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1.
Sci Total Environ ; 858(Pt 1): 159820, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36349623

RESUMEN

Parabens, triclosan (TCS), and triclocarban (TCC) are antimicrobial additives that are widely used in personal care products (PCPs) and may dysregulate infant gut microbiota and induce a series of chronic diseases. Dietary intake may be an underestimated exposure route of such antimicrobial additives in infants, but relevant data remain scarce. Therefore, this study determined five common preservatives, including methyl- (MeP), ethyl- (EtP), propyl- (PrP), butyl- (BuP), and benzyl-paraben (BeP), and two antimicrobials TCS and TCC, in major infant food sources (breastmilk, milk-based infant formula [MIF], and cereal-based complementary food [CCF]) in southern China. The health risks associated with dietary exposure among infants across different months of age were also evaluated. The results demonstrated a high incidence of MeP, EtP, PrP, and BeP in processed infant food products, while TCS and TCC were mainly detected in maternal breastmilk. Notably, MeP and EtP were found in all of the MIFs tested, while MeP, EtP, and BeP were detected in 85.6 %-100 % of the CCFs. By incorporating the human equivalent dose and an additional 10-fold margin of safety for infants into the health risk assessment, the 95th percentile hazard quotient of PrP via the ingestion of breastmilk among neonates exceeded 1. For the first time, the results showed that exposure to PrP via breastmilk intake may pose a considerable health risk to urban neonates in southern China. The health risks caused by antimicrobial exposure via ingesting MIF and CCF among infants were negligible. Thus, we recommend breastfeeding women reduce their consumption of PCPs and processed food, especially during the first month after delivery.


Asunto(s)
Antiinfecciosos , Triclosán , Lactante , Recién Nacido , Humanos , Femenino , Parabenos/análisis , Triclosán/análisis , Lactancia Materna , Antiinfecciosos/efectos adversos , Antibacterianos , China , Exposición a Riesgos Ambientales/análisis
2.
Immunol Allergy Clin North Am ; 43(1): 117-132, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36410998

RESUMEN

The safe management of allergic skin disorders during pregnancy is essential to maternal and fetal health. Poorly controlled allergic skin disease affects the health of mother and child. This article reviews the disease course and treatment of atopic dermatitis, chronic urticaria, and allergic contact dermatitis in pregnancy. It focuses on topical and systemic therapies in the context of pregnancy and breastfeeding. Because disease activity may vary in pregnancy, prescription stewardship is imperative; a balance among disease control, minimum effective dosing, and medication safety profiles should be maintained. Secondary complications and risks to maternal or infant health should also be avoided.


Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Atópica , Enfermedades de la Piel , Lactante , Embarazo , Femenino , Niño , Humanos , Piel , Dermatitis Atópica/terapia , Dermatitis Atópica/tratamiento farmacológico , Lactancia Materna
3.
J Interpers Violence ; 38(1-2): NP905-NP930, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35471844

RESUMEN

This study was conducted to determine the effect of domestic violence during pregnancy on the cortisol hormone release, preterm birth, low birth weight, and breastfeeding status. The cross-sectional study was conducted with 255 pregnant women in a Family Health Centre in the Southeastern Anatolia Region of Turkey between October 2017 and August 2018. The questionnaire, DVWDS (Domestic Violence to Women Determination Scale) and Breastfeeding Self-Efficacy Scale were used to collect the data. In the present study, the pregnant women were followed up three times. The first follow-up was applied to the pregnant women in the second trimester, the second follow-up was applied to those in the third trimester, and the third follow-up was applied to the postpartum women. At each follow-up from newborn, cortisol hormone level was taken with saliva and evaluated. It was determined that 9.8% of the pregnant women participating in the study were exposed to violence by their partners. An important result was found that those who were exposed to domestic violence during their pregnancy gave birth in the 37th week (p < 0.05). It was seen that the babies of those exposed to domestic violence during pregnancy had a higher mean cortisol hormone level (p < 0.05). It was found that the mean score of the Breastfeeding Self-Efficacy Scale in the third follow-up was lower for those who were exposed to domestic violence during pregnancy than those who were not (p < 0.05). It was observed during the pregnancy that domestic violence affected cortisol hormone secretion, breastfeeding after birth and newborn health.


Asunto(s)
Violencia Doméstica , Nacimiento Prematuro , Femenino , Embarazo , Recién Nacido , Humanos , Hidrocortisona , Lactancia Materna , Estudios Transversales
4.
Mol Cell Endocrinol ; 559: 111797, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-36243202

RESUMEN

Lactation invokes homeorhetic processes to ramp up and supply milk synthesis components to fulfil nutritional, immunological and microbiological requirements of developing offspring, overseen by complex neuroendocrine networks. The maternal gut meets these intense metabolic demands, supported by hyperphagia and rapid adjustments to process larger food quantities. Enteroplasticity describes an inherent ability of the gastrointestinal tract to harness metabolic and structural adaptations that increase nutrient absorption. Most shifts in response to increased demands are transitory and by secreting milk, the continuous energetic drain out of the maternal body avoids development of pathological metabolic diseases. Lactation has various positive benefits for long-term maternal health but many females do not lactate for long post pregnancy and younger women are increasingly pre-disposed to excessive body mass and/or metabolic complications prior to reproducing. Inadvertently invoking intestinal adaptations to harvest and store excess nutrients has negative health implications with increased risks for both mother and offspring.


Asunto(s)
Lactancia , Leche , Humanos , Embarazo , Femenino , Animales , Leche/metabolismo , Lactancia/metabolismo , Lactancia Materna , Nutrientes , Tracto Gastrointestinal
5.
Women Health ; 62(9-10): 788-798, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36404416

RESUMEN

This cross-sectional observational study was conducted to compare breastfeeding success and breastfeeding self-efficacy levels of mothers who gave birth via vaginal delivery (spontaneous or via epidural analgesia) or cesarean section (under general or spinal anesthesia). The study was conducted between September 2019 and February 2020 in the obstetric clinic. Data were collected using a Data Collection Form, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the LATCH Breastfeeding Evaluation Tool. Throughout the study, we followed the STROBE Checklist. Mothers who gave birth via spontaneous vaginal delivery had a statistically higher mean Breastfeeding Self-Efficacy score (54.92 ± 7.72; p < .001) than those who gave birth under spinal anesthesia (43.21 ± 10.04; p < .001) and then those who gave birth via cesarean section under general anesthesia (37.39 ± 10.64; p < .001). The difference between the delivery modes in terms of breastfeeding self-efficacy and breastfeeding success scores was statistically significant (respectively, KW = 40.168, p < .001 and KW = 52.420, p < .001). In order to increase the breastfeeding success of mothers who give birth via cesarean section under general anesthesia or spinal anesthesia, lactation nurses need to strengthen the perception of breastfeeding self-efficacy and provide more breastfeeding support to them compared to mothers who give birth via SVD.


Asunto(s)
Lactancia Materna , Cesárea , Embarazo , Humanos , Femenino , Estudios Transversales , Madres , Autoeficacia , Parto Obstétrico
6.
Gynecol Obstet Fertil Senol ; 50(12): 807-809, 2022 12.
Artículo en Francés | MEDLINE | ID: mdl-36435563

RESUMEN

Fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin) are antibiotics which pharmacological and therapeutic advantages resulted in a large use, now restricted because of resistances emergence and adverse effect risk. For pregnant or breastfeeding women they still are a cause of concern, based on the joint toxicity described in children directly treated, thus limiting their use in these populations. However, the data about exposed pregnancies published over time have not so far confirm these fears and allow, when a fluoroquinolone is clearly indicated, not to deprive pregnant patients of the therapeutic benefit of these important antibiotics and to envisage their use whatever the term of the pregnancy, within the current scope of their prescription. During breastfeeding the use of some of them can be considered.


Asunto(s)
Lactancia Materna , Fluoroquinolonas , Niño , Embarazo , Humanos , Femenino , Fluoroquinolonas/efectos adversos , Pruebas de Sensibilidad Microbiana , Levofloxacino/uso terapéutico , Antibacterianos/efectos adversos , Miedo
7.
BMJ Case Rep ; 15(11)2022 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-36446476

RESUMEN

We report a case of lactational mastitis complicated by Streptococcus pneumoniae bacteraemia in a breast feeding, healthy woman in her 20s. Numerous investigations showed that mastitis was the probable source of S. pneumoniae bacteraemia. While S. pneumoniae is known to cause non-lactational mastitis in patients with underlying diseases, such as systemic lupus erythematosus, reports of lactating mastitis in healthy individuals are scarce, with only six cases reported in the scientific literature published in English since 1995. Similar to previous reports, our patient had a good clinical course with antimicrobial therapy, and the infection was presumably transmitted from the asymptomatic child to the mother. Although the exact mechanisms that establish transmission from a child remain unclear, both host and pathogen factors, such as stagnant milk or bacterial virulence factors, are thought to play a key role. Caution should be exercised because serotypes not currently covered by pneumococcal vaccines are emerging.


Asunto(s)
Bacteriemia , Mastitis , Niño , Femenino , Humanos , Streptococcus pneumoniae , Lactancia , Lactancia Materna , Vacunas Neumococicas , Mastitis/diagnóstico , Mastitis/tratamiento farmacológico , Madres
8.
Nutrients ; 14(22)2022 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-36432608

RESUMEN

This study examined the relationship between maternal food source and preparation during pregnancy and the duration of breastfeeding among 751 mother-child dyads in the United States. The data collected from the Environmental influences on Child Health Outcomes (ECHO) Program included twelve cohorts of mothers (age ≥ 18) who delivered infant(s). Three categories of maternal food source and preparation including, High, Moderate, or Low Food Source Quality were derived from the mother report. The mean duration of breastfeeding differed strongly across the three categories. The High Food Source Quality group breastfed an average of 41 weeks, while shorter durations were observed for the Moderate (26 weeks) and Low (16 weeks) Food Source Quality groups. Cox proportional hazards models were used to estimate the relative hazard of time to breastfeeding cessation for each participant characteristic. The full model adjusted for clustering/cohort effect for all participant characteristics, while the final model adjusted for the subset of characteristics identified from variable reduction modeling. The hazard of breastfeeding cessation for those in the High Food Source Quality group was 24% less than the Moderate group (RH = 0.76; 95% CI, 0.63-0.92). Pregnant women in the High Food Source Quality group breastfed longer than the Moderate and Low groups. We encourage more detailed studies in the future to examine this relationship longitudinally.


Asunto(s)
Lactancia Materna , Madres , Lactante , Humanos , Femenino , Embarazo , Factores de Tiempo , Vitaminas , Evaluación de Resultado en la Atención de Salud
9.
Microbiome ; 10(1): 197, 2022 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-36419187

RESUMEN

BACKGROUND: Most previous studies attempting to prove the phenomenon of mother-to-infant microbiota transmission were observational, performed only at genus/species-level resolution, and relied entirely on non-culture-based methodologies, impeding interpretation. RESULTS: This work aimed to use a biomarker strain, Bifidobacterium animalis subsp. lactis Probio-M8 (M8), to directly evaluate the vertical transmission of maternally ingested bacteria by integrated culture-dependent/-independent methods. Our culture and metagenomics results showed that small amounts of maternally ingested bacteria could translocate to the infant gut via oral-/entero-mammary routes through lactation. Interestingly, many mother-infant-pair-recovered M8 homologous isolates exhibited high-frequency nonsynonymous mutations in a sugar transporter gene (glcU) and altered carbohydrate utilization preference/capacity compared with non-mutant isolates, suggesting that M8 underwent adaptive evolution for better survival in simple sugar-deprived lower gut environments. CONCLUSIONS: This study presented direct and strain-level evidence of mother-to-infant bacterial transmission through lactation and provided insights into the impact of milk microbiota on infant gut colonization. Video Abstract.


Asunto(s)
Bifidobacterium animalis , Animales , Femenino , Humanos , Lactante , Bacterias , Lactancia Materna , Lactancia , Leche , Mutación , Proteínas de Transporte de Monosacáridos/genética , Proteínas Bacterianas/genética
10.
JBI Evid Implement ; 20(4): 374-384, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36378095

RESUMEN

OBJECTIVES: To assess compliance with recommendations to alleviate nipple pain and/or trauma (NPT) and to reduce the rate of breastfeeding abandonment for this reason. INTRODUCTION: As a fundamental priority, health programmes encourage mothers to breastfeed exclusively for the first 6 months of the baby's life and to supplement breast milk with other foods up to the age of 2 years. However, the presence of NPT can reduce or prevent compliance with this recommendation. METHODS: The project was designed and carried out using a framework based on the JBI Practical Application of Clinical Evidence System (JBI-PACES). Six audit criteria were used in preaudits and postaudits to observe any changes in compliance with the recommendations. Between audits, the Getting Research into Practice (GRiP) tool was used to identify stakeholders, barriers and facilitators of the project. RESULTS: Two hundred and sixty-seven breastfeeding women were studied in the baseline phase and 275 during follow-up. Compliance in four criteria improved, and the rates of NPT decreased (pain: from 63.3 to 53.5%; P  = 0.02; trauma: from 37.8 to 24.7%; P  = 0.01). The proportion of women advised by qualified personnel increased from 63 to 88% whereas those who cited pain as the reason for abandoning exclusive breastfeeding decreased from 1.5 to 1.1%. CONCLUSION: This evidence-based implementation project achieved significantly improved compliance rates in most of the evidence-based criteria considered. In consequence, the prevalence of NPT fell significantly. Nevertheless, there was no significant impact on the proportion of mothers abandoning breastfeeding for this reason.


Asunto(s)
Lactancia Materna , Mastodinia , Lactante , Humanos , Femenino , Preescolar , España , Pezones/lesiones , Hospitales Universitarios
11.
BMC Med ; 20(1): 454, 2022 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-36424578

RESUMEN

BACKGROUND: Previous studies have reported that maternal smoking during pregnancy and breastfeeding may affect the occurrence of hypertension, but whether early life factors modify the impact of the offspring's genetic risk on hypertension is still unknown. The aim of this study was to investigate the relationships among maternal smoking and breastfeeding with adult-onset hypertension and the modified impact of offspring genetic susceptibility. METHODS: This study included 437,185 participants from the UK Biobank who were initially free of hypertension and provided a prospective cohort of individuals aged 40 to 69 years. The association of maternal smoking during pregnancy and breastfeeding with hypertension was examined by using the Cox regression model. Then, a polygenic risk score (PRS) for hypertension was used to test the gene-environmental interaction on hypertension. RESULTS: During a median follow-up period of 8.7 years, a total of 68,148 cases of hypertension were identified in this study. The hazard ratios (HRs) and 95% confidence intervals (CIs) of hypertension for maternal smoking and breastfeeding were 1.11 (1.09, 1.13) and 0.96 (0.94, 0.98), respectively. However, no evidence of an interaction between maternal smoking and breastfeeding was observed. Across all levels of genetic risk, including high genetic risk, maternal smoking and nonbreastfeeding had higher hypertension hazards than nonmaternal smoking and breastfeeding, respectively. The adjusted HRs (95% CIs) of hypertension were 1.80 (1.73, 1.87) in those who had high genetic predisposition plus maternal smoking and 1.67 (1.60-1.74) in those with nonbreastfeeding and high genetic risk. There were significant additive interactions between maternal smoking or breastfeeding and genetic factors on the incidence of hypertension. CONCLUSIONS: Maternal smoking and nonbreastfeeding were associated with a higher risk of hypertension in adulthood and may attenuate the risk of hypertension related to genetic factors. These results suggested that adherence to nonmaternal smoking and breastfeeding was associated with a lower risk of hypertension among participants with all gradients of genetic risk.


Asunto(s)
Lactancia Materna , Hipertensión , Adulto , Embarazo , Femenino , Humanos , Estudios Prospectivos , Fumar/efectos adversos , Fumar/epidemiología , Hipertensión/epidemiología , Hipertensión/genética , Madres , Factores de Riesgo , Predisposición Genética a la Enfermedad
12.
Int Breastfeed J ; 17(1): 79, 2022 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-36424636

RESUMEN

BACKGROUND: The 2013 WHO guidelines for nutritional rehabilitation of malnourished infants under six months (u6m) focus on inpatient re-establishment of exclusive breastfeeding and recommends discharge when infant is gaining weight on breastmilk alone. Guided by a breastfeeding support tool, breastfeeding peer supporters (BFPS) can support implementation of these guideline by providing continuous individualised breastfeeding counselling to mothers of malnourished infants u6m. Recording and sharing information plays an important role in shaping in-patient care but little is known about recording practices for inpatient nutrition rehabilitation of infants u6m or how such practices affect care. We set out to explore introduction of BFPS into hospitals, and how it shaped the recording and practices of care for acutely malnourished infants u6m. METHODS: We applied a descriptive, exploratory design involving a pre and during intervention audit of the infant u6m inpatient records in two hospitals in Kenya, as well as pre- and post-intervention in-depth interviews with health workers involved in the care of admitted infants u6m. We developed an audit tool and used it to extract routine data on patient information from hospital records. Data were entered into a REDCap database and analyzed using STATA 17.0 software. We conducted thirty in-depth interviews with health workers exploring their care practices and their perceived effect of the presence of the BFPS on health workers treatment practices. We analysed interview data using thematic framework approach. RESULTS: A total of 170 and 65 inpatient files were available for the audit during the pre- and post-intervention period respectively. The presence of the BFPS seemed to have encouraged the recording of (i) breastfeeding status upon admission, (ii) breastfeeding management plan and (iii) reporting of its implementation and progress during treatment. The breastfeeding peer support intervention had a positive impact on breastfeeding recording and reporting practices. Health workers reported that the BFPS facilitated the recording of observed breastfeeding data and how their records influenced final inputs of breastfeeding support provided in the inpatient file. CONCLUSIONS: Guideline implementation tools facilitate effective application of guidelines and should accompany any guideline formulation process and have their effectiveness at recording and monitoring progress evaluated.


Asunto(s)
Lactancia Materna , Trastornos de la Nutrición del Lactante , Lactante , Femenino , Humanos , Kenia , Pacientes Internos , Trastornos de la Nutrición del Lactante/terapia , Hospitales Públicos
13.
BMC Pregnancy Childbirth ; 22(1): 850, 2022 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-36401204

RESUMEN

BACKGROUND: Due to the nutritive and immunologic benefits of breastmilk, children should be exclusively breastfed for the first 6 months of life, even during the corona virus pandemic. However, fear of transmission risk and pandemic-related restrictions could undermine the practice of breastfeeding. This study aimed to assess the knowledge, attitude, and determinants of exclusive breastfeeding (EBF) during COVID-19 among lactating mothers in Mekelle, Tigrai, Ethiopia. METHODS: A community based cross-sectional study was conducted among 621 lactating mothers living in Mekelle city, Tigrai, from April to June, 2021. Data were collected using an adapted form of a standard KAP questionnaire. Binary logistic regression was used to determine the independent determinants of EBF at a statistical significance of p < 0.05. The strength of the association was measured by odds ratio and 95% confidence interval. RESULTS: Four hundred (64.4%) mothers exclusively breastfed their children. Infants from female-headed households had twice (AOR 2.21; 95% CI 1.31, 3.71) higher odds of EBF. Higher educational status was associated with higher odds of EBF practice. A unit increase in parity was associated with a 23% increase in the odds of EBF. Mothers who received breastfeeding information had a 73% (AOR 1.73; 95% CI 1.17, 2.56) higher odds of EBF. Moreover, mothers with high knowledge score and positive attitude showed a 74% higher (AOR 1.74; 95% CI 1.20, 2.51) and more than double (AOR 2.35; 95% CI 1.50, 3.70) odds of EBF, respectively. CONCLUSION: About two-thirds of the mothers practiced EBF. Household head, maternal educational, parity, breastfeeding information, knowledge of breastfeeding, and attitude towards EBF were significant determinants of EBF. Our study findings highlighted that programs that enhance women's participation in education and decision-making could improve EBF practice. Besides, during the COVID-19 pandemic, providing lactating mothers with adequate and up-to-date breastfeeding information could be significant in improving EBF practice.


Asunto(s)
Lactancia Materna , COVID-19 , Lactante , Embarazo , Niño , Femenino , Humanos , Madres , Estudios Transversales , COVID-19/epidemiología , Pandemias , Conocimientos, Actitudes y Práctica en Salud , Lactancia
14.
BMC Surg ; 22(1): 397, 2022 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-36401263

RESUMEN

PURPOSE: Optimal treatment of breast abscesses has been controversial. Herein, we report an innovative method for the operative treatment of lactational mammary abscesses. METHODS: Nineteen lactating patients diagnosed with breast abscesses were enrolled in the study, and abscess debridement and drainage were performed using an arthroscopic system. The clinical characteristics of the patients were recorded to evaluate the feasibility, efficacy, and cosmetic results of arthroscopic surgery for breast abscesses. RESULTS: All 19 patients were cured and did not relapse within the 6-month-follow-up period. One patient stopped breastfeeding due to breast leakage. All patients were satisfied with the postoperative appearance of the breast. CONCLUSION: Arthroscopic debridement and drainage are effective treatment methods for lactational breast abscesses, with a high cure rate, few complications, and satisfactory cosmetic outcomes.


Asunto(s)
Enfermedades de la Mama , Mastitis , Humanos , Femenino , Lactancia , Lactancia Materna , Absceso/etiología , Enfermedades de la Mama/cirugía , Enfermedades de la Mama/etiología , Mastitis/etiología , Mastitis/cirugía
15.
Afr Health Sci ; 22(2): 535-544, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36407345

RESUMEN

Background: Improving maternal and child health, one of the key UN Sustainable Development Goals (SDGs), is a major challenge in sub-Saharan Africa. Exclusive breast-feeding contributes significantly to child survival and development, but many mothers in Africa do not exclusively breastfeed their infants. This paper reports a study in Mulago hospital in Kampala. The study aims to identify factors influencing mothers' choices of infant feeding practices. Methods: Mixed methods were used. Respondents included 362 lactating mothers and health workers. Participants were who came for treatment were selected using simple random sampling. EpiInfor and SPSS were used for analysing the data and presented as descriptive study. Results: Results indicate that socio-demographic factors including age and education level influence mothers' ability and willingness to breastfeed exclusively for the first six months. Awareness about breast-feeding was mainly obtained from health centres, leaving mothers unable to attend these centres to miss out on vital information about exclusive breast-feeding. Around 43% of health workers were unaware of the country's Young and Infant Feeding Policy Guidelines. Conclusions: To increase the rate of exclusive breast-feeding in Uganda, it is important that community health is strengthened, and health workers are trained on national breast-feeding policies.


Asunto(s)
Lactancia Materna , Lactancia , Humanos , Lactante , Femenino , Niño , Estudios Transversales , Uganda , Hospitales
16.
Afr Health Sci ; 22(2): 545-559, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36407371

RESUMEN

Background: The Nigerian government initiated various national infant and young child feeding programmes (1992-2005) to improve juveniles well-being. Despite these efforts, under-five children feeding related diseases and mortality still escalate. Investigating the drivers of exclusive breastfeeding (EBF) is exigent in tackling this menace. Objective: To investigate maternal socio-demographic and index child variables that serve as predictors of EBF practice among nursing mother attending a healthcare facility in Lagos, western Nigeria. Methods: One hundred and twenty (N=120) consenting nursing mothers (15-49 years) with infants between 0-24 months completed a structured, self-administered questionnaire. Scores of current practice level for EBF was computed and adjusted odd ratios (aORs) generated from a logistic regression model. Results: Respondents mean age was 28.7 ± 2.3 years. Of 120 respondents, 82(68.3%) and 38(31.7%) had good and poor EBF practice respectively. Having an index child <6months age (aOR=5.02, 95% confidence intervalCI=1.28-15.43), being in monogamy (aOR=3.0, 95% CI=1.80-6.73), having tertiary education (aOR=3.12, 95% CI=1.39-8.96), being married (aOR=2.0, 95% CI=0.1-0.8) and vaginal delivery (aOR=2.96, 95% CI=1.75-7.48) increased the odds of EBF practice. Conclusion: Age of index child, marriage type, maternal education, marital status and nature of delivery independently predicted EBF practice.


Asunto(s)
Lactancia Materna , Madres , Humanos , Lactante , Femenino , Niño , Adulto , Nigeria , Instituciones de Salud , Atención a la Salud
17.
PLoS One ; 17(11): e0277599, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36395288

RESUMEN

BACKGROUND: Pregestational diabetes, obesity and gestational weight gain (GWG) are associated with adverse perinatal outcomes, however, the influence of excessive GWG on lactation at discharge is less known. Our aim is to evaluate the impact of excessive GWG using the LifeCycle project guidelines on exclusive breastfeeding (EBF) and any BF rates at discharge among 171 women with Type 1 and 294 Type 2 diabetes and obesity who intended to BF. METHODS AND FINDINGS: Retrospective cohort study. Obesity was defined by BMI (kg/m2) as grade 1 (30-34.9), grade 2 (35-39.9) or grade 3 (≥40). GWG was categorized as adequate, inadequate or excessive according to the 2019 LifeCycle Project guidelines. Women with Type 1 were younger (30 vs 33y), primiparous (51 vs 32%), delivered earlier (37 vs 38w) than women with Type 2 andwere different in grade 1 (40 vs 26%), grade 3 obesity (19 vs 49%) and median GWG (15 vs 11kg). Of all 465 women with Type 1 and Type 2 combined, 365 (78%) who had excessive GWG and 100 (22%) who had non-excessive GWG showed similar EBF (27 vs 25%) and any BF (72 vs 72%) rates. Regression analysis showed that after adjusting for potential confounders excessive GWG was not a predictor of EBF or any BF at discharge. CONCLUSION: Type 1 and Type 2 diabetes, obesity and excessive GWG are associated with low EBF, however, excessive GWG is not an independent predictor of low EBF or any BF at discharge.


Asunto(s)
Diabetes Mellitus Tipo 2 , Ganancia de Peso Gestacional , Embarazo , Femenino , Humanos , Lactancia Materna , Diabetes Mellitus Tipo 2/epidemiología , Estudios Retrospectivos , Aumento de Peso , Obesidad/epidemiología
18.
Int Breastfeed J ; 17(1): 77, 2022 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-36419119

RESUMEN

BACKGROUND: Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them. METHODS: Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (n = 25), grandmothers (n = 11), and healthcare providers (n = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers. RESULTS: Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow. CONCLUSIONS: There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.


Asunto(s)
Abuelos , Lactante , Niño , Humanos , Femenino , Lactancia Materna , México , Madres , Personal de Salud
19.
Clin Infect Dis ; 75(Supplement_4): S571-S578, 2022 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-36410383

RESUMEN

Long-acting agents hold significant promise for treating and preventing common illnesses, including infections. Pharmacokinetic and safety data during pregnancy and lactation are often unavailable for new drugs; these data are vital to facilitate optimal drug use by pregnant and lactating women and women who may conceive. In this commentary, we summarize the circumstances in which pregnant and lactating women are likely to use and benefit from long-acting agents. We focus on long-acting formulations of small molecules (rather than biologics such as monoclonal antibodies) and on several infections of global importance (human immunodeficiency virus, tuberculosis, malaria, and hepatitis C). We discuss pregnancy pharmacokinetic/pharmacodynamic and potential safety and efficacy considerations pertaining to the use of long-acting agents in pregnancy and lactation. Finally, we summarize existing preclinical and pregnancy pharmacokinetic data that are available (or expected in the near future) for several agents that are under development or approved, and how key research gaps may be addressed.


Asunto(s)
Hepatitis C , Lactancia , Embarazo , Femenino , Humanos , Lactancia Materna , Hepacivirus , Anticuerpos Monoclonales
20.
Medicine (Baltimore) ; 101(45): e31500, 2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36397371

RESUMEN

As newborns are highly vulnerable, they require essential care for adequate child development. This study aimed to assess the care provided to newborns during the first 28 days of life and identify factors associated with adequate care. This was a longitudinal study conducted with 415 mothers and full-term newborns from 4 public maternity hospitals in Natal, Brazil, in 2019. Assistance, socioeconomic, and demographic data were collected 3 times: 48 hours, 7 days, and 28 days after birth. Pearson's chi-square and Poisson regression tests were used with a confidence interval of 95%. Most mothers were between 20 and 29 years old (46.5%), had a high school or higher education (65.3%), a partner (79%), an income of ≤ 1 minimum wage (64, 6%), and were multiparous (62.9%). A total of 29 actions performed in maternity hospitals and 11 in primary healthcare were evaluated. Among the first, 8 (27.6%) were satisfactory; 11 (37.9%), partially satisfactory; and 10 (34.5%), unsatisfactory. In primary care, 2 actions (18.2%) were considered satisfactory; 3 (27.3%) partially satisfactory; and 6 (54.5%) unsatisfactory. In the multivariate analysis of the composite indicators related to adequacy of care, women undergoing vaginal delivery, those who are multiparous, and maternity hospitals at usual risk were associated with better adequacy of care indicators (P ≤ .05). Maternity hospitals accredited to the Baby-Friendly Hospital Initiative had lower chances of the adequacy of promotion to exclusive breastfeeding. The sample loss rate was 13.7% in the first week and 16.6% at the end of the study period. There was inadequacy in the performance of care actions for newborns regarding access and comprehensiveness of care. These weaknesses highlight the need for reassessing skills and coordinating actions in the child's healthcare network.


Asunto(s)
Cuidados Posteriores , Promoción de la Salud , Niño , Recién Nacido , Femenino , Embarazo , Humanos , Adulto Joven , Adulto , Estudios Longitudinales , Lactancia Materna , Maternidades
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