Health-enhancing behaviors correlated with breastfeeding among a national sample of mothers.

Participation in health-enhancing behaviors not only influences the health of the mother, but of the newborn child as well. Characteristics of the mother, especially with regard to the practice of health-enhancing behaviors, have typically been excluded from studies examining breastfeeding. The purpose of this study was to identify health-enhancing behaviors correlated with breastfeeding among a national sample of mothers. The third National Health and Nutrition Examination Survey (NHANES III) provided the sample for this study. All mothers between the ages of 17 and 45 (n = 578) with children aged 3 or younger at the time of the interview, who breastfed, were included. Seven health-enhancing behaviors served as the independent variables in a logistic regression analysis. Odds ratios and 95% confidence intervals were calculated from the estimated regression coefficients, and comparison of proportions were made using Pearson chi-square tests of homogeneity. Smoking less than 100 cigarettes in a lifetime, consuming five or more fruits and/or vegetables daily, and visiting a dentist annually were significantly associated with breastfeeding among the mothers in this sample. The results of this study point to a connection between the health-enhancing behaviors of the mother and breastfeeding. This information can be used to help professionals and practitioners gain a clearer picture of the breastfeeding mother. Multicomponent education programs targeted at new mothers can use this information to guide program development. Breastfeeding mothers may have better overall health as compared to mothers who do not breastfeed, therefore, they may serve as role models in peer-structured activities.

Bacterial meningitis: an update.

Antibiotics and improvements in supportive care have greatly reduced the mortality from bacterial meningitis. Nevertheless, the incidence of neurodevelopmental sequelae remains unacceptably high. Ampicillin and chloramphenicol remain the standard for antimicrobial therapy against which other agents must be compared. A number of adjunct therapies are being investigated for their possible effectiveness in reducing hearing loss and other neurologic effects of this disease. There continues to be a need for carefully performed follow-up studies to assess any possible benefit of these agents. A significant percentage of children surviving an episode of bacterial meningitis have obvious or subtle neurodevelopmental deficits. The role of the pediatric neurologist should not end with management of acute problems such as seizures but should be expanded to aid in close developmental monitoring of these high-risk children.

Antimicrobial activities and susceptibility testing considerations of ampicillin, cephalothin, cefaclor, and cefuroxime against invasive isolates of Haemophilus influenzae.

The activities of ampicillin, cefaclor, cephalothin, and cefuroxime against invasive clinical isolates of Haemophilus infleunzae were studied to determine the correlation between resistance and beta-lactamase production. Approaches to in vitro susceptibility testing of cephalosporins in the clinical laboratory were also assessed. Three hundred and eight isolates of H. influenzae were tested for ampicillin susceptibility, and those which required for inhibition greater than or equal to 1.0 micrograms/ml of ampicillin were tested for beta-lactamase production with a chromogenic cephalosporin. Twenty-two percent of isolates produced beta-lactamase and 85% were serotype b. All isolates considered resistant (MIC greater than or equal to 2.0 micrograms/ml) to ampicillin produced beta-lactamase. A single beta-lactamase-producing isolate was identified, but was inhibited by 1.0 microgram/ml of ampicillin, and a zone diameter of 20 mm was produced by disk diffusion testing. One hundred and ninety-seven isolates were tested for susceptibility to cefaclor, cefuroxime, and cephalothin. Chloramphenicol susceptibility testing by disk diffusion was also performed on these isolates. General agreement and interchangeable results were found among these three cephalosporins by both agar dilution and disk diffusion methods. We conclude that ampicillin-resistant H. influenzae not producing beta-lactamase is rare among these isolates of H. influenzae responsible for invasive disease. Susceptibility testing results of cephalothin, cefaclor, or cefuroxime appear to be interchangeable, although results of cephalothin testing would tend to underestimate the activities of cefaclor or cefuroxime.