (n = 156). Two out of 410 (0.49%) women who ever breastfed died compared with three out of 156
(1.92%) who never breastfed, a non statistically significant difference. Among the breastfeeding group, the proportion with
any morbidity was similar on those who breastfed for more than 3 months (14%) compared with those who breastfed for
less than 3 months (11%), even after controlling for CD4 cell counts and hemoglobin levels. The authors were unable to
confirm any deleterious effects of breastfeeding on the health of seropositive women.
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ever lactation had a borderline significantly reduced risk morbidity on iron status. The cohort consisted of 488
of about 17%. Almost 50% reduction of risk was observed normal term infants from primary healthcare centres in 11
in those having breastfed more than 3 children compared European areas. The prevalence of anaemia at 12 months
to those who never lactated. Women having breastfed was 9.4%, of iron deficiency 7.2%, and of iron deficiency
their first child for more than 13 months had also a risk anaemia 2.3%. More than 40% of anaemia was associated
reduced by about 50% compared to those who never with normal iron status and with an increased frequency of
breastfed. Further stratification by menopausal status recent infections. Iron deficiency anaemia was
showed a risk reduction related to lactation for both pre- significantly more frequent with low (5.1%) than high
and postmenopausal women, though the relationship was socio-economic status (0%). Dietary factors accounted for
less consistent for the latter. most of this variation in multiple regression analysis.
Early introduction of cow’s milk was the strongest
negative determinant of iron status. Feeding of iron-
Wang B, Miller JB, Sun Y, Ahmad Z, McVeagh P, Petocz P. A fortified formula was the main factor positively
longitudinal study of salivary sialic acid in preterm infants: influencing iron status. Other dietary factors, including
Comparison of human milk-fed versus formula-fed infants. J breastfeeding, did not play a significant role as
Pediatr 2001;138:914-6 determinants of iron status at age 12 months.
The saliva of preterm infants fed human milk contains
twice the level of sialic acid as that in infants fed Griffin IJ, Abrams SA. Iron and breastfeeding. Pediatr Clin
commercial formulas. The higher sialic acid level suggests North Am 2001;48:401-13
greater viscosity and enhanced protection against infection
of the mucosal surfaces in breastfed infants. Given the importance of iron nutrition during the first year
of life, there are surprisingly few true, randomized,
controlled studies addressing this issue. However, it seems
that iron deficiency is unlikely in full-term, breastfed
Breastfeeding, how... infants during the first 6 months of life because these
infants' body iron stores are sufficient to meet
Domellof M, Cohen RJ, Dewey KG, Hernell O, Rivera LL,
requirements. After this time, many infants exhaust their
Lonnerdal B. Iron supplementation of breastfed Honduran and
Swedish infants from 4 to 9 months of age. J Pediatr iron stores and become dependent on a secondary dietary
2001;138:679-87 iron supply. Although iron deficiency is a significant
nutritional problem worldwide, most of the adverse effects
In a randomized, placebo-controlled trial, term Swedish (n of iron deficiency in this age group are hypothetical and
= 101) and Honduran (n = 131) infants were assigned to 3 rely on extrapolation from animal studies or studies at
groups at 4 months of age: 1) iron supplements, 1 different ages. This, however, is also true of most of the
mg/kg/d, from 4 to 9 months, 2) placebo, 4 to 6 months adverse effects of iron excess in this age group. Given this
and iron, 6 to 9 months, and 3) placebo, 4 to 9 months. All uncertainty, it seems prudent to use the lowest dose of iron
infants were breastfed exclusively to 6 months and that prevents iron-deficiency anaemia. Currently, the best
partially to 9 months. From 4 to 6 months, the effect of evidence is that this is achieved by prolonged
iron (group 1 vs 2 + 3) was significant and similar in both breastfeeding, avoidance of unfortified formulas and cow's
populations for haemoglobin, ferritin, and zinc milk, and the introduction of iron-fortified and vitamin C-
protoporphyrin. From 6 to 9 months, the effect (group 2 vs fortified weaning foods at approximately 6 months of age.
3) was significant and similar at both sites for all iron There are many areas of uncertainty regarding iron
status variables except haemoglobin, for which there was supplementation of infants, including that: 1) The optimal
a significant effect only in Honduras, where the age for introducing iron-fortified supplemental foods is
prevalence of iron deficiency anaemia at 9 months was poorly defined. 2) The natural history of iron deficiency
29% in the placebo group and 9% in the supplemented and iron-deficiency anaemia during the first year of life is
groups. In Sweden, iron supplements caused no reduction unclear, as are its possible long-term effects, especially on
in the already low prevalence of iron deficiency anaemia developmental outcome. 3) The biologic variability
at 9 months (less than 3%). Iron supplementation from 4 among infants and their mothers that allows many infants
to 9 months or 6 to 9 months significantly reduced iron who do not receive iron-fortified foods to prevent iron
deficiency anaemia in Honduran breastfed infants. The deficiency while receiving only human milk throughout
4. the first year of life is intriguing and warrants additional on breastfeeding for preterm infants; individual
study. 4) The iron requirements of small-for-gestational- counselling by the research lactation consultant; weekly
age, term infants are unknown; their iron requirements are personal contact in the hospital; and frequent post-
likely to be higher than those of average term infants, but discharge contact through the infants' first year or until
whether iron supplements are required is unclear. 5) The breastfeeding was discontinued. The “standard” group had
optimum amount of dietary iron in the weaning diet needs standard breastfeeding support from regular staff members
to be further defined; similarly, the optimal source and confined to the period of hospitalisation in the NICU. The
amount of iron in infant formulas given to infants who mean duration of breastfeeding was 26.1 weeks in the
receive a mixture of human milk and formula is unclear. “counselling” group and 24.0 weeks in the “standard”
group (not statistically significant). These results may be
explained by the high motivation to breastfeed in both
Auestad N, Halter R, Hall RT, Blatter M, Bogle ML, Burks W, groups, a relatively advantaged population, and the
Erickson JR, Fitzgerald KM, Dobson V, Innis SM, Singer LT, availability of community breastfeeding resources, which
Montalto MB, Jacobs JR, Qiu W, Bornstein MH. Growth and may have diminished any significant differences that
development in term infants fed long-chain polyunsaturated fatty could have resulted from a breastfeeding intervention.
acids: a double-masked, randomized, parallel, prospective,
multivariate study. Pediatrics 2001;108:372-81
To evaluate the effect of the intake of long-chain Valdes V, Labbok MH, Pugin E, Perez A. The efficacy of the
polyunsaturated fatty acids on infant growth, lactational amenorrhea method (LAM) among working women.
Contraception 2000;62:217-9
psychological, mental and cognitive development,
intelligence, language, temperament and visual acuity, a The authors assessed the efficacy of the lactational
double-masked, randomized trial was conducted with term amenorrhea method (LAM) for family planning among
infants fed formula (formula group; N = 239) with or mothers who are separated from their infants by work. 170
without arachidonic acid (AA) and docosahexaenoic acid urban middle class women who planned to return to work
(DHA) for 1 year. Reference groups of breastfed infants before 120 days postpartum, were interviewed monthly for
(N = 165) weaned to formulas with or without AA+DHA 6 months postpartum and contacted at 12 months. They
were also studied. Infants in the formula group were received clinical support for expressing their milk and
randomized at 9 or less days of age to: 1) a control exclusively breastmilk feeding the infants, and for the use
formula with no AA or DHA (N = 77); 2) a formula of LAM. The cumulative pregnancy rate by 6 months was
containing AA+DHA from egg (N = 80) at levels similar 5.2%. LAM for working women might be associated with
to the average in breast milk; or 3) a formula containing a higher pregnancy risk than LAM among non-working
AA+DHA from fish or fungal oil (N = 82) at levels women. Women using LAM should be informed that
similar to the average in breast milk. All formulas separation from the infant might increase their risk of
contained 50% of energy from fat, including 10% from pregnancy.
linoleic acid and 1% from alpha-linolenic acid (essential
fatty acids). No developmental test results distinguished
among these groups in the follow-up. These findings do Giuliani M, Grossi GB, Pileri M, Lajolo C, Casparrini G. Could
not support adding AA+DHA to formulas containing 10% local anesthesia while breast-feeding be harmful to infants? J
energy as linoleic acid and 1% as alpha-linolenic acid to Pediatr Gastroenterol Nutr 2001;32:142-4
enhance growth, visual acuity, general development,
language, or temperament in healthy, term infants during A nursing mother may need dental treatment. The purpose
the first 14 months after birth. of this study was to determine the amount of lidocaine and
its metabolite monoethyl-glycinexylidide (MEGX) in
breast milk after local anesthesia during dental procedures.
Pinelli J, Atkinson SA, Saigal S. Randomized trial of Seven nursing mothers (aged 23-39) received 3.6 to 7.2
breastfeeding support in very low-birth-weight infants. Arch mL 2% lidocaine without adrenaline. The concentration of
Pediatr Adolesc Med 2001;155:548-53 lidocaine and MEGX in maternal plasma and maternal
milk 2 to 6 hours after injection corresponded to daily
Does breastfeeding counselling improve the duration of infant dosages of 73.41 +/- 38.94 microg/L/day and 66.1
breastfeeding in very low-birth-weight infants ? A +/- 28.5 microg/L/day, respectively, considering an intake
randomized trial with longitudinal follow-up at term, and of 90 mL breast milk every 3 hours. This study suggests
ages 1, 3, 6, and 12 months, was conducted in a tertiary- that a nursing mother undergoing dental treatment with
level neonatal intensive care unit (NICU) in Ontario, local anesthesia using lidocaine without adrenaline can
Canada. The “counselling” consisted of viewing a video safely continue to breastfeed.
Prepared by the Geneva Infant Feeding Association (GIFA), a member of the International Baby Food Action
Network (IBFAN). Editors: Marina Ferreira Rea, Adriano Cattaneo, Robert Peck. This issue Editorial had the contribution of Lida Lhotska.
Copies of Breastfeeding Briefs sent upon request to GIFA, Box 157, 1211 Geneva 19, Switzerland, Fax: +41-22-798 44 43, e-mail
info@gifa.org, or to UNICEF country offices. Available also in French, Spanish, Portuguese and Arabic. A contribution of Sfr. 10.-- for a
subscription to industrialized countries is gratefully accepted and can be sent by international postal order to account no. 12-17653-5