Determinants of underweight among lactating mothers in public health facilities, Siraro District, Southern Ethiopia: unmatched case-control study.

BACKGROUND: Ethiopia is reported to have one of the highest prevalence of underweight among lactating mothers in Africa. In our study setting, the nutritional report from the district health office showed a high number of underweight lactating mothers and recurrent malnutrition problems. However, the determinants of underweight among lactating mothers were not well understood in our study setting. The study aimed to assess the determinants of underweight among lactating mothers in public health facilities of Siraro District, Southern Ethiopia. METHODS: Unmatched case control study was conducted among 390 (130 cases and 260 controls) lactating mothers in public health facilities of Siraro District from April 30 to May 30/2022. Cases were lactating mothers with BMI < 18.5 kg/m2 and controls were mothers whose BMI was ≥ 18.5 kg/m2. To identify the determinants of underweight, bivariate and multivariable binary logistic regression analysis were carried out. The final model was interpreted using adjusted odds ratio (AOR), along with a 95% confidence interval (CI). Significance was declared at p-value < 0.05. RESULT: Multivariable logistic regression analysis revealed that having; antenatal care visits [AOR = 0.43, 95% CI (0.26,0.72)], latrine availability [AOR = 0.50,95% CI (0.27,0.93)], poor food consumption score [AOR = 5.40, 95% CI (3.15,9.27)], inadequate dietary diversity score [AOR = 1.66, 95% CI (1.20,2.78)], medium [AOR = 3.34, 95% CI (1.52,7.33)] and poor wealth index [AOR = 6.32, 95%CI(3.12,12.81)] were significantly associated with being underweight among lactating mothers. CONCLUSION: Antenatal care visits, latrine availability, poor food consumption scores, inadequate dietary diversity score, medium and poor wealth index were the determinants of underweight. A multi-sectoral approach focusing on latrine construction, economic empowerment and food diversification, as well as ongoing awareness creation, is essential to increase the nutritional status of lactating mothers and break the vicious cycle of malnutrition.

The effect of counseling with cognitive behavior approach on self-esteem and body image in lactating mothers: randomized clinical trial.

BACKGROUND: Some of the women experience low self-esteem and negative body image in pregnancy and postpartum. These two factors along with other factors can reduce the rate of exclusive breastfeeding among women. Cognitive-behavior therapy (CBT) is one of the psychological approaches that is effective on the betterment of many of the psychological and personality disorders such as body image disorders as well as improvement of self-esteem. The aim of this randomized control trial is to recognize the effects of CBT during pregnancy period on self-esteem, body image (primary outcome) and exclusive breastfeeding (secondary outcome). METHOD: In this randomized controlled trial, 70 eligible pregnant women referring to health centers of Tabriz- Iran were assigned to two groups of 35 as intervention and control groups using randomized blocking method. For intervention group, 8 sessions of CBT based on Cash and Strachan's body image protocol and Michael Free's for self-esteem were performed. Control group was received routine pregnancy care by their health provider. Rosenberg self-esteem scale and multidimensional body self-relation questionnaire (MBSRQ) were completed before intervention, immediately after intervention and 4 weeks after delivery. Likewise, exclusive breastfeeding questionnaire was completed 4 weeks after childbirth. Independent t-test, chi square and repeated measures ANOVA tests were used to analyze the data. RESULTS: According to repeated measures ANOVA test and with controlling baseline score, the mean scores on self-esteem (AMD): 7.18; 95%confidence interval (CI): 4.43 to 9.94; p < 0.001)) and body image (AMD: 49.74; 95%CI = 28.57 to 70.91; p < 0.001) in the intervention group were significantly higher than the control group. Also, after intervention, the mean score of body image subscales including appearance evaluation (p = 0.010), appearance orientation (p = 0.001), fitness evaluation (p = 0.004), fitness orientation (p = 0.001), health evaluation (p = 0.001), health orientation (p = 0.018), and illness orientation (p = 0.002) was significantly higher in the intervention group than the control group. CONCLUSIONS: CBT was effective on the improvement of self-esteem and body image and through which might lead to the increase of exclusive breastfeeding among women. TRIAL REGISTRATION NUMBER: IRCT20110524006582N33. First Date of registration: 17/10/2022. Submission ID 4ca86cd4-8459-4b86-9fe5-63f6a8184956.

Determinants of Malnutrition and its associated factors among pregnant and lactating women under armed conflict areas in North Gondar Zone, Northwest Ethiopia: a community-based study.

INTRODUCTION: Maternal malnutrition remains a major public health problem, particularly in low and middle-income countries and war-affected areas like Ethiopia. Malnourished pregnant and lactating women with low nutrient stores have babies with poor mental and physical development, increasing the risk of poor birth outcomes. Despite the fact that the majority of Ethiopian mothers are malnourished, there is little evidence in war-affected areas. Therefore, the objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant and lactating mothers in the war affected area of North Gondar Zone, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from April 10 to May 25, 2022. A multistage random sampling technique was used to select 1560 pregnant and lactating mothers. MUAC was to ascertain the outcome variable. Data was entered and analyzed by using EPI INFO version 3.5.3 and SPSS version 24, respectively. A multivariable logistic regression analysis was employed to identify the factors associated with acute malnutrition. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association. RESULTS: The prevalence of acute malnutrition among pregnant and lactating women was 34.3% at the 95% CI (31.9-36.8). The age of the mothers (AOR = 0.73; 95% CI: 0.54, 0.99), family size 6-8 (AOR = 1.21; 95% CI: 1.03, 1.82), and greater than or equal to 9 family sizes (AOR = 0.44; 95% CI: 0.19, 0.97), were significantly associated with acute malnutrition. CONCLUSIONS: In the current study, the prevalence of acute malnutrition among pregnant and lactating mothers is high in the study area. Mother's age and family size were factors associated with acute malnutrition in war-affected areas. As a result, mothers with large families will require special assistance to reduce the impact of malnutrition.

Undernutrition and associated factors among lactating mothers in rural Yilmana Densa District, Northwest Ethiopia: A community-based cross-sectional study.

Undernutrition is continued to be significant public health problem worldwide. The extra calories and nutrients required to support breastfeeding make lactating mothers at higher risk of malnutrition than general population. Undernourished lactating mothers have also been found to influence both the quantity and quality of breast milk and then the nutritional and health status of their offspring. Different evidence showed that undernutrition among lactating mothers is a serious public health problem in Ethiopia in which one of every four lactate mothers are undernourished. Despite this fact, the prevalence of undernutrition among lactating women in Ethiopian was not well investigated and very limited number of studies are conducted. This study aims to assess the prevalence of undernutrition and associated factors among lactating mothers in rural Yilmana Densa District, Northwest Ethiopia. A community-based cross-sectional study was conducted among 428 lactating mothers. The data were collected by using interviewers administered structured questionnaire; and also, anthropometric measurements were taken from the study participants. Binary logistic regression model was undertaken to identify significantly associated factors with undernutrition. The prevalence of undernutrition among lactating mothers was 22.6%. Household income, food security status, dietary diversity score, number of meals, potable water source, and latrine facility were found to be significantly associated with undernourishment of lactating mothers. A significant proportion of lactating mothers in the district suffered from undernutrition and hence, to improve nutritional status of lactating mothers, strategies should focus on nutrition counseling, advancing diversified production and consumption, improvement of access to potable water and latrine, as well as effective household food security interventions.

Utilization of Ambulance Services and Associated Factors during Pregnancy and Labor Among Lactating Mothers in Buno Bedele Zone, Southwest Ethiopia.

In Ethiopia, the use of ambulance services for urgent obstetric care improved institutional delivery and reduced maternal mortality. However, poor infrastructure, delayed response from dispatchers, and other socioeconomic factors influence service utilization. The present study assessed the utilization of ambulance services and associated factors during pregnancy and labor among lactating mothers in the Buno Bedele administrative zone of Southwest Ethiopia. Community-based cross-sectional study design with a sample of 792 lactating mothers was carried out. A multi-stage sampling technique was employed, and data were collected through structured questionnaire, and focus group discussions (FGD). Among the 792 study participants, 618 (78%) had antenatal care (ANC) follow up and 705 (89%) were aware of information on the availability of free ambulance services. Eighty one percent study participants requested for ambulance services, and 576 (79%) utilized during their pregnancy and delivery periods. Awareness of free ambulance service (AOR = 3, 95% CI [1.4, 7.1], P = .006), maternal formal education (AOR = 3.9, 95% CI [1.46, 9.8], P = .006) and ANC follow up (AOR = 4.5, 95% CI [8.9, 23.3], P = .001) were identified factors responsible for enhanced ambulance services utilization in the study area. The finding of the present study revealed that pregnant women had a higher tendency to use ambulance services during their obstetric emergency. However, poor communication and road infrastructure, as well as delayed dispatcher response hampered better service utilization.

Correlation between As, Cd, Hg, Pb and Sn concentration in human milk and breastfeeding mothers' food consumption: a systematic review and infants' health risk assessment.

Mothers' food and water consumption appear to be determining factors for infants' potentially toxic elements exposure through human milk. Therefore, this systematic review aimed to assess correlations between As, Cd, Hg, Pb and/or Sn concentration in human milk and breastfeeding mothers' food consumption, with later infants' health risk assessment. Estimated Daily Intakes of such elements by infants were also calculated and compared with reference values (RfD or BMDL01). Among 5.663 identified studies, 23 papers remained for analysis. Potentially toxic elements concentration in human milk presented positive correlation with seafood (As, Hg), fresh vegetables (Hg, Cd), cereals (Hg, Cd), cheese, rice, potatoes, private and well-water supply (Pb), wild meat (Pb, Cd) and milk, dairy products, dried fruits and oilseeds (Cd) mothers' consumption. Red meat, caffeinated drinks, and dairy products consume presented negative correlations (Pb). No correlations were found for Sn. Infants from three studies presented high Hg exposition through human milk (> 0. 1 µg/kg PC-1 day-1), as well as observed for Pb in one study (> 0. 5 µg/kg PC-1 day-1). Potentially toxic elements can damage infants' health when they are present in mothers' diet due to the infants' high vulnerability. Therefore, these results raise important issues for public health.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2056869 .

Human body burden of bisphenol A: a case study of lactating mothers in Florianopolis, Brazil.

Exclusive breast milk is the diet recommended by the World Health Organization (WHO) until 6 months of age. However, breastfeeding has the potential of transferring certain toxic chemicals from the mother to the infant. Bisphenol A (BPA) is a synthetic chemical used as a monomer in polycarbonate plastics and epoxy resins. Information on BPA concentration in the breast milk of lactating mothers is very limited; thus, this study aimed to determine the concentration of BPA in the colostrum of 64 post-partum women at a university-affiliated tertiary hospital in South Brazil. The results showed that all the breast milk samples contained a high concentration of BPA with a median value of 34.18 ng/mL. Furthermore, the concentration of BPA in mothers was influenced by the consumption of foods packaged in plastic packaging, especially when the plastic is heated (p = 0.0182). The total daily intake of BPA in breastfed infants was 19.5 µg/kg/day and 28.5 µg/kg/day was recorded at the 95th percentile of body weight per day, which is higher than the maximum daily intake estimated by the European Authority of Food Safety. These data showed a high concentration of BPA in the breastmilk of the lactating mothers which might be through the use of plastic containers as food/drink packages. This is of public health importance as the high concentration of BPA in their breast milk can be an indicator of potentially serious health problems in these mothers and much more in the babies breastfed with BPA-contaminated breast milk.

Human Milk output among mothers previously treated for severe acute malnutrition in childhood in Democratic Republic of Congo.

BACKGROUND: Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. METHODS: This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2-12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988-2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. RESULTS: The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). CONCLUSIONS: We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.

Magnitudes of Anemia and Its Determinant Factors Among Lactating Mothers in East African Countries: Using the Generalized Mixed-Effect Model.

Background: The number of studies on the magnitude of anemia and its determinant factors among lactating mothers is limited in East African countries regardless of its multivariate consequences. Even though few studies were conducted on the magnitude of anemia and its determinants, most of them focused on the country level and different parts of countries. Therefore, the current study is aimed to determine the magnitude of anemia and determinant factors among lactating mothers in East African countries. Methods: From nine East African countries, a total weighted sample of 25,425 lactating mothers was included in the study. Determinate factors of anemia were identified using generalized linear mixed models (GLMM). Variables with a p < 0.05 in the final GLMM model were stated to confirm significant association with anemia. Result: The magnitude of anemia in East African countries was found to be 36.5% [95% confidence interval (CI): 35.55%, 36.75%]. Besides, as for the generalized linear mixed-effect model, age, educational status, working status, country of residence, wealth index, antenatal care service, place of delivery, history of using family planning in a health facility, current pregnancy, and visited by fieldworker in the last 12 months were factors that have a significant association with anemia in lactating mothers. Conclusion: In East Africa, more than one-third of lactating mothers have anemia. The odds of anemia were significantly low among young mothers (15-34), who had primary education, were working, country of residence, and higher wealth index (middle and high). In addition, the likelihood of anemia was also low among lactating mothers who had antenatal care, used family planning, delivered at a health facility, were pregnant during the survey, and visited by fieldworkers. Therefore, promoting maternal care services (family planning, Antenatal Care (ANC), and delivery at health facilities) and a field visit by health extension workers are strongly recommended.

Assessment of dietary diversity and associated factors among lactating mothers in Debub Bench District.

OBJECTIVE: To identify dietary diversity and its associated factors among lactating women in the Debub Bench district. METHODS: Cross-sectional study design was conducted among 836 lactating women from January 1st to March 31st, 2019, in Debub Bench district. The outcome variable of the study was determined based on the proportion of lactating mothers who fed less than five major food groups to mothers who fed more than five major food groups out of nine (9) food groups. Lactating mothers who fed less than five of the major food groups were categorized under unacceptable dietary diversity. Data were first collected through face-to-face interviews by validated structured questionerers and then entered in Epi-data version 4.6.0.2 software. A bivariate and multivariate logistic regression analysis were later conducted using IBM SPSS version 26 software. During the analysis, multicollinearity was check by using the tolerance test and variance inflation factors (VIF), Hosmer-Lemeshow goodness of fit test was used to see model fitness, and adjusted odds ratios and their 95% confidence interval at P values ≤0.05 were considered to determine statistically significant factors. RESULT: A total of 836 lactating mothers had participated in the study. The response rate was 91.26%. The mean age of the participants was 29 years (SD ± 6.7). The study found that the magnitude of unacceptable dietary diversity score was 72.4% (95% CI: 69.5-75.5). The study also found that factors such as nutrition information (OR = 4, 95% CI: 2.64-6.08), absence of garden (OR = 2.35, 95% CI: 1.19-4.61), absence of latrine (OR = 6.86, 95% CI: 3.26-14.56) and household food insecurity (OR = 5.23, 95% CI: 3.64-7.46) were significantly associated with unacceptable dietary diversity. CONCLUSION: The finding of this study showed that information about nutrition, absence of latrine, absence of garden, and household food insecurity were significantly associated with dietary diversity. Based on the finding of the study, the following recommendations are made. First, strategies and programs targeted towards promoting dietary diversity and good health among lactating women should be made at all levels. Second, lactating mothers should be adequately provided with nutritional information. Three, mothers should be empowered to alleviate household food insecurity by leveraging their premises for gardening diversified and nutritious vegetables.

Trace element levels in mature breast milk of recently lactating Japanese women.

BACKGROUND: Many trace elements are essential for infant growth and development during early life. Their concentrations in breast milk vary depending on social and economic factors. Nonetheless, the present available values in Japan were derived from lactating mothers approximately 15 years ago. METHODS: Healthy mothers who gave birth to a single infant after 37 weeks of gestation at Teikyo University Hospital were recruited between July 2016 and December 2017. They were encouraged to collect breast milk samples and a self-administered food frequency questionnaire at 1 and 3 months postpartum. Anthropometric data for the mothers and their infants were also collected. Overall, 79 subjects were analyzed after excluding subjects with inadequate data in the food frequency questionnaire, insufficient breast milk samples, and medication that could affect dietary intakes. Trace element concentrations were determined by inductively coupled plasma mass spectrometry, and their correlation with several factors were investigated. RESULTS: Trace element concentrations were widely distributed as previously reported. Median concentrations of Cr, Mn, Fe, Cu, Zn, Se, and Mo were 0.8, 0.8, 98, 50, 272, 2.2, and 0.7 µg/dL at 1 month postpartum and 0.6, 0.7, 55, 33, 177, 2.1, and 0.7 µg/dL at 3 months postpartum, respectively. There were no correlations between trace element concentrations and either mothers' intakes or infants' growth. In contrast, there were significant correlations between several trace elements and macronutrients in addition to inter-element correlations among almost all trace elements. CONCLUSIONS: Trace element concentrations in mature breast milk were determined from recently lactating mothers in Japan.

The dynamic changes of gangliosides in breast milk and the intake of gangliosides in maternal and infant diet in three cities of China.

OBJECTIVE: To study the ganglioside intake of lactating mothers and its effect on the breast milk and infants. METHODS: The related information of mothers and infants was obtained by questionnaire survey, including the recipe, family information, and so on. The content of gangliosides in the mothers' food and breast milk was tested by HPLC-MS. The intake of gangliosides for infants was recorded and calculated. Then the dynamic changes of the content of gangliosides in breast milk and the impact on the development of infants were evaluated. RESULTS: GD3 was rich in milk and dairy products. The average intake of gangliosides for lactating mothers was 6.33 mg/day, of which GM3 was 3.02 mg/day and GD3 was 1.51 mg/day. The main food sources of gangliosides were meat (46.6%), eggs (26.6%), and dairy products (18.9%). The average content of gangliosides in breast milk was 9.58 mg/L. The content in 0-7 days after delivery (15.95 mg/L) was the highest, and then gradually decreased with time, getting the lowest in 6 months after delivery (6.47 mg/L). GM3 and GD3 were the two main types in breast milk. The average milk intake of infants under 6 months gradually increased from 570 mL to 1367 mL, and the daily intake of gangliosides was relatively stable, with a median of 6.4 mg. There was no significant relationship between the intake of gangliosides and physical development in infants. CONCLUSION: This study is the first to report the dietary ganglioside intake of Chinese city mothers. This study is also the first to indirectly infer the demand of infant ganglioside by detecting the components of breast milk. It will accumulate basic data for improving the diet of Chinese mothers and the recommended amount of infant nutrients.

[Dietary evaluation of 52 lactating mothers in Beijing in 2018 and its relationship with breast milk composition].

OBJECTIVE: To investigate the dietary nutrition status of lactating mothers in Beijing and the relationship between dietary nutrition level and breast milk composition. METHODS: Using convenient sampling, fifty-two lactating mothers were investigated and their breast milk was collected from May 2018 to July 2018. Dietary nutrient intake and the incidence of insufficiency nutrients intake were calculated. Dietary nutrient intake was compared with the dietary reference intake of Chinese residents. The relationship between dietary nutrition and breast milk composition was analyzed by multiple linear regression. RESULTS: The total energy intake was(1674. 15±655. 85) kcal, which was lower than the recommended value; protein(72. 77(45. 33, 92. 25)g), fat(66. 94(39. 26, 83. 83)g) and carbohydrates((208. 34±85. 77)g) were insufficient, of which the energy supply ratio of carbohydrates(49. 8%) was lower than the recommended value, while the protein(17. 39%) and fat(35. 99%) were higher than the recommended value. The insufficiency rate of vitamin A(73. 1%), folic acid(76. 9%), calcium(75. 0%) were also high. The ratio of energy produced by three meals was about 3∶4∶3, and the proportion of high-quality protein in dietary protein exceeded 50%. The fat(P=0. 007), dry matter(P=0. 006) and total energy(P=0. 006) in breast milk were affected by the protein in the diet, but protein(P=0. 283)and sugar(P=0. 307) in breast milk were not affected by dietary factors. CONCLUSION: The intakes of many nutrients of lactating mother are insufficient, especially energy and macronutrients. The fat, dry matter and total energy in breast milk are affected by the protein in the diet.

Correlation of serum levels of Vitamin D3 with serum parathormone in nursing mothers and infants 1-6 months' age from South Punjab, Pakistan.

BACKGROUND AND OBJECTIVE: Parathormone (PTH) and serum Vitamin D3 (VD3) share a complex interplay where increased VD3 leads to a negative response on parathormone level. Our objective was to determine the correlation of parathormone (PTH) and Vitamin D3 (VD3) levels in nursing mothers and infants 1-6 months' age from South Punjab, Pakistan. METHODS: This study is a secondary data analysis of previously conducted cross sectional study which was conducted at the Department of Pediatric Medicine, Nishtar Medical University, Multan, during August 2010 to June 2011. Study included 67 infants 1-6 months of age and 60 nursing mothers. A venous blood sample was drawn for estimation of VD3, calcium, phosphate, alkaline phosphatase, parathormone and albumin. Spearman correlation coefficient was calculated to determine the inverse correlation between PTH and VD3 levels. RESULTS: Mean age (in days) of the infants was 83±53.7 days whereas maternal mean age was 25.53 ± 4.12 years. Median VD3 level in infants was 20.90 ng/ml (IQR - 49.5). Median serum PTH levels were 20.90 pg/ml (IQR - 26.17). Median VD3 level in nursing mothers was 21.0 ng/ml (IQR 7.2- 43.8). Median maternal serum PTH levels were 20.89 pg/ml (IQR 2.9 - 232.4). Substantial negative relation between VD3 and parathormone in infants and mothers was not evident (r = - 0.027, p-value 0.83) and (r = 0.156, p-value 0.23) respectively. A significant positive association between infant and maternal VD3 was observed (rs -0.55, p-value < 0.001). CONCLUSION: Our study affirms that the customary negative correlation between VD3 and parathormone levels does not exist.

The Extent of Maternal Nutritional Knowledge and Practice During Lactation in Kombolcha Town, South Wollo Zone, Ethiopia: A Mixed Study Design.

OBJECTIVE: The study aimed to assess nutritional practice and its associated factors among lactating mothers in Kombolcha Town, South Wollo Zone, Amhara Region, Ethiopia, 2017. DESIGN AND SETTING: A community-based cross-sectional study design supplemented with qualitative research was conducted at Kombolcha Town from October 23 to November 10, 2017. A systematic sampling technique was used to select the study participants from listed households and purposive sampling was used for the qualitative inquiry. PARTICIPANTS: A total of 425 lactating mothers were interviewed using a pre-tested structured questionnaire. The data were analyzed using Statistical Package for Social Sciences version 23. For the qualitative data, thematic content analysis was used. Multiple logistic regression was used to evaluate the association between nutritional practice with independent variables. THE RESULTS: Lactating mothers who had good nutritional practice and knowledge were 28.7% (95% CI: 24.9%, 33.5%) and 52.0% (95% CI: 47.1%, 57.6%) respectively. This study revealed that government-employed mothers (AOR=6.0, 95% CI: 1.953, 18.485) and mothers with good nutritional knowledge (AOR=3.12, 95% CI: 1.832, 5.318) had statistically significant associations with nutritional practices of lactating mothers. CONCLUSIONS AND RECOMMENDATIONS: The nutritional practices and knowledge of lactating mothers were low in the study area. The mother's occupation and nutritional knowledge were significantly associated with nutritional practice. Hence, the provision of maternal nutritional education regarding a healthy diet, and timely and regular dissemination of nutritional information were recommended.

Incidental Trifid Median Nerve Unveiled in a Lactating Mother.

Several anatomical variations concerning the median nerve have surfaced in the medical literature. Among them, bifid median nerve or median nerve bifurcation with or without persistent median artery has been widely reported. Sporadic case reports describe median nerve trifurcation (trifid median nerve) as well. In the present report, we describe carpal tunnel syndrome manifestations in association with trifid median nerve unveiled incidentally under high-frequency musculoskeletal ultrasonogram in a lactating mother-a first in the medical literature.

Efficacy and Safety of Adsorptive Granulocyte and Monocyte Apheresis in Elderly and Pregnant Patients With Ulcerative Colitis.

In patients with active ulcerative colitis (UC), adsorptive granulocyte/monocyte apheresis (GMA) is expected to promote remission. We conducted a retrospective cohort study to evaluate the efficacy and safety of GMA in patients with active UC. Twenty-one UC patients including five pregnant or lactating mothers and four elderly patients (aged >60 years) received up to 10 GMA sessions. UC severity was evaluated at baseline and after GMA therapy according to Lichtiger's Clinical Activity Index (CAI). We defined clinical remission as CAI ≤4. Overall, the median CAI score after GMA therapy had decreased from 9 to 4 (P < 0.001). The clinical remission rate was 62%, but in the elderly and pregnant or lactating mothers, the remission rates were 100% and 60%, respectively. No severe adverse effects were seen in this study. Our results may support GMA as an effective and safe treatment for active UC patients, including elderly patients and pregnant cases.

Correlation of Serum Vitamin D Levels in Lactating Mothers and Their Infants.

BACKGROUND: Although Vitamin D deficiency is highly prevalent in Indians, data on Vitamin D eficiency in lactating mothers and exclusively breast fed infants is inadequate. OBJECTIVE: This study was done to evaluate the prevalence of Vitamin D deficiency in lactating mothers and their infants and to find out any correlation between them. MATERIALS AND METHODS: This hospital based, cross sectional study included 200 healthy infants between 1-30 days and their mothers. Serum sample was collected from both for Ca, inorganic phosphate (IP), alkaline phosphatase (ALP), and 25(OH)D. RESULTS: Mean serum 25(OH)D level of mothers was 11.33 ± 5.86 ng/ml with a range of 2-37 ng/ml. Hypovitaminosis D was defined as serum 25(OH)D level <10 ng/ml. Almost 94 (47%) of mothers were having hypovitaminosis D. Mean serum 25(OH)D level of infants was 11.92 ± 7.89 ng/dl with a range of 2.5-68 ng/dl. Ninety (45%) infants were having hypovitaminosis D. There was a moderate positive correlation between individual mothers' and infants' serum 25(OH)D values (Pearson coefficient = 0.516, P < 0.001). Using logistic regression, it was found that infants born to mothers with hypovitaminosis D carry a 4.47 times more risk of developing hypovitaminosis D as compared to infants born to mothers with normal serum 25(OH)D (Odds ratio = 4.47, P < 0.001). CONCLUSION: This study shows a high prevalence of Vitamin D deficiency in lactating mothers and their breastfeeding infants with a positive correlation between them. These results provide a justification for adequate Vitamin D supplementation of all exclusively breastfeeding infants and highlight the urgent need to improve maternal Vitamin D status.

Absence epileptic activity in Wistar Albino Glaxo Rijswijk rat mothers.

Absence epileptic activity was analyzed during pregnancy, the postpartum period and after weaning to establish alterations of seizures throughout the reproductive cycle. Wistar Albino Glaxo Rijswijk (WAG/Rij) rats were used in the study as a model of absence epilepsy and because their seizures do not interfere with rearing offspring. The number of spike-wave discharges (SWDs) was gradually elevated from the 19th pregnancy day to delivery. Meanwhile, the characteristics of individual SWDs did not change suggesting that SWD generation remained the same. In the postpartum and postweaning periods, the number of SWDs was not increased in the absence of pups. However, returning the pups to mothers resulted in a markedly elevated number of SWDs for 1h. If pups were taken away after 30min, the number of SWDs dropped immediately suggesting that the presence of pups increased the SWD number. The time mothers spent with the litter and in kyphosis suckling posture were in correlation with their SWD number further suggesting the importance of interaction with pups in SWD induction. Suckling elevates prolactin levels but surprisingly, its intracerebroventricular injection markedly reduced SWD number in suckled WAG/Rij mothers suggesting that the SWD-inducing effect of suckling is not mediated by prolactin. Rather, the elevated prolactin level may provide some protection against pro-epileptic effects of suckling. In conclusion, we first identified periods within the reproductive cycle with increased absence epileptic activity, implying that more attention should be devoted to epileptic activity changes in mothers.

NUTRITIONAL STATUS OF LACTATING MOTHERS AND THE COMPOSITION OF THEIR BREAST MILK / 营养学报

Two hundred and forty mothers and their milk secretion were investigated in Hu-bei district. 130 of them were workers in the urban district and 110 peasants in the rural area of Tian-men County. Milk secretion, dietary intake and the composition of breast milk were examined. The overall mean energy intake of lactating mothers were over 2700 kcal/day both in urban and rural lactating mothers. The amounts of protein ingested were over 90g/ day in urban and more than 70g/day in rural women. The protein intakes in the first two months were significantly higher than in the remaining months. The animal and soybean protein in rural women were lower than in urban. Both the amounts of ingested fat and carbohydrate were suitable. The milk secretion of urban lactating mothers was higher than rural. The protein content of breast milk fall steeply from an initially high level during the first seven days and then more slowly up to at least the second month. The fat content was usually low during the first few days of lactation, but increased slowly to a level which was characteristic of the individual by the second month. The lactose content of urban was lower than rural. The body weights of babies in both urban and rural were nearly the same in the first three months. After forth month the growth rate of the rural infants was slower than the urban infants. So the weaning foods to provide to infants in the rural area was more urgent.