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Breast Feeding (breast + feeding)
Selected AbstractsIn-hospital breast feeding rates among women with gestational diabetes and pregestational Type 2 diabetes in South AucklandDIABETIC MEDICINE, Issue 2 2005D. Simmons Abstract Aim To describe the uptake of breast feeding in mothers with either Type 2 diabetes or gestational diabetes (GDM) in a hospital serving a multiethnic community in South Auckland, New Zealand. Research design and methods A retrospective study of all women attending the Diabetes in Pregnancy clinic over a 4-year period was undertaken: 30 women had Type 2 diabetes and 373 GDM. Results Compared with mothers with GDM, mothers with Type 2 diabetes were less likely to breast feed in any way as the first feed (41.4% vs. 68.0%, P = 0.011) or at discharge (69.0% vs. 84.0%, P = 0.039). In the combined group, there were no differences in uptake of breast feeding by ethnicity, age, parity, body mass index, smoking or antenatal glycaemia, use of insulin or presence of hypertension. Breast feeding on discharge was associated with a higher APGAR score, breast feeding as the first feed (78.2% vs. 19.4%, P < 0.001) and lower rates of delivery by Caesarean section (17.0% vs. 31.8%, P = 0.006). Logistic regression showed breast feeding as the first feed, the major determinant for breast feeding on discharge. Conclusions Factors delaying breast feeding as the first feed are the major determinant of breast feeding on discharge. Strategies to increase breast feeding as the first feed among women with Type 2 diabetes, and those having a Caesarean section, may be useful in increasing the uptake of breast feeding in the longer term. [source] Maternal-infant transmission of hepatitis C virus infectionHEPATOLOGY, Issue 5B 2002Eve A. Roberts 555 University Ave. Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 106 copies per mL). The rate of mother-to-infant transmission is 4% to 7% per pregnancy in women with HCV viremia. Co-infection with human immunodeficiency virus (HIV) increases the rate of transmission 4 to 5 fold. The actual time and mode of transmission are not known. Elective Cesarean section is not recommended for women with chronic HCV infection alone. The role of treatment to prevent transmission is limited by the fetal toxicity of currently available medications for hepatitis C. Breast feeding poses no important risk of HCV transmission if nipples are not traumatized and maternal hepatitis C is quiescent. Pregnant women at high risk for HCV infection should be screened for anti-HCV, and HCV RNA testing should be performed if anti-HCV is positive. Infants of women with hepatitis C should be tested for HCV RNA on two occasions, between the ages of 2 and 6 months and again at 18 to 24 months, along with serum anti-HCV. The natural history of mother-to-infant hepatitis C remains uncertain, especially the course in the first year of life when some infants appear to have spontaneous resolution. [source] Maternal-infant transmission of hepatitis C virus infectionHEPATOLOGY, Issue S1 2002Eve A. Roberts M.D., FRCPC Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 106 copies per mL). The rate of mother-to-infant transmission is 4% to 7% per pregnancy in women with HCV viremia. Co-infection with human immunodeficiency virus (HIV) increases the rate of transmission 4 to 5 fold. The actual time and mode of transmission are not known. Elective Cesarean section is not recommended for women with chronic HCV infection alone. The role of treatment to prevent transmission is limited by the fetal toxicity of currently available medications for hepatitis C. Breast feeding poses no important risk of HCV transmission if nipples are not traumatized and maternal hepatitis C is quiescent. Pregnant women at high risk for HCV infection should be screened for anti-HCV, and HCV RNA testing should be performed if anti-HCV is positive. Infants of women with hepatitis C should be tested for HCV RNA on two occasions, between the ages of 2 and 6 months and again at 18 to 24 months, along with serum anti-HCV. The natural history of mother-to-infant hepatitis C remains uncertain, especially the course in the first year of life when some infants appear to have spontaneous resolution. (HEPATOLOGY 2002;36:S106,S113). [source] Review article: reproduction in the patient with inflammatory bowel diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007Z. S. HEETUN Summary Background, Inflammatory bowel disease (IBD) affects mainly the young population. The effect of IBD and its treatment on fertility and pregnancy is therefore an important clinical consideration. Aim, To review the best management of IBD in the reproductive and pregnant population. Methods, A MEDLINE and an EMBASE search were performed using mainly the search phrases ,pregnancy AND IBD,',sulphasalazine AND male fertility,',abdominal surgery AND female fertility,',AZA AND placenta' and ,infliximab AND pregnancy.' No language or date restrictions were placed. References of review articles were examined. Results, Overall male and female fertility are not affected by IBD. Sulphasalzine reduces male fertility. No other drugs used in IBD affect significantly fertility in humans. The risk of pregnancy-related complications and the disease behaviour during pregnancy depends mainly on disease activity at time of conception. Proactive treatment for maintenance of disease remission during gestation is recommended. Except for methotrexate, drugs used in IBD appear safe in pregnancy. Breast feeding should be encouraged. Conclusion, The management of IBD in the young and pregnant population remains controversial because the literature comes mostly from retrospective studies. Further studies particularly large prospective trials are needed to guide clinicians in decision making. [source] International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of lifePEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 5 2010Luis Garcia-Marcos Garcia-Marcos L, Mallol J, Solé D, Brand PLP and EISL group. International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life. Pediatr Allergy Immunol 2010: 21: 878,888. © 2010 John Wiley & Sons A/S Risk factors for wheezing during the first year of life (a major cause of respiratory morbidity worldwide) are poorly known in non-affluent countries. We studied and compared risk factors in infants living in affluent and non-affluent areas of the world. A population-based study was carried out in random samples of infants from centres in Latin America (LA) and Europe (EU). Parents answered validated questionnaires referring to the first year of their infant's life during routine health visits. Wheezing was stratified into occasional (1,2 episodes, OW) and recurrent (3 + episodes, RW). Among the 28687 infants included, the most important independent risk factors for OW and RW (both in LA and in EU) were having a cold during the first 3 months of life [OR for RW 3.12 (2.60,3.78) and 3.15 (2.51,3.97); population attributable fraction (PAF) 25.0% and 23.7%]; and attending nursery school [OR for RW 2.50 (2.04,3.08) and 3.09 (2.04,4.67); PAF 7.4% and 20.3%]. Other risk factors were as follows: male gender, smoking during pregnancy, family history of asthma/rhinitis, and infant eczema. Breast feeding for >3 months protected from RW [OR 0.8 (0.71,0.89) in LA and 0.77 (0.63,0.93) in EU]. University studies of mother protected only in LA [OR for OW 0.85 (0.76,0.95) and for RW 0.80 (0.70,0.90)]. Although most risk factors for wheezing are common in LA and EU; their public health impact may be quite different. Avoiding nursery schools and smoking in pregnancy, breastfeeding babies >3 months, and improving mother's education would have a substantial impact in lowering its prevalence worldwide. [source] Breast-feeding and a subsequent diagnosis of measlesACTA PAEDIATRICA, Issue 4 2009SA Silfverdal Abstract Background: Breast-feeding protects against many infectious diseases and may also influence immunization outcomes. Aim: This study investigated if breast-feeding protects against clinical measles and if it modified the effect of immunization. Methods: We used logistic regression with data for 10 207 individuals from the 1970 British Cohort study (BCS70). Breast-feeding data were collected at five years of age, and information on clinical measles infection, as well as socio-economic measures was collected at the age of ten years. Breast feeding was categorized as: breast-fed <1 month (n = 1611), breast-fed for 1,3 months (n = 1016), breast-fed for more than three months (n = 1108), breast-feeding of uncertain duration (n = 21) and never breast-fed (n = 6451). Results: Breast-feeding for more than three months was negatively associated with a diagnosis of clinical measles infection after adjustment for crowding, social class, measles vaccination, parity and sex with an odds ratio (95% confidence interval) of 0.69 (0.60,0.81) compared with those who never breast-fed. Measles vaccination was highly associated with low risk for measles with: 0.14 (0.13,0.16). Age at acute measles infection was not associated with breastfeeding. Breast-feeding did not notably alter measles immunization efficacy. Conclusion: Immunization against measles provides effective protection against the disease. A more modest reduction in the risk of a measles diagnosis is associated with breast-feeding. The associations with a diagnosis of measles for breast-feeding and measles immunization are independent of each other. [source] In-hospital breast feeding rates among women with gestational diabetes and pregestational Type 2 diabetes in South AucklandDIABETIC MEDICINE, Issue 2 2005D. Simmons Abstract Aim To describe the uptake of breast feeding in mothers with either Type 2 diabetes or gestational diabetes (GDM) in a hospital serving a multiethnic community in South Auckland, New Zealand. Research design and methods A retrospective study of all women attending the Diabetes in Pregnancy clinic over a 4-year period was undertaken: 30 women had Type 2 diabetes and 373 GDM. Results Compared with mothers with GDM, mothers with Type 2 diabetes were less likely to breast feed in any way as the first feed (41.4% vs. 68.0%, P = 0.011) or at discharge (69.0% vs. 84.0%, P = 0.039). In the combined group, there were no differences in uptake of breast feeding by ethnicity, age, parity, body mass index, smoking or antenatal glycaemia, use of insulin or presence of hypertension. Breast feeding on discharge was associated with a higher APGAR score, breast feeding as the first feed (78.2% vs. 19.4%, P < 0.001) and lower rates of delivery by Caesarean section (17.0% vs. 31.8%, P = 0.006). Logistic regression showed breast feeding as the first feed, the major determinant for breast feeding on discharge. Conclusions Factors delaying breast feeding as the first feed are the major determinant of breast feeding on discharge. Strategies to increase breast feeding as the first feed among women with Type 2 diabetes, and those having a Caesarean section, may be useful in increasing the uptake of breast feeding in the longer term. [source] Experiences of pregnancy-related body shape changes and of breast-feeding in women with a history of eating disordersEUROPEAN EATING DISORDERS REVIEW, Issue 2 2003Gunilla Larsson Abstract In spite of the growing problems of eating disorders in society, no publications have reported the cumulative prevalence of eating disorders among childbearing women. The condition may constitute a risk during pregnancy and the childbirth period. This study examined the frequency of self-reported eating disorder histories in women who had been delivered 3,7 months earlier as well as their experiences of body shape changes and breast feeding and the length of the breast-feeding periods. Five hundred and sixteen women were invited to participate, of whom 454 responded to a questionnaire (88 per cent). A history of an eating disorder was reported by 11.5 per cent of the respondents, with a predominance of younger women. Significantly fewer women among those reporting an eating disorder breast-fed their 3-month-old baby. However, no difference was seen regarding feelings related to the transformed body shape. Almost all women described such feelings as positive. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Preterm birth but not mode of delivery is associated with an increased risk of developing inflammatory bowel disease later in lifeINFLAMMATORY BOWEL DISEASES, Issue 11 2007Barbara Sonntag MD Abstract Background: Exposure to bacterial antigens and other environmental factors in combination with a genetic susceptibility have been implicated in the etiology of inflammatory bowel disease (IBD). As certain perinatal circumstances, e.g., delivery by cesarean section, predispose to a different intestinal colonizations the aim of this analysis was to define a potential influence on the development of IBD in later life. Methods: In a case-control study design, birth data were recorded from patients diagnosed with IBD (Crohn's disease [CD], n = 1096; ulcerative colitis [UC], n = 763) and healthy controls ([C], n = 878) by a self-administered questionnaire. Results: Preterm birth (CD: odds ratio [OR] 1.5 [95% confidence interval 1.1,2.0], UC: OR 1.3 [0.9,1.9]), mother's disease during pregnancy (CD: OR 1.9 [1.3,2.9], UC: OR 1.6 [1.0,2.4]), and disease in the first year of life (CD: OR 2.2 [1.6,2.9], UC: OR 1.7 [1.3,2.3]) are associated with the development of IBD in later life. No significant associations were found for the mode of delivery and breast feeding. In a logistic regression analysis female sex, smoking, appendectomy, maternal IBD, and disease in the first year of life were independently associated with CD. Female sex, appendectomy, and disease in the first year of life were independently associated with UC. Conclusions: Preterm birth and other perinatal circumstances are associated with the development of IBD, of which disease in the first year of life is an independent risk factor in multivariate analysis. (Inflamm Bowel Dis 2007) [source] Climate change and vector-borne viral diseases potentially transmitted by transfusionISBT SCIENCE SERIES: THE INTERNATIONAL JOURNAL OF INTRACELLULAR TRANSPORT, Issue 1 2009M. Rios Vector-borne diseases occur when infectious agents (virus, protozoa, bacteria, or helminthes) are transmitted to their hosts by a carrier organism. Climate conditions and their changes play a role in the inter-relationship between these agents, the vectors and the host (or hosts). This review is focused on arthropod-borne viruses (Arboviruses). These viruses are transmitted between susceptible vertebrate hosts by blood-feeding arthropods, and may be transmitted by blood transfusion, tissue and organ transplantation and breast feeding. The lifecycle of arboviruses is influenced by changes in temperature, rainfall, humidity, length of day, average daily solar radiation and/or storm patterns, as well as changes in the frequency of rare events such as floods or droughts. A plethora of studies have suggested that climate changes, particularly temperature changes, are likely to be induced by increase in the amount of greenhouse gases, such as methane, carbon dioxide (CO2) and chlorofluorocarbons, which deplete ozone in the atmosphere leading to an increase in ultraviolet radiation. Current models predict that ambient temperature will increase by 3,5°C on average with a doubling in CO2 concentration in the atmosphere. Vectors, pathogens and hosts each survive and reproduce within a range of optimal climatic conditions: temperature and precipitation being most important, while sea level elevation, wind and daylight duration are also important. Climate changes may affect important determinants of vector-borne disease transmission including (i) vector survival and reproduction, (ii) the vector's biting rate, and (iii) the pathogen's incubation rate within the vector organism. Droughts can increase the dissemination of arboviral diseases in urban areas by allowing a boost in the population of mosquitoes in foul water concentrated in catch basins where they breed. Furthermore, eggs can be vertically infected with arboviruses and heat waves speed up the maturation of the mosquitoes and of the viruses within mosquitoes. Droughts also cause a decline in mosquito predators like frogs, darning needles and dragonflies. In addition, birds congregate around shrinking water sites, enhancing circulation of viruses among birds and mosquitoes. In conclusion, the seriousness of some of the recent epidemics like West Nile virus and Dengue appear to has been influenced by climate change. As most of the arboviral infections are asymptomatic in humans, there is an increased opportunity for blood, organ and tissue donations by infected individuals during the viraemic period, resulting in an increased risk of transmission of arboviruses. [source] Types of drinks consumed by infants at 4 and 8 months of age: sociodemographic variationsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2000K. North Aim To investigate the variations in sociodemographic characteristics of mothers in relation to the types of milk and supplementary drinks consumed by their infants at 4 and 8 months of age. Study design The carers of a randomly chosen population sample of over 1000 infants from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) were asked to record all foods and drinks consumed by the child in a 24-h period at both 4 and 8 months of age. Self-completion postal questionnaires were used to ascertain sociodemographic characteristics of the mothers and their infants. Methods Significant differences in the types of milks and supplementary drinks consumed within sociodemographic groups were identified. Infants were also grouped according to the types of milks they were receiving at each age and further differences in sociodemographic characteristics were investigated. Results Highly significant differences existed among various sociodemographic characteristics with regard to the types of drinks used at both ages. Maternal educational level was the most influential of the sociodemographic variables in explaining the differences in consumption of all types of drinks given at 4 months, in particular for breast milk use. Maternal age was also significantly associated with breast feeding. The use of fruit drinks was significantly associated with the presence of older siblings in the family and the use of herbal drinks with the duration of breast feeding. At 8 months of age maternal educational level was again the most highly associated of the sociodemographic variables, being significantly associated with the use of most of the drinks. The presence of older siblings also had a significant independent effect as did duration of breast feeding. The feeding of cows' (or animal) milk as a main drink at 8 months, contrary to recommendation, was most likely in the group of mothers with vocational education, those in council accommodation, those with two or more children and those with difficulty affording food. Conclusion We have identified certain characteristics of mothers who were more likely than others not to follow current recommendations on infant feeding. The educational level of mothers appears to be of major significance in the choices made about the types of drinks given to infants. It may be possible to target information about infant feeding to certain groups of mothers thus improving weaning patterns. [source] Third S. S. Ratnam Memorial Lecture 2007.JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2009Ovarian cancer: Is there hope for women? Abstract Ovarian cancer is today the most lethal female cancer with an overall survival of only 49.9%. The currently available screening modalities are disappointing in detecting highly curable early stage ovarian cancer. Natural history of ovarian cancer is unknown; it appears it can develop quickly from normal looking ovaries. Timely referral of women with non-specific symptoms (such as abdominal bloating, pelvic pain) for an ultrasound scan or blood CA125 assessments may help in the early diagnosis. Patients with Stage IA or IB disease with grade 1 tumors have a cure rate of >90%; this is likely to be compromised by laparoscopic surgery. In selected patients fertility preservation with good obstetric outcome is possible. However, the relapse rate in ,high risk' early stage ovarian cancers is 40,45%; adjuvant chemotherapy is needed. Only 20,25% of those with stage III and IV disease are cured. Despite a high primary response (70%) majority (70,75%) will relapse and all are likely to succumb. Optimal debulking surgery followed by adjuvant chemotherapy are needed for stages III and IV disease; the outcome is superior if managed by gynecologic oncologists. Where cost of drugs is an important consideration, an alternative is carboplatin (an affordable and equally effective drug). The role of vaccines needs further study. When relapses occur palliation will be the aim in most instances. Oral contraceptives, breast feeding, tubal sterilization and hysterectomy also have a protective effect. Risk-reducing salpingo-oopherectomy has been suggested in women with BRCA mutations. [source] The effect of breastfeeding on child development at 5 years: A cohort studyJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2001PJ Quinn Objective: It is uncertain to what degree the relationship between breastfeeding and later cognitive development is a true biological effect, or is confounded by psychosocial factors. The study aim was to further investigate this relationship and the effect of duration of breast feeding on cognitive development. Methods: A total of 3880 children were followed from birth. Breastfeeding duration was measured by questionaire at 6 months of age and a Peabody Picture Vocabulary Test Revised (PPVT-R) was administered at 5 years. PPVT-R scores were adjusted for the effects of a large array of biological and psychosocial confounders. The relationship between breastfeeding and the mean PPVT-R scores were examined using analysis of variance and multiple linear regression. Results: A strong positive relationship was demonstrated between breastfeeding and the PPVT-R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed. Conclusion: These findings suggest a significant benefit to child development is conferred by breastfeeding and is related independently to longer periods of breastfeeding. [source] Water Consumption and Nursing Characteristics of Infants by Race and EthnicityJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2000Keith E. Heller DDS Abstract Objective: The purpose of this project was to determine racial/ethnic differences in water consumption levels and nursing habits of children younger than 2 years old. Methods: Data from the 1994,96 Continuing Survey of Food Intakes by Individuals (CSFII) were used for these analyses. Water consumption and breast-feeding data on 946 children younger than 2 years old were used. Results: For black non-Hispanic children younger than 2 years old (n=121), 5.3 percent of the children were currently being breast fed. This percentage was less than that seen in other racial/ethnic groups. For white non-Hispanic children (n=620), this percentage was 10.8 percent; for Hispanic children (n=146), 12.2 percent; for "other" children, 18.5 percent (n=59). Black non-Hispanic children had the highest total water consumption (128.6 ml/kg/day) among all groups, white non-Hispanic had the lowest (113.2 ml/kg/day). These differences were not statistically significant in multivariate regression modeling. Black non-Hispanic children also drank moretap water (21.3 ml/kg/day) than white non-Hispanic children (12.7 ml/kg/day) and Hispanic children (14.9 ml/kg/day). The difference was statistically significant in multivariate regression modeling. Conclusions: The differences in breast feeding and water consumption observed among black children younger than 2 years of age could be a factor in the observed higher levels of fluorosis in black children compared to other children. [source] The impact of caesarean delivery and type of feeding on cow's milk allergy in infants and subsequent development of allergic march in childhoodALLERGY, Issue 6 2009F. Sánchez-Valverde Background:, The incidence of IgE-mediated cow's milk allergy (CMA) has increased over the last few years. There are several genetic and environmental risk factors that may be related to this allergy and the subsequent allergic march (AM). Methods:, A prospective, cohort study was conducted in patients recruited into the study between 1998 and 2002. Information on clinical variables and complementary tests, perinatal and obstetric factors and the type of hydrolysed formula used was recorded. A cross sectional study on the prevalence of allergic diseases in this cohort was performed in 2004. Results:, We compared IgE-mediated CMA patients with non-IgE-mediated CMA patients and found that IgE-mediated CMA is associated with caesarean delivery (OR = 2.14 95% CI: 1.02,4.49), duration of breast feeding (>2 months, OR = 4.14; 95% CI: 2.17,7.89) and the use of supplementary artificial formula whilst breast feeding (OR = 2.86; 95% CI: 1.33,6.13). The factors associated with AM in IgE-mediated CMA patients were caesarean delivery (OR = 0.42; 95% CI: 0.19,0.92) and the use of more extensively hydrolysed high grade hydrolysates (+EH/HGH) (OR = 0.44; 95% CI: 0.20,0.98), both as protective factors. Conclusions:, Caesarean delivery is demonstrated as being a risk factor for IgE-mediated CMA, but it does not increase the risk of AM in these infants. The use of +EH/HGH appears to protect IgE-mediated CMA patients from eventually developing AM. [source] Breast feeding very-low-birthweight infants at discharge: a multicentre study using WHO definitionsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2009Riccardo Davanzo Summary Human milk has several advantages in the nutrition of very-low-birthweight (VLBW) infants. However, there are limited data on breast feeding (BF) in neonatal intensive care units (NICU). The aim of this study was to identify a practical definition of BF rate in VLBW infants and to test its applicability and reproducibility in Italian NICUs. The study population included all VLBW infants discharged from 12 level 3 NICUs, over a 12-month period. Type of feeding was recorded according to the World Health Organisation (WHO) definition, with a 72-h recall period. We enrolled 594 VLBW infants. Mean birthweight was 1105 g (SD: 267), mean gestational age was 29.2 weeks (SD: 2.7) and mean length of stay in NICUs was 62.5 days (SD: 56.5). At discharge, 30.5% of VLBW infants were exclusively breast fed, 0.2% were predominantly breast fed, 23.8% were on complementary feeding and 45.5% were exclusively formula fed. A wide variability in BF rates was seen between centres. Among exclusively breast-fed VLBW infants, only 10% sucked directly and exclusively at the breast. WHO definitions can be used to assess type of feeding at discharge from NICUs. We speculate that common feeding definitions may allow both comparisons among different NICUs and ratings of quality improvement programmes. [source] Maternal use of folic acid supplements during pregnancy and four-year-old neurodevelopment in a population-based birth cohortPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2009Jordi Julvez Summary The use of folic acid supplements during very early pregnancy is recommended in order to reduce the incidence of neural tube defects. Little is known about the possible benefits of folic acid on child neurodevelopment. A total of 420 children (87% of those eligible) from a birth cohort had complete data for final analyses at age 4 years. Information about folic acid and other over-the-counter dietary supplements was obtained prospectively using interviewer-administered questionnaires at the end of the first trimester of pregnancy. Psychological outcomes were assessed by two psychologists and teachers 4 years later. Low maternal socio-economic status, smoking, high parity and short duration of breast feeding were associated with lower prevalence of folic acid supplement use. Verbal (b = 3.98, SE = 1.69), motor (b = 4.54, SE = 1.66) and verbal-executive function (b = 3.97, SE = 1.68) scores, social competence (b = 3.97, SE = 1.61) and inattention symptom [OR = 0.46; 95% CI 0.22, 0.95] scores were associated with reported folic acid use. Reported folic acid supplement use during pregnancy was associated with improved neurodevelopment in children after adjusting for a number of sociodemographic and behavioural factors. [source] Questions regarding the basis of the analyses in study of the relationship of maternal concentrations of dichlorodiphenyl dichloroethylene (DDE) and initiation and duration of breast feeding: extrapolations of organochlorine levels for estimating exposure levelsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2006Beth Gladen First page of article [source] Does maternal smoking during pregnancy cause childhood overweight?PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2003Marius Widerře Summary The objective of this study was to examine a possible association between maternal smoking in pregnancy and childhood overweight. From a population-based cohort of 5722 women from Trondheim, Bergen (Norway) and Uppsala (Sweden) enrolled in early pregnancy during 1986,92, a random sample of 482 women was selected for participation. They were followed up throughout pregnancy, and their children from birth until 5 years of age. Data on maternal smoking and diet, socio-economic determinants and breast feeding were recorded prospectively. During pregnancy and childhood, anthropometric measures were also recorded. Maternal smoking status was based on reported number of cigarettes smoked in week 17 of pregnancy. Child overweight was defined by body mass index (BMI) and sum of skinfold thickness (SFT) , 85th percentile at 5 years of age. Children of mothers who smoked in pregnancy had increased risk of overweight at 5 years of age (RR 2.5, 95% CI 1.5, 4.2 for BMI; and RR 1.8, 95% CI 1.1, 3.0 for SFT). Adjusting for maternal diet, breast feeding, maternal obesity and socio-economic status did not suggest confounding. However, adjustment for birthweight increased the observed risk. A linear increase in BMI and SFT was observed with increasing number of cigarettes smoked. In conclusion, smoking during pregnancy may be a risk factor for development of childhood overweight. This study may support the hypothesis of ,fetal origin of adult disease', but the risk of overweight associated with smoking during pregnancy was independent of intrauterine growth retardation, and may thus be attributed to specific effects of cigarette smoke. [source] Maternal factors associated with the duration of breast feeding in Jeddah, Saudi ArabiaPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2003Sherine Shawky Summary Recently, there has been increasing concern about the decline in breast-feeding pattern in developing countries. The objectives of this study were to document the recent breast-feeding trends in Jeddah during the first year of an infant's life and identify the probable maternal risk factors implicated in breast-feeding cessation. Data were collected from six randomly selected primary health care centres in Jeddah City. All married women with an infant , 12 completed months of age were interviewed, and information on socio-demographic characteristics, breast feeding and contraceptive use were collected. Cox proportional hazard regression model was used to calculate the adjusted odds ratios for the various maternal risk factors related to breast-feeding cessation. A total of 400 women were enrolled in the study. Their mean age at delivery was 28.0 years (SD = 4.1 years). Approximately 40.0% had never attended school, 43.0% had at least five children and 13.8% were smokers. Deliveries by caesarean section were reported by 13.0% of women and contraceptive use by 44.7%, among whom oral contraceptives were the commonest method. Around 94.0% of women ever initially breast fed their infants, and this proportion dropped to 40.0% by the infant's 12th month. Women who delivered by caesarean section (OR = 1.9 [95% CI 1.3, 2.8]P = 0.001) and those who used oral contraceptives (OR = 1.5 [95% CI 1.1, 2.2]P = 0.031) were at higher risk of stopping breast feeding and lower probability of maintaining breast feeding to the 12th month post partum than those who delivered vaginally and did not use oral contraceptives. Breast-feeding practice seems to decline rapidly during the first year of the infant's life. Health care professionals should promote breast-feeding practice as early as the antenatal period. They should also take into consideration the impact of caesarean section deliveries and early oral contraceptive use to avoid their negative impact on breast-feeding practice. [source] Weight and weight gain at 4 months (The Netherlands 1998): influences of nutritional practices, socio-economic and ethnic factorsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2002Anneke M. W. Bulk-Bunschoten Summary We describe the determinants of weight gain in the first 4 months of life in a cohort of 3256 infants. The study was designed as a survey with follow-up. In the period 1 April to 1 July 1998, all infants, usually 4 weeks old but not older than 4 months, brought to a well-baby clinic for the first time were included. Nutritional practices, demographic data on mother and child, birthweight and a second weight measured between days 118 and 147 were recorded. Simple and multiple linear regression analyses were performed. The average weight gain over 4 months was 27.7 g/day for boys and 24.5 g/day for girls. Weight gain was lower with high parity and if the mother was a native Dutch speaker. Nutritional practices affected weight gain only slightly: exclusive breast feeding for 4 months lowered the weight gain by 0.06 g/day. However, because of their higher birthweight, breast-fed infants weighed a little more than formula-fed infants at 4 months. In addition, we compared the median weight at the age of 4 months with the median weight at the same age in previous Dutch growth studies. The median weight, adjusted to day 133, was higher in 1998 than in 1965, 1980 and 1997 (boys 7.15 vs. 6.85, 6.77 and 6.95 kg; girls 6.59 vs. 6.49, 6.39 and 6.45 kg respectively). [source] Maternal, paternal and environmental tobacco smoking and breast feedingPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2002Gabriel M. Leung Summary The effects of environmental tobacco smoke (ETS) on breast-feeding patterns are poorly understood, while those of parental smoking on breast-feeding initiation vs. duration have not been clearly delineated. We conducted a prospective, population-based birth cohort study to examine the independent effects of maternal, paternal and ETS on breast-feeding initiation and duration. A total of 6747 Hong Kong Chinese infants were recruited and followed up in 1997,8. We obtained detailed household smoking history and recorded breast-feeding patterns in three follow-up interviews over 9 months. We found that both maternal and paternal smoking were associated with not initiating breast feeding (odds ratio [OR] for ever maternal smoking = 2.51, 95% confidence interval [CI] = 1.63, 3.86; OR for ever paternal smoking = 1.22, 95% CI = 1.08, 1.39). Exposure to ETS in utero and post partum were also related to not starting breast feeding (ORETS in utero = 1.10, 95% CI = 0.99,1.24; ORETS post partum = 1.21, 95% CI = 1.08, 1.36). These effects, however, did not persist for breast-feeding duration of , 4 months. Cox proportional hazards modelling confirmed the lack of association between any form of smoking and breast-feeding duration. Our findings suggest that smoking of any kind, during or after pregnancy, is a strong risk indicator for not initiating breast feeding. Smoking as a risk indicator for underlying socio-economic, demographic and psychosocial factors is probably responsible for most of the observed adverse effects, although we cannot rule out direct contributions from pathophysiological mechanisms. Public health strategies directed at these underlying factors should be vigorously pursued to reduce the adverse effects of tobacco on breast feeding and infant health in general. [source] Rehospitalisation for neonatal jaundice: risk factors and outcomesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2001Ann M. Geiger Summary This case,control study sought to determine whether rehospitalisation for jaundice in newborns is associated with the length of hospital stay after birth and to identify risk factors for and outcomes of rehospitalisation for jaundice. It was carried out among women who delivered a normal, term infant vaginally at any of 10 medical centres from 1992 to 1994. Cases were infants rehospitalised with jaundice within 14 days of birth. Controls were randomly selected from normal, term infants delivered vaginally but not rehospitalised within 90 days of birth. Maternal medical records for pregnancy, labour and delivery care, records for all the birth hospitalisations, and rehospitalisations for the cases were abstracted. The length of birth hospitalisation did not differ between case and control infants, whether length was measured as a categorical variable or as a continuous measure (median = 22.8 h for cases and 23.3 h for controls, P = 0.931). Rehospitalisation for jaundice was associated with race/ethnicity, primiparity, preterm birth, breast feeding and suspicion of jaundice during the birth hospitalisation. None of the rehospitalised infants died, were diagnosed with kernicterus or required resuscitation. Attention to risks associated with jaundice rehospitalisation might reduce this undesirable, but not commonly severe, outcome. [source] Duration of breast feeding and bovine serum albumin antibody levels in type 1 diabetes: a case-control studyPEDIATRIC DIABETES, Issue 4 2003Francisco Pérez-Bravo Abstract:,Objective:, To compare the levels of bovine serum albumin (BSA) antibodies and their relationship with duration of breast feeding, age of exposure to cow's milk, and human leukocyte antigen (HLA-DQ) genotype in children with and without type 1 diabetes. Methods:, Serum samples from 143 (0.3,14.7 yr) newly diagnosed children with type 1 diabetes and 107 unrelated control children (0.8,13.5 yr) were evaluated for BSA antibodies. Duration of breast feeding and exposure to cow's milk were recorded on questionnaires. HLA-DQ typing was determined by polymerase chain reaction. Results:, One hundred percent of the diabetic children were positive for BSA antibodies compared to 1.9% for healthy controls (p < 0.001). Diabetic children also had higher levels of immunoglobulin G antibodies than unrelated controls (55.1 vs. 17.8 ng/mL, p < 0.0001). Duration of breast feeding (5.4 vs. 7.6 months, p < 0.02), but not age of exposure to cow's milk (8.3 vs. 9.2 months, p = 0.11), differed between cases and controls. There was no difference in antibody titer by duration of breast feeding or age of exposure to cow's milk in the cases or controls. Conclusion:, Higher levels of antibodies to BSA were found in children recently diagnosed with type 1 diabetes compared to the controls, particularly those with high or moderate HLA-DQ genotypes. The BSA profile, however, does not seem to depend on duration of breast feeding or age of exposure to cow's milk in this population. [source] Aspiration during swallowing in typically developing children of the first nations and inuit in CanadaPEDIATRIC PULMONOLOGY, Issue 10 2006Gina R. Rempel MD Abstract Children of the First Nations and Inuit in Canada have a high propensity for lower respiratory tract infections. Overcrowding, poor housing, passive smoke exposure, and lack of breast feeding (Martens P, Bond R, Jebamani L, Burchill C, et al. http://www.umanitoba.ca/centres/mchp/reports/pdfs/rfn_pdfs/rfn_report.pdf.; MacMillan H, Walsh C, Jamieson E, Crawford A, Boyle M. http://www.hcsc.gc.ca/fnihbdgspni/fnihb/aboriginalhealth/reports_summaries/regional_survey_ch1.pdf.; Wardman AE, Khan NA. Int J Circumpolar Health 2004;63:81,92) have been cited as important contributing factors in the occurrence of lower respiratory tract infections. However, aspiration during swallowing has thus far not been considered as a co-factor in the occurrence of lower respiratory tract infections in these children. We present a retrospective case series of seven typically developing children of the Canadian First Nations and Inuit, in whom aspiration during swallowing was detected in the course of investigating associations with recurrent lower respiratory tract infections. None of the children had any of the known risk factors for aspiration during swallowing such as developmental variation, prematurity, neuromotor problems, or anatomic abnormalities of the upper aerodigestive tract. We speculate that aspiration during swallowing in typically developing children may be an important, previously unrecognized co-factor in the occurrence of lower respiratory tract infections, particularly in the communities of the Canadian First Nations and Inuit. Further prospective studies will be needed to determine whether aspiration during swallowing represents an independent risk factor for the occurrence of lower respiratory tract infections in these children. Pediatr Pulmonol. 2006, 41:912,915. © 2006 Wiley-Liss, Inc. [source] ORIGINAL ARTICLE: Predictors of Inflammatory Breast Diseases During Lactation , Results of a Cohort StudyAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 1 2010Achim Wöckel Problem, Inflammatory breast diseases during lactation are major reasons for early weaning. Method of study, A prospective cohort study was performed to examine the association between stress and inflammatory breast diseases. Psychometric data, cytokine levels in breast milk and blood samples were analysed postpartum (T1). Psychometric data and course of breast feeding were evaluated twelve weeks later (T2). Patients were divided into case- and control-groups (according to the presence of breast diseases). Results, Mothers of the case group (n = 23) were significantly older and showed significantly increased stress levels between T1 and T2 compared with the control group (n = 43). Leucocytes in the postpartum blood count were significantly decreased in the case group. There were no significant differences between groups in the concentrations of Th-1- and Th-2-cytokines in breast milk postpartum. Conclusion, Higher maternal age, postpartum increase in stress perception and low number of leucocytes are associated with a higher incidence of inflammatory breast diseases. Further studies must examine the causality of this effect. [source] BS13 THE EFFECT OF ANTIBIOTIC TREATMENT OF INFLAMMATORY BREAST DISEASE ASSOCIATED WITH THE ISOLATION OF LIPOPHILIC CORYNEBACTERIAANZ JOURNAL OF SURGERY, Issue 2007A. M. Skinner Granulomatous mastitis is a rare benign condition effecting women of reproductive age and is most commonly treated surgically. It is an inflammatory disease of the breast associated with the isolation of intracellular lipophilic corynebacteria and has a course of chronicity with recurrences. Purpose , Our aim was to observe the clinical response and subsequent course of women diagnosed with granulomatous mastitis and treated by a long course of lipophilic antibiotics. We also recorded the concurrent requirement for surgical intervention. Methodology , The clinical course of seventeen women with inflammatory breast disease and microbiologic and histologic evidence of infection with Corynebacterium kroppenstedtii were prospectively followed. 11 received treatment with doxycycline (or clindamycin if breast feeding), 5 women received alternative antibiotics, and one patient received no antibiotics. Results , Among the 11 who received doxycycline, full resolution without surgery of disease was achieved in 9 women while another woman showed improvement at follow up, further surgical management was required by 2. All the five women who received alternative antibiotics also had surgery. They each had full resolution of disease at follow up. Further admissions were required by one woman. Conclusion , Optimal treatment for granulomatous mastitis is yet to be determined. We found promising results with a small group of young women who were treated with the lipophilic antibiotic doxycycline alone. These had resolution of disease without requiring surgical intervention. [source] Factors determining HIV viral testing of infants in the context of mother-to-child transmissionACTA PAEDIATRICA, Issue 4 2010K Peltzer Abstract Aim:, The aim of this study was to investigate factors determining HIV viral testing of infants in the context of Prevention of Mother-to-Child Transmission of HIV (PMTCT). Methods:, Post-delivery HIV infected mothers 18 years and above with babies aged 3,6 months were interviewed on HIV viral testing of infants and factors associated with it. Results:, Among 311 HIV infected women 61.7% had their infant tested for HIV between 4 and 8 weeks. Bivariate analyses found that older age of the mothers, lower depression scores, higher PMTCT knowledge, low PMTCT risk behaviour (maternal and infant nevirapine adherence, health facility delivery and exclusive formula feeding), HIV status disclosure and attending a support group were associated with PCR test participation. In multivariate analyses higher PMTCT knowledge, infant nevirapine adherence, and not exclusive breast feeding were associated with polymerase chain reaction test participation. Conclusion:, Various determinants of acceptance of participation in HIV viral testing of infants in the context of PMTCT were identified that can guide infant testing and diagnosis counselling and support services of PMTCT programmes. [source] The effect of passive smoking and breast feeding on serum antioxidant vitamin (A, C, E) levels in infantsACTA PAEDIATRICA, Issue 3 2009Gonca Y, lmaz Abstract Aim: Toxic substances in tobacco smoke are known to have negative effects on the antioxidant capacity of human body. In order to investigate the effect of passive smoking on serum antioxidant levels in infants, serum vitamin A, E, C levels and urinary cotinine/creatinine levels were measured in 254 infants at the age of 6 months. Methods: The information about infants' nutrition and exposure to tobacco smoke was obtained from the mothers by the help of a questionnaire. The infants were grouped according to both smoking status of mother and urinary cotinine/creatinine levels. Results: The mean serum vitamin A, C and E levels of infants of smoking mothers were significantly lower than those of non-smoking mothers (p < 0.05). Vitamin A, E and C levels were negatively correlated with urinary cotinine/creatinine levels (p < 0.05, r: ,0.61, ,0.42, ,0.53, respectively). Multivariate analysis revealed independent factors determining the serum vitamin A, E and C levels of infants as maternal smoking and breast feeding (p < 0.05). Conclusion: Tobacco smoke exposure of infants significantly decreases their serum antioxidant vitamin A, C and E levels. However, breast feeding may help to prevent the decrement of antioxidant vitamin levels of passive smoking infants. [source] The quantity of thyroid hormone in human milk is too low to influence plasma thyroid hormone levels in the very preterm infantCLINICAL ENDOCRINOLOGY, Issue 5 2002Aleid G. Van Wassenaer Summary background Thyroid hormone is crucial for brain development during foetal and neonatal life. In very preterm infants, transient low levels of plasma T4 and T3 are commonly found, a phenomenon referred to as transient hypothyroxinaemia of prematurity. We investigated whether breast milk is a substantial resource of thyroid hormone for very preterm neonates and can alleviate transient hypothyroxinaemia. Both the influence of breast feeding on plasma thyroid hormone levels and the thyroid hormone concentration in preterm human milk were studied. methods Two groups were formed from the placebo group of a randomized thyroxine supplementation trial in infants born at < 30 weeks' gestational age on the basis of the mean breast milk intake during the third, fourth and fifth weeks of life. One group received more than 50% breast milk (mean breast milk intake 84%, n = 32) and the other group less than 25% breast milk (mean breast milk intake 3·3%, n = 25). Plasma thyroid hormone concentrations were compared between the two groups. Breast milk was collected from mothers of infants participating in the same trial and the thyroxine concentration in breast milk was measured with RIA after extraction. results No significant differences were found between both groups in plasma concentrations of T4, free T4, T3, TSH, rT3 and thyroxine-binding globulin (TBG), which were measured once a week. Thyroxine concentration in breast milk ranged between 0·17 µg/l and 1·83 µg/l (mean 0·83, SD 0·3 µg/l) resulting in a maximum T4 supply of 0·3 µg/kg via ingested breast milk. In formula milk, the T4 concentration was equally low. Protease treatment did not influence the measured T4 concentrations. conclusions No differences in plasma thyroid hormone between breast milk-fed and formula-fed infants were found. The amount of T4 present in human milk and formula milk is too low to alter the hypothyroxinaemic state of preterm infants. [source] | ||||||||||||||||||||||||||||