The Secret to Pain Free Breastfeeding
The World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) published a joint statement in 1989 entitled Protecting, Promoting and Supporting Breastfeeding The Special Role oj Maternity Services, with a view to increasing global awareness of the impact of health care services Systematic assessment of the breastfeeding dyad Repeated scoring identifies changes in the breastfeeding experience Higher score (9-10) indicates successful breastfeeding with minimal assistance Adapted from Jensen D.Wallace S, Kelsay P. LATCH a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs 1994 23 27-32. oil breastfeeding advocacy. From their statement came the Ten Steps to Successful Breastfeeding. a guideline for hospitals and other health care providers to follow to ensure that breastfeeding is promoted and adopted in their facility. Proven practice of these steps, listed in Table 6-9, will, in part, earn the facility a baby...
Young and Miller and then Levine et al. showed that non-Hodgkin's lymphomas (NHL) histopathologically similar to BL as described in Africa also occurred in the United States, with a yearly incidence rate averaging 0.06-0.10 100,000 children (28,29). International registry data showed that Iraq, Israel, and Algeria were intermediate risk areas for BL incidence (30-32). In these areas, the predominant clinical feature is abdominal involvement. On a global scale, the association with EBV appears to depend upon the socioeconomic level, ranging from a weak association (10-15 ) in BL arising in European children (Lenoir, unpublished data) to 85 in Algerian cases (32) and 98 in Uganda (see below and refs. 41,42). These international patterns suggested a critical role of breast feeding and saliva in the transmission of EBV from a mother to her young infant.
Perinatal infection currently accounts for about 10 of all HIV infections. The risk of infection from an infected mother to her baby has been estimated as 12-40 in various studies. The precise routes are not clearly understood but probably include prenatal transmission across the placenta, intrapartum transmission via blood and or genital secretions during parturition, and postnatal transmission via breast milk. Risk factors have been shown to include the stage and severity of the maternal infection (maternal virus titers being highest early and late in the mother's infection), low maternal titers of neutralizing antibody, prematurity at delivery, and breast-feeding obstetric procedures may also be significant.
Even though breast feeding must remain the gold-standard and the common recommendation, supplementing infant formulas with inulin-type fructans and other prebiotics is a promising approach that is likely to help in improving the intestinal health and well-being of babies who are not breast-fed at all, breast-fed only for a short period, or are mixed-fed. As compared to the probiotics, the prebiotics stimulate the growth of indigenous bacteria (especially indigenous bifidobacteria strains) and are thus expected to maintain and favor a more natural and physiological microflora, creating the conditions for an optimum crosstalk between the prokaryotic and the eukaryotic worlds that live in symbiosis in the intestine. An optimum crosstalk situation such as this is more and more recognized as a condition for a healthy development during early life which contributes to good health throughout life.
Melanie Klein (1882-1960) is often credited with providing one of the first detailed accounts of object relations between mothers and infants. Klein contended that the Oedipal conflict began at the intersection of the oral and anal stages of infant development and was centered on the frustrations experienced by the infant in its attempts to breast feed during weaning and to toilet train. Accordingly, the infant feels simultaneously deprived of the mother's breast literally in terms of nourishment and figuratively in terms of affection, nurturance, and withholding of the love object and concomitantly pressured to conform to social standards of cleanliness and responsibility. Such frustrations toward the mother create in the child anxieties that are then exacerbated during the phallic stage when the child notes anatomical distinctions between the sexes. The boy child believes that the mother, not the father, may again deny him need or pleasure through castration, as she has done...
It is now widely recognized that breastmilk is the optimal choice of feeding for both full-term and premature newborn infants. The nutritional, immunologic, physiologic. health, psychologic, and socioeconomic benefits to baby and mother are many (Table 6-1). prompting a recent increase in the number of mothers initiating breastfeeding postpartum. Despite an increase to nearly 60(7 of mothers breastfeeding their newborns in 1995. however, only 21.6r ( continued to breastfeed infants aged 5 to 6 months.' While promising, these numbers fall far below the Healthy People 2000 goals of a minimum 75r r of mothers breastfeeding initially and 50' i continuing to breastfeed infants up to the age of 5 to 6 months. The American Academy of Pediatrics, in conjunction with the World Health Organization, strongly recommends that infants receive breastmilk solely through the lirst 6 months of life and continue to receive breastmilk w ith complementary foods through at least the first year of life.'-4...
Since young children are not consistent in their eating habits and cannot recognize symptoms of hypoglycemia, strict blood glucose control is not usually attainable. Generally, higher blood glucose goals are accepted (see Table 23-5), and the main goal is to avoid hypoglycemia. Infants with diabetes may certainly continue to breastfeed. Toddlers are more independent in their eating habits. Their appetites are decreasing, and they are often more selective in their food choices. Toddlers should be allowed to eat in a calm, relaxed manner and should never be force-fed. Meal plans encouraging consistent meals and snacks should be taught at this age but the variability in a toddler's eating habits must be acknowledged and accepted. Parents are ultimately responsible for providing appropriate meals and snacks the child will decide how much and what to eat. Insulin can be given after meals for young children who are especially unpredictable in their eating habits, with the dose based on the...
Increased disease severity is associated with low socioeconomic status, ethnicity, male gender, young age, body mass of 5 kg, prematurity, chronic lung disease, congenital heart disease especially in association with pulmonary hypertension, and T-cell immunodeficiency. Increased risks of acquiring the disease occur with a maternal education level of grade 12 or less, crowding (two or more individuals sharing a bedroom), school-age siblings, multiple births, lack of breastfeeding, passive smoke exposure, day-care attendance, and birth within 6 mo prior to an anticipated RSV season (52,54).
Two physiological signals stimulate the secretion of oxy-tocin by hypothalamic magnocellular neurons. Breast-feeding stimulates sensory nerves in the nipple. Afferent nerve impulses enter the CNS and eventually stimulate oxytocin-secreting magnocellular neurons. These neurons fire in synchrony and release a bolus of oxytocin into the bloodstream. Oxytocin stimulates the contraction of myoepithelial cells, which surround the milk-laden alveoli in the lac-tating mammary gland, aiding in milk ejection.
She felt exhausted by her demands and struggled to breastfeed her. She said that her daughter was always hungry, but that her breasts had little milk and it hurt her and that she was going to give her daughter the bottle. She was so exasperated at times that she was contemplating giving the baby up for adoption. She said that her social worker visited her once a week but that this did not help.
Because it is not well known how H. pylori is disseminated, control measures are difficult to implement. Based on epidemiological studies cited above, improvement of socioeconomic standards of living, such as less crowded housing in childhood and uncontaminated water supplies, may reduce the risk of infection. Consumption of untreated water is significantly associated with H. pylori infection in subjects under 40 years of age (111). The importance of bacterial transmission through food products remains unknown. Whether long-term breast-feeding reduces the risk of infection in childhood is also unclear. Nevertheless, sucklings appear to be temporarily protected by H. pylori-specific IgA present in breast milk (112). Supplementing breast-feeding in the first months of life with unclean water is not advisable because this practice may increase the risk of H. pylori exposure (113).
Prevention of ATL by reducing transmission of HTLV-I is obviously a more attractive goal. To prevent infection with HTLV-I by blood transfusion, all donated blood at blood centers was subjected to HTLV-I antibody testing beginning in November 1986 in Japan. None of the recipients, even patients with hematologic disorders who received multiple transfusions, have subsequently seroconverted. An absolute decline of the carrier rate among young Japanese has been achieved through comprehensive blood donor screening and by persuading most carrier mothers to refrain from breast-feeding (86).
FDA searched MAUDE and DEN for reports of maternal-child problems attributed to a woman's breast implants 26 and identified 339 relevant reports. Nearly half of these reports (46 ) described actual problems with breastfeeding or expressed concern that implants would be unsafe or interfere with breastfeeding 44 of reports (n 149) described either nonspecific or specific signs, symptoms, or illnesses in children thought to be related to their mother's implants. For the most part, these reports were vague and did not specify an illness or signs and symptoms, but simply stated that a child was ill due to his her mother's implants (106 of 149 reports). In those reports in which illness, signs, or symptoms were specified, the majority reported gastrointestinal problems (24 of 43 reports in which it was specified) or
The etiology and pathogenesis of IBD probably involve an interaction between genetic and environmental factors the precise mechanism for the beginning of the intestinal inflammation remains unclear. There is increasing evidence that both environmental and host genetic factors are important in determining not only disease susceptibility, but also disease clinical course and response to therapy. Many factors have been suggested including family history of IBD, cigarette smoking, appendectomy, oral contraceptive agents, diet, breastfeeding, perinatal or early childhood infections, hygienic factors and physical activity. It has been proposed that the expression of IBD may be influenced by events in early childhood such as mode of feeding, domestic hygiene or perinatal infections. Although several studies have suggested an inverse association between breastfeeding and IBD 86, 92, 93 , in most cases the odds ratios were not statistically significant and other studies have not demonstrated...
There is abundant evidence for the efficacy of antibody in preventing infection. For example, artificial passive immunization (injection of antibodies) temporarily protects against hepatitis A or B, rabies, measles, varicella, and several other viral infections (see Chapter 13). Furthermore, natural passive immunization protects the newborn for the first few months of life against most of the infections that the mother has experienced. In humans this occurs in two ways (1) maternal antibodies of the IgG class cross the placenta and protect the fetus and the newborn infant during pregnancy and for several months after birth (2) antibodies of the fgA class are secreted in the mother's milk at a concentration of 1.5 grams per liter (and considerably higher in the early colostrum), conferring protection against enteric infections as long as breast-feeding continues. If the infant encounters viruses when maternal immunity is waning, the virus replicates to only a limited extent, causing no...
These drugs are used cautiously in the elderly and in patients with undiagnosed abdominal pain, liver disease, history of addiction to the opioids, hypoxia, supraventricular tachycardia, prostatic hypertrophy, and renal or hepatic impairment. The obese must be monitored closely for respiratory depression while taking the narcotic analgesics. The drug is used cautiously during lactation (wait at least 4 to 6 hours after taking the drug to breastfeed the infant). The narcotics are used cautiously in patients undergoing biliary surgery because the drug may cause spasm of the sphincter of Oddi.
The disease is spread through contact of infected body fluids, usually blood, semen or breast milk, by the mucous membranes or directly into the recipient's blood or an open wound. The vast majority of cases of HIV-1 infection in the world are the result of heterosexual intercourse. In the United States, the disease was originally largely confined to homosexual men and then spread into intravenous drug users through the sharing of needles. HIV infection is now rapidly increasing among women, both through intravenous drug use and via sexual intercourse with infected men. Pediatric HIV infection usually occurs during labor and delivery from an infected mother but may also occur earlier in gestation or later, as a result of breast feeding.
To minimize the total number of visits OPV is most conveniently administered at the same time as other inoculations, that is, with DPT (diphtheria-pertussis-tetanus) at 2 months and 4 months of age, then again with MMR (measles-mumps-rubella) at 15 months. An additional dose should be given on entry into elementary school. No further boosters are required, except in the case of adults traveling to developing countries. The reason for the initial course of three doses is that, although one successful lake would suffice, concurrent infection with another enterovirus may interfere with the replication of the vaccine viruses, as commonly occurs in the developing countries of the tropics. Earlier concern that breast-feeding may represent a contraindication has not been substantiated though colostrum contains moderate titers of maternal IgA, milk itself does not contain enough antibody to neutralize the vaccine virus.
Teratogenicity is a potential risk of methotrexate when used to treat RA. The foetal aminopterin-methotrexate syndrome is well documented in children of women taking high-dose methotrexate for malignancies. This syndrome includes skeletal abnormalities, microcephaly and hydrocephalus. With low-dose methotrexate, the risk is less clear though many reported pregnancies have resulted in births of full-term healthy infants. Nevertheless, pregnancy is a contraindication for methotrexate treatment. Women taking methotrexate who are at risk of pregnancy should use reliable methods of birth control. After methotrexate treatment is stopped, women should wait at least three months before trying to conceive many national teratology agencies and companies recommend a longer period of withdrawal of up to six months because of the tendency for methotrexate to be retained in tissues. Methotrexate has no effect on fertility in women, and if the drug is stopped at least 30 days prior to attempting...
Crease in the secretion of prolactin. Milk production is therefore stimulated. If a woman does not wish to breast-feed her baby she may take oral estrogens to inhibit prolactin secretion. A different drug commonly given in these circumstances, and in other conditions in which it is desirable to inhibit prolactin secretion, is bromocriptine. This drug binds to dopamine receptors, and thus promotes the action of dopamine. The fact that this action inhibits prolactin secretion offers additional evidence that dopamine functions as the prolactin-inhibiting hormone (PIH). Breast-feeding, acting through reflex inhibition of GnRH secretion, can also inhibit the secretion of gonadotropins from the mother's anterior pituitary and thus inhibit ovulation. Breastfeeding is thus a natural contraceptive mechanism that helps to space births. This mechanism appears to be most effective in women with limited caloric intake and in those who breast-feed their babies at frequent intervals throughout the...
There are two distinct types of breast abscesses. Lactational abscesses occur in women who are breastfeeding and are usually peripheral in nature. Non-lactational abscesses occur as an extension of periductal mastitis and have a classical distribution at the edge of the nipple, often associated with nipple inversion. They usually occur in young female smokers. Occasionally a non-lactating abscess may discharge spontaneously through an abnormal communication between the inflamed duel and the skin. The classical position of ihis fistula is at the areolocutaneous border (Fig. 2.55),
Galactosemia is an inherited disorder of galactose metabolism resulting from a defect in one of the enzymes required to convert galactose to glucose. The most common defect is in the galactose-1-phosphate uridyltrans-ferase (GALT) enzyme. Symptoms of vomiting, diarrhea, failure to thrive, jaundice, hepatomegaly, cataracts, and Escherichia col i sepsis are usually seen within the first 2 weeks of life. Galactosemia is treated by restricting dietary galactose. Because lactose is hydrolyzed into galactose and glucose, both lactose and galactose must be eliminated from the diet. Galactosemia is therefore one of the few true contraindications to breastfeeding. Dietary restrictions should be followed for life.
500,000 infants become infected with HIV each year. The majority of these infections result from transmission of virus from HIV-infected mothers during childbirth or by transfer of virus from milk during breast-feeding. The incidence of maternal acquired infection can be reduced as much as 67 by treatment of the infected mother with a course of Zidovudine (AZT) for several months prior to delivery, and treatment of her infant for 6 weeks after birth. This treatment regimen is widely used in the U.S. However, the majority of worldwide HIV infection of infants occurs in sub-Saharan Africa and other less developed areas, where the cost and timing of the Zidovudine regimen render it an impractical solution to the problem of maternal-infant HIV transmission.
THC is concentrated in and secreted in human breast milk and absorbed by the nursing infant. Thus, it is not appropriate to include nursing women in cannabis-administration studies. Because of the health advantages to the infant of breast feeding over bottle feeding, care should be taken to avoid research participation becoming an incentive for the mother to stop nursing. This can be done by eliciting nursing status early in the screening process, before potential subjects are aware of the exclusion of nursing women.
After fertilization, rat eggs make their way into a complex uterus which can hold eight to sixteen fetuses. There, each attaches to the uterine wall and develops, over three weeks, into a rat pup. The pups are born pink, hairless, blind, and incompletely developed. They are then nurtured by their mothers, who have the instinct of all mammals to care for their offspring. Rats breast-feed
New Mothers Guide to Breast Feeding
For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.