Not only bottles. Glass baby's bottles in between the second half of XIXth century and the first decades of the XXth]

Mother's milk is the best food for the baby. The need to use foods other than mother's milk has always represented a challenging problem to be solved. The author warns that the high mortality during the first year of life during the early years of the XXth century (20%) peaked at an amazing 80% in children artificially fed at orphanages. In the considered years, the usage of baby's bottle spread among babies that could not be fed by mothers or wet-nurses. The idea of rubber teat 1845 and of automatic devices for the production of glass bottle - 1903 - contributed to the diffusion of the baby's bottle. First baby's bottles were variously shaped. However, the finding of severe gastroenteritis caused by a long rubber tube attached to the rubber teat (the so-called death-bottle), together with the necessity of a careful cleaning and the diffusion of Soxhket's system (sterilization of many bottles in the same container) will lead to the choice of large mouthed cylindrical bottles, very similar to the plastic bottles used nowadays.     

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.     

Breastfeeding: a course for health professionals

Breastfeeding advocates say that breastfeeding is health promotion in its purest form. Its considerable health benefits to the infant and the mother are well documented. Recent research has identified breastfeeding as a key factor in the prevention of sudden infant death syndrome and increased cognitive functioning. As a method of feeding, breastfeeding offers immediate economic advantages to the parents and long-term economic savings to society. One author reports that the exclusive breastfeeding of infants for four months could save the Province of Ontario at least $862,000 a year just by reducing the need for the treatment of otitis media. Another researcher calculated the cost of treating 150 bottle-fed babies hospitalized for gastroenteritis at $450,000 Canadian, while reminding us that "hospitalization for gastroenteritis is almost unknown for exclusively breast-fed infants." With all these known benefits, why is breastfeeding not more prevalent among Canadian mothers?     

Prevention of bovine mastitis by a premilking teat disinfectant containing chlorous acid and chlorine dioxide

The objective of this study was to evaluate the efficacy of a premilking teat disinfectant for the prevention of mastitis in dairy cows under natural exposure conditions. Predipping was compared with a negative control using a split udder experimental design. All teats were dipped after milking with the same teat dip. Percentage of quarters newly infected by major mastitis pathogens was 34% lower in quarters with teats predipped and postdipped than in quarters with teats postdipped only. New IMI by Streptococcus uberis and Staphylococcus aureus were significantly lower in quarters with teats predipped and postdipped than in quarters with teats postdipped only. Differences in incidence of clinical mastitis between treatment groups approached significance. Predipping and postdipping were no more effective against Gram-negative bacteria, coagulase-negative Staphylococcus species, and Corynebacterium bovis than postdipping only. No chapping or irritation of teats was observed, and no adverse effects were noted using the test product as a premilking and postmilking teat disinfectant. Results of this study suggest that predipping and then postdipping with the test product was a more effective procedure against major mastitis pathogens than postdipping only.     

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.     

Baby feeding: the thoughts behind the statistics

AIM: To investigate attitudes towards baby feeding and to identify reasons why women stop breast feeding. METHOD: A series of six focus groups were held with thirty eight mothers with babies aged between 3 and 18 months, who had been breast and/or bottle fed. RESULTS: The discussions identified a number of significant themes. Decisions on baby feeding were made before birth. Women felt under considerable pressure to breast feed and felt guilty about bottle feeding. Information available about baby feeding was generally inconsistent, unrealistic and incomplete although all women were well informed about the benefits of breast feeding. Most women found breast feeding more difficult than anticipated and needed more help with common problems. A number of difficulties were identified with bottle feeding. Those women who enjoyed breast feeding were most likely to continue. The best support for breast feeding came from other mothers and supportive partners. Ceasing breast feeding was difficult for some women. CONCLUSION: Exploring mothers' attitudes to breast feeding highlighted the need for non judgemental attitudes to baby feeding and consistent information and support on both breast and bottle feeding. Duration of breast feeding is likely to be improved if problems can be addressed. A larger, more detailed prospective study would more accurately identify problem areas and suggest ways of solving them.     

Relationship between thickness, chapping and Staphylococcus aureus colonization of bovine teat tissue

Post-milking measurements of teat skin chapping score, teat thickness and colonization by Staphylococcus aureus were determined for 11.5 d. Three teats on each of twelve Holstein cows, free from Staph. aureus intramammary infections, were immersed in 1 M-NaOH solution to induce teat chapping; the fourth teat served as a control. To achieve different degrees of chapping, one teat per cow received one immersion after each milking for three consecutive milking periods, a second teat received two immersions, and the third teat received one immersion which coincided with the last immersion of the other two teats. All teats were challenged twice with a skim milk broth culture of Staph. aureus (5 x 10(6) cfu) after the first and second milking following NaOH treatment. Measures were initiated with the milking following the last Staph. aureus challenges. Tissue thickness of the lateral side of the teat (barrel) and colonization by Staph. aureus declined with time. Thickness of the teat end varied more erratically. Teat skin chapping score was positively correlated (P < 0.001) with tissue thickness of the barrel and Staph. aureus colonization. Thickness of the barrel was not significantly correlated with Staph. aureus colonization. Barrel thickness as a covariate had a significant effect (P < 0.05) on teat skin colonization of Staph. aureus, whereas teat skin score and teat end thickness had no significant effect. Thus, thickness of the lateral side of the teat explained the greatest variation in Staph. aureus teat skin colonization in the model tested.     

Mothers' birth weight and survival of their offspring: population based study

OBJECTIVE: To test the hypothesis that a baby's survival is related to the mother's birth weight. DESIGN: Population based dataset for two generations. SETTING: Population registry in Norway. SUBJECTS: All birth records for women born in Norway since 1967 were linked to births during 1981-94, thereby forming 105104 mother-offspring units. MAIN OUTCOME MEASURES: Perinatal mortality specific for weight for offspring in groups of maternal birth weight (with 500 g categories in both). RESULTS: A mother's birth weight was strongly associated with the weight of her baby. Maternal birth weight was associated with perinatal survival of her baby only for mothers with birth weights under 2000 g. These mothers were more likely to lose a baby in the perinatal period (odds ratio 2.3, 95% confidence interval 1.4 to 3.7). Among mothers with a birth weight over 2000 g there was no overall association between mother's weight and infant survival. There was, however, a strong interaction between mother's birth weight, infant birth weight, and infant survival. Mortality among small babies was much higher for those whose mothers had been large at birth. For example, babies weighing 2500-2999 g had a threefold higher mortality if their mother's birth weight had been high (> or = 4000 g) than if the mother had been small (2500-2999 g). CONCLUSION: Mothers who weighed less than 2000 g at birth have a higher risk of losing their own babies. For mothers who weighed > or = 2000 g their birth weight provides a benchmark for judging the growth of their offspring. Babies who are small relative to their mother's birth weight are at increased risk of mortality.     

Bentall operation, total aortic replacement and mitral valve replacement for a young adult with Marfan syndrome: a case of three-staged operation

BACKGROUND: Early postpartum discharge of babies was gradually introduced in Sweden in the 1980s on ideological grounds, based on the premise that maternity wards were unnatural settings for mothers and babies and hampered breastfeeding. From about 1990, early discharge was used as a means to reduce costs. The purpose of this study was to examine if mandated early discharge at Central Hospital of Karlstad, Sweden, influenced subsequent breastfeeding. METHOD: Breastfeeding outcomes of infants up to six months of age of all births in 1993 (n = 3231) were compared with the outcome of newborns in 1990 (n = 1462). RESULTS: Breastfeeding at six months postpartum continued to increase during the early 1990s for both healthy and sick infants, irrespective of whether or not they were discharged early. In infants born in 1995 the breastfeeding rate at six months was 64 percent for healthy newborns and 53 percent for sick newborns. CONCLUSION: Factors other than the time of discharge, most likely a positive change of attitude in society and vigorous introduction of the Baby Friendly Hospital Initiative, seem to have been more important for successful breastfeeding.     

The morphological assessment of bone marrow infiltration in neuroblastoma]

BACKGROUND: The purpose of this study was to describe the relationship between breastfeeding intention among socioeconomically disadvantaged pregnant women and maternal demographics, previous breastfeeding experience, and social support. METHODS: A cross-sectional, convenience sampling strategy was employed for data collection. Low-income women (n = 1001) in a public hospital completed a six-page questionnaire about their infant feeding plans, demographics, and social support. Simple regression analyses were conducted to compare maternal breastfeeding intention with the hypothesized correlates. RESULTS: Breastfeeding intention was positively correlated with older maternal age, higher education, more breastfeeding experience, Hispanic ethnicity, and hearing about breastfeeding benefits from family members, the baby's father, and lactation consultants, but not from other health professionals. Health professionals' attitudes were less influential on women's infant feeding decisions than the attitudes and beliefs of members of women's social support networks. When controlling for breastfeeding experience (none vs any), some findings, varied, indicating a need for breastfeeding interventions tailored to women's level of experience. CONCLUSION: Use of peer counselors and lactation consultants, inclusion of a woman's family members in breastfeeding educational contacts, and creation of breastfeeding classes tailored to influential members of women's social support networks may improve breastfeeding rates among low-income women, especially those with no breastfeeding experience, more effectively than breastfeeding education to pregnant women that is solely conducted by health professionals.     

Promoting breastfeeding: a view of the current position and a proposed agenda for action in Scotland

The prevalence of breastfeeding in Scotland is the second lowest in Europe. There is good evidence that breastfeeding results in decreased gastrointestinal, and to a lesser extent respiratory infections, in the first year of life, and reduced serious infections in low-birthweight babies. Published evidence for the effectiveness of interventions which seek to promote successful breastfeeding within populations is scanty and of poor quality, although numerous studies have highlighted hospital practices which discourage and undermine breastfeeding. Changing these poor practices has been shown to be achievable and can lead to improved breastfeeding rates. Experience in other industrialized countries such as Canada, Australia and Norway has shown that substantial increases in breastfeeding are achievable through combined government and health service action over a period of one or two decades. We recommend a combination of government and health service action to promote breastfeeding in Scotland including: implementation of the International Code on Marketing of Breastmilk Substitutes; reviews of health professional basic and in-service training in breastfeeding management, maternity leave and allowances, and workplace facilities for breastfeeding mothers; promotion of the Baby Friendly Initiative; development of community support for breastfeeding mothers; routine collection of breastfeeding data to support annual monitoring of breastfeeding rates; and support for research on the effectiveness of strategies which seek to promote breastfeeding.     

A survey of attitudes of obstetric patients to a new-old concept of postnatal care

One hundred and thirty six mothers who were patients in a low dependency postnatal maternity unit were surveyed to assess their attitudes to this kind of care, and whether they preferred it to the more traditional acute care maternity unit. Their confidence in caring for their babies was also assessed. A three month follow-up study sought a retrospective opinion of the unit and measured the incidence of breast feeding. The findings indicated an overwhelming support for this kind of unit.     

Oestradiol measurement in women on oral hormone replacement therapy: the validity of commercial test kits

This study examined the attitudes toward breastfeeding of medical professionals working with pregnant or new mothers. Most advocated breastfeeding to mothers who had not made an infant feeding decision; fewer talked about breastfeeding during the first trimester; and many recommended that mothers supplement a breastfed infant with prepared commercial baby milk. All agreed that a mother's return to work led to early discontinuance of breastfeeding and that the family is a major influence on a mother's decision to breastfeed. To increase the prevalence of breastfeeding, the study group recommended prenatal education, participation in support groups, and promotion of breastfeeding through the media.     

Breastfeeding support services in the neonatal intensive-care unit

OBJECTIVE: To describe a model for providing breastfeeding support in the neonatal intensive-care unit (NICU). DESIGN: Naturalistic, participant observation. SETTING: Suburban Level III NICU. PATIENTS: One hundred thirty-two mother-infant pairs over 1 year. Infants were hospitalized in the NICU, and mothers had initiated lactation efforts. INTERVENTIONS: Investigators provided breastfeeding interventions for the mother-infant pairs, based on identified problems, the research literature, or both. MAIN OUTCOME MEASURES: Percentage of mothers who were breastfeeding at the time of discharge from the NICU. RESULT: Interventions were classified into five categories: expression and collection of mothers' milk, gavage feeding of expressed mothers' milk, in-hospital breastfeeding sessions, postdischarge breastfeeding management, and additional consultation. CONCLUSIONS: This model was effective in preventing breastfeeding failure for this population. The model can provide the basis for NICU breastfeeding standards of care, protocols, and chart records, or for reimbursement purposes. The model also provides a framework for studying a specific category or breastfeeding intervention.     

Screening tests for new teat dips

Increased use of after-milking teat dips has resulted in the appearance of many new teat dips and a need for methods of evaluation of efficacy. A method was developed for determining the ability of a disinfectant to kill bacteria on the teat ends. Results from several known efficacious products indicated an approximate 95% reduction in bacterial flora. Additional data are presented on some experimental products. This method will provide a measure of effectiveness of a producton teat-skin disinfection. The effect of some changes in the testing procedure on bacterial reduction is demonstrated: 1) Increased times between inoculation and dipping and between dipping and swabbing tended to decrease recoveries on control teats. 2) Saline dips on controls teats provided increased recoveries of test organisms.     

Breastfeeding, dummy use, and adult intelligence

BACKGROUND: Several studies show that children who were breastfed as babies gain higher scores on intelligence tests than those who were bottlefed. Although these findings suggest that breastfeeding in early life may promote cognitive development, their interpretation is complicated by the current association between breastfeeding and higher social class. We investigated the relation between method of feeding in infancy and adult intelligence in a setting where breastfeeding was not linked with socioeconomic advantage. METHODS: We followed up 994 men and women, born between 1920 and 1930 in Hertfordshire, UK, for whom information on infant feeding had been recorded by health visitors. Intelligence was measured by the AH4 IQ test, taken on a computer. Factors significantly linked with IQ were investigated by multivariate analysis. FINDINGS: Study participants who had been exclusively breastfed gained slightly higher scores on the IQ test than those who had been exclusively bottlefed, or fed with both breast and bottle. IQ was lower in participants who had used a dummy (pacifier) in infancy, in those whose fathers were in manual occupations at the time of their birth, and in those whose mothers were young at the time they were born. Scores on the IQ test fell as the number of older siblings increased. In multivariate analysis, after adjustment for the effect of all other variables, no association was found between adult intelligence and method of feeding. Dummy use in infancy, number of older siblings, maternal age at birth of the participant, and father's occupational class remained independent predictors of adult intelligence. INTERPRETATION: The mechanisms that link type of feeding in early life with later intelligence may have more to do with the child's social environment that with the nutritional qualities of the milk.     

Observation of proliferative capacity of rat salivary gland cells

Nursing interventions to enhance breastfeeding affect the health of mothers and babies. Fatigue may interfere with breastfeeding, so interventions minimizing fatigue are important. This repeated measures study of 20 postpartum women investigated the relative efficacy of one intervention, promoting use of the side-lying position. Using the Modified Fatigue Symptoms Checklist, fatigue was measured after breastfeeding in two positions. In mothers who had vaginal deliveries (n = 14), significantly less fatigue was reported following nursing in the side-lying versus the sitting position. Instruction regarding restfulness of the side-lying position should be considered as part of routine postpartum or home health nursing care.     

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.     

Crib death in the eastern regions of Norway 1984-1992. A survey of risk factors

Cot death is the most important cause of death during the first year of life after the newborn period in Norway. A case control study was performed by sending questionnaires to 188 cot death parents and 475 control parents with infants matched for age, sex and time of birth. 76% of the cot death parents and 79% of the control parents completed the questionnaires. The male/female ratio of the babies in both groups was 64/36. The age distribution showed a peak between two and four months. 65% succumbed during the winter months. During the winter 32% died outdoors. This was true for only 16% of those who died during summer. A higher proportion of the cot death cases than the controls were premature (more than eight weeks). 78% of the cot death victims usually slept prone, whereas this was true for only 50% of the controls (p < 0.01). 91% of the cot death victims were found dead in a prone position. When comparing live babies during the first three months of life, significantly more cot death mothers than control mothers had stopped breastfeeding. A larger proportion of the cot death victims than the controls had had apparent life threatening events (p < 0.01). Foam mattresses were equally frequent in both groups.     

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.