Does early supplementation affect long-term breastfeeding?

The purpose of this secondary data analysis from two different samples was to examine the effect of early supplementation with manufactured milks on breastfeeding status at 20 weeks postpartum in mothers of healthy term infants. In two convenience samples of 120 and 223, respectively, breastfeeding mothers were followed up for 20 weeks postpartum or until weaning occurred. The breastfeeding rate at 20 weeks postpartum was significantly greater for mothers who reported feeding exclusively mother's milk the second week after delivery compared with mothers who breastfed and simultaneously supplemented with manufactured infant milks. Of the mothers in samples one and two who exclusively fed human milk during week 2 postpartum, 63.0% and 59.7%, respectively, were still breastfeeding at week 20, compared with 28.1% and 24.2%, respectively, who supplemented with artificial milks. There was no significant difference between these two groups of mothers and their intended duration of breastfeeding. Early introduction of supplemental bottles of artificial milks is associated with a decrease in the amount of human milk the infant receives as well as with early weaning.     

Venous embolism of diathermy evolved gases complicating endometrial ablation using glycine irrigant

OBJECTIVE: To evaluate the relationship between the time elapsed from the administration of ampicillin prophylaxis to delivery and its efficacy in interrupting intrapartum transmission of group B streptococcus. METHODS: During the 12-month study period, all women who came to the Virgen de las Nieves Hospital (Granada, Spain) for delivery were screened for group B streptococcus vaginal carriage by a pigment-detection culture-based procedure. Colonized women were treated with ampicillin (2 g intravenously), and the interval between ampicillin administration and delivery was recorded. Newborns from colonized mothers also were screened to detect group B streptococcus colonization. RESULTS: During the study period, 4525 women were admitted to the hospital for delivery and screened for group B streptococcus vaginal colonization. Group B streptococcus was detected in 543 women (12%), of whom 454 gave birth vaginally to 454 liveborn infants. Intrapartum ampicillin was given to 201 of these 454 women (44%), and 10% of the newborns from mothers who received intrapartum ampicillin prophylaxis were colonized by group B streptococcus. The relationship between timing of ampicillin administration and rate of neonatal group B streptococcal transmission was as follows: less than 1 hour before delivery, 46%; 1-2 hours, 29%; 2-4 hours, 2.9%; and more than 4 hours, 1.2%. Among the 253 mothers who received no intrapartum prophylaxis, colonization was found in 120 of their newborns (47%). CONCLUSION: When the time between the start of ampicillin prophylaxis and delivery is at least 2 hours, vertical transmission of group B streptococcus is minimized.     

Postdischarge telephone follow-up program for breastfeeding preterm infants discharged from a special care nursery

There is little research about mothers' concerns and management strategies for breastfeeding preterm infants in the postdischarge period. However, preterm infants have unique needs, and their mothers often face overwhelming challenges when trying to breastfeed in the early postdischarge period. The purpose of this project was to provide support to breastfeeding mothers whose babies had been recently discharged and to help the SCN team to develop a discharge plan. A telephone follow-up form was developed to help identify real or potential problems, plan realistic interventions, and evaluate the effectiveness of the plan. The first part of the form includes information about the baby's stay in the hospital. The second part of the form is used postdischarge. Space is provided to document any identified problems and suggested interventions. Feedback from the mothers who have received the telephone follow-up has been very favorable.     

Active anticarcinogenic chemical components in ordinary garlic and selenium-enriched garlic

A prospective cohort study was carried out to determine the factors affecting initiation of breastfeeding, and describe patterns of breastfeeding and supplemental feeding in the multiethnically and culturally diverse population of Al Ain, UAE. Two-hundred-and-twenty-one infants completed the 4 weeks of follow up. None of the mothers opted not to breastfeed, but only 4 per cent of them practiced exclusive breastfeeding during the first month of the infants' life; 51 per cent of them initiated breastfeeding on the first day of life. Factors associated with delayed initiation of breastfeeding beyond the first day of life included low birth weight, complicated delivery, ignorance of the advantages of colostrum, and young maternal age. Non-milk supplements fed to babies included water, tea, juice, yansun, and babunj (local herbal drinks). The preferred method of feeding the supplements was the feeding bottle. There were significant associations between the use of these supplements and the mother's nationality and education.     

Personal experience with non-contact tonometry in children

In 1990 the Innocenti Declaration on promoting breastfeeding was proclaimed in Florence/Italy. It became the subject of resolution 45.34 of the World Health Assembly in 1992. In the Federal Republic of Germany there was no wide-scale mass-media campaign to promote breastfeeding as in other countries. But mother-to-mother support groups, medical services and the newly founded National Breastfeeding Committee supported prolonged breastfeeding in public. The effects of the joint effort could be estimated by comparing the results of two postal surveys in 1991 and 1995. The surveys were conducted in Lower Saxony, North-Rhine-Westphalia and Berlin. A tendency could be shown toward more exclusive breastfeeding. Breastfeeding with supplementary food increased by a factor of 1.3 after adjusting for the variables mother's age, sleeping in parents' room or bed and no-smoking household. In Lower Saxony the increase was by a factor of 1.5 starting from a lower base value. The baby sleeping in the parents' room or in their bed furthered breastfeeding by a factor of 1.5 to 4. Non smoking mothers are 4 times more willing to breastfeed their infants than smoking mothers. German mothers breastfeed their infants two to three times more often than turkish mothers.     

Infant feeding practices in St. Vincent and factors which affect them

A survey was conducted in the summer of 1975 in 2 towns in St. Vincent--Layou and Georgetown--in the effort to obtain information regarding infant feeding practices and some of the factors which may influence them. Mothers of children from 1-2 years of age were interviewed in their homes. Complete data sets were obtained on 192 of the 216 eligible children in the 2 towns. For most children the period of exclusive breastfeeding (no other milk product given) was very short. About 1/2 of the children had received milk by 2 weeks of age, and 75% by 1 month. This was followed by a much longer period of "mixed" feeding--both breast and bottle--until breastfeeding was stopped at a median age of 6.8 months. Many types of milk were used for infant feeding. For 73% of the infants, infant formula was the 1st type of milk given. This was commonly replaced by a "heavier" full cream powdered milk at a few months of age. Prelacteal feeds were very common, predominantly glucose water. "Tonics," often consisting of vitamin preparations, were another common supplement during the early months of life. Among solid foods, arrowroot, "custard," and commercial infant cereals were the first to be introduced. Relatively inexpensive locally bagged staple foods and milk powders were available in both towns, but most mothers relied heavily on packaged brand name products for infant feeding even though the cost was 2-10 times higher. It was not possible to pinpoint the exact causes for the high levels of bottle feeding, nor for the possible recent decline in breastfeeding, but several important factors were identified. Part of the problem appeared to be due to poor health and nutritional status of the mothers. In addition, in several cases the mothers reported that they had wanted to continue breastfeeding but had received no support from health professionals, and in a few instances had been ordered to stop for seemingly trivial medical reasons.     

Relationships between maternal glucose intolerance and neonatal blood glucose

Blood glucose changes in 63 infants during the first three hours of life were related to indices of glucose tolerance of their mothers. Of the mothers, 34 had insulin-dependent diabetes, 16 had gestational diabetes, and 11 had minor abnormalities of glucose tolerance. The fasting blood glucose level of the mother and the umbilical cord blood glucose level were both proportional to the rate of glucose decline in the infant after birth which, in turn, was inversely related to the lowest glucose level attained within three hours. Hypoglycemia occurred in 77% of the infants of diabetic mothers, 25% of the infants of mothers with gestational diabetes, and one of 12 (8%) of infants of mothers with minor degrees of glucose intolerance. The blood glucose level at two hours during an oral glucose tolerance test in the mother can be used to predict the probability of her infant having neonatal hypoglycemia.     

Scoring criteria for preimplantation genetic diagnosis of numerical abnormalities for chromosomes X, Y, 13, 16, 18 and 21

Breastfeeding has long been believed to protect against infection in infants, but protection against respiratory illnesses has not been consistently demonstrated in studies in developed countries. Between 1988 and 1992, the authors assessed the effect of breastfeeding on incidence and duration of respiratory illnesses during the first 6 months of life in a prospective study that actively tracked breastfeeding and respiratory illnesses. A cohort of 1,202 healthy infants, born in Albuquerque, New Mexico, between January 1, 1988 and June 30, 1990, from homes without smokers was enrolled. The daily occurrences of respiratory symptoms and breastfeeding status were reported by the mothers every 2 weeks. Illnesses were classified as lower respiratory illness (LRI) if wheezing or wet cough was reported; the remaining illnesses were classified as upper respiratory. The annualized incidence rates for LRI were 2.8, 2.6, and 2.1 during follow-up time with no, partial, or full breastfeeding, respectively, but the incidence rates for upper respiratory illness and lower respiratory illness combined were similar in the three categories. After adjustment for potential confounding factors, full breastfeeding was associated with a reduction in lower respiratory illness risk (odds ratio=0.81, 95% confidence interval 0.68-0.96). Median duration of all respiratory illnesses was 5 days for the fully breastfed infants during the first 6 months of life compared with a median of 6 days for not breastfed and partially breastfed infants. Multivariate analysis confirmed that breastfeeding significantly reduced the duration of respiratory illness. This pattern of reduced incidence of LRI and shorter duration of all respiratory illnesses suggests that breastfeeding reduces the severity of infant respiratory illnesses during the first 6 months of life.     

Factors influencing the duration of breast-feeding

A group of 239 Scottish mothers breastfeeding on leaving hospital were followed up 6 months later by a postal questionnaire. 216 (90%) responded. Of these, 41% had discontinued breastfeeding before the end of the 12th week, the greatest decline occurring within the 1st 6 weeks. Duration of breastfeeding was significantly influenced by social class and, for parous mothers, previous breastfeeding success. 72% of the mother who stopped breastfeeding within the 1st 12 weeks gave inadequacy of the milk supply or an unsettled baby as contributory reasons. Maternal fatigue and painful nipples were the other 2 most frequent contributory problems. Only 6% of all mothers admitted to not enjoying breastfeeding. The person most commonly consulted about breastfeeding problems was the health visitor. Regardless of how long they had breastfed, 43% of the mothers would have liked more help.     

Naloxone in the parturient and her infant

Eighteen women in labor received analgesia with moderately large total doses of meperidien. Various doses of naloxone (8, 12, 18, 27, 40, or 60mug/kg of body weight) were given intravenously to the mothers before delivery in an attempt to find the dose that would prevent neonatal narcotic depression. Maternal and neonatal blood gas values, Apgar scores, and postnatal neurobehavioral examinations were used to assess the effects. Infants born of mothers who had received neither meperidine, promethazine, nor naloxone served as controls. After the naloxone injection, the mothers showed an improvement in consciousness and blood gas values. When the study infants, as a group, were compared with control infants, there was very little difference in blood gas values or neurobehavioral examination. Infants in the groups receiving naloxone in doses of 18, 27, and 40mug/kg compared most favorably with the control infants, indicating that naloxone may be effective in preventing neonatal narcotic depression.     

Effect of not breastfeeding on the risk of diarrheal and respiratory mortality in children under 2 years of age in Metro Cebu, The Philippines

The effects of not breastfeeding on mortality due to diarrhea and acute lower respiratory infection (ALRI) in children under 2 years of age were examined using data from a 1988-1991 longitudinal study of 9,942 children in Metro Cebu, The Philippines. Cox regression methods were used to study the magnitude of the risks, possible interactions with birth weight and nutritional status, and the effect of additional confounding factors. Not breastfeeding had a greater effect on diarrheal mortality than on ALRI mortality. In the first 6 months of life, failing to initiate breastfeeding or ceasing to breastfeed resulted in an 8- to 10-fold increase in the rate of diarrheal mortality. The rate of mortality associated with both ALRI and diarrhea was increased nearly six times by not breastfeeding, but the rate of ALRI mortality alone was not increased. The data also suggested that the risk of mortality associated with not breastfeeding was greater for low birth weight infants and infants whose mothers had little formal education. After age 6 months, the protective effects of breastfeeding dropped dramatically. These findings underscore the importance of promoting breastfeeding, especially during the first 6 months of life, and of targeting high risk groups such as low birth weight babies and those of low socioeconomic status.     

Increased incidence of sepsis at birth in neutropenic infants of mothers with preeclampsia

Neutropenia is often found at birth in infants born to mothers with preeclampsia, and is most likely present in utero. To determine whether this neutropenia is associated with an increased incidence of early-onset sepsis, we reviewed the hospital records of 301 low birth weight infants of mothers with preeclampsia. Early-onset sepsis was proved if the result of a culture of blood or cerebrospinal fluid in the first 48 hours of life was positive, or presumed if culture results were negative but two or more clinical signs of sepsis were present and the attending neonatologist believed that an infant was infected and needed at least 7 days of antibiotic therapy. Forty-eight percent of low birth weight infants of mothers with preeclampsia had neutropenia at less than 12 hours of age. Infants with neutropenia had mothers with more severe preeclampsia, were more premature (30 weeks vs 32 weeks), weighed less (1097 gm vs 1615 gm), and were more likely to be small for gestational age. Although maternal and obstetric risk factors for infection were less common in the group with neutropenia, rates of proven or presumed early-onset sepsis were higher (14% vs 2%; p < 0.001). Sepsis was proved in 6% of infants with neutropenia and in none of the infants without neutropenia (p = 0.03). A logistic regression analysis of the relative effects of birth weight, gestational age, and absolute neutrophil count on the incidence of sepsis revealed that only a low absolute neutrophil count correlated significantly with an increased risk of early-onset sepsis in infants with neutropenia.     

The prevalence of breast feeding in Calgary, 1979-1980

The breastfeeding practices of infants in Calgary, Alberta in 1979 and 1980 were studied using annual cohorts. Approximately 63% of infants were breastfed during the 1st week and the proportion did not change significantly during the 1st month. This proportion is higher than in an earlier study in Calgary and surveys in Canada several years ago. Most infants not breastfed during the 1st month were given commercially available infants' formula, and only a small percentage of infants were given cow's milk. The proportion of breastfed infants fell significantly after 3 months, suggesting that encouragement of breast feeding should continue for several months after delivery.     

The effect of Leboyer delivery on blood viscosity and other hemorheologic parameters in term neonates

OBJECTIVE: This study was done to compare postnatal alterations in blood viscosity, hematocrit value, plasma viscosity, red blood cell aggregation, and red blood cell deformability in term neonates undergoing both early umbilical cord clamping and delivery according to the Leboyer method. STUDY DESIGN: The umbilical cords of 15 healthy, term infants were clamped within 10 seconds of birth (early cord clamping), and 15 infants delivered according to the Leboyer method were placed on the mother's abdomen, and the umbilical cords were clamped 3 minutes after birth. Hemorheologic parameters were studied in umbilical cord blood at 2 hours, 24 hours, and 5 days from the time of delivery. RESULTS: The residual fetal placental blood volume decreased from 45 +/- 8 ml/kg (x +/- SD) after early cord clamping to 25 +/- 5 ml/kg after delivery by the Leboyer method. After Leboyer-method delivery, the hematocrit value rose from 48% +/- 5% at birth to 58% +/- 6% 2 hours after delivery, 56% +/- 7% at 24 hours, and 54% +/- 8% after 5 days. Blood viscosity in the Leboyer-method group increased by 32% within the first 2 hours but did not change significantly during the following 5 days. Plasma viscosity, red blood cell aggregation, and red blood cell deformability were not affected by the mode of cord clamping. CONCLUSIONS: Delivery by the Leboyer method leads to a significant increase in blood viscosity as a result of increasing hematocrit value, whereas other hemorheologic parameters are similar to those of infants with early cord clamping.     

Retarded object permanence development in methylmercury exposed Macaca fascicularis infants.

Mothers of 12 full-term, normal birth-weight Macaques (Macaca fascicularis) received methylmercury (MeHg) hydroxide orally in apple juice at 50 μg/kg/day for 4 mo to 2 yrs before conception and at individual doses during pregnancy. Mothers of 12 control infants received apple juice without MeHg. Infants were separated from their mothers on delivery and were laboratory reared. Beginning at 14 days of age, infants were tested for object permanence development using a plain reach task and hiding tasks. Results indicate that the performance of the MeHg-exposed infants on the full hiding task was significantly retarded compared with controls. On average, exposed infants required nearly twice as many sessions and were over 1 mo older than control infants when they would retrieve the fully hidden object. Although not all of the MeHg-exposed infants who exhibited retarded object permanence development showed signs of attentional problems, it is suggested that for some infants, these attentional problems may be an early precursor to later cognitive deficits. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infantile colic as maternal reason of consulting a pediatrician: characteristics of mother and child

About 10-20% of infants under four months of age suffer from infantile colic (IC), an excessive screaming behaviour caused by multiple factors. WESSELS et al. (1954) definition is that babies in usually good health and nutritional condition are screaming/whining more than three hours daily, more than three days weekly for no apparent reasons. The question is whether/in what way daily routines of infants concerned differ from normal infants. Mothers of colicky infants (n = 25) and mothers in a control group (n = 25) record characteristics of the mother/child relationship, their assumptions why the child is screaming, care and attention they provide and babies' reactions. For seven days the mothers kept a diary about the babies' behaviour and worked on questionnaires concerning social support received, depressant effects and exhaustion. Interviews about the extent of care provided as well as personal thoughts and emotions were conducted. The "colic group" formed two subgroups: one fulfilling Wessels criteria (Wessel-Koliker; WK), the other more conforming with the "control group" babies though mothers complained about screaming (Non-Wessel-Koliker; NWK). "Colic group"-babies received more attention and care (compared to the "control group" babies), attempts to calm them down frequently failed and mothers in this group reacted less promptly to their babies' screaming. "NWK-group"-mothers strongly tend to attribute the babies' screaming to "meteorism" or "discontent". No differences existed between groups concerning social support, depressant effects and exhaustion. There is a risk that the colic may negatively influence the mother/child interaction beyond three months.     

Plasma trace element (Se, Zn, Cu) concentrations in maternal and umbilical cord blood in Poland. Relation with birth weight, gestational age, and parity

Selenium (Se), copper (Cu), and zinc (Zn) concentrations were determined in plasma of 64 mothers at delivery, 58 nonpregnant women, 64 neonates, and 12 infants, aged 2-12 mo. Se and Zn concentrations in mothers at delivery were significantly lower, and Cu higher than in nonpregnant women. Mean Se and Cu concentrations in newborns were statistically lower than those in mothers at delivery, and Zn and Cu concentrations in preterm infants (n = 13) were significantly higher than in fullterm infants (n = 51). Maternal parity had no significant influence on the distribution of plasma trace element levels. No significant differences were observed in Se and Zn levels in maternal and cord blood plasma according to birth weight, contrary to maternal Cu concentration. Significant correlations were found between maternal and cord blood Se content, and between maternal plasma Cu concentration and birth weight of neonates.     

Breast feeding at maternity hospitals in France in 1995. National perinatal survey

The objectives of the study were to estimate the current level of breast-feeding at hospital discharge in France, and to identify maternal factors and characteristics of the pregnancy and delivery associated with breast-feeding. DATA AND METHODS: The sample included all births during 1 week in France in 1995 (n = 12,179 babies). The data were collected during the postnatal stay in hospital. Factors associated with breast-feeding were identified, using bivariate analysis and multiple logistic regression. As the relations between the studied factors and breast-feeding differed between French women and women of foreign nationality, multivariate analysis was carried out separately in the two groups. RESULTS: In 1995, 52% of babies were breastfed at hospital discharge, including 10% of babies partially breastfed. Breastfeeding was more common among women of foreign nationality than among French women, 76 vs 49%. In both groups, breastfeeding was more common among older women, women with a high level of education or a qualified occupation; breastfeeding was also more frequent among non smokers during pregnancy and among women who attended antenatal classes. On the contrary, among French women, induction of labour and delivery in a small hospital were associated with a low level of breastfeeding; among women of foreign nationality, a low level of breastfeeding was observed for unmarried women, women who had an induction or a caesarean section, and those who delivered in a private hospital. CONCLUSION: France was at the lowest level among Western countries for which national data on breastfeeding were available. Efforts to promote breastfeeding are needed, both towards sub-groups of pregnant women and towards health professionals. Maternity hospitals should provide support to breastfeeding mothers, and avoid practices which may affect breastfeeding.     

Attitudes to the use of dummies in New Zealand; a qualitative study

AIMS: To explore experiences with, and attitudes to, the use of dummies (pacifiers). METHODS: Seven focus group discussions were held with groups of mothers and of health professionals. RESULTS: Most mothers and health care workers had a generally negative view of dummy use. This related particularly to dislike of toddlers with them and practical issues such as getting lost or dirty. All would allow their use in a very unsettled baby. No mothers had personally experienced problems with breastfeeding due to the use of a dummy, but concern about this possibility was expressed by some health care workers. Recommendations varied about the length of time that dummies need to be avoided. CONCLUSIONS: Mothers in New Zealand use dummies selectively for their infants and were concerned with issues of weaning the baby from the dummy, keeping it clean and not losing it. In analysing the relationships between dummy use and breastfeeding it is important to take into consideration the context of dummy use.     

Multiple food allergy: a possible diagnosis in breastfed infants

Six infants suspected of food allergy during breastfeeding were evaluated using prick tests, total IgE, RASTs and intestinal permeability measurements during fast and provocation with mother's milk. An elimination diet was undertaken in mothers, removing first cow's milk protein (CMP), then, when inefficient, all foods suspected on the clinical history or a positive prick test in the child, followed by oral challenges in mother's diet with the corresponding food. The sole CMP-free diet in mothers always proved insufficient. In four, an additional diet excluding two to three other foods cleared the symptoms. Oral provocations in mother's diet with those foods were positive in all. In two, mothers turned down a diet excluding more than four foods, symptoms cleared while feeding the child with an extensively hydrolysed formula, whereas challenges with mother's milk induced immediate reactions. Intestinal permeability was altered during provocation tests with mother's milk sampled before maternal diet. Food allergy during breastfeeding may be due to multiple foods and the inefficacy of the sole CMP elimination in mothers does not rule out food sensitization.