This study assessed how mothers learn about proper handling of infant formula and whether they follow safe practices. The study found that most mothers did not receive instruction from health professionals on formula preparation or storage. Many mothers did not fully read or understand package label instructions. While most believed following safety directions was important, many mothers engaged in unsafe practices like not always washing hands before preparing formula or heating bottles in microwaves. No consistent maternal traits predicted unsafe practices. More education is needed to promote proper formula handling and reduce risks of illness.
The Infant Feeding Practices Study II (IFPS II) was a longitudinal study that collected data from over 4,900 pregnant women from 2005 to 2007 regarding infant feeding practices, health, and related issues during the first year of the infant's life. Questionnaires were administered prenatally and monthly during the first year. The study aimed to understand infant feeding in the context of changes since the previous IFPS study in the 1990s. It provided detailed information on breastfeeding, formula feeding, complementary foods, and other factors to help evaluate infant feeding recommendations and policies.
Infant Feeding And Feeding Transitions During The First Year Of LifeBiblioteca Virtual
This document summarizes infant feeding patterns during the first year of life based on data from the Infant Feeding Practices Study II. Key findings include:
1) While 83% of infants were breastfed in the hospital, 42% of these infants also received formula supplementation. By 3 months, 61% of infants received formula.
2) Solid foods were introduced earlier than recommended, with 40% of infants consuming cereal and 17% consuming fruits/vegetables by 4 months of age.
3) Early introduction of solids was associated with discontinuing breastfeeding earlier and consuming more fatty/sugary foods by 12 months.
Evidence the use of probiotics in infants for prevention of allergic diseaseAriyanto Harsono
This document summarizes a review of evidence on using probiotics in infants to prevent allergic disease and food hypersensitivity. The review found insufficient evidence that probiotics reduce the risk of allergic disease or food hypersensitivity in infants. While probiotic use was associated with a reduction in infant eczema in some studies, the effect was inconsistent between studies and all studies had substantial losses to follow up, indicating caution is needed in interpreting the results due to methodological limitations. In conclusion, the review found the evidence is currently insufficient to recommend adding probiotics to infant feeds to prevent allergic conditions.
Effectiveness Of Exclusive Breastfeeding Promotion In Low Income Mothers A Ra...Biblioteca Virtual
The study compared the antifungal effects of human milk, cow's milk, and various infant formulas against environmental fungi. Human milk showed significantly greater antifungal activity than the other substances tested, inhibiting nearly all fungal growth. Both prebiotic and probiotic formulas also demonstrated antifungal effects, though to a lesser degree than human milk. The results indicate that human milk protects infants from fungal infections not only through nutrition but also via its antifungal properties.
Probiotic administration in early life, atopy, and asthma, a meta analysis of...Ariyanto Harsono
The document summarizes a meta-analysis of clinical trials on the effects of probiotic supplementation in children. The analysis found that prenatal and early-life probiotic administration reduced the risk of atopic sensitization and decreased total immunoglobulin E levels. However, probiotic administration may not reduce the risk of asthma or wheezing. The effects also depended on the probiotic strain used and the duration of follow-up. While probiotics seemed to reduce infant eczema, the evidence was heterogeneous and did not find an effect on confirmed atopic eczema. Overall, the review concluded there was insufficient evidence that probiotics prevent allergic disease or food hypersensitivity in infants.
This study examined the relationship between infant temperament and formula intake and weight gain in 3-month-old infants in the Philippines. The researchers administered the Carey Early Infant Temperament Questionnaire to mothers of 222 healthy formula-fed infants enrolled in a randomized controlled trial of infant formulas. Multivariate regression models controlling for confounders found inverse relationships between several temperament traits (adaptability, mood, distractibility, manageability) and both the frequency and total daily intake of formula. This suggests that infants with more difficult temperaments received more formula feeds and intake, which could lead to excessive weight gain. The study was the first to demonstrate an association between infant temperament and feeding practices.
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.
The Infant Feeding Practices Study II (IFPS II) was a longitudinal study that collected data from over 4,900 pregnant women from 2005 to 2007 regarding infant feeding practices, health, and related issues during the first year of the infant's life. Questionnaires were administered prenatally and monthly during the first year. The study aimed to understand infant feeding in the context of changes since the previous IFPS study in the 1990s. It provided detailed information on breastfeeding, formula feeding, complementary foods, and other factors to help evaluate infant feeding recommendations and policies.
Infant Feeding And Feeding Transitions During The First Year Of LifeBiblioteca Virtual
This document summarizes infant feeding patterns during the first year of life based on data from the Infant Feeding Practices Study II. Key findings include:
1) While 83% of infants were breastfed in the hospital, 42% of these infants also received formula supplementation. By 3 months, 61% of infants received formula.
2) Solid foods were introduced earlier than recommended, with 40% of infants consuming cereal and 17% consuming fruits/vegetables by 4 months of age.
3) Early introduction of solids was associated with discontinuing breastfeeding earlier and consuming more fatty/sugary foods by 12 months.
Evidence the use of probiotics in infants for prevention of allergic diseaseAriyanto Harsono
This document summarizes a review of evidence on using probiotics in infants to prevent allergic disease and food hypersensitivity. The review found insufficient evidence that probiotics reduce the risk of allergic disease or food hypersensitivity in infants. While probiotic use was associated with a reduction in infant eczema in some studies, the effect was inconsistent between studies and all studies had substantial losses to follow up, indicating caution is needed in interpreting the results due to methodological limitations. In conclusion, the review found the evidence is currently insufficient to recommend adding probiotics to infant feeds to prevent allergic conditions.
Effectiveness Of Exclusive Breastfeeding Promotion In Low Income Mothers A Ra...Biblioteca Virtual
The study compared the antifungal effects of human milk, cow's milk, and various infant formulas against environmental fungi. Human milk showed significantly greater antifungal activity than the other substances tested, inhibiting nearly all fungal growth. Both prebiotic and probiotic formulas also demonstrated antifungal effects, though to a lesser degree than human milk. The results indicate that human milk protects infants from fungal infections not only through nutrition but also via its antifungal properties.
Probiotic administration in early life, atopy, and asthma, a meta analysis of...Ariyanto Harsono
The document summarizes a meta-analysis of clinical trials on the effects of probiotic supplementation in children. The analysis found that prenatal and early-life probiotic administration reduced the risk of atopic sensitization and decreased total immunoglobulin E levels. However, probiotic administration may not reduce the risk of asthma or wheezing. The effects also depended on the probiotic strain used and the duration of follow-up. While probiotics seemed to reduce infant eczema, the evidence was heterogeneous and did not find an effect on confirmed atopic eczema. Overall, the review concluded there was insufficient evidence that probiotics prevent allergic disease or food hypersensitivity in infants.
This study examined the relationship between infant temperament and formula intake and weight gain in 3-month-old infants in the Philippines. The researchers administered the Carey Early Infant Temperament Questionnaire to mothers of 222 healthy formula-fed infants enrolled in a randomized controlled trial of infant formulas. Multivariate regression models controlling for confounders found inverse relationships between several temperament traits (adaptability, mood, distractibility, manageability) and both the frequency and total daily intake of formula. This suggests that infants with more difficult temperaments received more formula feeds and intake, which could lead to excessive weight gain. The study was the first to demonstrate an association between infant temperament and feeding practices.
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.
Efficacy Of Breastfeeding Support Provided By Trained Clinicians DuringBiblioteca Virtual
This study evaluated the efficacy of breastfeeding support provided by trained clinicians during an early routine preventive visit. The study involved 226 mother-infant pairs who were randomized to an intervention group that received an additional preventive visit within 2 weeks postpartum or a control group that received usual care. The intervention group had higher rates of exclusive breastfeeding at 4 weeks and longer breastfeeding duration. The intervention group also reported fewer breastfeeding difficulties. The study provides preliminary evidence that breastfeeding support during an early routine preventive visit can improve breastfeeding outcomes.
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
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.
Optimizing Breastfeeding for Better Health Outcomes The Way Forwardijtsrd
Breastfeeding is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. However, breastfeeding seems to be under attack by the commercial influence of the baby food industry, supported at work places and in the hospitals where they come to deliver. Artificial baby milk formula cannot meet the gold standards of breast milk. Provisions of IMS Act exists but widespread awareness and effective enforcement is required. Various studies reveal the gaps in the provision and implementation of the laws and awareness programs and to suggest appropriate solutions. It, thus, becomes necessary to emphasize upon the provisions of IMS Act, 2003 and evidently bring forward the commercial influence of baby food industry. Review revealed that the provisions of IMS Act has been violated at various online and offline platforms. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the country are recommended, including community health and education programmes and -˜baby friendly’ hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this country. Dr. Ritu Pradhan | Anupreet Kaur Sobti "Optimizing Breastfeeding for Better Health Outcomes: The Way Forward" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45105.pdf Paper URL: https://www.ijtsrd.com/home-science/family-health/45105/optimizing-breastfeeding-for-better-health-outcomes-the-way-forward/dr-ritu-pradhan
The EAT study was a randomized controlled trial that evaluated whether introducing common allergenic foods like peanut, egg, and milk earlier would prevent food allergies in breastfed infants compared to exclusive breastfeeding for 6 months. Over 1300 infants were randomly assigned at 3 months of age to either the early introduction group, which introduced the foods between 3-6 months, or the standard introduction group. The primary outcome was food allergy to one of the foods between 1-3 years of age. The intention-to-treat analysis found no significant difference in food allergy rates between the groups. However, per-protocol and consumption-based analyses raised the possibility that prevention may be dose-dependent.
A STUDY ON THE PRACTICE OF LACTATING MOTHERS IN THANJAVUR DISTRICTIAEME Publication
This document summarizes a study on breastfeeding practices of lactating mothers in Thanjavur District, India. The study aimed to understand breastfeeding cultural practices and the association between breastfeeding practices and socioeconomic factors. 50 mothers were surveyed using interviews. Key findings include that most mothers were below age 27, Hindu, and from backward castes. The majority (66%) breastfed exclusively while others supplemented with formula or solids. Most deliveries were in hospitals. Knowledge of optimal breastfeeding and complementary feeding was low. The study concluded breastfeeding practices in rural areas were better but nutritional education programs are still needed to address issues like malnutrition and obesity.
In this study, we focused on the effect of β-glucan supplementation of children with chronic respiratory problems. We measured the levels of cortisol, salivary IgE and cotinine in 56 children and evaluated the effect of 30 day supplementation with 100 mg/day oral dose of yeast-derived β-glucan. Our results showed strong decrease of cotinine and cortisol levels in saliva of β-glucan-supplemented children. The increase of total salivary IgE levels in both groups was not statistically significant. The positive effects of complex curative treatment using β-glucan were accompanied by increased physical endurance and by significant reduction of negative clinical problems of affected children.
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
Nutritional Status of School Age Children in Private Elementary Schools: Basi...IJAEMSJORNAL
Department of Education (DepEd) organizes nutritional programs to improve the health status of children in public schools. Likewise, the researcher believes that health awareness must be raised in private schools as well. This study aimed to affect the community to be aware and more knowledgeable about nutrition. Specifically, this study focused on the nutritional status of school age children in private elementary schools in Santa Rosa, Nueva Ecija. It sought to determine the profile of the learners, anthropometrics, clinical data and the knowledge of the learners as to dietary and the significant relationship between the profile of the learners and the nutritional status of the school aged children. With all the data gathered a meal management program was proposed. The study employed the quantitative description design. The study manifests that majority of the respondents were not yet aware of what they eat. In addition, age, greatly affects the respondent’s anthropometrics as to height. More so, age, number of siblings and family income, greatly affect the respondents’ anthropometrics as to weight. The researcher adopted the Nutritional Guidelines for Filipino program that was developed by the DOST- FNRI.
This document summarizes a research study that evaluated the effectiveness and cost-effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding mothers in primary care settings in Scotland. The study was a cluster randomized controlled trial that compared breastfeeding outcomes in localities that established new breastfeeding groups to those that did not change existing group activities. The primary outcome was the percentage of infants receiving any breastfeeding at 6-8 weeks. Secondary outcomes included breastfeeding rates at birth, 5-7 days, and 8-9 months as well as maternal satisfaction. The results found no significant differences in breastfeeding rates between the intervention and control localities at 6-8 weeks.
There are two main feeding methods for preterm infants in the NICU - practitioner-driven feeding (PDF) and infant-driven feeding (IDF). Recent research shows IDF decreases time to full oral feeds and earlier hospital discharge. IDF relies on infant feeding cues rather than scheduled intervals. While physicians and nurses initially resisted IDF due to biases, education increased confidence in the method. IDF is now widely adopted as it improves outcomes for infants and lowers hospital costs without compromising safety. Further research is still needed on high-risk infants and implementing IDF protocols.
The document summarizes an international collaboration between four allergy organizations to develop consensus guidelines on food allergy. An author group was formed and divided into committees to write sections on the definition of food allergy, epidemiology, diagnosis, and treatment. Food allergy is defined as an adverse immune response to a food, which can be IgE-mediated, non-IgE mediated, or both. IgE-mediated reactions typically cause acute symptoms within 2 hours of exposure. While many foods can cause allergies, a minority cause most reactions and common allergens vary by region. Treatment involves avoidance of trigger foods and medications to manage symptoms, as there is currently no cure.
1) A new diagnostic test called A1Care has been developed to measure glycated hemoglobin (HbA1c) levels in cats and dogs with diabetes. This is the first affordable and easy-to-use test that provides a glucose average over the past 70-110 days for cats and dogs, respectively.
2) The test involves collecting a few drops of dried blood and mailing it to the company for analysis. Results are then emailed or available online within 3-5 business days.
3) Measuring HbA1c levels provides veterinarians a longer-term view of glucose management than traditional tests, allowing for better diabetes treatment and monitoring in pets.
1) While family history increases the risk of developing allergies, it is not a reliable predictor as most children with allergies do not have a family history and most children with a family history do not develop allergies.
2) Studies on maternal dietary avoidance during pregnancy show no significant difference in rates of eczema, allergic rhinitis, or asthma in children at age 5.
3) Introduction of solid foods like peanut products, eggs, and milk/milk products between 4-12 months based on individual risk is not associated with increased risk of asthma or allergy according to several studies. Delayed introduction beyond 12 months may be associated with increased risk.
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.
Impact of bpa exposure on behavior in childrenricguer
This study examined the impact of early-life exposure to bisphenol A (BPA) on child behavior and executive function. The study used a prospective birth cohort of 244 mother-child pairs. BPA exposure during pregnancy was associated with more anxious and depressed behavior in children at age 3, as well as poorer emotional control and inhibition. These associations were stronger for girls than boys. Exposure to BPA during childhood was not significantly associated with child neurobehavior. The results suggest that prenatal exposure to BPA may negatively impact behavioral and emotional regulation, especially in girls.
Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life.
WAO will again provide resources for its member societies to use for local activities.
1) The study examined the effect of probiotics in preventing necrotizing enterocolitis (NEC) in preterm neonates compared to a control group.
2) 115 preterm infants weighing 750-1500g or less than 32 weeks gestation received probiotics or did not (control). The probiotic group had significantly lower incidence of NEC and fewer cases of elevated C-reactive protein.
3) However, there were no significant differences between the groups in duration of oxygen therapy, total parenteral nutrition, time to full feeding, or length of hospital stay. The study results suggest probiotics have a protective effect against NEC in preterm infants.
The document discusses molecular allergy testing for peanut allergies. It begins with an introduction of the speakers and agenda. It then provides biographies of Dr. Maeve O'Connor and Dr. Rob Reinhardt, who will discuss the physician and science perspectives on molecular allergy testing. The objectives are to raise awareness of molecular allergy testing and its role in diagnosing and managing peanut allergies. Dr. O'Connor then presents on the burden of peanut allergies and limitations of traditional testing. Dr. Reinhardt discusses the science behind molecular testing and peanut components. Case studies demonstrate how component testing provides more accurate risk assessments to guide patient management decisions.
This document provides an overview of several IT and test and measurement vendors. It summarizes the offerings of vendors such as Apposite Technologies, Xena Networks, Ixia, SmartNA, and TestWise. It describes their product lines including network emulation tools, traffic generators, switches, taps, and monitoring and testing solutions. The document aims to help customers choose the right vendor based on their specific testing and measurement needs.
El documento habla brevemente sobre el uso de hipervínculos y botones. Menciona que los hipervínculos son enlaces que permiten navegar entre páginas web, mientras que los botones son elementos interactivos que permiten realizar acciones como enviar formularios.
Efficacy Of Breastfeeding Support Provided By Trained Clinicians DuringBiblioteca Virtual
This study evaluated the efficacy of breastfeeding support provided by trained clinicians during an early routine preventive visit. The study involved 226 mother-infant pairs who were randomized to an intervention group that received an additional preventive visit within 2 weeks postpartum or a control group that received usual care. The intervention group had higher rates of exclusive breastfeeding at 4 weeks and longer breastfeeding duration. The intervention group also reported fewer breastfeeding difficulties. The study provides preliminary evidence that breastfeeding support during an early routine preventive visit can improve breastfeeding outcomes.
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
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.
Optimizing Breastfeeding for Better Health Outcomes The Way Forwardijtsrd
Breastfeeding is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. However, breastfeeding seems to be under attack by the commercial influence of the baby food industry, supported at work places and in the hospitals where they come to deliver. Artificial baby milk formula cannot meet the gold standards of breast milk. Provisions of IMS Act exists but widespread awareness and effective enforcement is required. Various studies reveal the gaps in the provision and implementation of the laws and awareness programs and to suggest appropriate solutions. It, thus, becomes necessary to emphasize upon the provisions of IMS Act, 2003 and evidently bring forward the commercial influence of baby food industry. Review revealed that the provisions of IMS Act has been violated at various online and offline platforms. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the country are recommended, including community health and education programmes and -˜baby friendly’ hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this country. Dr. Ritu Pradhan | Anupreet Kaur Sobti "Optimizing Breastfeeding for Better Health Outcomes: The Way Forward" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45105.pdf Paper URL: https://www.ijtsrd.com/home-science/family-health/45105/optimizing-breastfeeding-for-better-health-outcomes-the-way-forward/dr-ritu-pradhan
The EAT study was a randomized controlled trial that evaluated whether introducing common allergenic foods like peanut, egg, and milk earlier would prevent food allergies in breastfed infants compared to exclusive breastfeeding for 6 months. Over 1300 infants were randomly assigned at 3 months of age to either the early introduction group, which introduced the foods between 3-6 months, or the standard introduction group. The primary outcome was food allergy to one of the foods between 1-3 years of age. The intention-to-treat analysis found no significant difference in food allergy rates between the groups. However, per-protocol and consumption-based analyses raised the possibility that prevention may be dose-dependent.
A STUDY ON THE PRACTICE OF LACTATING MOTHERS IN THANJAVUR DISTRICTIAEME Publication
This document summarizes a study on breastfeeding practices of lactating mothers in Thanjavur District, India. The study aimed to understand breastfeeding cultural practices and the association between breastfeeding practices and socioeconomic factors. 50 mothers were surveyed using interviews. Key findings include that most mothers were below age 27, Hindu, and from backward castes. The majority (66%) breastfed exclusively while others supplemented with formula or solids. Most deliveries were in hospitals. Knowledge of optimal breastfeeding and complementary feeding was low. The study concluded breastfeeding practices in rural areas were better but nutritional education programs are still needed to address issues like malnutrition and obesity.
In this study, we focused on the effect of β-glucan supplementation of children with chronic respiratory problems. We measured the levels of cortisol, salivary IgE and cotinine in 56 children and evaluated the effect of 30 day supplementation with 100 mg/day oral dose of yeast-derived β-glucan. Our results showed strong decrease of cotinine and cortisol levels in saliva of β-glucan-supplemented children. The increase of total salivary IgE levels in both groups was not statistically significant. The positive effects of complex curative treatment using β-glucan were accompanied by increased physical endurance and by significant reduction of negative clinical problems of affected children.
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
Nutritional Status of School Age Children in Private Elementary Schools: Basi...IJAEMSJORNAL
Department of Education (DepEd) organizes nutritional programs to improve the health status of children in public schools. Likewise, the researcher believes that health awareness must be raised in private schools as well. This study aimed to affect the community to be aware and more knowledgeable about nutrition. Specifically, this study focused on the nutritional status of school age children in private elementary schools in Santa Rosa, Nueva Ecija. It sought to determine the profile of the learners, anthropometrics, clinical data and the knowledge of the learners as to dietary and the significant relationship between the profile of the learners and the nutritional status of the school aged children. With all the data gathered a meal management program was proposed. The study employed the quantitative description design. The study manifests that majority of the respondents were not yet aware of what they eat. In addition, age, greatly affects the respondent’s anthropometrics as to height. More so, age, number of siblings and family income, greatly affect the respondents’ anthropometrics as to weight. The researcher adopted the Nutritional Guidelines for Filipino program that was developed by the DOST- FNRI.
This document summarizes a research study that evaluated the effectiveness and cost-effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding mothers in primary care settings in Scotland. The study was a cluster randomized controlled trial that compared breastfeeding outcomes in localities that established new breastfeeding groups to those that did not change existing group activities. The primary outcome was the percentage of infants receiving any breastfeeding at 6-8 weeks. Secondary outcomes included breastfeeding rates at birth, 5-7 days, and 8-9 months as well as maternal satisfaction. The results found no significant differences in breastfeeding rates between the intervention and control localities at 6-8 weeks.
There are two main feeding methods for preterm infants in the NICU - practitioner-driven feeding (PDF) and infant-driven feeding (IDF). Recent research shows IDF decreases time to full oral feeds and earlier hospital discharge. IDF relies on infant feeding cues rather than scheduled intervals. While physicians and nurses initially resisted IDF due to biases, education increased confidence in the method. IDF is now widely adopted as it improves outcomes for infants and lowers hospital costs without compromising safety. Further research is still needed on high-risk infants and implementing IDF protocols.
The document summarizes an international collaboration between four allergy organizations to develop consensus guidelines on food allergy. An author group was formed and divided into committees to write sections on the definition of food allergy, epidemiology, diagnosis, and treatment. Food allergy is defined as an adverse immune response to a food, which can be IgE-mediated, non-IgE mediated, or both. IgE-mediated reactions typically cause acute symptoms within 2 hours of exposure. While many foods can cause allergies, a minority cause most reactions and common allergens vary by region. Treatment involves avoidance of trigger foods and medications to manage symptoms, as there is currently no cure.
1) A new diagnostic test called A1Care has been developed to measure glycated hemoglobin (HbA1c) levels in cats and dogs with diabetes. This is the first affordable and easy-to-use test that provides a glucose average over the past 70-110 days for cats and dogs, respectively.
2) The test involves collecting a few drops of dried blood and mailing it to the company for analysis. Results are then emailed or available online within 3-5 business days.
3) Measuring HbA1c levels provides veterinarians a longer-term view of glucose management than traditional tests, allowing for better diabetes treatment and monitoring in pets.
1) While family history increases the risk of developing allergies, it is not a reliable predictor as most children with allergies do not have a family history and most children with a family history do not develop allergies.
2) Studies on maternal dietary avoidance during pregnancy show no significant difference in rates of eczema, allergic rhinitis, or asthma in children at age 5.
3) Introduction of solid foods like peanut products, eggs, and milk/milk products between 4-12 months based on individual risk is not associated with increased risk of asthma or allergy according to several studies. Delayed introduction beyond 12 months may be associated with increased risk.
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.
Impact of bpa exposure on behavior in childrenricguer
This study examined the impact of early-life exposure to bisphenol A (BPA) on child behavior and executive function. The study used a prospective birth cohort of 244 mother-child pairs. BPA exposure during pregnancy was associated with more anxious and depressed behavior in children at age 3, as well as poorer emotional control and inhibition. These associations were stronger for girls than boys. Exposure to BPA during childhood was not significantly associated with child neurobehavior. The results suggest that prenatal exposure to BPA may negatively impact behavioral and emotional regulation, especially in girls.
Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life.
WAO will again provide resources for its member societies to use for local activities.
1) The study examined the effect of probiotics in preventing necrotizing enterocolitis (NEC) in preterm neonates compared to a control group.
2) 115 preterm infants weighing 750-1500g or less than 32 weeks gestation received probiotics or did not (control). The probiotic group had significantly lower incidence of NEC and fewer cases of elevated C-reactive protein.
3) However, there were no significant differences between the groups in duration of oxygen therapy, total parenteral nutrition, time to full feeding, or length of hospital stay. The study results suggest probiotics have a protective effect against NEC in preterm infants.
The document discusses molecular allergy testing for peanut allergies. It begins with an introduction of the speakers and agenda. It then provides biographies of Dr. Maeve O'Connor and Dr. Rob Reinhardt, who will discuss the physician and science perspectives on molecular allergy testing. The objectives are to raise awareness of molecular allergy testing and its role in diagnosing and managing peanut allergies. Dr. O'Connor then presents on the burden of peanut allergies and limitations of traditional testing. Dr. Reinhardt discusses the science behind molecular testing and peanut components. Case studies demonstrate how component testing provides more accurate risk assessments to guide patient management decisions.
This document provides an overview of several IT and test and measurement vendors. It summarizes the offerings of vendors such as Apposite Technologies, Xena Networks, Ixia, SmartNA, and TestWise. It describes their product lines including network emulation tools, traffic generators, switches, taps, and monitoring and testing solutions. The document aims to help customers choose the right vendor based on their specific testing and measurement needs.
El documento habla brevemente sobre el uso de hipervínculos y botones. Menciona que los hipervínculos son enlaces que permiten navegar entre páginas web, mientras que los botones son elementos interactivos que permiten realizar acciones como enviar formularios.
Africa youth culture is changing so fast due to global youth culture and media influence. This is causing a growing gap between the youth and adult worlds in Africa. Youth are disconnecting from much of African society including church and faith. What are some ways forward.
Medications And More Newsletter Volume 35, October 2008Biblioteca Virtual
This document contains several articles related to breastfeeding:
1. The lead article discusses melamine contamination of infant formulas and estimates the transfer of melamine into human milk would be quite low based on its chemical properties.
2. The guest author discusses how formula company discharge bags given to mothers in hospitals negatively impact breastfeeding rates and are a form of marketing by the formula industry.
3. Brief summaries are provided for upcoming conferences and publications from Hale Publishing on topics including breastfeeding, perinatal health, and women's health.
Clinician Support And Psychosocial Risk Factors Associated With BreastfeedingBiblioteca Virtual
This study examined factors associated with breastfeeding discontinuation at 2 and 12 weeks postpartum in a cohort of 1007 low-risk mothers who initiated breastfeeding. The study found that breastfeeding rates declined over time, with 13% discontinuing by 2 weeks and 45% discontinuing by 12 weeks. Factors associated with earlier discontinuation included lack of breastfeeding confidence, early breastfeeding problems, Asian race, lower education, and depressive symptoms. Receiving encouragement from clinicians was associated with lower risk of discontinuing by 12 weeks, as was not returning to work or school by 12 weeks. The results suggest clinician support and addressing maternal mental health could help promote longer breastfeeding duration.
The document discusses child slavery in Africa. It defines child slavery as involuntary servitude performed by minors. Millions of children across the world do hazardous work in harmful conditions, putting their health, education, and lives at risk. Examples of risks to children include full-time work at an early age, dangerous workplaces, excessive hours, and abuse. In 2006, the ILO estimated 218 million children aged 5-17 worked, with 126 million in worst forms of child labor. 8.4 million children are in slavery, trafficking, and forced labor situations. Child slavery occurs across industries like domestic work, agriculture, and armed conflict.
The document lists and describes 8 attractions to visit in Jackson County, Alabama. It highlights the Unclaimed Baggage Center, Lake Guntersville for fishing, Goose Pond Colony Resort, Russell Cave National Monument, Gorham's Bluff inn, The Walls of Jericho nature area, Pisgah Gorge waterfalls, and the many caves in the county including Neversink cave. The county has natural attractions like lakes, gorges and caves as well as tourist destinations such as shops and resorts to explore.
Breastfeeding And Early Weaning Practices In Northeast BrazilBiblioteca Virtual
This study examined breastfeeding practices in 4 towns in northeast Brazil by interviewing 364 mothers. The researchers found:
1) While mothers were positive about breastfeeding, exclusive breastfeeding was rare and the median duration of exclusive breastfeeding was 0 days.
2) The median age for introducing other milk was 24 days, and the median duration of breastfeeding was 65 days for mothers who introduced other milk within the first month compared to 165 days for other mothers.
3) Pacifier use in the first week, intention to introduce other milk in the first month, giving water/tea in the first week, and leaving the maternity ward before breastfeeding was established were associated with introducing other milk within the first month
Sustainable Design - Transportation and TravelStephen Thomas
Minimal environmental impact is important because resources are running out and climate change affects everyone globally. We must change how we think about production to be more sustainable. Small design changes can improve efficiency and reduce waste, such as using less ink in printing or making products easier to open. Various industries like shipping, travel, and hotels are implementing sustainability initiatives including reducing fuel usage, increasing recycling, and supporting local communities.
A Father’S Day Report – Men, Boys And Environmental Health ThreatsBiblioteca Virtual
Boys appear to be at greater risk than girls for several health issues including cancer, asthma, learning disabilities, and birth defects. Environmental toxins like air pollution, pesticides, and chemicals in household products may contribute to these health problems facing boys. While the reasons for increased male vulnerability are unknown, factors like genetic differences, brain development and hormone production could play a role. More research is needed to understand why boys seem to be more adversely affected. In the meantime, reducing exposure to toxic chemicals may help safeguard children's health.
The International Code In Relation To Agreements Of The World Trade Organisat...Biblioteca Virtual
This document discusses the relationship between international trade agreements through the World Trade Organization (WTO) and the International Code of Marketing of Breast-milk Substitutes. Specifically, it addresses concerns that WTO priorities of facilitating international trade could undermine the implementation and enforcement of the International Code, which aims to protect public health by regulating the marketing of breastmilk substitutes. The document concludes that explicitly exempting the International Code from WTO agreements would help prevent it from being challenged as a "barrier to trade." It also discusses potential risks of trying to include the Code in WTO agreements, as that could transform it from a minimum health requirement to a maximum requirement that prioritizes trade over public health protections.
The document lists several paintings by Henry Bismuth for sale through Turtles & Ravens LLC, including the title, medium, dimensions, year, and price for each painting. Contact information is provided for Susan C. Beer at Turtles & Ravens LLC. The paintings cover a range of subjects and date from 2001 to 2009.
Symptoms Of Postpartum Depression And Early Interruption Of Exclusive Breastf...Biblioteca Virtual
Postpartum depression may increase the risk of early interruption of exclusive breastfeeding in infants. A study of 429 infants in Brazil found that infants of mothers with symptoms of postpartum depression had a higher risk of interrupted exclusive breastfeeding in the first and second months of life. However, for mothers who exclusively breastfed through the first month, postpartum depression was not associated with interrupted breastfeeding in the second month. The results suggest postpartum depression can impact exclusive breastfeeding duration in early infancy.
Interventions In Primary Care To Promote Breastfeeding An Evidence Review For...Biblioteca Virtual
Primary care-initiated interventions can effectively promote breastfeeding. A systematic review of 38 randomized controlled trials found that breastfeeding promotion interventions in developed countries significantly increased short-term (1 to 3 months) and long-term (6 to 8 months) exclusive breastfeeding rates. Combining pre- and postnatal interventions and including lay support, such as peer counseling, were most effective in increasing breastfeeding duration. No harms from breastfeeding promotion interventions were reported.
Blue Hive is a premier design and manufacturing firm located in Worcester, MA specializing in trade show exhibits, events, and experiential environments. They have a 75,000 sq ft facility called "The Hive" that houses talented designers, partners, and clients. Blue Hive has created exhibits and displays for many well-known companies across various industries. Their clients praise Blue Hive for their creative solutions, on-time and on-budget deliveries, and exceptional customer service.
Antidepressants In Amniotic Fluid Another Route Of Fetal ExposureBiblioteca Virtual
This study analyzed antidepressant concentrations in amniotic fluid samples from 27 pregnant women taking antidepressants. The study found:
1) Amniotic fluid antidepressant concentrations varied widely between individuals but on average were about 12% of concentrations in maternal serum.
2) For some antidepressants like venlafaxine, amniotic fluid concentrations were substantially higher than average, over 170% of maternal serum levels.
3) Metabolite concentrations in amniotic fluid did not consistently match parent drug concentrations, being higher than or lower than maternal levels in about equal numbers of samples.
4) The results demonstrate that maternally administered antidepressants do cross into amniotic fluid and thus represent
The Chisholm Gallery is presenting the artwork of William Ersland. The document provides descriptions and prices for over 20 of Ersland's acrylic paintings depicting horses and hunting scenes. It also includes a biographical sketch of the artist, which details his passion for horses and riding, as well as his process of underpainting all works in red.
Characteristics Of Breastfeeding Practices Among Us MothersBiblioteca Virtual
1) More than half of breastfeeding mothers exclusively breastfed (breast milk only) until 4 months of age, after which exclusive breastfeeding declined sharply. Formula supplementation peaked at 42% at 1 month and declined to 15% at 1 year.
2) Around 6% of mothers reported exclusively pumping breast milk rather than directly breastfeeding.
3) Maternal reports showed considerable variation in behaviors related to common breastfeeding advice on frequency, duration, and intervals of feedings over the infant's first year.
This study analyzed survey responses from 1,323 mothers who stopped breastfeeding their infants before 12 months to identify the primary reasons for stopping breastfeeding at different infant ages. The researchers conducted factor analysis to group mothers' reasons into seven constructs: lactation issues, psychosocial factors, nutritional concerns, lifestyle interference, medical issues, pumping difficulties, and self-weaning. Across all ages, mothers most frequently cited their infant not being satisfied by breast milk alone as a key reason for stopping. Younger, unmarried, and lower-income mothers tended to stop earlier. Reasons for stopping varied by infant age, from lactation issues in early months to self-weaning in later months.
Opinions And Practices Of Clinicians Associated With Continuation Of Exclusiv...Biblioteca Virtual
This study examined how clinician opinions and practices are associated with continuation of exclusive breastfeeding. The study prospectively followed 288 low-risk mother-newborn pairs who were breastfeeding at 4 weeks. Mothers completed interviews at 4 and 12 weeks, and their obstetric and pediatric clinicians completed surveys. The primary outcome was exclusive breastfeeding at 12 weeks. The study found that clinicians who recommended formula supplementation if an infant was not gaining weight or who felt their breastfeeding advice was not important were associated with early discontinuation of exclusive breastfeeding. Continued exclusive breastfeeding support from clinicians may help improve breastfeeding rates at 6 months.
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
Success Of Strategies For Combining Employment And BreastfeedingBiblioteca Virtual
1) The study examined strategies that mothers use to combine breastfeeding and paid employment, and the impact of these strategies on breastfeeding intensity and duration.
2) The strategies included: directly breastfeeding from the breast, pumping milk, a combination of pumping and direct breastfeeding, and neither pumping nor direct breastfeeding during work.
3) Pumping milk only and directly breastfeeding only were the most common strategies. These strategies as well as a combination of pumping and direct breastfeeding were associated with smaller decreases in breastfeeding intensity compared to neither pumping nor direct breastfeeding.
4) Directly breastfeeding from the breast, with or without pumping, was associated with longer breastfeeding duration compared to pumping only.
Vita D Perrine Cg Ea At Adherence To Vit D Recommendations Among Us Infants P...alisonegypt
This study examined adherence to vitamin D recommendations among US infants using data from the Infant Feeding Practices Study II from 2005-2007. The researchers estimated the percentage of infants meeting the 2003 and 2008 vitamin D recommendations from the American Academy of Pediatrics at various ages from 1 to 10.5 months. They found that use of oral vitamin D supplements was low, ranging from 1% to 13% regardless of whether infants were breastfed, formula-fed, or mixed-fed. Most infants did not consume adequate amounts of vitamin D according to the 2008 recommendation, suggesting pediatricians should encourage vitamin D supplementation for breastfed and partially breastfed infants.
Current evidence suggests that Human Milk Oligosaccharides (HMO) plays a role in promoting immune health in infants through changes to the microbiome. Angela Lim, senior manager, global regulatory affairs lead, HMO shares on the science behind it, and the opportunities and challenges that lie ahead.
1) The study aimed to identify factors associated with exclusive breastfeeding (EB) in children under 4 months old in Botucatu, Brazil.
2) 38% of children were exclusively breastfed, while 33.4% consumed cow's milk, 29.2% tea, and 22.4% water.
3) The use of a pacifier and difficulty breastfeeding were associated with an absence of EB, while the population attributable risk percentage for pacifier use was estimated at 46.8%.
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.
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.
Mothers And Clinicians Perspectives On Breastfeeding Counseling During Routin...Biblioteca Virtual
This document summarizes a study examining breastfeeding counseling provided during routine preventive visits from the perspectives of both mothers and their clinicians. The study involved surveying 429 mother-newborn pairs and their 121 obstetric and pediatric clinicians. The results identified several areas of disagreement between what mothers reported discussing with clinicians regarding breastfeeding duration, continuation after returning to work, and specific advice provided, highlighting potential unintentional gaps in communication around breastfeeding counseling during routine visits.
Patterns and determinants of breast feeding among mother infant pairs in dera...Zubia Qureshi
Background: Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. The objective of the present study was to determine the patterns and explore the determinants associated with breast feeding practices among the nursing women in Dera Ghazi Khan. Methods: A cross sectional study was conducted on randomly selected lactating mother infant pairs in Dera Ghazi Khan. Structured questionnaire was used for data collection. Analysis was done by using SPSS, chi square test was applied to see the association between breast feeding practices and its determinants such as knowledge of breast feeding practices. Results: Majority 372 (93%) of mothers mentioned that they had ever breastfed the youngest child. About 292 (73%) mothers gave colostrum to the child, and 48 (12%) exclusively breastfed. Weaning babies before four month of age was practiced by 84 (21%) of the mothers, 120 (55%) mothers started weaning at 4-6 months of child age, while 72 (18%) started to give additional food after baby turned six months old. Out of total 276 (69%) mothers reported that they had knowledge regarding breast feeding. Significant association was found between knowledge of breastfeeding and initiation and Exclusive Breast Feeding (EBF) practices (p-values <0.05). Income, family type, mode of delivery and assistance for child were significantly associated with initiation of breastfeeding within one hour after birth (p-value <0.001). Conclusion: Breast feeding practices in the studied area were not up to the mark. There is a strong need to improve the breastfeeding practices by Behavior Change Communication. Keywords: Breast feeding; Early initiation; Exclusive Breast Feeding (EBF); Colostrum; Supplementary feeding; Infants
Lamotrigine In Breast Milk And Nursing Infants Determination Of ExposureBiblioteca Virtual
This study characterized lamotrigine concentrations in breast milk and nursing infant plasma in 30 women taking lamotrigine who were breastfeeding their infants. The mean ratio of lamotrigine in breast milk compared to maternal plasma was 41.3%. There was a non-significant trend for higher concentrations in breast milk 4 hours after the maternal dose. Infant plasma concentrations were 18.3% of maternal plasma concentrations. The theoretical infant dose was 0.51 mg/kg per day and the relative infant dose was 9.2%. Mild thrombocytosis was seen in 7 of 8 infants tested but no adverse effects were reported in breastfed infants. The study provides valuable data on lamotrigine exposure during breastfeeding.
Home Preparation Of Powdered Infant Formula Is It SafeBiblioteca Virtual
This document summarizes a study that assessed how 131 parents in Italy prepared powdered infant formula (PIF) compared to World Health Organization (WHO) guidelines. The study found that only 11% of parents followed all four WHO safety criteria for preparing PIF. Specifically, most parents did not sterilize bottles at each feeding, warm water to at least 70°C before adding PIF, use formula immediately, and discard leftovers. The researchers were concerned that health professionals may be providing incorrect advice on PIF preparation and that product labels do not clearly state the need to warm water to inactivate bacteria. They recommend educating parents and health workers on safer PIF handling practices.
DOI 10.1542peds.2011-3552; originally published online Feb.docxmadlynplamondon
- Breastfeeding and human milk are recommended as the normative standards for infant feeding and nutrition. Exclusive breastfeeding is recommended for about the first 6 months of life, with continued breastfeeding along with complementary foods for at least the first year and beyond as mutually desired.
- Breastfeeding rates in the US continue to fall short of targets, with disparities across socioeconomic and racial/ethnic groups. Rates of exclusive breastfeeding are particularly low.
- Breastfeeding confers numerous short- and long-term medical benefits for infants and children, including reduced risks of respiratory and ear infections, gastrointestinal disease, SIDS, obesity, diabetes, and other chronic conditions. These benefits appear to have a
The study identified 11 factors that contribute to stunting in children under 5 years old in Putrajaya, Malaysia. The strongest associated factor was complications during pregnancy like intrauterine growth restriction. Other significant factors included mid-parental height less than 150cm, low household income, low birth weight, use of pacifiers, lower maternal education, unemployed fathers, anemia in children, bottle feeding, lack of minimum dietary diversity, and care by babysitters. Addressing these maternal, socioeconomic, childcare and nutritional factors through community interventions and policies could help reduce the high prevalence of stunting in Putrajaya.
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.
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.
POSTER Influence of breastfeeding on infant allergy developmentAnya Guy
This document discusses the influence of breastfeeding on infant allergy development. It finds that exclusive breastfeeding for 6 months and any breastfeeding for 1 year is most beneficial for decreasing food allergy risk. Components in breast milk like food antigens, antimicrobial peptides, and cytokines provide immunoprotective effects that help infants digest potentially allergenic foods. The duration of breastfeeding is correlated with decreased infant allergy development.
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.
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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%.
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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.
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2. SUPPLEMENT ARTICLE
Infant Formula–Handling Education and Safety
Judith Labiner-Wolfe, PhDa, Sara B. Fein, PhDa, Katherine R. Shealy, MPH, IBCLC, RLCb
aCenter for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland; bDivision of Nutrition, Physical Activity, and Obesity, Centers for
Disease Control and Prevention, Atlanta, Georgia
The authors have indicated they have no financial relationships relevant to this article to disclose.
ABSTRACT
OBJECTIVES. Our goal was to assess the extent to which mothers learn about proper
handling of infant formula from health professionals and package labels; mothers’
beliefs about the likelihood of germs being in infant formula and the importance of www.pediatrics.org/cgi/doi/10.1542/
peds.2008-1315k
following safe-use directions; whether they take measures while handling infant
formula to prevent foodborne illnesses and injury to their infants; and maternal doi:10.1542/peds.2008-1315k
characteristics associated with unsafe infant formula– handling practices. The findings and conclusions in this article
are those of the authors and do not
PARTICIPANTS AND METHODS. The study cohort consisted of mothers participating in the necessarily represent the official position of
the Centers for Disease Control and
2005–2007 Infant Feeding Practices Study II who fed their infant formula. We Prevention or the Food and Drug
conducted frequency and multiple logistic regression analyses. Sample sizes for the Administration.
analyses ranged from 860 to 1533. Key Words
infant formula, food handling, food
RESULTS. The majority of formula-feeding mothers did not receive instruction on labeling
formula preparation (77%) or storage (73%) from a health professional. Thirty Abbreviations
percent did not read some of the safe-use directions on the formula package label; an IFPS—Infant Feeding Practices Study
approximately equal percentage (38%) thought that both powdered (which is not FDA—Food and Drug Administration
sterile) and ready-to-feed (which is sterile) formula were unlikely to contain germs; Accepted for publication Jun 4, 2008
and 85% believed that following safe-storage directions was very important. Among Address correspondence to Judith Labiner-
Wolfe, PhD, Food and Drug Administration,
the mothers of the youngest infants analyzed, 55% did not always wash their hands Center for Food Safety and Applied Nutrition,
with soap before preparing infant formula, 32% did not adequately wash bottle 5100 Paint Branch Pkwy, HFS 020, College
nipples between uses, 35% heated formula bottles in a microwave oven, and 6% did Park, MD 20740. E-mail: judy.labiner@fda.hhs.
gov
not always discard formula left standing for 2 hours. The prevalence of these unsafe
PEDIATRICS (ISSN Numbers: Print, 0031-4005;
practices was similar among mothers of older infants. No consistent pattern of Online, 1098-4275); published in the public
maternal characteristics was associated with unsafe practices. domain by the American Academy of
Pediatrics
CONCLUSIONS. Many mothers do not follow safe practices when preparing infant for-
mula. Additional research is needed to understand why more mothers do not follow
safe formula-handling recommendations. Pediatrics 2008;122:S85–S90
C OMMERCIAL INFANT FORMULA is the only safe source of food for nonbreastfed infants up to 6 months old and an
important food source for nonbreastfed infants through their first year.1 Although the majority of US infants
begin breastfeeding, most receive formula at some point by 6 months, either instead of or as a supplement to breast
milk.2
In the United States, infant formulas are available in 3 types: ready-to-feed, liquid concentrate, and powdered.
Liquid concentrates and powders require appropriate dilution with clean water. Adding too much water may lead to
inadequate intake of calories and nutrients, whereas adding too little water may lead to dehydration, diarrhea, and
excessive intake of calories. The safety of liquid concentrate and powdered formulas can be compromised if they are
diluted with water of poor quality.1 Unlike ready-to-feed and liquid concentrates, powdered formulas are not sterile
when purchased and could contain bacteria. To reduce the risk of infant illness caused by bacteria in powdered
formula,3 the World Health Organization urges caregivers to use water no less than 158°F when reconstituting
powdered formula.4
Four safe-handling practices for all types of infant formula have been recommended as means of reducing infants’
risk of being burned or infected with foodborne pathogens: (1) wash hands with soap before preparing formula; (2)
wash bottles and bottle nipples thoroughly between uses; (3) discard formula left at room temperature for 2 hours;
and (4) never heat formula bottles in a microwave oven.1,5
In this study, we sought to determine (1) whether mothers learn about proper handling of infant formula from
health professionals and package-label information, (2) mothers’ beliefs about the safety of infant formula and the
importance of following safe-storage directions, (3) the percentage of mothers who fail to follow each of the 4 safe
formula-handling practices described above, and (4) the maternal characteristics associated with lack of adherence
to these practices.
PEDIATRICS Volume 122, Supplement 2, October 2008 S85
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3. PARTICIPANTS AND METHODS poverty level; whether they had more than a high school
Data for this analysis are from the 2005–2007 Infant education; whether they were aged 30 years; whether
Feeding Practices Study II (IFPS II). The IFPS II is a they were white; whether they had other children; and
longitudinal mail survey of mothers from pregnancy whether they fed their infant at least as much breast
through their infants’ first birthday. The study sample milk as formula. Because of missing data, the sample
was limited to adult mothers of healthy, term singletons. sizes for logistic regression models fell from 1527 to 1336
The study was approved by the US Food and Drug Ad- for the 1.5- to 4.5-month data, from 1392 to 972 for the
ministration (FDA) Research Involving Human Subjects 4.5- to 6.5-month data, from 1364 to 911 for the 6.5-
Committee. The methodologic details of the IFPS II are to 8.5-month data, and from 1323 to 860 for the 8.5-
described elsewhere in this supplement.6 to 10.5-month data.
The cohort for this analysis consisted of IFPS II par-
ticipants who reported that their infant was fed any RESULTS
formula in the previous 2 weeks on 4 questionnaires
sent when the infant was between 2 and 9 months old. Infant Formula Use
Regardless of what the mother reported feeding her The majority of mothers of infants in all age groups
infant on 1 questionnaire, she was asked whether she reported that their infant was fed some amount of for-
was feeding formula on subsequent questionnaires. The mula. The distribution of demographic characteristics
number of mothers who reported feeding their infant among mothers who fed formula was similar to that
formula declined throughout the study as a result of among all IFPS II participants6 except that the mothers
diminishing survey response rates, which were 83% for who fed formula to infants younger than 4.5 months old
the month 2 questionnaire but dropped to 67% for the were less likely to be college educated than mothers who
month 9 questionnaire. did not (32% vs 40%).
In the questionnaire sent when their infants were 2 The percentage of mothers who reported that their
months old, formula-feeding mothers (n 1533) were infant was fed formula in the previous 2 weeks increased
asked about their use of the package labels on infant with infant age, from 62% among mothers with infants
formula and their perceptions of the importance of fol- aged 1.5 to 4.5 months to 72% among mothers with
lowing formula directions and the likelihood that germs infants aged 8.5 to 10.5 months. When their infants
were in the formula. In questionnaires sent at 2 and 5 were aged 1.5 to 4.5 months, 70% of mothers who used
months postpartum, formula-feeding mothers were formula reported feeding their infant a milk-based for-
asked whether a health professional had instructed them mula with docosahexaenoic acid (DHA) and arachidonic
on formula preparation and storage (n 1446). For the acid (ARA), 88% reported feeding them powdered for-
analysis of these once- or twice-asked questions, we mula from a can, and 98% reported feeding them an
were interested in responses regardless of the exact age iron-fortified formula. These percentages remained rel-
of the infant at the time that the mother responded. atively consistent across age groups. Of 881 mothers
Questions about formula-handling practices were re- who reconstituted powdered formula mixed with tap
peated on 4 questionnaires, which were sent when the water for infants aged 1.5 to 4.5 months, 30% boiled the
infants were 2, 5, 7, and 9 months old. For the analysis water first; and of 790 who mixed powdered formula
of handling practices, we were interested in evaluating with bottled water, 17% boiled the water first. Lower
differences in the mothers’ behavior as their infants percentages of mothers boiled either type of water as
aged. To do this we limited the sample of formula- infant age increased.
feeding mothers to those who responded when their
infant was within a certain age range. We used the age of Receipt of Instructions on Preparation and Storage of Infant
the infant at the time the mother completed each ques- Formula
tionnaire to set up 4 mutually exclusive age groups. The Most mothers did not receive instruction on formula
age groups and sample sizes of formula feeding mothers preparation or storage from a health professional. In the
for the 2-, 5-, 7-, and 9-month questionnaire data were 2-month questionnaire, 88% of the mothers reported
1.5 to 4.5 months (n 1527), 4.5 to 6.5 months (n not having received instruction on formula preparation,
1392), 6.5 to 8.5 months (n 1364), and 8.5 to 10.5 and 82% reported not having received instruction on
months (n 1323), respectively. formula storage from a doctor, other health professional,
With SAS software (SAS Institute, Inc, Cary, NC), we or birthing class instructor. By the 5-month question-
analyzed the data cross-sectionally by using frequency naire, 77% of the mothers who reported having fed
procedures. We used 16 multiple logistic regression formula on the 2-month questionnaire indicated that
models to evaluate whether maternal characteristics they still had not received instruction on formula prep-
were independently associated with the likelihood that aration from any of these sources, and 73% reported not
the mothers of infants in each of the 4 age groups did not having received instruction on formula storage (n
follow each of the 4 safe-use recommendations de- 1118).
scribed previously. The characteristics that we evaluated Although a majority of the mothers did read the
were whether mothers received relevant instruction on various categories of safe-handling information on the
formula use from a health professional; whether they formula-package label, a substantial minority did not
read relevant package-label information; whether their (Table 1). Of 1420 mothers who read any information
annual income was no more than 185% of the federal on the formula label, 3% found the information difficult
S86 LABINER-WOLFE et al
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4. TABLE 1 Mothers Who Did Not Read Various Categories of Label prepared formula was kept at room temperature for 2
Information on the Package of the Formula They Used hours, and only 17% to 23% of all the mothers, depend-
Most Often (Month 2 Questionnaire, n 1533) ing on the age of the infant, said prepared formula was
never kept at room temperature. The majority of those
Label Information %
who did report sometimes keeping formula at room
Ingredient list 44.8 temperature reported doing so for 1 hour.
Pictures on the container showing how to prepare 34.1
Directions for storing formula package after opening 30.5
Maternal Characteristics Associated With Unsafe Formula-Use
Directions for what do with formula left over after feeding 30.0
Directions for storing formula after it is prepared 25.1 Practices
Directions for preparing formula 11.7 Results from the multiple logistic regression analyses
indicated that no maternal characteristic was consis-
tently associated with failing to follow all of the safe
to understand, and 9% found the print size too small to formula-handling recommendations while controlling
read easily (data not shown). for the other characteristics in the models (Table 3). In
our analysis of whether bottles of formula were left
standing at room temperature for 2 hours, the likeli-
Beliefs About Infant Formula Safety
hood-ratio test indicated that the group of maternal
Although 30% of the mothers did not read the package
characteristics was not a good predictor of this practice.
directions on what to do with leftover formula, 85%
Therefore, this practice is not included in Table 3.
believed that it was very important for their infant’s
White mothers were more likely than nonwhite
health to follow the label directions to refrigerate or
mothers to not always wash their hands with soap be-
discard prepared formula. Another 14% believed this
fore preparing formula. Mothers who were 30 years
practice was somewhat important (data not shown).
old and those with more than a high school education
Thirty-eight percent of the mothers thought it was
were more likely to not always wash their hands with
unlikely that either ready-to-feed or powdered formula
soap when feeding infants older than 4.5 months than
contained germs, and 32% thought it was unlikely that
were older mothers and those with less education.
liquid concentrate formula contained germs (data not
Mothers of infants aged 1.5 to 8.5 months who fed at
shown).
least as much breast milk as formula were less likely
than those who fed less or no breast milk to inade-
Infant Formula Handling
quately clean formula bottle nipples between uses.
Many mothers of infants aged 1.5 to 4.5 months did not
Mothers at 185% of the federal poverty line were
follow safe formula-handling recommendations to pre-
more likely than those with a higher family income to
vent foodborne illness and burns. The percentages of
inadequately clean formula bottle nipples for infants
those who did not follow specific recommendations
aged 1.5 to 4.5 and 6.5 to 8.5 months.
(shown in Table 2 and highlighted below) were gener-
Two maternal characteristics were associated with
ally similar to corresponding percentages among moth-
microwave heating of formula bottles in all 4 infant age
ers of older infants, unless otherwise noted. Fifty-five
groups: mothers with other children were more likely
percent of these mothers said that they did not always
than those with no other children to do so, whereas
wash their hands with soap before preparing formula (vs
mothers who fed breast milk at least as often as formula
63% among mothers of infants aged 8.5–10.5
were less likely to heat bottles of formula in a microwave
months), and 3% of those who did not always wash
oven.
their hands reported always using hand sanitizer before
preparing infant formula. In addition, 33% reported that
DISCUSSION
their infant’s bottle nipples were at least sometimes only
This analysis suggests that there are gaps in mothers’
rinsed with water before being reused, 5% reported that
education on safe infant formula– handling practices that
the nipples were at least sometimes not cleaned in any
could reduce the risk of infant illness and injury. To help
way before being reused. Thirty-five percent reported
protect infants, the FDA requires that formula labels
that bottles were at least sometimes heated in a micro-
include directions for proper formula handling and a
wave oven, and almost 20% reported that bottles were
warning statement that cautions caregivers that their
always heated this way. However, only 6% reported that
infant’s health depends on carefully following the direc-
tions.7 The results of our analysis showed that many
mothers do not read this information. However, the
TABLE 2 Mothers Who Reported That Formula for Their 1.5- to
analysis also showed no association between mothers’
4.5-Month-Old Infant Was Sometimes or More Frequently
instruction on safe formula handling from a package
Handled With Various Unsafe Practices label or a health professional and the likelihood of han-
Unsafe Practice n (%) dling formula properly. Package-label use and instruc-
Did not wash hands with soap before preparing formula 1469 (55.0) tion on formula handling from a health professional may
Reused bottle nipples after just rinsing with water 1399 (33.1) not impact mothers’ behaviors. Alternatively, the data
Reused bottle nipples without cleaning in any way 1399 (5.1) may not adequately capture the relationship for some of
Left formula at room temperature for 2 h 1483 (6.0) the practices. Although the mothers were asked to re-
Heated bottle in microwave oven 1488 (35.3) port only on their own hand-washing practices, they
PEDIATRICS Volume 122, Supplement 2, October 2008 S87
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5. were asked about other handling practices by anyone
8.5–10.5 mo
(n 860)
who feeds their infant. To the extent that mothers were
1.79a
0.47a
0.80
0.99
1.44
1.04
0.99
1.03
reporting on the practices of other caregivers, rather
than their own, it is the education of these other care-
Heat Bottles in a Microwave Oven givers that would be expected to predict formula-han-
6.5–8.5 mo dling practices.
(n 906)
1.62a
0.60a
1.01
0.74
1.04
1.08
0.96
1.40
The data on mothers’ beliefs about germs in formula
suggest that consumers are not aware that there are
different risks associated with powdered formulas,
which are not sterile when purchased, compared with
4.5–6.5 mo
(n 965)
ready-to-feed and liquid concentrates, which are com-
1.53a
0.60a
0.84
1.13
1.39
1.02
0.89
1.21
mercially sterile. The IFPS II data do not have enough
detail to know whether mothers who prepared pow-
dered formula followed the World Health Organization
1.5–4.5 mo
(n 1326)
1.46a recommendation to use water warmer than 158°F. The
0.56a
0.99
0.99
0.84
0.87
1.24
1.01
data do indicate that most mothers did not boil tap
(70%) or bottled (83%) water used to reconstitute for-
mula. We assume that even fewer who do boil water
mix the formula when the water is hotter than 158°F,
8.5–10.5 mo
(n 875)
because some may use water that was boiled and then
1.25
1.06
1.17
1.01
1.18
1.35
0.97
0.57
cooled before reconstituting the formula.
The incidence of infection with pathogens often asso-
Not Adequately Clean Bottle Nipples
ciated with food, such as Salmonella, Yersinia enterocolitica,
6.5–8.5 mo
(n 911)
and Campylobacter, is significantly higher for children 1
1.46a
0.43a
0.88
1.23
0.93
1.26
1.00
1.10
year of age than for older age groups.8 This increased
TABLE 3 Adjusted Odds Ratios Associated With 3 Unsafe Formula-Handling Practices, According to Infant Age Group
incidence may largely be attributable to the vulnerability
of a developing intestinal system and the increased like-
lihood among parents to report and seek care for infant
4.5–6.5 mo
(n 972)
illness versus illness observed in older children or adults.
1.53a
0.44a
1.23
0.91
1.03
1.13
0.90
0.76
Infants who are fed formula, rather than breast milk,
have been shown to be at increased risk for infection
with Salmonella, which may be a result of the protective
1.5–4.5 mo
(n 1336)
effects of breast milk or contamination of formula during
1.36a
0.51a
1.23
1.00
1.00
0.94
0.82
0.96
its handling.9
Risk of foodborne illness in infants should be reduced
when caregivers wash their hands with soap before pre-
8.5–10.5 mo
paring food, including formula; do not feed formula held
(n 875)
0.65a
1.64a
1.80a
at room temperature for 2 hours; and adequately wash
1.18
0.77
1.01
1.11
0.94
bottle nipples between uses. This analysis suggests that
most mothers believe it is very important to refrigerate
Not Always Wash Hands With Soap
or discard prepared formula, and almost all follow the
6.5–8.5 mo
(n 911)
recommendation to never leave formula standing for 2
0.62a
1.65a
2.10a
1.08
0.82
1.02
1.23
0.92
hours. However, over half of the mothers, of even young
infants, did not always wash their hands with soap be-
fore preparing formula, and one third did not always
4.5–6.5 mo
adequately wash bottle nipples between uses, thereby
(n 972)
0.63a
1.35a
1.49a
increasing their infant’s risk of being exposed to a food-
0.85
1.35
1.03
1.05
0.99
borne pathogen and suffering an illness.
Some mothers may not wash their hands or ade-
quately wash bottle nipples because they do not perceive
1.5–4.5 mo
(n 1336)
these actions to be a threat to their infant’s health.
1.59a
0.69a
0.83
1.19
1.06
0.87
1.10
1.05
Although such unsafe food-handling practices increase
.05 level.
infants’ risk for illness, they do not always lead to an
illness, and even when they do, the relationship be-
185% of federal poverty
significant at the
tween these unsafe practices and the illness is not always
breast milk as formula
Received instruction on
obvious. As a result, mothers may incorrectly attribute
Read label directions
Characteristic
Fed at least as much
formula handling
Has other children
their infant’s illness to a cause other than foodborne
High school
pathogens and, thus, not recognize the need to improve
Aged 30 y
a Statistically
their food-handling hygiene.
In the FDA’s 2006 Food Safety Survey, a random-
White
digit-dial survey of 4600 US adult consumers, 75% of
S88 LABINER-WOLFE et al
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6. those surveyed reported that they always washed their tices were asked. At 2 months postpartum, 38% of the
hands with soap before preparing food (unpublished mothers did not sterilize bottles and nipples; this number
data). However, mothers who participated in the IFPS II increased to 54% at month 5 and increased again to
were considerably less likely to report always washing 60% at month 7. In 2005–2007, mothers were asked a
their hands before preparing infant formula, despite in- series of questions about how often they washed nipples
fants being more vulnerable to foodborne illness than in several different ways. Although 74% of the mothers
people over 1 year of age. Perhaps a reason for this of the youngest infants (1.5– 4.5 months), and increasing
disparity is that adults are unlikely to prepare food for to 87% of those of the oldest infants ( 8.5–10.5
themselves or for older children when away from a months), said that they did not boil or sterilize bottle
home or other venue with easy access to soap and water, nipples regularly, these mothers had the opportunity
because packing a nonperishable item or purchasing earlier to indicate that nipples were adequately cleaned
prepared food is often a convenient alternative. These in a dishwasher or by hand with detergent. The 1993–
options do not exist for mothers who are not breastfeed- 1994 study did not include questions about mothers
ing and have an infant who is not yet eating comple- washing their hands before preparing formula.13
mentary foods. Although hand sanitizer is recom- Despite lower rates of some unsafe-handling practices
mended for cleaning hands when soap and water are in 2005–2007, mothers were less likely than in 1993–
unavailable,10 and alcohol gel hand sanitizers can be 1994 to have received instruction on formula prepara-
effective in reducing bacteria on hands that are free of tion from a health care professional (12% of mothers
debris,11 very few mothers who did not always wash responding to the 2-month postpartum questionnaire in
their hands reported always using hand sanitizer before 2005–2007% vs 21% of mothers responding to the
preparing formula. 2-month postpartum questionnaire in 1993–1994 re-
The widespread use of inadequately washed bottle ceived such instruction).13
nipples may be because consistent use of clean bottle
nipples requires access to running water and soap or a CONCLUSIONS
supply of extra bottle nipples. Some mothers may heat Although some formula-handling practices seem to have
bottles in a microwave oven despite the risk of burns to improved in the past decade, data from the IFPS II sug-
their infant’s mouth simply because it is faster than gest areas for further progress to reduce the risk to
alternative warming options. The association between infants of foodborne illness and burns. Unfortunately,
feeding at least as much breast milk as formula and a our results do not suggest any obvious strategies that
decreased likelihood of inadequately cleaning bottle nip- might be used to reduce the number of mothers who
ples between uses and heating bottles in a microwave engage in unsafe practices or characteristics of mothers
oven may be because breastfeeding mothers can choose associated with unsafe practices that might be used to
to feed formula only when they have a clean bottle target interventions, because neither formula-use edu-
nipple or the time to safely warm a bottle or because cation nor any maternal characteristics were consistently
they are more likely to engage in other health behaviors associated with the likelihood of engaging in the unsafe-
than are nonbreastfeeding mothers. The results of pre- handling practices we examined. Although, as noted
vious research suggest that not smoking and participat- previously, the wording of the IFPS II questionnaires, in
ing in childbirth education classes are both positively which mothers were asked to report on the behaviors of
associated with duration of breastfeeding.12 other caregivers, may have confounded our analyses,
Although there remain shortfalls in mothers’ reports IFPS I results showed a similar lack of consistent associ-
of safe infant formula– handling practices, fewer mothers ation between improper formula-handling practices and
reported 2 risky behaviors in 2005–2007 than a decade maternal characteristics.13
earlier. When comparing data from the IFPS II with data The results of our analyses of IFPS II data suggest a
from the IFPS I (a 1993–1994 study with similar design, need for additional research on why caregivers may not
sampling frame, and data-collection procedures), moth- follow recommendations for safe infant formula han-
ers were more careful about discarding formula and dling. The results of such research could help to identify
avoiding microwave heating in 2005–2007. In the 1993– ways of increasing compliance with the recommenda-
1994 IFPS I, 15% of the mothers left bottles at room tions designed to help protect infants.
temperature for 2 hours, whereas in 2005–2007 the
estimate was 6%. The 1993–1994 study found that 39%, ACKNOWLEDGMENTS
increasing with greater infant age to 48%, reported heat- This study was funded by the Food and Drug Adminis-
ing bottles in a microwave oven 50% of the time. In tration, Centers for Disease Control and Prevention, Of-
2005–2007, approximately one quarter of the mothers fice of Women’s Health, National Institutes of Health,
reported that their infant’s bottles were heated in a and Maternal and Child Health Bureau in the US De-
microwave oven approximately half of the time or more partment of Health and Human Services.
frequently.13
The question about washing bottle nipples that was REFERENCES
asked in 1993–1994 is not directly comparable with the 1. American Academy of Pediatrics. Caring for Your Baby and
measure used in 2005–2007. In 1993–1994, mothers Young Child: Birth to Age 5. Shelov SP, Hannemann RE, eds.
were asked whether bottles and nipples were usually New York, NY: Bantam; 2004
sterilized, but no other questions about cleaning prac- 2. Centers for Disease Control and Prevention. Breastfeeding re-
PEDIATRICS Volume 122, Supplement 2, October 2008 S89
Downloaded from www.pediatrics.org at IRCCS Burlo Garofalo on October 13, 2008
7. port card, United States: 2007— outcome indicators. Available dence of infection with selected bacterial enteric pathogens in
at: www.cdc.gov/breastfeeding/data/report card2.htm. Ac- children younger than five years of age, 1996 –1998. Pediatr
cessed April 2, 2008 Infect Dis J. 2006;25(2):129 –134
3. Edelson-Mammel SG, Buchanan RL. Thermal inactivation of 9. Rowe SY, Rocourt JR, Shiferaw B, et al. Breast-feeding de-
Enterobacter sakazakii in rehydrated infant formula. J Food Prot. creases the risk of sporadic salmonellosis among infants in
2004;671(1):60 – 63 FoodNet sites. Clin Infect Dis. 2004;38(suppl 3):S262–S270
4. World Health Organization. Safe Preparation, Storage, and Han- 10. Centers for Disease Control and Prevention. Clean hands save
dling of Powdered Infant Formula: Guidelines. Geneva, lives! Available at: www.cdc.gov/cleanhands. Accessed April 2,
Switzerland: World Health Organization Press; 2006 2008
5. US Food and Drug Administration. Food safety for moms-to-be. 11. Brown J, Avens J, Kendall P, Hyatt D, Stone M. Survey of
Available at: www.cfsan.fda.gov/ pregnant/pregnant.html. Ac- consumer attitudes and the effectiveness of handwashing in
cessed April 2, 2008 the home. Food Prot Trends. 2007;27(8):603– 611
6. Fein SB, Labiner-Wolfe J, Shealy KR, Li R, Chen J, Grummer- 12. Piper S, Parks PL. Predicting the duration of lactation: evidence
Strawn LM. Infant Feeding Practices Study II: study methods. from a national survey. Birth. 1996;23(1):7–12
Pediatrics. 2008;122(suppl 2):S28 –S35 13. Fein SB, Falci CD. Infant formula preparation, handling, and
7. Infant Formula, Directions for Use. 21 CFR §107.20 (2002) related practices in the United States. J Am Diet Assoc. 1999;
8. Koehler KM, Lasky T, Fein SB, et al. Population-based inci- 99(10):1234 –1240
S90 LABINER-WOLFE et al
Downloaded from www.pediatrics.org at IRCCS Burlo Garofalo on October 13, 2008
8. Infant FormulaHandling Education and Safety
Judith Labiner-Wolfe, Sara B. Fein and Katherine R. Shealy
Pediatrics 2008;122;S85-S90
DOI: 10.1542/peds.2008-1315k
Updated Information including high-resolution figures, can be found at:
& Services http://www.pediatrics.org/cgi/content/full/122/Supplement_2/S8
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