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1.
Am J Perinatol ; 37(S 02): S46-S53, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32898882

RESUMO

OBJECTIVE: We aimed at reviewing the currently available guidelines and scientific recommendations regarding the neonatal in-hospital management and feeding in the light of the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: We systematically searched the guideline databases, Medline, Embase, and nationale/international neonatal societies websites as of June 19, 2020, for guidelines on neonatal management and feeding during the COVID-19 pandemic, at the same time assessing the methodological quality using the Appraisal of Guidelines for Research and Evaluation II tool. RESULTS: Eleven guidelines were included. The Chinese and American recommendations suggest separation of the mother and her neonate, whereas in French, Italian, UK, Canadian, and World Health Organization consensus documents the rooming-in is suggested, with Centers for Disease Control and Prevention guidelines suggesting to decide on a case-by-case basis. All the guidelines recommend breastfeeding or feeding with expressed maternal milk; the only exception is the Chinese recommendations, these last suggesting to avoid breastfeeding. CONCLUSION: This review may provide a useful tool for clinicians and organizers, highlighting differences and similarities of the existing guidelines on the management and feeding strategies in the light of the COVID-19 pandemic. KEY POINTS: · This study compares guidelines on management and nutrition of a newborn born to a mother with SARS-CoV-2 infection.. · Existing guidelines on neonatal management and nutrition during the SARS-CoV-2 pandemic show many differences.. · The majority of recommendations are mainly based on experts' opinion and are not evidence-based..


Assuntos
Aleitamento Materno/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Leite Humano , Pandemias , Organização Mundial da Saúde
2.
FP Essent ; 496: 11-15, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32902241

RESUMO

the first 6 months of life to achieve optimal growth, development, and health. The World Health Organization recommends continuation of breastfeeding, with the addition of complementary foods, for at least 2 years. Despite this guidance, while most newborns and infants in the United States receive some breast milk, most are not exclusively breastfed, and breastfeeding frequently is discontinued earlier than recommended. The reasons for noninitiation or early cessation of breastfeeding are multifactorial. Commonly cited reasons for early discontinuation of breastfeeding include lactation and latching issues, concerns about infant nutrition and weight, concerns about taking drugs while breastfeeding, milk pumping, unsupportive work policies, and lack of social support. Racial and ethnic disparities exist regarding the initiation and duration of breastfeeding.


Assuntos
Aleitamento Materno , Comportamentos Relacionados com a Saúde , Grupos Étnicos , Feminino , Humanos , Lactente , Recém-Nascido , Apoio Social , Estados Unidos
3.
Int Breastfeed J ; 15(1): 68, 2020 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-32762723

RESUMO

BACKGROUND: In China, mothers with confirmed or suspected COVID-19 pneumonia are recommended to stop breastfeeding. However, the evidence to support this guidance is lacking. There have been relatively few cases reported about direct breastfeeding an infant by a mother with SARS-CoV-2 pneumonia. Therefore, it is necessary to assess the safety of breastfeeding and the possible protective effects of breast milk on infants. CASE PRESENTATION: This report analyzes the case of a mother who continued breastfeeding her 13 month-old child when both were diagnosed with confirmed COVID-19 pneumonia. We describe the clinical presentation, diagnosis, treatment, and outcome. The presence of SARS-CoV-2 nucleic acid was determined in maternal serum, breast milk, nasopharyngeal (NP) swabs and feces, and in infant serum, NP swabs and feces. IgM and IgG antibodies against SARS-CoV-2 were assessed in maternal serum and breast milk and in infant serum. SARS-CoV-2 nucleic acid was not detected in the breast milk, and antibodies against SARS-CoV-2 were detected in the mother's serum and milk. CONCLUSIONS: The present case further confirms that the possibility of mother-to-child transmission about SARS-CoV-2 via breast milk alone was very small, and breast milk is safe for direct feeding of infants.


Assuntos
Anticorpos Antivirais/análise , Betacoronavirus/isolamento & purificação , Aleitamento Materno , Infecções por Coronavirus/transmissão , Leite Humano/virologia , Pneumonia Viral/transmissão , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
4.
Int Breastfeed J ; 15(1): 69, 2020 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-32770999

RESUMO

BACKGROUND: The first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants. METHODS: A series of 22 case studies of newborns to mothers with COVID-19 infection from March 14th to April 14th, 2020 was conducted. Mothers and newborns were followed for a median period of 1.8 consecutive months. RESULTS: Out of 22 mothers, 20 (90.9%) chose to breastfeed their babies during hospital admission. Timely initiation and skin to skin contact at delivery room was performed in 54.5 and 59.1%, respectively. Eighty two percent of newborns to mothers with COVID-19 were fed with breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 (37.5%) mothers with COVID-19 required transitory complementary feeding until exclusive breastfeeding was achieved. During follow-up period, there were no major complications, and no neonates were infected during breastfeeding. CONCLUSIONS: Our experience shows that breastfeeding in newborns of mothers with COVID-19 is safe with the adequate infection control measures to avoid mother-baby contagion. Supplementing feeding with pasteurized donor human milk or infant formula may be effective, until exclusive breastfeeding is achieved.


Assuntos
Betacoronavirus , Aleitamento Materno/métodos , Infecções por Coronavirus/complicações , Leite Humano , Pneumonia Viral/complicações , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Mães/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
5.
Adv Exp Med Biol ; 1252: 9-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816257

RESUMO

Physical exam of the breast is a very important part of breast assessment both for breast cancer screening, and when approaching breast lesions. Examination during pregnancy and breastfeeding follows exactly the same method as non-pregnancy periods. However, physical changes that occur in the breast during these times due to hormonal effects cause alterations that can on one hand conceal some pathologic disorders, and may on the other hand appear as pathologic findings while being purely physiologic. This chapter focuses first on some key points for an accurate breast examination, and then reviews some challenging controversial findings that may be noticed during breast exam in a pregnant or lactating woman.


Assuntos
Doenças Mamárias/diagnóstico , Mama/anatomia & histologia , Mama/patologia , Lactação/fisiologia , Exame Físico , Mama/fisiologia , Doenças Mamárias/patologia , Aleitamento Materno , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Feminino , Humanos , Gravidez
6.
Adv Exp Med Biol ; 1252: 33-39, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816260

RESUMO

The breast tissue undergoes significant physiological change during pregnancy and lactation. These changes can give rise to some unique disorders during pregnancy , puerperium and lactation or exaggerate pre-existing conditions. Clinical examination becomes less reliable due to textural change and density of breast tissue as a result of hormonal changes. The main symptoms during pregnancy and lactation are breast pain, mastitis, lactational abscess, breast lump, and blood- stained nipple discharge.Lactational mastitis/ abscess must be treated without delay. Open incision and drainage of lactational abscess is rarely required, any lactational abscess should be treated with appropriate antibiotics and ultrasound guided aspiration of the pus.Any breast lump during pregnancy and lactation should be investigated with triple assessment. Pregnancy associated breast cancer (PABC ) must be ruled out. The choice of investigations and treatment needs careful consideration. While ultrasound is the investigation of choice, mammography can be performed with abdominal shielding if malignancy is suspected. Core biopsy is necessary for evaluation of any breast pathology but it comes with risk of infection, bleeding, hematoma and even milk fistula.The treating clinical specialist must be aware of certain unusual unique clinical conditions in pregnancy and lactation including accessory axillary breast tissue, gigantomastia and Raynaud's phenomenon.


Assuntos
Doenças Mamárias/diagnóstico , Doenças Mamárias/fisiopatologia , Lactação , Complicações na Gravidez , Abscesso , Mama , Doenças Mamárias/patologia , Aleitamento Materno , Feminino , Humanos , Mastite , Gravidez
7.
Adv Exp Med Biol ; 1252: 53-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816262

RESUMO

Breastfeeding is immunoprotective and World Health Organization recommends exclusive breastfeeding for about six months with continuation of breastfeeding for one year or longer as mutually desired by mother and infant. But the target for duration of exclusive breastfeeding has not been reached in a significant number of women. It may be due to inflammatory breast disease such as milk stasis or lactational mastitis.In this chapter we discuss the most common complications of breastfeeding including milk stasis, mastitis, and breast abscess. Also idiopathic granulomatous mastitis, a less common condition, is discussed due to its confusing characteristics and not universally-accepted treatment strategies .Breastfeeding mastitis is inflammation of the breast that can be infectious or non-infectious. With proper diagnosis and treatment of this condition, more severe complications like breast abscess could be avoided, so that breastfeeding could be continued in some circumstances.


Assuntos
Abscesso , Aleitamento Materno , Mastite Granulomatosa , Lactação , Mastite , Empiema Pleural , Feminino , Humanos
8.
Adv Exp Med Biol ; 1252: 63-72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816263

RESUMO

Papillomas, atypical hyperplasias, and lobular carcinoma in situ of the breast are not malignant tumors, but present serious management challenges when they are diagnosed in a breast biopsy . Upgrading after excision and increased possibility of future cancer are risks that accompany these lesions. While some features have been defined as high-risk for upgrading, many practitioners now recommend conservative non-surgical treatment and vacuum-assisted biopsy . However, the challenge gets worse when the patient is pregnant or breastfeeding because of the limitations in imaging and treatment in relation to the fetus. This chapter deals with these problems, although the best management strategy cannot be defined because of lack of evidence at present.


Assuntos
Aleitamento Materno , Lactação , Lesões Pré-Cancerosas , Complicações na Gravidez , Mama , Neoplasias da Mama , Feminino , Humanos , Hiperplasia , Gravidez
9.
Adv Exp Med Biol ; 1252: 101-105, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816268

RESUMO

During pregnancy and lactation, breast vascularity increases and edema occurs in the breast . As a consequence, rate of complications of breast biopsy and surgery like bleeding, infection, delayed healing and wound dehiscence is expected to be higher. Milk fistula is a rare event that may complicate surgery or needle biopsy of the breast in a breastfeeding woman, or in late stages of pregnancy . Suppression of lactation has been proposed in the literature as both a preventive and a therapeutic step. However, the advantages of nursing for both mother and child are numerous, and the author do not propose it as a preventive measure nor as a must in treatment of milk fistula. Prevention and management of milk fistula are discussed in this chapter.


Assuntos
Mama/cirurgia , Lactação , Complicações na Gravidez , Biópsia por Agulha , Aleitamento Materno , Neoplasias da Mama/cirurgia , Feminino , Fístula/etiologia , Fístula/prevenção & controle , Fístula/terapia , Humanos , Lactente , Leite Humano , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/terapia
10.
Adv Exp Med Biol ; 1252: 159-163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816277

RESUMO

Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for the baby. Unfortunately, many drugs taken by the mother may pass into her milk and exert an effect on the newborn. Very limited data is available and a cautionary approach is warranted especially when the woman receives anticancer treatment including chemotherapy , hormonal treatment and the recently introduced target agents as well as monoclonal antibodies. In all these conditions breastfeeding should be put on hold.More and more often physicians are faced with women that are pregnant years after the diagnosis of cancer: this has long been considered dangerous for the mother, but data show that prognosis is definitely not worse. If the woman is no longer being actively treated, breastfeeding is advisable every time it is possible, even if patients that received breast radiation may be unable to produce a sufficient amount of milk on that side.


Assuntos
Aleitamento Materno , Neoplasias da Mama/terapia , Lactação , Complicações Neoplásicas na Gravidez/terapia , Mama/efeitos da radiação , Feminino , Humanos , Recém-Nascido , Lactação/efeitos da radiação , Leite Humano/metabolismo , Gravidez , Fatores de Tempo
11.
Adv Exp Med Biol ; 1252: 195-197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816282

RESUMO

Pregnancy and lactation represent the most effective protective elements against breast cancer; counter-intuitively breast cancer incidence shows a small but noticeable increase up to 5 years after delivery. The cumulative effect is however favourable and women show a reduction in breast cancer risk which is proportional to the total duration of lactation and to the number of full-term pregnancies.


Assuntos
Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Lactação , Gravidez , Fatores de Proteção , Aleitamento Materno , Feminino , Humanos , Fatores de Risco
12.
Adv Exp Med Biol ; 1252: 199-207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816283

RESUMO

Young breast cancer patients face numerous challenges during the cancer trajectory. As in the last decade, women tend to delay pregnancies to a later time in life, and clinicians are often faced with young breast cancer patients who want to start a family or complete it. Becoming a mother is a delicate developmental process in which the woman redefines and restructures her identity as she gets prepared for her new role and responsibilities. When there is a history of cancer or cancer diagnosis is communicated during the pregnancy, fears, worries, and concerns emerge and specific support may be necessary. Follow-ups during the post-partum period are also recommended as lactation issues should not be overlooked. In this chapter, we analyze the psychological aspects of cancer survivors and women with pregnancy-associated breast cancer, and the management of these issues.


Assuntos
Neoplasias da Mama/psicologia , Lactação/psicologia , Complicações Neoplásicas na Gravidez/psicologia , Ansiedade , Aleitamento Materno , Feminino , Humanos , Período Pós-Parto/psicologia , Gravidez
14.
Breastfeed Med ; 15(8): 488-491, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32614251

RESUMO

Background: Limited data are available on the perinatal and postnatal transmission of novel coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) recommended breastfeeding with necessary precautions to mothers with COVID-19. Case Presentation: A 20-year-old pregnant woman with no symptoms of COVID-19 presented to the hospital for delivery at 39 weeks of gestation. She was tested for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR) because her father had been diagnosed with COVID-19. A nasopharyngeal swab RT-PCR test was positive for SARS-CoV-2. Therefore, the baby and the mother were cared for separately after delivery. Breast milk obtained after first lactation was tested by real-time RT-PCR and was positive for SARS-CoV-2. Conclusions: In this article, we aimed to report the presence of SARS-CoV-2 in breast milk. Although further studies are needed, this situation may have an impact on breastfeeding recommendations.


Assuntos
Betacoronavirus/isolamento & purificação , Aleitamento Materno , Infecções por Coronavirus , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Leite Humano/virologia , Pandemias , Pneumonia Viral , Complicações Infecciosas na Gravidez , Adulto , Doenças Assintomáticas/terapia , Aleitamento Materno/efeitos adversos , Aleitamento Materno/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/prevenção & controle , Parto Obstétrico , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/fisiopatologia
15.
Breastfeed Med ; 15(8): 492-494, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32644841

RESUMO

Aim: The objective of our study was to determine whether the SARS-CoV-2-positive mothers transmit the virus to their hand-expressed colostrum. Methods: This is an observational prospective study that included pregnant women who tested positive for SARS-CoV-2 by PCR test on a nasopharyngeal swab at the moment of childbirth and who wanted to breastfeed their newborns. A colostrum sample was obtained from the mothers by manual self-extraction. To collect the samples, the mothers wore surgical masks, washed their hands with an 85% alcohol-based gel, and washed their breast with gauze that was saturated with soap and water. Results: We obtained seven colostrum samples from different mothers in the first hours postdelivery. SARS-CoV-2 was not detected in any of the colostrum samples obtained in our study. Conclusion: In our study, breast milk was not a source of SARS-CoV-2 transmission. Hand expression (assuring that a mask is used and that appropriate hygienic measures are used for the hands and the breast), when direct breastfeeding is not possible, appears to be a safe way of feeding newborns of mothers with COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Aleitamento Materno/métodos , Extração de Leite/métodos , Colostro/virologia , Infecções por Coronavirus , Leite Humano/virologia , Pandemias , Pneumonia Viral , Complicações Infecciosas na Gravidez , Adulto , Técnicas de Laboratório Clínico/métodos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Triagem Neonatal/métodos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Espanha/epidemiologia
16.
PLoS One ; 15(7): e0236080, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667942

RESUMO

BACKGROUND: Exclusive breastfeeding (EBF) means that an infant should be breastfed only for the first six months of life to achieve optimal child development and to prevent infant morbidity and mortality. The aim of this analysis was to determine the individual-, household-, and community-level factors associated with EBF practice in Bangladesh. METHODS: A total of 1,440 women-child pairs data were analysed extracted from 2011 and 2014 Bangladesh Demographic and Health Survey. Multilevel logistic regression models were used separately for individual-, household-, and community level factors to identify the different level of factors associated with EBF practice. RESULTS: Around 61% women in Bangladesh practiced EBF with significant variation across several individual-, household-, and community-level factors. At the individual level, higher odds of EBF practice was found among mothers' received higher number of antenatal care and lower age of child. Mothers' higher education and engagement in formal jobs were found negatively associated with EBF practice. At the community level, higher odds of EBF was found among women live in Barishal, Dhaka, and Rajshahi divisions, and resided in the community with moderate level of female education, higher level of fertility, and higher use of antenatal and delivery care. CONCLUSIONS: One in every three children in Bangladesh do not breastfeed exclusively which needs special attention for the policymakers. In this case, educated women engaged in income generating activities and women did not use antenatal care should be given priority. At the community level, priority should be given for the women's resides in the community with lower level of antenatal and delivery healthcare services use.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Mães/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Bangladesh , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
17.
PLoS One ; 15(7): e0235080, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639959

RESUMO

Detailed information about the lives and deaths of children in antiquity is often in short supply. Childhood dietary histories are, however, recorded and maintained in the teeth of both juveniles and adults. Primary tooth dentinal collagen does not turn over, preserving a sequential record of dietary changes. The use of nitrogen (δ15N) and carbon (δ13C) isotope values of incrementally sampled dentin are used in the study of breastfeeding practices but evidence for the addition of weaning foods, both in terms of mode and, particularly, duration, has remained analytically inaccessible to date. Here, we demonstrate how the novel use hydrogen isotope (δ2H) values of sequentially micro-sampled dentin collagen, measured from individuals excavated from a Punic cemetery, in Sardinia, Italy, can serve as a proxy for weaning food type and duration in ancient childhood diet. The weaning rate and age, based on the decline in δ15N and δ13C values of permanent first molars and the concomitant increase in δ2H, appears to be broadly similar among six individuals. Hydrogen isotopes vary systematically from a low value soon after birth, rising through early childhood. The early post-birth values can be explained by the influence of 2H-depleted lipids from mother's breastmilk and the later δ2H rise is consistent with, among other things, a substantial portion of boiled foodstuffs, such as the higher δ2H values observed in porridge. Overall δ2H in dentin shows great promise to elucidate infant and childhood feeding practices, and especially the introduction of supplementary foods during the weaning process.


Assuntos
Dieta/história , Aleitamento Materno/história , Pré-Escolar , Colágeno/análise , Dentina/química , Deutério/análise , Feminino , História Antiga , Humanos , Lactente , Itália , Desmame
18.
PLoS One ; 15(7): e0235888, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649685

RESUMO

BACKGROUND: Puerperal period is an important and thought-provoking period for puerperal mothers. Surprisingly, reports have indicated that there is increasing number of women resuming menstruation within six weeks of childbirth (puerperal menstruation). To the best of knowledge, there is no prior study on predictors of puerperal menstruation. OBJECTIVE: To determine frequency and predictors of puerperal menstruation. METHODS: This was a single tertiary health institution cross-sectional study at ESUT Teaching Hospital, Parklane, Enugu, Nigeria that included data from May 2015 to December 2018. Women were interviewed at the end of the first six weeks of their childbirth. Women with HIV positive or had uterine rupture or peripartum hysterectomy were excluded. Bivariate analysis was performed by the chi-squared test and conditional logistic regression analysis was used to determine variables associated with puerperal menstruation. Statistical significance was accepted when P- value is <0.05. RESULTS: A total of 371 women met the inclusion criteria. The return of menses within 6 weeks was present in 118(31.8%) women versus 253 (68.2%) women without puerperal menstruation, given a ratio of 1:3. Of the 371 women, 249 (67.1%) were on exclusive breastfeeding. The significant associated risk factors were age (p = 0.009), parity (p<0.001), early use of family planning (p = 0.001), socio-economic status (p<0.001) and manual removal of placenta (p = 0.007). At conditional logistic regression analysis, early use of family planning (p = 0.001), exclusive breastfeeding (p = 0.027) and manual removal of placenta (p = 0.012) were independently associated with puerperal menstruation. Induction/augmentation of labor, postpartum misoprostol use and mode of delivery were not statistically significant (p>0.05, for all). CONCLUSION: One in 3 women resumes menstruation within 6 weeks of childbirth. The major predictor was early initiation of family planning, and exclusive breastfeeding with manual removal of placenta a major protective factor. These interesting issues require further investigation to better understand the mechanism of puerperal menstruation.


Assuntos
Menstruação , Período Pós-Parto , Adulto , Aleitamento Materno , Estudos Transversais , Parto Obstétrico , Serviços de Planejamento Familiar , Feminino , Humanos , Lactação , Nigéria , Fatores Socioeconômicos , Adulto Jovem
19.
PLoS One ; 15(7): e0235223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614839

RESUMO

BACKGROUND: The naïve neonatal gut is sensitive to early life experiences. Events during this critical developmental window may have life-long impacts on the gut microbiota. Two experiences that have been associated with variation in the gut microbiome in infancy are mode of delivery and feeding practices (eg, breastfeeding). It remains unclear whether these early experiences are responsible for microbial differences beyond toddlerhood. AIMS: Our study examined whether mode of delivery and infant feeding practices are associated with differences in the child and adolescent microbiome. DESIGN, SUBJECTS, MEASURES: We used an adoption-sibling design to compare genetically related siblings who were reared together or apart. Gut microbiome samples were collected from 73 children (M = 11 years, SD = 3 years, range = 3-18 years). Parents reported on child breastfeeding history, age, sex, height, and weight. Mode of delivery was collected through medical records and phone interviews. RESULTS: Negative binomial mixed effects models were used to identify whether mode of delivery and feeding practices were related to differences in phylum and genus-level abundance of bacteria found in the gut of child participants. Covariates included age, sex, and body mass index. Genetic relatedness and rearing environment were accounted for as random effects. We observed a significant association between lack of breastfeeding during infancy and a greater number of the genus Bacteroides in stool in childhood and adolescence. CONCLUSION: The absence of breastfeeding may impart lasting effects on the gut microbiome well into childhood.


Assuntos
Aleitamento Materno , Microbioma Gastrointestinal , Fórmulas Infantis , Adolescente , Bactérias/classificação , Bactérias/isolamento & purificação , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino
20.
Int Breastfeed J ; 15(1): 67, 2020 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-32711567

RESUMO

BACKGROUND: In an effort to prevent infants being infected with SARS-CoV-2, some governments, professional organisations, and health facilities are instituting policies that isolate newborns from their mothers and otherwise prevent or impede breastfeeding. WEIGHING OF RISKS IS NECESSARY IN POLICY DEVELOPMENT: Such policies are risky as was shown in the early response to the HIV pandemic where efforts to prevent mother to child transmission by replacing breastfeeding with infant formula feeding ultimately resulted in more infant deaths. In the COVID-19 pandemic, the risk of maternal SARS-CoV-2 transmission needs to be weighed against the protection skin-to-skin contact, maternal proximity, and breastfeeding affords infants. CONCLUSION: Policy makers and practitioners need to learn from the mistakes of the HIV pandemic and not undermine breastfeeding in the COVID-19 pandemic. It is clear that in order to maximise infant health and wellbeing, COVID-19 policies should support skin-to-skin contact, maternal proximity, and breastfeeding.


Assuntos
Infecções por Coronavirus/transmissão , Infecções por HIV/epidemiologia , Política de Saúde , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral/transmissão , Betacoronavirus , Aleitamento Materno , Infecções por Coronavirus/epidemiologia , Humanos , Relações Mãe-Filho , Apego ao Objeto , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Fatores de Risco , Organização Mundial da Saúde
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