Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
This document summarizes a study on trends in infant nutrition in Saudi Arabia and compliance with WHO recommendations. The study found:
1) Breastfeeding initiation was high at 91.6%, but 28.1% of infants began breastfeeding over 6 hours after birth.
2) Bottle feeding was introduced by 1 month for 51.4% of infants and by 6 months for 90%.
3) The majority (80.8%) of infants began solid foods between 4-6 months, and 40% of infants under 12 months were given whole milk.
4) Current infant feeding practices in Saudi Arabia do not comply with WHO recommendations of exclusive breastfeeding for 6 months. Early introduction of complementary foods reduces
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Este artigo publicado no Pediatrics tenta analisar e relacionar o volume e frequência das mamadas com o conteúdo de gordura do leite materno durante 24h.
Conclui que os lactentes devem ser amamentados em livre demanda de dia e de noite.
Annals of Nutritional Disorders & Therapy is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients leading to various Nutritional diseases including obesity, eating disorders, malnutrition, developmental abnormalities that could be prevented by diet, hereditary metabolic disorders that retort to dietary treatment, food allergies and intolerances, and potential hazards in the food supply. It also focuses upon the chronic diseases caused due to improper nutrition such as cardiovascular disease, hypertension, cancer, and diabetes mellitus.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Annals of Nutritional Disorders & Therapy journal accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients.
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.
This document compares two methods for estimating fetal weight near term - Johnson's formula based on symphysiofundal height measurements and Hadlock's formula based on ultrasound measurements. A study of 100 pregnancies found that Johnson's formula overestimated fetal weight in all cases, while Hadlock's formula both overestimated and underestimated depending on actual birth weight. Hadlock's formula produced a more accurate estimation of fetal weight within 100g in 68% of cases compared to 30% for Johnson's formula. Although ultrasound using Hadlock's formula was more accurate, Johnson's formula provides a low-cost alternative that is still reasonably accurate when ultrasound is unavailable.
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.
Risk Factors For Excess Weight Loss And Hypernatremia In Exclusively Breast F...Biblioteca Virtual
The document discusses risk factors for excessive weight loss and hypernatremia in exclusively breastfed infants. It found that factors like primiparity, delayed initiation of breastfeeding after delivery, fewer than 4 stools per day, pink diaper color, breast conditions making breastfeeding difficult, cesarean delivery, and use of extra heaters were associated with greater weight loss and higher rates of hypernatremia in the infants studied. The results suggest that prompt initiation of breastfeeding and interventions if breastfeeding problems occur can help promote successful breastfeeding and prevent issues like excessive weight loss and dehydration in newborns.
This document summarizes a study on trends in infant nutrition in Saudi Arabia and compliance with WHO recommendations. The study found:
1) Breastfeeding initiation was high at 91.6%, but 28.1% of infants began breastfeeding over 6 hours after birth.
2) Bottle feeding was introduced by 1 month for 51.4% of infants and by 6 months for 90%.
3) The majority (80.8%) of infants began solid foods between 4-6 months, and 40% of infants under 12 months were given whole milk.
4) Current infant feeding practices in Saudi Arabia do not comply with WHO recommendations of exclusive breastfeeding for 6 months. Early introduction of complementary foods reduces
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Este artigo publicado no Pediatrics tenta analisar e relacionar o volume e frequência das mamadas com o conteúdo de gordura do leite materno durante 24h.
Conclui que os lactentes devem ser amamentados em livre demanda de dia e de noite.
Annals of Nutritional Disorders & Therapy is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients leading to various Nutritional diseases including obesity, eating disorders, malnutrition, developmental abnormalities that could be prevented by diet, hereditary metabolic disorders that retort to dietary treatment, food allergies and intolerances, and potential hazards in the food supply. It also focuses upon the chronic diseases caused due to improper nutrition such as cardiovascular disease, hypertension, cancer, and diabetes mellitus.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Annals of Nutritional Disorders & Therapy journal accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of nutritional disorders resulting from either excessive or inadequate intake of food and nutrients.
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.
This document compares two methods for estimating fetal weight near term - Johnson's formula based on symphysiofundal height measurements and Hadlock's formula based on ultrasound measurements. A study of 100 pregnancies found that Johnson's formula overestimated fetal weight in all cases, while Hadlock's formula both overestimated and underestimated depending on actual birth weight. Hadlock's formula produced a more accurate estimation of fetal weight within 100g in 68% of cases compared to 30% for Johnson's formula. Although ultrasound using Hadlock's formula was more accurate, Johnson's formula provides a low-cost alternative that is still reasonably accurate when ultrasound is unavailable.
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.
Risk Factors For Excess Weight Loss And Hypernatremia In Exclusively Breast F...Biblioteca Virtual
The document discusses risk factors for excessive weight loss and hypernatremia in exclusively breastfed infants. It found that factors like primiparity, delayed initiation of breastfeeding after delivery, fewer than 4 stools per day, pink diaper color, breast conditions making breastfeeding difficult, cesarean delivery, and use of extra heaters were associated with greater weight loss and higher rates of hypernatremia in the infants studied. The results suggest that prompt initiation of breastfeeding and interventions if breastfeeding problems occur can help promote successful breastfeeding and prevent issues like excessive weight loss and dehydration in newborns.
The document summarizes a consumer news article and primary research journal article on the relationship between human milk oligosaccharides (HMOs) found in breast milk and infant body composition. The consumer article provided a brief overview of a study that found associations between specific HMOs and increased or decreased infant fat mass at 6 months. The journal article described a study that analyzed breast milk from 37 mothers and found that higher levels of certain HMOs correlated with lower infant weight and fat mass, while others correlated with higher fat mass. The implications are that nutrition professionals may educate mothers on HMO sources, and consumers may be intrigued but find the information inconclusive due to need for more research.
This study assessed mothers' knowledge of breastfeeding in Kirkuk governorate, Iraq. A questionnaire was administered to 72 mothers to evaluate their knowledge of breastfeeding. The results found that over half of mothers were young, nearly half completed primary school, and over 60% regularly visited health centers during pregnancy. However, only 40% received education on breastfeeding. The study also found that over 60% of mothers correctly answered questions about the benefits of breastfeeding, and there was a significant relationship between education during pregnancy and breastfeeding knowledge. The study recommends increased health education on breastfeeding during pregnancy to improve mothers' knowledge.
Peer support interventions can increase breastfeeding rates. A systematic review found that peer support significantly decreased the risk of discontinuing exclusive breastfeeding in low and middle-income countries. Another study found that a telephone-based peer support program effectively maintained breastfeeding rates to 3 months postpartum among primiparous women and improved satisfaction with infant feeding. However, one randomized controlled trial found that peer support did not statistically significantly increase breastfeeding rates in the studied population.
Effectiveness of pre delivery preparation on anxiety among Primigravida mothe...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Constraints of exclusive breastfeeding practice among breastfeeding mothers i...Oba Adeboye
Exclusive breastfeeding is recommended for the first six months of life as the best way of feeding an infant. The result of this study will increase the knowledge and encourage mothers on exclusive breastfeeding in Alimosho General Hospital, Igando and also show them the dangers of not practicing exclusive breastfeeding. It will also help the Nurse to debunk myths about exclusive breastfeeding. Using a concurrent mixed method approach, a structured questionnaire was administered to 100 breastfeeding mothers. Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. The research however reveals larger percentage of the respondents are between 25-35 years in the study
This document summarizes research on the optimal duration of exclusive breastfeeding. It discusses how the WHO recommendation had been 4-6 months but was changed to around 6 months in 2001 based on evidence from over 3,000 studies. The resolution passed by the World Health Assembly urges exclusive breastfeeding for six months as a global recommendation, taking into account the expert committee's findings that exclusive breastfeeding for six months does not harm growth and protects against infection.
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.
The Effects Of Early Pacifier Use On Breastfeeding DurationBiblioteca Virtual
This study examined the effects of pacifier use on breastfeeding duration in a cohort of 265 breastfeeding mother-infant dyads in the United States. The researchers found that:
1) Pacifier introduction by 6 weeks was associated with a 53% increased risk of shortened duration of full breastfeeding and a 61% increased risk of shortened overall breastfeeding duration.
2) Mothers who introduced pacifiers tended to breastfeed less frequently, with statistically significant differences at 2 and 12 weeks.
3) At 12 weeks, mothers using pacifiers were more likely to report breastfeeding being inconvenient and having insufficient milk supply.
4) Pacifier use begun before 2 weeks or 6 weeks was not significantly associated
This document compares the use of intravaginal misoprostol tablets and intracervical dinoprostone gel for cervical ripening and labor induction. A study of 200 women found that dinoprostone gel resulted in a shorter mean induction to delivery interval, more spontaneous vaginal births, and fewer C-sections and instrument-assisted deliveries than misoprostol. Neonatal outcomes were similar between the two groups, with most babies experiencing no complications. The study concluded that dinoprostone gel is more effective than misoprostol for cervical ripening and labor induction in nulliparous and primiparous women at term with an unfavorable cervix.
This randomized controlled trial evaluated the effects of high-dose docosahexaenoic acid (DHA) supplementation on neurodevelopmental outcomes in preterm infants. The study found that:
1) Overall, high-DHA supplementation did not significantly improve Bayley Mental Development Index (MDI) scores at 18 months corrected age compared to standard DHA supplementation.
2) However, girls who received high-DHA supplementation had significantly higher MDI scores than girls who received standard supplementation.
3) Infants born weighing less than 1250g who received high-DHA supplementation tended to have higher MDI scores, but the difference was not statistically significant after adjustment for confounders.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
Impact of breast crawl to breast milk production on puerperium mothers in ros...IJRES Journal
- The document discusses a study on the impact of breast crawling on breast milk production in puerperium mothers at Abdoel Wahab Sjahranie Regional Public Hospital in Samarinda, Indonesia in 2014.
- The study found that 90% of mothers who performed breast crawling for 1 hour after birth had smooth breast milk production, while only 20% of mothers who did not perform proper breast crawling reported smooth production.
- Statistical analysis found the difference in breast milk production between the two groups to be significant, with breast crawling having a significant positive impact on production.
Stone-Jimenez, Anthony Kouyate, & Bongiovanni (2010) ACCESS FP LAM Brief - Th...Robin Anthony Kouyate, PhD
The document discusses the Lactational Amenorrhea Method (LAM), a modern temporary contraceptive method for postpartum women who breastfeed. LAM relies on three criteria for effectiveness: 1) menstrual periods have not resumed, 2) the infant is fully or nearly fully breastfed frequently day and night, and 3) the infant is under six months of age. The document outlines key elements of LAM services including counseling, support for exclusive breastfeeding, discussing return to fertility and transitioning to another contraceptive method when LAM criteria are no longer met. LAM is over 98% effective when used correctly, has child and maternal health benefits, and can attract previous non-users to modern contraceptive methods.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
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.
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
Moringa oleifera (malunggay) leaves were studied to determine if they increase breastmilk production in mothers of preterm infants. In a double-blind randomized controlled trial, 68 mothers were given either Moringa oleifera capsules or placebo capsules from postpartum days 3 to 5. Mothers pumped their breasts every 4 hours and the milk volume was measured. On days 4 and 5, mothers taking Moringa oleifera produced significantly higher volumes of breastmilk compared to the placebo group, demonstrating that Moringa oleifera leaves can increase breastmilk production in mothers of preterm infants.
This study evaluated the effectiveness of applying breast milk to treat sore nipples among postnatal mothers. It found that applying breast milk significantly reduced nipple soreness in the experimental group compared to the control group. Specifically, the mean nipple soreness score decreased from 13.53 to 5.27 in the experimental group after applying breast milk for one week, while it only decreased from 9.43 to 6.53 in the control group. This provides evidence that applying breast milk is an effective treatment for sore nipples among postnatal mothers.
1. The document presents a study on the effectiveness of early ambulation on uterine involution among postnatal mothers.
2. The study aims to assess uterine involution levels before and after early ambulation in an experimental group, and compare this to a control group without early ambulation.
3. A quasi-experimental design is used with 60 postnatal mothers divided into experimental and control groups, with uterine involution measured on a scale before and after the intervention of early ambulation for the experimental group.
Comparison of prolonged low volume milk and routine volume milk onamir mohammad Armanian
This study compared outcomes for very low birth weight neonates who were fed using either a prolonged low volume milk strategy (20 mL/kg/day for 7 days before increasing) or a routine advancing volume strategy (increasing volumes by 20 mL/kg/day). The study found that the incidence of necrotizing enterocolitis was significantly lower in infants fed with the prolonged low volume strategy compared to those fed with advancing volumes. However, infants fed with advancing volumes reached full enteral feeding volumes sooner. Overall hospital stay times and weight gain at 30 days were similar between the two groups. The study suggests prolonged low volume feeding may help reduce NEC risk in very low birth weight neonates.
The document summarizes a consumer news article and primary research journal article on the relationship between human milk oligosaccharides (HMOs) found in breast milk and infant body composition. The consumer article provided a brief overview of a study that found associations between specific HMOs and increased or decreased infant fat mass at 6 months. The journal article described a study that analyzed breast milk from 37 mothers and found that higher levels of certain HMOs correlated with lower infant weight and fat mass, while others correlated with higher fat mass. The implications are that nutrition professionals may educate mothers on HMO sources, and consumers may be intrigued but find the information inconclusive due to need for more research.
This study assessed mothers' knowledge of breastfeeding in Kirkuk governorate, Iraq. A questionnaire was administered to 72 mothers to evaluate their knowledge of breastfeeding. The results found that over half of mothers were young, nearly half completed primary school, and over 60% regularly visited health centers during pregnancy. However, only 40% received education on breastfeeding. The study also found that over 60% of mothers correctly answered questions about the benefits of breastfeeding, and there was a significant relationship between education during pregnancy and breastfeeding knowledge. The study recommends increased health education on breastfeeding during pregnancy to improve mothers' knowledge.
Peer support interventions can increase breastfeeding rates. A systematic review found that peer support significantly decreased the risk of discontinuing exclusive breastfeeding in low and middle-income countries. Another study found that a telephone-based peer support program effectively maintained breastfeeding rates to 3 months postpartum among primiparous women and improved satisfaction with infant feeding. However, one randomized controlled trial found that peer support did not statistically significantly increase breastfeeding rates in the studied population.
Effectiveness of pre delivery preparation on anxiety among Primigravida mothe...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Constraints of exclusive breastfeeding practice among breastfeeding mothers i...Oba Adeboye
Exclusive breastfeeding is recommended for the first six months of life as the best way of feeding an infant. The result of this study will increase the knowledge and encourage mothers on exclusive breastfeeding in Alimosho General Hospital, Igando and also show them the dangers of not practicing exclusive breastfeeding. It will also help the Nurse to debunk myths about exclusive breastfeeding. Using a concurrent mixed method approach, a structured questionnaire was administered to 100 breastfeeding mothers. Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. The research however reveals larger percentage of the respondents are between 25-35 years in the study
This document summarizes research on the optimal duration of exclusive breastfeeding. It discusses how the WHO recommendation had been 4-6 months but was changed to around 6 months in 2001 based on evidence from over 3,000 studies. The resolution passed by the World Health Assembly urges exclusive breastfeeding for six months as a global recommendation, taking into account the expert committee's findings that exclusive breastfeeding for six months does not harm growth and protects against infection.
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.
The Effects Of Early Pacifier Use On Breastfeeding DurationBiblioteca Virtual
This study examined the effects of pacifier use on breastfeeding duration in a cohort of 265 breastfeeding mother-infant dyads in the United States. The researchers found that:
1) Pacifier introduction by 6 weeks was associated with a 53% increased risk of shortened duration of full breastfeeding and a 61% increased risk of shortened overall breastfeeding duration.
2) Mothers who introduced pacifiers tended to breastfeed less frequently, with statistically significant differences at 2 and 12 weeks.
3) At 12 weeks, mothers using pacifiers were more likely to report breastfeeding being inconvenient and having insufficient milk supply.
4) Pacifier use begun before 2 weeks or 6 weeks was not significantly associated
This document compares the use of intravaginal misoprostol tablets and intracervical dinoprostone gel for cervical ripening and labor induction. A study of 200 women found that dinoprostone gel resulted in a shorter mean induction to delivery interval, more spontaneous vaginal births, and fewer C-sections and instrument-assisted deliveries than misoprostol. Neonatal outcomes were similar between the two groups, with most babies experiencing no complications. The study concluded that dinoprostone gel is more effective than misoprostol for cervical ripening and labor induction in nulliparous and primiparous women at term with an unfavorable cervix.
This randomized controlled trial evaluated the effects of high-dose docosahexaenoic acid (DHA) supplementation on neurodevelopmental outcomes in preterm infants. The study found that:
1) Overall, high-DHA supplementation did not significantly improve Bayley Mental Development Index (MDI) scores at 18 months corrected age compared to standard DHA supplementation.
2) However, girls who received high-DHA supplementation had significantly higher MDI scores than girls who received standard supplementation.
3) Infants born weighing less than 1250g who received high-DHA supplementation tended to have higher MDI scores, but the difference was not statistically significant after adjustment for confounders.
Aleitamento materno e adiposidade adultaLaped Ufrn
Aleitamento materno e adiposidade adulta (JPed 2014) - Artigo apresentado em Reunião Científica da Liga Acadêmica de Pediatria da UFRN - LAPED UFRN - Natal - RN - Brasil.
Impact of breast crawl to breast milk production on puerperium mothers in ros...IJRES Journal
- The document discusses a study on the impact of breast crawling on breast milk production in puerperium mothers at Abdoel Wahab Sjahranie Regional Public Hospital in Samarinda, Indonesia in 2014.
- The study found that 90% of mothers who performed breast crawling for 1 hour after birth had smooth breast milk production, while only 20% of mothers who did not perform proper breast crawling reported smooth production.
- Statistical analysis found the difference in breast milk production between the two groups to be significant, with breast crawling having a significant positive impact on production.
Stone-Jimenez, Anthony Kouyate, & Bongiovanni (2010) ACCESS FP LAM Brief - Th...Robin Anthony Kouyate, PhD
The document discusses the Lactational Amenorrhea Method (LAM), a modern temporary contraceptive method for postpartum women who breastfeed. LAM relies on three criteria for effectiveness: 1) menstrual periods have not resumed, 2) the infant is fully or nearly fully breastfed frequently day and night, and 3) the infant is under six months of age. The document outlines key elements of LAM services including counseling, support for exclusive breastfeeding, discussing return to fertility and transitioning to another contraceptive method when LAM criteria are no longer met. LAM is over 98% effective when used correctly, has child and maternal health benefits, and can attract previous non-users to modern contraceptive methods.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
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.
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
Moringa oleifera (malunggay) leaves were studied to determine if they increase breastmilk production in mothers of preterm infants. In a double-blind randomized controlled trial, 68 mothers were given either Moringa oleifera capsules or placebo capsules from postpartum days 3 to 5. Mothers pumped their breasts every 4 hours and the milk volume was measured. On days 4 and 5, mothers taking Moringa oleifera produced significantly higher volumes of breastmilk compared to the placebo group, demonstrating that Moringa oleifera leaves can increase breastmilk production in mothers of preterm infants.
This study evaluated the effectiveness of applying breast milk to treat sore nipples among postnatal mothers. It found that applying breast milk significantly reduced nipple soreness in the experimental group compared to the control group. Specifically, the mean nipple soreness score decreased from 13.53 to 5.27 in the experimental group after applying breast milk for one week, while it only decreased from 9.43 to 6.53 in the control group. This provides evidence that applying breast milk is an effective treatment for sore nipples among postnatal mothers.
1. The document presents a study on the effectiveness of early ambulation on uterine involution among postnatal mothers.
2. The study aims to assess uterine involution levels before and after early ambulation in an experimental group, and compare this to a control group without early ambulation.
3. A quasi-experimental design is used with 60 postnatal mothers divided into experimental and control groups, with uterine involution measured on a scale before and after the intervention of early ambulation for the experimental group.
Comparison of prolonged low volume milk and routine volume milk onamir mohammad Armanian
This study compared outcomes for very low birth weight neonates who were fed using either a prolonged low volume milk strategy (20 mL/kg/day for 7 days before increasing) or a routine advancing volume strategy (increasing volumes by 20 mL/kg/day). The study found that the incidence of necrotizing enterocolitis was significantly lower in infants fed with the prolonged low volume strategy compared to those fed with advancing volumes. However, infants fed with advancing volumes reached full enteral feeding volumes sooner. Overall hospital stay times and weight gain at 30 days were similar between the two groups. The study suggests prolonged low volume feeding may help reduce NEC risk in very low birth weight neonates.
This document provides an introduction and background for a study examining the effectiveness of a Breastfeeding Empowerment Programme (BEP) on knowledge, skills, self-confidence, and breastfeeding outcomes among first-time mothers in India. The study aims to evaluate the impact of the BEP, correlate outcomes with domains, and associate outcomes with background variables. It outlines the objectives, hypotheses, variables, sample size, population, sampling technique, data collection tools, and data analysis methods for the randomized controlled study.
The document discusses lactation management and breastfeeding. It provides objectives of lactation management including reviewing public health impacts and understanding physiology. It outlines recommendations for exclusive breastfeeding for six months and continued breastfeeding for at least one year. Common breastfeeding problems like low milk supply, mastitis and breast abscess are identified. The physiology of lactation including galactokinesis, lactogenesis and galactopoiesis is explained. Benefits of breastfeeding for both mother and infant are highlighted. Drugs to improve milk production and positions for breastfeeding are outlined. Contraindications and problems in breastfeeding are also discussed.
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.
CLINICAL BRIEF
A Quality Improvement Initiative: Improving Exclusive
Breastfeeding Rates of Preterm Neonates
Amanpreet Sethi1 & Meena Joshi1 & Anu Thukral1 & Jagjit Singh Dalal1 &
Ashok Kumar Deorari1
Received: 7 October 2016 /Accepted: 31 January 2017 /Published online: 24 February 2017
# Dr. K C Chaudhuri Foundation 2017
Abstract This study is a single center quality improve-
ment (QI) initiative in a tertiary care neonatal intensive
care unit which was done with an objective to increase
the proportion of neonates receiving mother’s own milk
(at postnatal age of 7 d) from the current rate of 12.5%
to 30% over a period of six weeks. Additional objec-
tives were to evaluate the proportion of mothers’ ex-
pressing breast milk within 3 h of birth, on day one
and three and the amount of expressed breast milk
(EBM) on day one and day seven. A team was formu-
lated to evaluate the reasons for inadequate breast milk
expression and to plan the steps for promoting the
same. Comprehensive postnatal breast feeding counsel-
ing (CPNC) to promote early breast milk expression
was initiated soon after the birth of a preterm neonate.
CPNC was done for next fifteen mothers and their
breast feeding support was streamlined. The effect of
CPNC and teamwork was discussed amongst the team
members every day and adjustments incorporated (Plan-
Do-Study-Act cycle). The proportion of neonates receiv-
ing mother’s only milk (MOM) on day 7 increased to
80% (12/15) after 4 wk of QI. Thus, a simple and
feasible CPNC package lead to improved breast milk
output in mothers.
Keywords Breast milk . Neonate . Quality improvement
Introduction
Exclusive breastfeeding for six months is the most effective
preventive strategy for under-five mortality [1]. Host resis-
tance factors are abundant in fresh breast milk and when prop-
erly collected and stored, it provides the highest quality of
anti-infective properties. [2, 3] However, for various reasons,
mothers of these neonates face multiple challenges in estab-
lishing and maintaining an adequate supply of milk, this phe-
nomenon being more common in preterm neonates [4, 5]. The
gap in current evidence based implementation is the strategy
to reduce the time to first milk expression and to increase
frequency of expression and night time expression of milk in
these mothers. It is also known that mothers of extremely
preterm neonates should be taught early and effective milk
expression techniques [6].
The authors identified problem of delayed breast milk ex-
pression by mothers of preterm neonates whose babies were
admitted in the neonatal intensive care unit (NICU). The fre-
quency of milk expression in these mothers was limited to two
to three times in the entire day leading to most neonates re-
ceiving predominant formula feed for the first one week.
In view of the existing evidence and the identified problem,
the authors formulated an aim to increase the proportion of
breast milk intake in the admitted preterm neonates o.
This quality improvement study conducted in a neonatal intensive care unit aimed to increase exclusive breastfeeding rates of preterm neonates from 12.5% to 30% over 6 weeks. The team implemented comprehensive postnatal breastfeeding counseling for mothers, which focused on early and frequent milk expression. This led to improved breast milk output, with the proportion of neonates receiving mother's own milk increasing from 12.5% to 80%. Sustaining efforts like allocating breast pumps and celebrating successes helped maintain high exclusive breastfeeding rates of over 80% in follow up periods. The simple counseling approach improved breastfeeding outcomes without external funding or additional staffing.
Breastfeeding is recommended for infants for the first year of life and provides health benefits for both mother and baby. While sulfonylureas like glipizide were previously discouraged during breastfeeding due to transfer into breastmilk, recent studies found negligible levels of glyburide and glipizide in breastmilk. Metformin is also considered safe during breastfeeding as studies found low levels in breastmilk below 10% of the maternal dose, with no adverse effects seen in infants. Therefore, sulfonylureas and metformin appear to be compatible with breastfeeding for diabetic mothers.
Breastfeeding is recommended for infants for the first year and provides health benefits for both mother and baby. While sulfonylureas like glipizide cross the placenta during pregnancy, studies have found negligible or undetectable levels of glipizide and glyburide in breastmilk. Metformin is also considered safe during breastfeeding as studies have found low levels in breastmilk below 1% of the maternal dose, with no adverse effects seen in infants. Therefore, glipizide and metformin can be used during breastfeeding while managing diabetes.
This document discusses nutritional requirements and dietary recommendations during lactation. It begins by introducing lactation as the process by which a mother's body produces milk tailored to her offspring's needs. It emphasizes that optimal nutrition for the breastfeeding mother is critical because the newborn receives all its nutrition from breastmilk in the first few months. The document then outlines dietary recommendations for lactating mothers, including consuming a well-balanced diet and galactagogues (foods that increase milk supply). It describes a study conducted to assess breastfeeding knowledge, attitudes and practices among mothers. The study found high breastfeeding knowledge but some gaps in attitudes and practices, such as introducing other foods and liquids too early. It concludes by recommending improved breast
Rooming in refers to allowing mothers and infants to room together in the hospital. The document discusses benefits of rooming in such as establishing and maintaining breastfeeding as studies found higher breastfeeding rates for roomed-in infants. Rooming in also reduces infant exposure to infections and supports better infant sleep. Cost analyses found rooming in saves on personnel and capital costs compared to separate recovery rooms. However, some mothers request the nursery due to lack of understanding of rooming in benefits.
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.
This study examined the association between phototherapy treatment for neonatal jaundice and breastfeeding duration and exclusivity. The study analyzed data from a national survey of over 4,000 mothers who initiated breastfeeding. Around 5% of infants received phototherapy for jaundice. The study found phototherapy was associated with decreased exclusive breastfeeding at 1-4 months but did not find significant decreases in any breastfeeding until 12 months. The results suggest greater breastfeeding support may help mothers maintain confidence in exclusive breastfeeding during and after phototherapy treatment.
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.
Breastfeeding Training For Health Professionals And Resultant Changes In Brea...Biblioteca Virtual
This study aimed to quantify changes in breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC breastfeeding promotion course, compared to control hospitals not exposed. The study randomly assigned 8 Brazilian hospitals to an exposed group (staff attended the course) or control group. For each hospital, cohorts of 50 children born before and after the course were followed up at 1 and 6 months. Results showed increases in exclusive (29%) and full (20%) breastfeeding rates in exposed hospitals, but no changes in control hospitals. The study supports training health professionals to promote longer breastfeeding duration.
The document discusses the revised training package for the Baby Friendly Hospital Initiative (BFHI). Some key points:
- The BFHI was launched in 1991 to promote breastfeeding. Over 15,000 facilities in 134 countries have achieved Baby-Friendly status.
- However, progress in designating new hospitals has slowed since 1996. On average, less than seven hospitals per country are designated each year.
- WHO and UNICEF have developed a revised 20-hour training course package to revitalize the BFHI both quantitatively and qualitatively.
- The package includes updates to certain steps and new/optional criteria on areas like HIV/AIDS, labor/childbirth care, and compliance with
1) The study examined the effects of a digital prenatal program called the Baby Care Program (BCP) on 512 first-time mothers. The BCP included mindfulness activities like meditation, yoga, music, and baby bonding exercises.
2) Results showed statistically significant benefits for mothers who used the BCP, including lower stress, better sleep, fewer preterm births and higher birth weights, compared to mothers who did not participate.
3) The BCP was found to help mothers develop a stronger bond with their babies, better manage nutrition and pregnancy symptoms, and have an overall healthier pregnancy experience.
The potential of_moringa_oleifera_for_agricultural_and_industrial_usesSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Study of moringa_effect_on_gastric_and_duodenal_ulcersSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
This study evaluated the effects of drinking Moringa oleifera tea on blood sugar levels in 43 individuals with normal or hyperglycemic blood sugar levels. For those with normal blood sugar levels, their levels did not significantly change after drinking the tea. However, for those with hyperglycemic levels, their blood sugar levels significantly dropped an average of 28 mg/dl after drinking the tea. The results suggest Moringa oleifera tea may be beneficial for managing hyperglycemia.
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
The document discusses the results of a study on the impact of climate change on coffee production. Researchers found that suitable land for coffee production could decline by up to 50% by 2050 due to rising temperatures and changing rain patterns associated with climate change. Arabica coffee was found to be most at risk, as its growing regions would shrink significantly according to the study's climate models. The study concludes that climate change poses a serious threat to the coffee industry worldwide if steps are not taken to mitigate future warming and help farmers adapt to the new conditions.
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Potential of-moringa-oleifera-as-livestock-fodder-cropSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Nutritive value-of-moringa-stenopetala-and-moringa-oleiferaSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
The document analyzes the nutritional composition of Moringa oleifera leaves of the South African ecotype. It finds the dried leaves contain 30.3% crude protein with 19 amino acids. Notable mineral contents include 3.65% calcium, 1.5% potassium, and 0.3% phosphorus. Fatty acid analysis identified 17 fatty acids, with alpha-linolenic acid at 44.57%. Vitamin E was the highest vitamin at 77 mg/100g. The fiber contents were 11.4% NDF and 8.49% ADF. Overall, the amino acids, fatty acids, minerals, and vitamins reflected a desirable nutritional balance for the Moringa leaves.
Moringa tree-poverty-alleviation-and-rural-developmentSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
This document reports on a comparative study of the chemical compositions and feeding values of leaves from Moringa stenopetala and Moringa oleifera trees. The study found that M. oleifera leaves contained higher levels of crude protein, fat, essential amino acids, and gross energy than M. stenopetala leaves. However, M. stenopetala leaves had higher fiber fractions like crude fiber, acid detergent fiber and cellulose. In vitro gas production analysis showed M. stenopetala leaves produced more gas and had higher metabolizable energy, organic matter digestibility and short chain fatty acids than M. oleifera leaves. Both Moringa species showed potential as protein supplements for ruminants and non
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa l’aliment-et-à-la-santé-propriétés-nutritionnelles-et-fonctionnellesSilentdisco Berlin
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
The document summarizes research investigating the anti-fungal properties of Moringa oleifera extracts. Ethanol extracts of M. oleifera seeds and leaves showed inhibitory effects against common fungal skin pathogens like Trichophyton rubrum in in vitro tests. Chemical analysis of the essential oil from M. oleifera leaves identified 44 compounds, with (E)-phytol and pentacosane as major constituents. Certain extracts, like the ethyl acetate fraction of seeds, exhibited minimum inhibitory concentrations below 10 mg/ml against the test fungi. The results suggest M. oleifera extracts could potentially be developed into anti-fungal agents for skin diseases.
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
Moringa is a plantfood of high nutritional value, ecologically and economically beneficial and readily available in the countries hardest hit by the food crisis. http://miracletrees.org/ http://moringatrees.org/
1. ORIGINAL ARTICLES
Moringa breastfeeding
A double-blind, randomized controlled trial on the use of malunggay
(Moringa oleifera) for augmentation of the volume ofbreastmilk among
non-nursing mothers of preterm infants
Ma. Corazon P. Estrella, M.D., Jacinto Bias V. Man taring III, M.D., Grace Z. David, M.D.,
Michelle A. Taup, M.D.*
ABSTRACT
OBJECTIVES: To determine if there is a significant difference in the
volume of breastmilk on postpartum days 3 to 5 among mothers with
,preterm infants who take malunggay (Moringa oleifera) leaves compared
to those who were given placebo.
SETTING: Tertiary government hospital
STUDY DESIGN: Double-blind, randomized controlled trial
PATIENTS AND METHODS: A total of 68 postpartum mothers admitted
at a tertiary government hospital and whose infants had pediatric
ages of less than 37 weeks and admitted to the NICU for tube feedings
were included in the study. The mothers were randomized to receive
Moringa oleifera(encapsulated in a commercial preparation containing
250 mg of leaves) or an identical capsule containing flour as placebo.
They were asked to pump their breasts using a standardized
breastpump from day 1 to day 5 postpartum. The mothers were given
capsules on postpartum days 3 to 5 . The contents Of the capsules
were unknown to both Investigator and subjects. T-test was used to
determine differences in baseline variables. Chi-square was used to
determine difference in baseline proportions between groups. Oneway
ANOVA was used to determine if there were significant differences
in the volume of breastmilk between treatment and control groups. A
p-value of <0.05 was considered significant.
RESULTS: There was a trend towards increased milk production among
those on Moringa oleifera leaves (Day 3: 114.1 ml ± 62.9 vs. 87.2 ±
49.1; Day 4: 190 ml ± 103.5 vs. 128.8 ± 84.9; Day 5: 319.7 ml ± 154.10
vs. 120.2 ± 54.7). This was statistically significant on Day 4 (p = 0.007)
and on Day 5 (p = 0.000).
CONCLUSION: Moringa oleifera leaves increase milk production on
postpartum days 4 to 5 among mothers who delivered preterm infants.
KEYWORDS: breastmilk, malunggay
Feeding breastmilk to premature infants
is of interest because of its potential
nutritional and immunologic benefits. The
prevailing consensus is that early milk pro-
* From the Department of Pediatrics, UPPGH
Medical Center
Vol. 49 No. 1 January-March 2000
duced by women who deliver prematurely
is more appropriate for VLBW infants than
is donor milk from later stages of lactation,
and that is to feed each infant milk produced
by his/her mother minimizes potential
risks from contaminants. To implement
this consensus, mothers ofVLBW infants
must produce sufficient milk to meet the
nutritional needs imposed by the accelerated
growth rates of their infants. More
often than not, however, the biggest obstacle
to the initiation of feeding breast
milk is collection. Most mothers after initiating
expression of breastmilk on the first
few days after birth complain of insufficient
volume ofbreastmilk. This complaint
has prompted most mothers to use milk
formula, shift to bottle feeding, and discontinue
breastfecding.
Little quantitative data are available
with which to evaluate protocols for the
initiation and maintenance of successful
lactation during the long periods of infantmother
separation that commonly follow
premature delivery. De Carvalho, et al
( 19'85)1 reported that the frequency of milk
expression was associated positively with
milk production in mothers of premature
infants, but the mean volumes of milk produced
by women in that study did not meet
the nutrient needs of VLBW infants and
declined production are common problems
associated with premature delivery.
A pilot study was done by the authors
among 10 mothers who delivered
neonates whose pediatric ages were less
than 37 weeks in a tertiary government
hospital. The total amount of volume of
breastmilk expressed for 24 hours was plotted
from Day 1 to Day 7. Results showed
that there was a steady increase in milk
volume from days 1 to 3 after which a constant
or lower volume was recovered from
days 3 to 5. The authors determined that 3
to 5 days postpartum is critical for the success
of implementing a breastfeeding program
among mothers who deliver preterm
golacta.com. Used with permission. 3
2. infants.2
OBJECTIVES
This investigation is being undertaken
with the following objectives: to determine
the volume of breast milk that is expressed
on postpartum days 3 to 5 among mothers
who delivered prematurely who were given
mulunggay leaves compared to those who
were given placebo and to determine if
there is a significant difference in the volume
of breast milk on postpartum days 3
to 5 between the two groups.
PATIENTS & METHODS
This is a double-blind randomized
controlled trial.
All mothers who delivered live infants
Jess than 37 weeks and admitted to the
NICU for tube feedings were eligible for
inclusion into the study. Excluded were
mothers with hypertension post-delivery,
diabetes mellitus, chorioamnionitis,
chronic illness or taking any medication
on a regular basis, breast anomalies, and
those with infants with congenital anomalies.
After informed consent, mothers were
randomized using a table of random numbers.
Randomization was done by a person
not involved in the study. Assignments
were concealed using sealed opaque
envelopes. Those assigned to the treatment
group were given Moringa oleifera
leaves in a commercial capsule preparation
250 mg every 12 hours starting on the 3rd
postpartum day. Those who were assigned
to the placebo group were given flour contained
in identical capsules. Capsules were
prepared by a research assistant who was
not directly involved in the study. Treatment
assignments were unknown to both
the investigators and study subjects.
After proper orientation, demonstration
and training, mothers were then instructed
to pump their breasts every 4
hours using a standardized breast pump.
Volume was measured using standardized
containers and recorded in standard notebooks
provided by the study personnel.
When available, the volume of milk collected
was also measured by the study
personnel. Total milk volumes were tabu-
4
lated from post-partum days 3 to 5.
All data were entered using Microsoft
Excel 97. Statistical analysis was clone
using SPSS version 9.0 software.
T-test was used to determine differences
in numeric baseline variables. Chisquare
was used to determine difference
in baseline proportions between groups.
One-way ANOVA was used to determine
if there were significant differences
in the collected volume of breastmilk
among mothers on the study medication
compared to placebo. A p-value of <0.05
was considered significant.
RESULTS
A total of 82 mothers were recruited.
There were 14 subjects who did not sub
mit their notebooks and who were consid
ered drop-outs, 9 from the treatment grOUJ
and 5 from the control group. There wen
11 mothers whose data were not complet1
because their infants expired before the 6tl
postpartum day. Thus, a total of 68 moth
ers were analyzed. Thirty-one (31) moth
ers were in the Treatment Group and 3 ~
mothers were in the Control Group.
There is no significant difference ir
the gravidity, maternal age, and infants
pediatric ages and infants' birthweights.
The mean volume of milk collectec
among the treatment groups from postpar·
tum days 3 to 5 are presented in Table ~
and Figures 1.
On day 3, the Treatment Group had 2
Table 1
BASELINE CHARACTERISTICS OF TREATMENT AND
CONTROL GROUP
Baseline Characteristic Treatment Group Control Group
Maternal Age (years) 25.8 ± 5.1 30.9 ± 15.7
Pediatric Age (weeks) 33.7 ± 1.9 33.1± 2.3
Infant's Weight:(grams) 1,532.7 ± 361.5 1,424.6 ± 359.2
Median gravidity 2 3
Table2
p- value
0.09
0.30
0.22
0.32
VOLUME OF BREASTMILK (in m1) ON PASTPARTUM DAYS 3 TO 5
OF TREATMENT AND CONTROL GROUPS
Day Post-partum Treatment Group Control Group
Day3
Day4
Day 5
114.1+1-62.9 87.2+1-49.1
190.0+-103.5 123.8 +- 84.9
319.7+-154.1 120.2+1-54.7
Figure 1
VOLUME OF BREAST MILK COLLECTED FROM
POST-PARTUM DAYS 3 TO 5
400
300
~
g200
l3
~
~
{00
I
::r:I ~I INTERVENTION
I
.. Plaoollo
I
o.J-. --,..,---:---:-:----::---::,.-::..- ___. o r-
OAY
p- value
0.052
0.007
0.000
golacta.com. Used with peTrhme Pihsilispipoinen J.ournal of Pediatrics
3. mean breastmilkvolumeof 114.1 ± 62.9 m1
compared to the Control Group with a
mean of 87.2 ± 49.1 mi. This showed a
mean difference of20-30 ml or a 28-32%
increase in breast milk volume in favor of
treatment.
On day 4, the Treatment Group had a
higher mean breast milk volume of 190 ±
103.5 ml compared to the Control Group
with only 123.8 ± 84.9 ml. This showed a
mean difference of 54-77 ml or a 51.:.58 %
increase in favor of treatment.
On day 5, the difference was even bigger
with the Treatment Group haviiig a
breast milk volume of319.7 ± 154.1 m1 compared
to the Control Group who had 120.2
± 54.7 mi. This had a mean difference of
154-245 ml or a 152-176% increase in
breast milk volume in favor of treatment.
There were no reported adverse effects
in both groups. ·
DISCUSSION
Lactogenes.is is initiated in the postpartum
period by a fall in plasma progesterone
in the presence of maintained prolactin
concentrations. Initiation of the process
does not depend on suckling of the
infant although the rate of milk secretion
after the third or fourth day postpartum
declines if milk removal is not practiced at
regular intervals.3 A foreign study4 on milk
volume produced by women aged 20 to 38
years who delivered at 28 to 30 weeks gestation
showed that optimal milk production
was associated with five or more milk
expressions per day and pumping
durations that exceeded 100 minutes per
day.
After deli very, the basal levels of prolactin
fall and, even in women who
breastfeed, they approach the normal
range by 2 to 3 weeks postpartum.5 When
suckling occurs prolactin is promptly released,
the levels rising 5 to 10 fold for
about 30 minutes. Tactile sensitivity of the
nipple, markedly reduced during pregnancy,
increases within a few hours of delivery
and is clearly geared to efficient suckling.
~ Vol. 49 No. 1 January-March 2000
In the early puerperium, the amount
of milk produced correlates with the
amount of prolactin released during suckling,
significantly larger amounts of prolactin
being released by "good" feeders
(over 700 ml of milk a day) than by "poor"
feeders, both the yield of milk and the
amount of prolactin released increases.6
Many physiologic factors influence
milk composition and volume. These include
premature delivery, age of the
mother, within-feed regulation of milk release,
and the baby's demand for milk.'
There is little infonnation on milk volume
produced by mothers giving birth prematurely.
1 Anecdotally, premature deliveries
have been associated with a decrease in
volume of breastmilk compared to term
deliveries because of the relative absence
of sucking stimulation among mothers of
preterm infants who cannot nurse because
of the long infant-mother separation and
because their infants may be too small to
suckle directly.
Honnonal stimulation of the mammary
gland, such as occurs during nursing, is
an important regulator of amount of milk
produced. In the non-nursing mother,
breast stimulation by pump can also induce
prolactin release comparable with that
induced by suckling.6 As long as sucking
stimulation continues, in this study, the
pumping action of a breast pump/reliever,
there is pr.oduction of large volumes of
milk. Conversely, if there is a decrease in
blood flow, as occurs in response to stress,
milk secretion declines because the mammary
supply of oxygen, glucose, fatty adds,
and amino adds is reduced.R Maternal
stress was not evaluated during the study,
although each family was experiencing
strain due to their infants' hospitalization.
Lactagogues or galactogues are special
foods, drinks, or herbs which people
believe can increase a mother's milk supply.
In most parts of the Philippines, women
take malunggay (Moring a oleifera) leaves
mixed in chicken or shellfish soups to enhance
breast milk production. The mechanism
of action has not been explained but
it was effective as a galactogogue and has
been used by generations of nursing llJOthers
especially those with inadequate lac-tation.
9
A local study done in 1996 by
Almirante and Lim demonstrated the lactation-
enhancing effect of malunggay
leaves as evidenced by a greater increase
in maternal serum prolactin levels and percentages
of gains in the infants' weights
among the lactating mothers who took the
malunggay leaves.10 This ca.n probably
explain its mechanism of actiQQ. A followup
study done by the same authors among
hypertensive mothers showed similar results,
with significant increases of tin values
in the treatment group (Moring a
oleifera group) compared to the placebo. 11
The authors in the same study recorded
the breastmilk volume of a subgroup of
mothers (eight out of 31 mothers) whom
they did direct measurements of expressed
milk on the first, second, and fourth month
postpartum. They recommenced adding
more subjects to this subgroup of mothers
to increase the level of significance.11
So far, no study has demonstrated the
clinical effect of malunggay leaves on a
more clinically relevant outcome, that of
breast milk volume, particularly on mothers
of pretem1 infants.
Our current study demonstrated the
lactation-enhancing effect of malunggay
(Natalac capsules) leaves as evidenced by
the significantly greater increase in the
volume of milk expressed by mothers on
the 3rd to the 5th postpartum day given
Moringa oleifera capsules compared to
those given placebo. The increase in volume
of breastmilk on the third day postpartum
only had a tendency to be significant
at p < 0.052. This may be due to the
fact that we only started giving the treatment
drug (Moringa oleifera capsules) on
this day. We recommend either giving the
treatment drug earlier, probably on postpartum
day 2 or increasing the sample size
to increase the level of significance for statistical
analysis on day 3 postpartum.
CONCLUSION ·
We, conclude that Moringa oleifera
leaves increase the volume of breastmilk
produced by mothers of preterm infants
on post-partum days 3 to 5. We therefore
golacta.com. Used with permission. 5
4. recommend its routine use among mothers
of preterm infants to augment lactation,
thereby ensuring an adequate supply
of breastmilk in the population that
needs it the most.
REFERENCES
1. De Carvalho M & Anderson DM. Frequency
of Milk Expression and Milk
Production by Mothers of Non-Nursing
Premature Neonates. AJDC.
1985:139:483-85.
2. Estrella MCP & Man taring JB III. Volume
ofBreastmilk Expressed by NonNursing
Mothers of Preterm infants
on the First Post-partum Week: A Pilot
Study. March 1999. (Unpublished)
3. Woolridge MW & Greasely V. The
Initiation of Lactation: The Effect of
Early versus Delayed Contact for 7.
Suckling on Milk Intake in the First
Week Postpartum. Early Human Development.
1985: 12:269-278.
Metabolism,44, 1101.
Anderson GH. Human Milk Feeding.
Pediatric Clinics of North America.
1985: 32 (2): 335-53.
4. Hopkinson JM & Schanier RJ. Milk
Production by Mothers of Premature
Infants. Pediatrics. 1988:81:815-20.
5. Neville MC. Regulation of Mammary
Development and lactation. Lactation,
Physiology, Nutrition, and
Breastfeeding. New York: Plenum
Press, 1983: 103-40.
6. Aono T, Sihoji T, Shoda T, & Kurach
K. The Initiation of Human Lactation
and Prolactin Response to Suckling.
Journal of Clinical Endocrinology and
8. Tucker HA. Endocrinology of Lactation.
Seminars in Perinatology. 1979:
33: 199-223.
9. Department of Health, Philippines.
Helping Mothers to Breastfeed. Published
by UNICEF, 1991.
10. Alrnirante CY & Lim CHTN. Effectiveness
of natalac as a Galactogogue.
Journal of Philippine Medical Association.
1996: 71: 265-272.
11. Almirante CY & Lim CHTN. Enhancement
ofBreastfeeding Among Hypertensive
Mothers. Increasingly Safe
and Successful Pregnancies. 1996:
279-286.
moringa breastfeeding
golacta.com. Used with permission.