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Healthy Newborns (healthy + newborn)
Selected AbstractsComparison of two doses of breast milk and sucrose during neonatal heel prickPEDIATRICS INTERNATIONAL, Issue 2 2010Tutku Ozdogan Abstract Background:, The aim of the present study was to test analgesic effects of double- versus single-dose breast milk and compare this effect with efficacy of double- versus single-dose sucrose in a group of healthy term newborns during heel prick blood sampling. Methods:, Healthy newborns (n= 142) were consecutively allocated to one of the six groups: group 1, single-dose breast milk; group 2, single-dose sterile water; group 3, single-dose 12.5% sucrose; group 4, two doses breast milk; group 5, two doses sterile water; and group 6, two doses 12.5% sucrose before the heel prick. The medians for crying time and the pain scores according to the neonatal facial coding system were recorded. Results:, Crying times were 117 s, 126 s, 82 s, 128 s, 117 s, and 95 s in groups 1,6, respectively (P= 0.053). The mean pain scores were 4.60, 5.82, 3.91, 4.94, 5, and 4.05 in groups 1,6, respectively (P= 0.068). There was a significant difference between the groups for mean pain scores at 1 min and 3 min. There was a significant difference between the single-dose sucrose group and single-dose sterile water group at 1 min (P= 0.002). The babies in the sucrose group were active awake, whereas the ones in the breast milk group were asleep before heel prick. Conclusion:, Two doses of sucrose solution were not superior to single-dose sucrose. Neither single nor double doses of breast milk were effective in relieving pain in neonates. Two milliliters breast milk does not reduce response to pain during minor painful procedures in term neonates even when two doses have been given. Further studies are needed. [source] Continuous gastric drip versus intravenous fluids in low birthweight infantsACTA PAEDIATRICA, Issue 4 2002M Becerra This multicentre randomized study compared a continuous gastric drip (CGD) with intravenous (i.v.) fluid administration. Healthy newborns with birthweight from 1501 to 2000 g whose physician ordered i.v. fluids were randomized before the 2nd hour of life to CGD or i.v. fluids. The major outcome variable was the need for an i.v. line in the CGD group. Serum glucose was measured at 30 min, 1 h and every 6 h thereafter. Serum sodium and potassium were measured at least once during the first 72 h of life. Enteral feedings, feeding intolerance, number of venous lines and i.v. line-related complications were recorded until the interruption of CGD or the i.v. line. Twenty-nine infants were randomized to each group. The two groups were comparable in terms of birthweight and gestational age. Ten percent (3/29) of the infants randomized to the CGD group required i.v. fluids and 90% of them received electrolytes and glucose through an orogastric tube. The incidence of hypoglycaemia, hyponatraemia and episodes of feeding intolerance did not differ between the groups. Conclusion: Fluid administration by CGD reduces the need for i.v. lines without increasing the risk of complications. [source] Indicators Nurses Employ in Deciding to Test for HyperbilirubinemiaJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 6 2001Anita J. Gagnon RN Objective: To identify the indicators nurses employ in deciding to test healthy full-term newborns for total serum bilirubin in the absence of a written protocol. Design: Secondary analysis of data available on 130 mother-newborn pairs and informal interviews of 30 postpartum unit nurses. Setting: Two university teaching hospitals. Participants: All tested newborns and a 33% random sample of remaining newborns from a control group data set created during a previous study and a convenience sample of postpartum nurses from all shifts. Measurement: Outcome data were obtained from a review of records. Background data were obtained from a review of records and questionnaires. Nurse data were obtained through a modified form of participant observation. Results: Ninety-one percent of newborns tested for bilirubin were tested unnecessarily. In logistic regression analyses, variables predictive of nurse-driven total serum bilirubin testing were presence of jaundice, odds ratio (OR) = 31.95 (95% confidence interval, 6.71, 152.03), and feeding frequency, OR = 0.28 (0.11, 0.72). Identifying both presence and location of jaundice simultaneously did not significantly predict testing, OR = 1.82 (0.66, 5.04). Fifty-three percent of nurses who were interviewed identified both the presence of jaundice and feeding as indicators to consider for testing. Conclusion: Newborns are overtested for bilirubin. Indicators used by nurses in deciding to test a healthy newborn for total serum bilirubin are the presence of jaundice and feeding frequency. Nurses who assess feeding frequency are less likely to order bilirubin testing. [source] REVIEW ARTICLE: B7 Family Molecules as Regulators of the Maternal Immune System in PregnancyAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 6 2010Margaret G. Petroff Citation Petroff MG, Perchellet A. B7 family molecules as regulators of the maternal immune system in pregnancy. Am J Reprod Immunol 2010 Placental and fetal growth and development are associated with chronic exposure of the maternal immune system to fetally derived, paternally inherited antigens. Because maternal lymphocytes are aware of fetal antigens, active tolerance mechanisms are required to ensure unperturbed progression of pregnancy and delivery of a healthy newborn. These mechanisms of tolerance may include deletion, receptor downregulation, and anergy of fetal antigen-specific cells in lymphoid tissues, as well as regulation at the maternal,fetal interface by a variety of locally expressed immunoregulatory molecules. The B7 family of costimulatory molecules comprises one group of immunoregulatory molecules present in the decidua and placenta. B7 family members mediate both inhibitory and stimulatory effects on T-cell activation and effector functions and may play a critical role in maintaining tolerance to the fetus. Here, we review the known functions of the B7 family proteins in pregnancy. [source] Evaluation of Protein S-100 serum concentrations in healthy newborns and seven newborns with perinatal acidosisACTA PAEDIATRICA, Issue 5 2000J Maschmann We measured Protein S-100 serum levels in 66 healthy newborns during the first week of life and in 7 newborns with perinatal acidosis. Normal values (n= 66) constantly ranged between 0.66 and 3.33 ug/1 (2.5 and 97.5 percentiles) during the evaluation period. Conclusions: Newborns with signs of hypoxic-ischaemic encephalopathy (HIE) after perinatal acidosis showed elevated Protein S-100 serum levels, whereas newborns without these signs had normal concentrations. S-100 might thus be a marker of central nervous system damage in newborns. [source] The Effect of Ultra Low Dose Epidural Analgesia on Newborn Breastfeeding BehaviorsJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2003RN assistant professor, Sharon Radzyminski PhD, graduate program director Objective: To determine whether a difference in breastfeeding behaviors could be observed between newborns whose mothers received epidural analgesia for labor pain relief and those newborns whose mothers received no pain medication in labor. Design: There were two groups of neonates in this study. One group was born to mothers who received epidural analgesia, and one group was born to mothers who received no pain medication for labor. Both groups were observed for initial breastfeeding behaviors using the Premature Infant Breastfeeding Behavior Scale following birth and at 24 hours. Central nervous system functioning in the newborn was measured with the Neurologic and Adaptive Capacity Score at 2 and 24 hours of age. Setting: A large tertiary hospital in northeast Ohio. Participants: Fifty-six breastfeeding mother-newborn dyads. All mothers were healthy multiparae who gave birth vaginally to normal, full-term, healthy newborns. Main Outcome Measures: Newborns were observed for rooting, latch on, sucking, swallowing, activity state, and neurobehavior. Results: There were no statistically significant differences in breastfeeding behaviors at birth or at 24 hours of age. Conclusion: A possible cause for the lack of significant results may have been the ultra low dose of bupivacaine and fentanyl used in this sample. [source] Regional ventilation distribution in non-sedated spontaneously breathing newborns and adults is not differentPEDIATRIC PULMONOLOGY, Issue 9 2009Andreas Schibler MD Abstract Background: In adults, ventilation is preferentially distributed towards the dependent lung. A reversal of the adult pattern has been observed in infants using radionuclide ventilation scanning. But these results have been obtained in infants and children with lung disease. In this study we investigate whether healthy infants have a similar reverse pattern of ventilation distribution. Study Design: Measurement of regional ventilation distribution in healthy newborn infants during non-REM sleep in comparison to adults. Methods: Twenty-four healthy newborns and 13 adults were investigated with electrical impedance tomography (EIT) in supine and prone position. Regional ventilation distribution was assessed with profiles of relative impedance change. The phase lag between dependent and non-dependent ventilation was calculated as a measure of asynchronous ventilation. Results: In newborns and adults the geometric center of ventilation was centrally located in the lung at 52.2,±,6.2% from anterior to posterior and at 50.5,±,14.7%, respectively. Using impedance profiles, ventilation was equally distributed to the dependent and non-dependent lung regions in newborns. Ventilation distribution in adults was similar. Phase lag characteristics of the impedance signal showed that infants had slower emptying of the dependent lung than adults. Conclusion: The speculated reverse pattern of regional ventilation distribution in healthy infants compared to adults could not be demonstrated. Gravity had little effect on ventilation distribution in both infants and adults measured in supine and prone position. Pediatr Pulmonol. 2009; 44:851,858. © 2009 Wiley-Liss, Inc. [source] Serum pro-hepcidin levels in term and preterm newborns with sepsisPEDIATRICS INTERNATIONAL, Issue 2 2009Ece Yapakç Abstract Background:, An iron regulatory peptide hormone, hepcidin, is also part of the innate immune system and is strongly induced during infections and inflammation. The aim of the present study was to determine serum levels of the 60 aa pro-hormone form of hepcidin (pro-hepcidin) in full-term and preterm newborns with sepsis and to determine the possible relationships between pro-hepcidin levels and serum iron and complete blood count parameters. Methods:, Fifteen preterm newborns with sepsis, 17 healthy preterm, six full-term newborns with sepsis and 16 healthy full-term newborns were included the study. Blood samples were collected from patients with sepsis at the time of clinical diagnosis. Each blood sample was analyzed for complete blood count, serum iron and ferritin concentrations, iron-binding capacity, and pro-hepcidin level. Results:, The mean serum pro-hepcidin level (mean ± SD) in preterm neonates with sepsis and in healthy preterm newborns was 565.4 ± 519.5 ng/mL and 279.8 ± 227.6 ng/mL, respectively (P < 0.05). The mean serum pro-hepcidin level in full-term newborns with sepsis and in healthy full-term neonates was 981.4 ± 415.4 ng/mL and 482 ± 371.9 ng/mL, respectively (P < 0.05). Although the mean serum ferritin levels in the two groups with sepsis were higher when compared with the healthy groups, the difference was not statistically significant in full-term newborns. No statistically significant correlations were found between serum pro-hepcidin levels and any other parameters in each group. Conclusions:, Serum pro-hepcidin levels were higher in newborns with sepsis (either premature or full-term) than they were in healthy newborns at the time of clinical diagnosis. [source] Microvolt T-Wave Alternans during Holter Monitoring in Children and AdolescentsANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2010Leonid Makarov M.D. Background: Time-domain microvolt T-wave alternans (TWA) has been described as a noninvasive marker of sudden cardiac death in adults. The incidence of TWA in pediatric populations has not been defined well. The aim of the study was to determine peculiarities of TWA in children. Methods: We examined 68 healthy patients,newborns (20) and children in age group of 7,17 years (48),and 85 pediatric patients: ventricular premature beats,65; dilated cardiomyopathy (DCMP),2; long QT syndrome (LQTS),10; Brugada syndrome (BrS),5, catecholaminergic ventricular tachycardia (CVT),3. All underwent Holter monitoring (HM) with definition of the peak value of TWA by modified moving average method. Results: In healthy newborns, TWA was 32 ± 8 (12,55) ,V (HR 123,156 bmp). In healthy children (7,17 years) it was 30 ± 11 (10,l 55) ,V, (HR 64,132 bmp) without any differences between boys and girls. In all group of patients, TWA were significantly higher (P < 0.05) than in healthy. Circadian peak of TWA was found (90%) in a second part of day and at sleep (8%). Among them 60% (LQTS, BrS, and DCPM) had TWA > 55 ,V. Conclusion: Time-domain TWA during HM in children was independent of age, gender, and heart rate. In 94% healthy children, values of TWA do not exceed 55 ,V but 20,50% children with cardiac pathology had TWA more than 55 ,V. Night circadian type of TWA in diseases with risk of life-threatening arrhythmias associated with TWA was more than 55 ,V. Ann Noninvasive Electrocardiol 2010;15(2):138,144 [source] Does Bathing Newborns Remove Potentially Harmful Pathogens from the Skin?BIRTH, Issue 3 2001Jennifer M. Medves RN Background: Newborn infants are routinely bathed after birth partly to reduce the possibility of transmitting potential pathogens to others. The extent to which a mild soap reduces the quantity and type of microbes found on the skin through normal colonization has not been reported. The objective of the study was to compare colonization rates between infants bathed in soap and water and infants bathed in plain water. Method: One hundred and forty infants were randomly assigned to one group bathed in a mild pH neutral soap and water or to another group bathed in water alone. Microbiology swabs were taken on three occasions (before the first bath, 1 hour after the bath, and 24 hours after birth) from two sites (anterior fontanelle and umbilical area). Results: No difference occurred between groups on type or quantity of organisms found at each time period. Skin colonization is a function of time, and the quantity of organisms identified increased over time (Friedman A 2= 111.379, df = 5, p < 0.001). Conclusions: Bathing with mild soap as opposed to bathing in water alone has minimal effect on skin bacterial colonization. Skin colonization increased over time. The findings did not support the efficacy of bathing with soap and water to reduce skin colonization of bacterial pathogens. Although the incidence of potential pathogens colonizing the skin during the first day of life is low and unlikely to pose a risk to healthy newborns, health care professionals may wish to wear gloves until the infant has been bathed. [source] Presence of both parents during consent process in non-therapeutic neonatal research increases positive responseACTA PAEDIATRICA, Issue 10 2010Irina Korotchikova Abstract Aim:, To investigate factors that influenced parental consent/non-consent in a non-therapeutic electroencephalogram (EEG) study in healthy newborns. Methods:, Parents of healthy newborns were approached to participate in a neonatal EEG study within 36 h of birth. The rationale and risks/benefits of the study were explained. Any concerns were discussed, and detailed information about the EEG study was provided in the consent form. In the case of refusing/withdrawing consent, an informal interview was used to investigate the reasons, which were subsequently analysed and grouped according to the four principles of the consent process. Results:, A total of 123 parents were included in the study. Parental consent was obtained in 72/123 (59%) cases, 10/123 (8%) parents subsequently withdrew their consent and 41/123 (33%) parents refused to participate in the study. Consent was more likely if both parents were present (p < 0.0001). When the mothers were approached alone, obtaining consent was significantly more difficult within the first 6 hours of delivery, compared to a later approach (37% vs. 67% respectively; p = 0.009). Refusals were classified into issues of voluntariness (7%), informed choice (10%), understanding (54%) and competence (29%). Conclusion:, Parents of healthy newborns demonstrated a positive attitude towards non-therapeutic neonatal research with maximal consent occurring when both parents were present. Parental perception of harm was the main reason for declining consent. [source] Prolonged unconjugated hyperbilirubinaemia associated with the haem oxygenase-1 gene promoter polymorphismACTA PAEDIATRICA, Issue 5 2010OG Bozkaya Abstract Aim:, To elucidate the genetic factors causing hyperbilirubinaemia in prolonged jaundice of the newborns, we investigated whether the HO-1 gene promoter polymorphism is a cause in unexplained pathological or prolonged jaundice. Methods:, Three groups were defined: healthy newborns with no clinical jaundice, newborns hospitalized for jaundice without any identifiable pathological cause and newborns with prolonged jaundice associated with breast milk. Genomic DNA was extracted from the white blood cells and the promoter region of the HO-1 gene was amplified using PCR and their allelic repeats were determined. Results:, We did not detect any significant difference in the allele frequencies between the healthy newborns and the newborns whose serum total bilirubin levels were >12.9 mg/dL. However, the patients with short (<24 GT) dinucleotide repeat in the HO-1 gene promoter on either allele had significantly higher prolonged unconjugated hyperbilirubinaemia than the healthy newborns. There was no significant difference between the groups 2 and 3. Conclusion:, The results indicate that polymorphism of HO-1 gene promoter region can be an underlying cause of the prolonged unconjugated hyperbilirubinaemia associated with breast milk. In this patient population, short repeat alleles of the HO-1 gene promoter polymorphism were associated with prolonged jaundice. [source] Evaluation of the acceptability of a new oral vitamin K prophylaxis for breastfed infantsACTA PAEDIATRICA, Issue 3 2010E-M Strehle Abstract Aim:, The aim of this study was to investigate the acceptability and tolerability of the oral food supplement Neokay for the prevention of vitamin K deficiency bleeding in newborns. Methods:, A questionnaire survey was conducted among 45 midwives in which they were asked 10 questions about their use of Neokay, its advantages and disadvantages, and their perceptions of parental attitudes towards this new prophylactic treatment. Results:, During a 6-month period one dose of Neokay was given to 1794 healthy newborns at birth and further daily doses were given to 812 breastfed infants for 3 months. The midwives listed as main advantages ease of administration, no need for prescription or written consent, and transfer of responsibility to parents. As disadvantages, they mentioned possible reduced compliance as a result of the frequency of dosing, decreased parental confidence in breastfeeding and technical issues with packaging. Conclusion:, A prophylactic vitamin K dosage regimen of 1 mg oral vitamin K (Konakion MM Paediatric or Orakay) given to all healthy neonates at birth, combined with daily doses of 50 ,g Neokay for 3 months for breastfed babies is well tolerated and acceptable to midwives and parents. [source] Bhutani-based nomograms for the prediction of significant hyperbilirubinaemia using transcutaneous measurements of bilirubinACTA PAEDIATRICA, Issue 12 2009YA Bental Abstract Aim:, Prospectively establish the relationship between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB), and develop nomograms similar to Bhutani's nomograms, based on our TcB data. Methods:, Our study sample was from a total population of 1069 infants, near term and term healthy newborns, admitted during 2.5 month period of the study. TSB was performed on all infants who were felt to be clinically jaundiced. Before obtaining the TSB, a TcB was performed (Jaundice Meter Minolta/Draeger JM-103). Measurements were performed on two sites: forehead and mid-sternum, and the mean of both measurements was calculated. Results:, A total of 1091 paired measurements were obtained from 628 infants. Linear regression showed a significant relation between TSB and TcB (R2 of 0.846). In multiple regression analysis, all independent variables studied, i.e. gestational age (or birthweight), age at sampling and ethnicity had a negligible influence on the relationship. We subsequently developed our local-nomograms of hour-specific mean TcB with 40, 75 and 95 percentile lines. Conclusions:, In our local settings and population, we found a reliable correlation between laboratory measurements of TSB and TcB. We were able to develop our local-Bhutani-based TcB nomograms for screening babies during hospital stay and pre-discharge for assessing the risk of hyperbilirubinaemia. [source] Pulse oximetry screening as a complementary strategy to detect critical congenital heart defectsACTA PAEDIATRICA, Issue 4 2009Alf Meberg Abstract Objective: To compare strategies with and without first-day of life pulse oximetry screening to detect critical congenital heart defects (CCHDs). Study design: Population based study including all live born infants in Norway in 2005 and 2006 (n = 116 057). Postductal (foot) arterial oxygen saturation (SpO2) was measured in apparently healthy newborns after transferral to the nursery, with SpO2 < 95% as cut-off point. Out of 57 959 live births in the hospitals performing pulse oximetry screening, 50 008 (86%) were screened. Results: A total of 136 CCHDs (1.2 per 1000) were diagnosed, 38 (28%) of these prenatally. Of the CCHDs detected after birth, 44/50 (88%) were detected before discharge in the population offered pulse oximetry screening (25 by pulse oximetry), compared to 37/48 (77%) in the non-screened population (p = 0.15). Median times for diagnosing CCHDs in-hospital before discharge were 6 and 16 h after birth respectively (p < 0.0001). In the screened population 6/50 (12%) CCHDs were missed and recognized after discharge because of symptoms. Two of the six missed cases failed the pulse oximetry screening, but were overlooked (echocardiography not performed before discharge). If these cases had been recognized, 4/50 (8%) would have been missed compared to 11/48 (23%) in the non-screened population (p = 0.05). Of the cases missed, 14/17 (82%) had left-sided obstructive lesions. Conclusion: First-day of life pulse oximetry screening provides early in-hospital detection of CCHDs and may reduce the number missed and diagnosed after discharge. [source] HUVECs from newborns with a strong family history of myocardial infarction overexpress adhesion molecules and react abnormally to stimulating agentsCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2005A. Paez Summary Atherosclerosis is a complex disease involved in major fatal events such as myocardial infarction and stroke. It is the result of interactions between metabolic, dietetic and environmental risk factors acting on a genetic background that could result in endothelial susceptibility. Our aim was to determine the patterns of expression of adhesion molecules and whether phosphatidylserine is translocated to the cell surface of human umbilical vein endothelial cells (HUVECs) isolated from healthy newborns born to parents with a strong family history of myocardial infarction under TNF-, or oxLDL stimulated conditions. Compared to control HUVECs, experimental cords showed: (a) a four-fold increase in VCAM-1 expression under basal conditions, which showed no change after stimulation with the pro-atherogenic factors; (b) a two-fold increase in basal P-selectin expression that reached a 10-fold increase with any of the pro-atherogenic factors; (c) a basal ICAM-1 expression similar to P-selectin that was not modified by the pro-atherogenic molecules; (d) a similar PECAM-1 expression. Unexpectedly, phospathidylserine expression in experimental cord HUVECs was significantly increased (211 817 versus 3354 TFU) but was not associated to apoptotic death as the percentage of dead cells induced by TNF-, treatment was very low (0·55 versus 9·87% in control HUVECs). The latter result was corroborated by TUNEL staining. T cell adherence to HUVECs was highly up-regulated in the genetically predisposed samples. The analysis of nonpooled HUVECs, from newborns to family predisposed myocardial-infarction individuals, might represent a useful strategy to identify phenotypical and functional alterations, and hopefully, to take early preventive actions. [source] Noninvasive peripheral perfusion index as a possible tool for screening for critical left heart obstructionACTA PAEDIATRICA, Issue 10 2007A de-Wahl Granelli Abstract Aim: Peripheral perfusion index (PPI) has been suggested as a possible method to detect illness causing circulatory embarrassment. We aimed to establish the normal range of this index in healthy newborns, and compare it with newborns with duct-dependent systemic circulation. Design: We conducted a case,control study. Setting: Our study population comprised 10 000 prospectively recruited newborns from Västra Götaland, Sweden. Patients: A total of 10 000 normal newborns and 9 infants with duct-dependent systemic circulation (left heart obstructive disease [LHOD] group) participated in the study. Methods: We conducted single pre- and postductal measurements of PPI with a new generation pulse oximeter (Masimo Radical SET) before discharge from hospital. Results: PPI values between 1 and 120 h of age show an asymmetrical, non-normal distribution with median PPI value of 1.70 and interquartile range of 1.18,2.50. The 5th percentile = 0.70 and 95th percentile = 4.50. All infants in the LHOD group had either pre- or postductal PPI below the interquartile range, and 5 of 9 (56%) were below the 5th percentile cut-off of 0.70 (p < 0.0001, Fisher's exact test). A PPI value <0.70 gave an odds ratio for LHOD of 23.75 (95% CI 6.36,88.74). Conclusion: PPI values lower than 0.70 may indicate illness and a value <0.50 (1st percentile) indicates definite underperfusion. PPI values might be a useful additional tool for early detection of LHOD. [source] Correlates of breastfeeding duration in an urban cohort from ArgentinaACTA PAEDIATRICA, Issue 8 2003S Berra Aim: To analyse factors associated with the duration of breastfeeding in a representative cohort of mothers and children, including socio-demographic and cultural characteristics, breastfeeding antecedents, perinatal factors and perinatal healthcare practices. Methods: The study was conducted in the city of Cordoba, between 1993 and 1998. Mother-child binomials from all public and private hospitals were asked to participate. Follow-up consisted of home visits at 30 d, 6, 12, 24, 36, 48 and 50 mo. Information was obtained on 650 healthy newborns. Cessation of breastfeeding during the first 24 mo of life was analysed using the Kaplan-Meier method, and factors associated with weaning were studied using Cox's proportional risk regression. Results. The median duration of breastfeeding was 4 mo. Factors associated with weaning were: the introduction of artificial formulas within 30 d postpartum [relative risk (RR) = 2.27; 95% confidence interval (CI) = 1.82,2.82]; breastfeeding of a previous child for less than 6 mo (RR=1.64; 95% CI = 1.32,2.02); delay in the first mother-child contact for over 90 min (RR=1.50; 95% CI = 1.17,1.93); mother's having completed primary or partially completed secondary education (RR= 1.40; 95% CI = 1.01,1.92) or completed secondary education or higher (RR= 1.59; 95% CI = 1.14,2.22); primiparous mother (RR= 1.39; 95% CI = 1.12,1.74) and; the mother recalling having been breastfed for less than 6 mo (RR = 1.27; 95% CI = 1.01,1.61). Conclusions. The purpose of strategies to promote breastfeeding should be to eliminate inappropriate care practices, such as delay in the first mother-child contact, as well as reducing the impact of other factors leading to the introduction of artificial milk. Moreover, mothers need more and better support from professionals and peers. [source] Plasma nitrite/nitrate and endothelin-1 concentrations in neonatal sepsisACTA PAEDIATRICA, Issue 5 2003J Figueras-Aloy Aim: To determine the changes in plasma nitrite/nitrate (NOx) and endothelin-1 (ET-1) concentrations during neonatal sepsis. Methods: In a prospective study, 60 consecutive newborns meeting the criteria for sepsis and without receiving exogenous nitric oxide (25 haemoculture-positive [HC+] and 35 haemoculture-negative [HC,]) were compared with 68 healthy newborns (46 full-term and 22 preterm). NOx and ET-1 concentrations were measured in each newborn within 48 h of diagnosis of sepsis and then every third day up to three determinations. SNAP-II and SNAPPE-II severity scores were performed at the moment of highest clinical severity. Results: At the beginning of the sepsis period, controls and septicaemic newborns had similar NOx and ET-1 levels, with the exception of infants with severe HC+ sepsis. Throughout the sepsis period, NOx increased in moderate HC+ sepsis and decreased in HC, sepsis, reaching a significant difference at the end of the study period (59.9 ± 72.7 vs 33.9 ± 15.3 ,mol/L; p= 0.036). Meanwhile, ET-1 in newborns with severe HC+ sepsis remained higher than that in the moderate HC+ sepsis group and HC, group, reaching significant differences in all the periods. The highest ET-1 value was positively correlated with SNAP-II and SNAPPE-II scores. Conclusion: NOx concentrations increased throughout the neonatal HC+ sepsis period, reaching significant differences after 7,9 d. The highest ET-1 levels in neonatal HC+ sepsis emerged before the NOx peak, at 3,5 d, and later decreased. Only newborns with severe HC+ sepsis presented a significant increase in ET-1 concentrations from the beginning of the septicaemic process. [source] | ||||||||||||||||||||||||||||