This is a compilation of recommendations for feeding of HIV-exposed infants based on WHO-UNICEF and the DOH Administrative Order. Ideally, patient's choice should still be considered whether exclusively breastfeeding or exclusively replacement feeding.
This is a compilation of recommendations for feeding of HIV-exposed infants based on WHO-UNICEF and the DOH Administrative Order. Ideally, patient's choice should still be considered whether exclusively breastfeeding or exclusively replacement feeding.
Impact of Hepatitis B Virus (HBV) Vaccination in Childrens Born to HBV Positi...IOSR Journals
Perinatal HBV transmission is common in South East Asia approximately 25- 30% of the carrier
pool. The problem is not only to the mother but also pertains to the offspring, in pregnancy hepatitis; the
immune alterations in pregnancy may modify the dynamics of the disease. The infants of the mothers, who are
carrying both HBsAg and HBeAg, have the highest risk of acquiring the HBV infection by the perinatal route.
The over all risk may vary from one population to another, depending on the prevalence of HBeAg positivity in
the pregnant women. It is reported and estimated that 22,000 pregnant women in the United States get infected
with hepatitis B virus, which necessitated hepatitis B vaccination of the newborn mandatory in the United
States.
This study was aimed to bring about authenticated documentation on impact of preventive measures by
vaccination that are essential features to plan and implement health measures package in a country.
Results: Inspite of neonatal vaccination against hepatitis B given to all 158 children born to their HBsAg
positive mothers, 6.8% (6/87) of these infants reached the status of chronic HBV infection from their infected
mothers after 12 months follow-up.
Conclusion: 6.8% (6/87) of the infants developed chronic HBV infection in spite of hepatitis B vaccination all
the children by acquiring HBV from their infected mothers as confirmed by twelve months of follow-up
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
A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
Protegendo, promovendo e apoiando a Amamentação em maternidades - diretrizes atualizadas pela OMS.
Esta diretriz fornece recomendações globais e fundamentadas em evidências científicas sobre proteção, promoção e apoio à amamentação ideal em maternidades, como uma intervenção de saúde pública.
Pretende-se contribuir para discussões entre as partes interessadas ao selecionar ou priorizar as ações apropriadas em seus esforços para alcançar os Objetivos de Desenvolvimento Sustentável e as metas globais para 2025, conforme proposto no Plano Integral de Implementação de Nutrição Materna e Infantil, endossado pela 65ª. Assembléia Mundial da Saúde, em 2012, na resolução WHA65.6, a Estratégia Global para a saúde das mulheres, crianças e adolescentes (2016-2030) e a Estratégia Global para alimentação infantil e de crianças.
Ratifica a importância da implementação da IHAC – Iniciativa Hospital Amigo da Criança.
Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services
Guideline
A STUDY ON THE PRACTICE OF LACTATING MOTHERS IN THANJAVUR DISTRICTIAEME Publication
Childhood mortality is one of the important indicators of a country’s general medical and public health conditions, and consequently, the country’s level of socio-economic development. Its decline is therefore not only desirable but also indicative of an improvement in general living standards. In India, 2.1 million children die before their fifth birthday. Half of these children die even before they are 28 days old, accounting for one-fourth global infant deaths. Of the 9.7 million child deaths worldwide annually, one-third occur in India. The statistics are equally shocking among neonate’s children new born to a maximum age of 28 days old.
Relatório apresenta uma análise do estado atual da BFHI - Baby-Friendly Hospital Initiative (No Brasil, IHAC – Iniciativa Hospital Amigo da Criança) em países ao redor do mundo.
Com base na 2 ª revisão da política global de nutrição, implementado pela OMS em 2016-2017, o documento apresenta a implementação da iniciativa, 25 anos após o seu lançamento.
O relatório descreve a cobertura do programa, o atual processo de designação, razões para rescisão em locais onde o programa foi descontinuado, integração dos dez passos para outras normas e políticas globais, e lições aprendidas. Além disso, o relatório fornece informação qualitativa em alguns dos países que enfrentaram desafios na implementação da BFHI.
Excelente publicação – o Brasil é citado várias vezes.
Number of pages: 60
Publication date: 2017
Languages: English
ISBN: 978 92 4 151238 1
Impact of Hepatitis B Virus (HBV) Vaccination in Childrens Born to HBV Positi...IOSR Journals
Perinatal HBV transmission is common in South East Asia approximately 25- 30% of the carrier
pool. The problem is not only to the mother but also pertains to the offspring, in pregnancy hepatitis; the
immune alterations in pregnancy may modify the dynamics of the disease. The infants of the mothers, who are
carrying both HBsAg and HBeAg, have the highest risk of acquiring the HBV infection by the perinatal route.
The over all risk may vary from one population to another, depending on the prevalence of HBeAg positivity in
the pregnant women. It is reported and estimated that 22,000 pregnant women in the United States get infected
with hepatitis B virus, which necessitated hepatitis B vaccination of the newborn mandatory in the United
States.
This study was aimed to bring about authenticated documentation on impact of preventive measures by
vaccination that are essential features to plan and implement health measures package in a country.
Results: Inspite of neonatal vaccination against hepatitis B given to all 158 children born to their HBsAg
positive mothers, 6.8% (6/87) of these infants reached the status of chronic HBV infection from their infected
mothers after 12 months follow-up.
Conclusion: 6.8% (6/87) of the infants developed chronic HBV infection in spite of hepatitis B vaccination all
the children by acquiring HBV from their infected mothers as confirmed by twelve months of follow-up
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
A publicação designada
‘Amamentação, o Presente de Mãe para Cada Criança’,
revela que “aumentar as taxas de aleitamento materno ajudaria a prevenir mais 20 mil mortes de mães por CA de mama”.
A investigação lembra que amamentar ajuda também a proteger a mulher das hemorragias e das depressões pós-parto, do CA nos ovários – além do CA de mama –, problemas cardíacos e diabetes do tipo 2.
...
Nosso presente de Dia das Mães! :)
Prof. Marcus Renato de Carvalho
www.aleitamento.com
Protegendo, promovendo e apoiando a Amamentação em maternidades - diretrizes atualizadas pela OMS.
Esta diretriz fornece recomendações globais e fundamentadas em evidências científicas sobre proteção, promoção e apoio à amamentação ideal em maternidades, como uma intervenção de saúde pública.
Pretende-se contribuir para discussões entre as partes interessadas ao selecionar ou priorizar as ações apropriadas em seus esforços para alcançar os Objetivos de Desenvolvimento Sustentável e as metas globais para 2025, conforme proposto no Plano Integral de Implementação de Nutrição Materna e Infantil, endossado pela 65ª. Assembléia Mundial da Saúde, em 2012, na resolução WHA65.6, a Estratégia Global para a saúde das mulheres, crianças e adolescentes (2016-2030) e a Estratégia Global para alimentação infantil e de crianças.
Ratifica a importância da implementação da IHAC – Iniciativa Hospital Amigo da Criança.
Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services
Guideline
A STUDY ON THE PRACTICE OF LACTATING MOTHERS IN THANJAVUR DISTRICTIAEME Publication
Childhood mortality is one of the important indicators of a country’s general medical and public health conditions, and consequently, the country’s level of socio-economic development. Its decline is therefore not only desirable but also indicative of an improvement in general living standards. In India, 2.1 million children die before their fifth birthday. Half of these children die even before they are 28 days old, accounting for one-fourth global infant deaths. Of the 9.7 million child deaths worldwide annually, one-third occur in India. The statistics are equally shocking among neonate’s children new born to a maximum age of 28 days old.
Relatório apresenta uma análise do estado atual da BFHI - Baby-Friendly Hospital Initiative (No Brasil, IHAC – Iniciativa Hospital Amigo da Criança) em países ao redor do mundo.
Com base na 2 ª revisão da política global de nutrição, implementado pela OMS em 2016-2017, o documento apresenta a implementação da iniciativa, 25 anos após o seu lançamento.
O relatório descreve a cobertura do programa, o atual processo de designação, razões para rescisão em locais onde o programa foi descontinuado, integração dos dez passos para outras normas e políticas globais, e lições aprendidas. Além disso, o relatório fornece informação qualitativa em alguns dos países que enfrentaram desafios na implementação da BFHI.
Excelente publicação – o Brasil é citado várias vezes.
Number of pages: 60
Publication date: 2017
Languages: English
ISBN: 978 92 4 151238 1
A Study to Assess the Effectiveness of Structured Teaching Programme on Knowl...ijtsrd
Aim This study aimed to determine the effectiveness of structured teaching programme on knowledge regarding dangerous sign of new born among postnatal mothers at selected hospital Lucknow, Uttar Pradesh India and to find out various factors associated with it.Materials and methods An evaluative research approach with Pre experimental one group pretest posttest design and convenient sampling technique were used to select 60 postnatal mothers at selected hospitals Lucknow, Uttar Pradesh, India. A self structured knowledge questionnaire was used for assessing the knowledge among the subjects. SPSS version 25 was used for data analysis. Result There was significant difference between Pre test and Post test intervention level of knowledge t=40.533, p=0.0001 regarding dangerous sign of newborn among postnatal mothers. There was no significant association between pretest knowledge score about dangerous sign of newborn among postnatal mothers with their demographic variables p 0.05 . Conclusion Structure teaching programme was effective to enhance the knowledge of dangerous sign of newborn among postnatal mothers. Anubha Verma | D Regina Rabello "A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Dangerous Signs of New Born Among the Postnatal Mothers at Selected Hospitals, Lucknow" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-7 , December 2022, URL: https://www.ijtsrd.com/papers/ijtsrd52446.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/52446/a-study-to-assess-the-effectiveness-of-structured-teaching-programme-on-knowledge-regarding-dangerous-signs-of-new-born-among-the-postnatal-mothers-at-selected-hospitals-lucknow/anubha-verma
To evaluate traditional neonatal beliefs and care practices among urban and rural residents and assessing predictors of early initiation of breastfeeding, a cross-sectional study was conducted in two districts, Lahore and Rawalpindi of Pakistan. A total of 218 mothers having infants (< 2 years of age) were interviewed through collecting information through a questionnaire. In the logistic regression analysis, presence of professional birth attendant (P-value = 0.012, OR = 3.909), sterilization of feeding bottle (P-value = 0.013, OR = 3.280) and knowledge about reason of vaccination (P-value = 0.010, OR = 2.058) we re significantly associated with urbanization. Maternal education was significantly associated with correct timing to start weaning practice, breast milk was sufficient for infant, hand washing practice before breastfeeding, good cord care, vaccination status, reason of vaccination and knowledge about Jaundice in neonatal period (P <0.05). The results of multivariate ordinal regression showed that young literate mothers ((P < 0.001; OR = 3.192) started breastfeeding earlier than the elder and illiterate mothers. Furthermore, the women with normal delivery (P < 0.01; OR = 0.301) and low socioeconomic class (P < 0.10; OR = 0.339) started breastfeeding earlier. Among 218 mothers 44.5%, newborns were bathed immediately. A significant proportion of mothers 77.1% reported giving prelacteals as fi rst feed. Majority of mothers 30.7% apply oil on umbilical cord. also, 72.5% mothers administered gripe water to their infants. Traditional risky newborn care practices stress the need for promoting health education programs on improving newborn care practices.
This was a lecture given during the CME activitiy for POGS Region 7 by the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) at Casino Espanyol in Cebu City.
Emily Chambers Sharpe of the Office of the Global AIDS Coordinator discusses the importance of nutrition and the relationship between ARVs and breastfeeding in preventing mother to child transmission of HIV.
NCCR 2020: Conference Of Very Important Disease (COVID-19) | 24 - 26 August 2020
Young Investigator Awards Presentation
Mohammad Hasnan Ahmad
Nutritionist
Principal Investigator
Centre for Nutrition Epidemiology Research
Institute for Public Health
National Institutes of Health
Ministry of Health Malaysia
https://doi.org/10.5281/zenodo.4004505
2. CONTENTS
Background – why this is a critical research problem?
Research question (s) / issue
Aim of the research
Study design
a. Description of intervention
b.Phases of intervention
c.Pre-intervention / preparatory phase (scoping / baseline
studies, capacity building, SA, etc.)
d.Implementation phase – Methodology
e.Evaluation phase – indicators and monitoring framework
Expected outcome (Theory of Change)
Ethical issues
Timeline
3. BACKGROUND
Mother-to-child transmission - Transmission
of HIV from an HIV-positive mother to her
child during pregnancy, labor, delivery or
breastfeeding
Without treatment, around 15-30 percent of babies
born to HIV-infected women will become infected
with HIV during pregnancy and delivery. A further 5-
20 percent will become infected through
breastfeeding.
4. BACKGROUND
For most babies, breastfeeding is without question the best way to be
fed, but unfortunately breastfeeding can also transmit HIV. If no
antiretroviral drugs are being taken, breastfeeding for two or more
years can double the risk of the baby becoming infected to around 40
percent
Replacement feeding at the same time –INCREASES RISK OF
DIARRHOEA.
As extended breastfeeding and mixed feeding is only safe when
antiretroviral drugs are taken, there is now an emphasis on using
antiretroviral drugs to prevent the baby becoming infected as well as
an emphasis on breastfeeding..
But Nevirapine and lamivudine given to mothers are transmitted to
infants via breastfeeding in quantities sufficient to have biologic
effects on the virus; this may lead to an increased risk of a breastfed
infant's development of resistance to maternal antiretrovirals and
cause other ARV side effects
5. THE ISSUE
27 million pregnancies per year*
0.7%
prevalence**
1,89,000 infected pregnancies per year
30% transmission
Cohort of 56,700 infected newborns per
year
*Derived from population estimates (SRS) AND Crude Birth rate, adding 10% pregnancy
wastage
**Weighted average of estimates numbers of rural and urban HIV prevalence amongst
women15-19 years
6. RESEARCH QUESTION
How effective is Milk Bank in reducing mother to
child HIV transmission due to breastfeeding in the
state of Andhra Pradesh?
7. AIM
To reduce the prevalence of HIV transmission from
mother to child due to breastfeeding from 5-20% to
0-1% by introducing human milk banking system.
8. OBJECTIVES
GENERAL OBJECTIVES
To compare the effect of donated bottled milk with infected mother’s
bottled milk in the state Andhra Pradesh
SPECIFIC OBJECTIVES
To find out if mothers would feel comfortable with their child being
fed donated breast milk if they were unable to breast feed.
To find out if donor mothers would be comfortable to donate milk.
To find out various barriers attached to milk donation.
To assess that milk banking can reduce the risk of HIV transmission
from mother to child.
To explore the scope of health voucher incentives in encouraging
milk donation.
10. HEALTH BELIEF MODEL
Perceived Susceptibility- emotional bond
Perceived benefits- save an infants life
Perceived Severity- chest congestion, hardening of
breasts, chances of breast cancer, purity of milk
Perceived barriers- cultural issues, psychosocial
issues
Cues to threat- incentives
11. DESCRIPTION OF INTERVENTION
Breastfeeding is the normal way to feed infants by
providing them with adequate amount of nutrients that
they need for healthy growth and development.
But in case if mothers are infected from HIV infection
than the best possible solution to deal with this is to
provide them milk through Human Milk Banking
System (wet nursing).
Encouraging more and more donors to be part of this
intervention by giving them health voucher incentives.
This intervention would play a major role in reducing
the risk of transmitting HIV infection from mother to
child and would lead to safe and secure child bearing.
12. TI - PMTCT
Incentives-
Referrals donors Storage
mothers
Screening
and
Donors Processing Distribution
milk
Recipient-
Screenin non-
Collection
g infected
children
13. PRE - INTERVENTION
PHASE I: Base line Survey- Focus Group Discussion with
donor mothers and receivers
PHASE II: Selection of donor/funding agencies
PHASE III: Promotion through IEC Material among the
Donor mothers through SBA/TBA /ASHA/ANM/DOCTORS
Referrals
Pre-testing of IEC Material for both
PHASE IV: Giving them details about the incentives i.e.
cash incentive of Rs. 500 for each bottle
giving a kit for their new born child
dry ration card with fenugreek seeds
14. PHASE IV: Pilot testing of intervention- feasibility
study, scalability study, reliability study
PHASE V:Informed Consent from the donor mothers and
ethical consent from IRB
PHASE V: Initial screening of donor mothers
to donate excess breast milk and ensure that
donor mother is not suffering from any of the
communicable diseases
PHASE VII: Medical confirmation form
quality of product ensuring through the
medical provider of donor mother and her
infant's pediatrician
a confirmation form from doctor ensuring that
both mother and baby are healthy and mother
can donate her excess milk.
15. PRE - INTERVENTION
PHASE VIII: Donor Testing
Donor Test Kit will be posted at their homes
(free of cost) contain blood testing instrument and
DNA screening
Screening blood test
DNA in the milk will be matched with the DNA
identity profile make sure that milk donor is the
same who are being screened if they are donating
through different medium of transport.
16. STAKEHOLDERS
Donor and receiver mother and their families
Child birth Educator, Nursing mother group
Local TI- NGOs and CBOs
Health Care Providers: social
worker, nurses, nursing assistant doctors
International Donors/Agencies ( USAID, World
Bank, UNITAID, PEPFAR)
Media Professionals
Policy Makers
Business/Finance Professionals
State Medical Providers
17. STAKEHOLDER MAPPING
KEEP SATISFIED
HIGH MANAGE CLOSELY
POWE
R MONITOR KEEP INFORMED
LO
W LO HIGH
INTREST
W
18. CAPACITY BUILDING
PERSONNELS METHOD
PEER EDUCATOR Demonstration, Manuals
DOCTORS Workshop
OUT-REACH WORKERS Demonstration, Manuals
CHILD BIRTH EDUCATOR Training Workshop
PROGRAM OFFICERS Training Workshop, Management
Workshop
COUNCELLORS Workshop
MONITORING AND EVALUATION Data collection tools
TEAM
19. IMPLEMENTATION PHASE
Study Area: Andhra Pradesh
Study design: Randomized Control Trial
Sampling method: Cluster Sampling Method
Sampling Size: Two groups would be selected randomly
from the targeted population i.e. children with HIV infected
mothers and they are randomly divided into experimental
and non- experimental group.
one group of children would be given donated milk
and others would be receiving infected mothers
bottled milk
20. Children with HIV
infected mothers
Randomization
Receive infected
Received donated
mother’s bottled
bottled milk
milk
Non
Disease Non Disease
Disease
d Diseased d
d
21. MONTHLY MONITROING AND
EVALUATION PHASE
S.No Materials Number
1. Number of IEC Material
Distributed
2. Number of donor mother’s
milk screened
3. Number of mother’s milk
received from other
sources
3. Number of donated milk
distributed
4. Number of vouchers
provided
5. Number of milk bottle to
be met by our project
22. EXPECTED OUTCOME
Reduction in HIV transmission from mother to child
from 5-20% to 1%
Awareness about importance of breast-feeding
among the mass population.
23. ETHICAL CONSIDERATIONS
Pasteurizedhuman donor breast milk will
only be prescribed following written
informed consent from a parent or guardian.
Privacy and confidentiality
Precaution and risk minimization
Professional competence
Totality of responsibility; and compliance
with ethical concerns
24. TIMELINE
Our project will take 6 months for completion
27. Activity Week Week Week Week Week Week Week
1-2 3-4 5-6 6-7 7-8 9-10 11-12
Review of literature
Selection of staff and
investigators
Study plan
Listing & purchasing of
materials
Formulation ,
pretesting & finalization
of tools
Training of
investigators
Data collection
Analysis plan
Data entry and
cleaning of data
Data analysis
Editor's Notes
A collateral benefit could be that donor milk banks may heighten breastfeeding awareness in the community at large