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J Hum Lact ; 33(2): 419-421, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28056181


Inducing lactation in the absence of pregnancy (nonpuerperal lactation) is not always successful and, in many cases, only partial breastfeeding is achieved. Different protocols have been described, but scientific evidence and research are lacking in this area. The authors describe the case of a woman with a history of a miscarriage, for whom the lactation induction process was so effective that she became a milk donor even before she received her adopted child. She had not previously used hormone treatment. She was given domperidone as a galactogogue for 1 month. The pumping protocol began with a double electric breast pump combined with manual pumping 6 months before her child was delivered, and 3 months later, she was accepted as a donor by our milk bank. This highlights the importance of regular stimulation as a milk production mechanism. This is the first case of human milk donation in an adoptive mother described in the literature.

Adoção/psicologia , Amenorreia/patologia , Galactorreia/patologia , Leite Humano/metabolismo , Mães/psicologia , Doadores de Tecidos/psicologia , Adulto , Amenorreia/psicologia , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Feminino , Galactorreia/psicologia , Humanos , Infertilidade/etiologia , Lactação/metabolismo , Lactação/fisiologia
J Hum Lact ; 32(4): 613-626, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27492981


BACKGROUND: The Baby-Friendly Hospital Initiative (BFHI) has a positive effect on breastfeeding in maternity wards; however, few studies have examined to what degree it affects care in neonatal intensive care units (NICUs). Recently, the BFHI has been adapted to the NICUs (Neo-BFHI). OBJECTIVE: This study aimed to compare breastfeeding support in Spanish NICUs in hospitals with BFHI accreditation or in the process of being accredited (group 1) with NICUs in hospitals that have not yet begun this initiative (group 2). METHODS: A validated questionnaire on breastfeeding support was distributed to level II and III NICUs in Spanish public hospitals. A univariate analysis and an analysis adjusted for the number of beds in NICUs were conducted. The results of the analysis of 36 breastfeeding support measures are presented in accordance with the Ten Steps to Successful Breastfeeding adapted to NICUs. RESULTS: Of the 141 participating NICUs, 129 (91%) responded to the questionnaire: 38 NICUs from group 1 and 91 NICUs from group 2. Group 1 had implemented a higher number of breastfeeding support measures than group 2. There were significant differences in 18 measures related to steps 2, 4, 5, 7, and 8 of the Neo-BFHI. In addition, a comparison of NICUs in hospitals with full accreditation (7 of 129) with those in group 2 revealed significant differences in 7 measures pertaining to steps 2, 5, 8, and 9. CONCLUSION: The Spanish NICUs in hospitals with BFHI accreditation or in the process of being accredited have better implementation of practices to promote and support breastfeeding.

Aleitamento Materno/métodos , Promoção da Saúde/métodos , Hispano-Americanos/estatística & dados numéricos , Acreditação/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Hispano-Americanos/psicologia , Hospitais/normas , Hospitais/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva Neonatal/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/estatística & dados numéricos , Inquéritos e Questionários
An Pediatr (Barc) ; 85(1): 26-33, 2016 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-26458522


INTRODUCTION: There is currently no unified policy on either breastfeeding support or enteral nutrition practices, as regards human milk (HM) in pre-term newborns. The aim of this study was to describe breastfeeding support measures, as well as the use of HM in very preterm infants in Spanish public hospitals. METHOD: A questionnaire on enteral feeding practices was distributed. Data were analysed from units caring for newborns less than 32 weeks or 1,500g. A univariate analysis was performed comparing level ii and iii care units. RESULTS: There was a 91% response rate. A total of 93 units cared for infants less than 32 weeks or 1,500g (17 level ii and 76 level iii), and 49% of the units recorded the breastfeeding rate on discharge. Around 75% (70/93) had a guideline on managing HM (level iii 81 vs. level ii 47%, P=.002), and 25% had access to donor human milk. Just under half (46%) started trophic feeding in the first 6h. Target enteral feeding volume in stable preterm infants was ≥ 180ml/kg/day in 89% of the units (level iii 93% vs. level ii 70%, P =.017). HM fortifier was used in 96% of the units. In 92%, it was added when the required enteral volume was tolerated. In 59% of the units, adjustments in the quantity of fortifier were made according to weight, and in 36%, it depended on analytical criteria. Some units (9%) used pure protein fortifier. CONCLUSIONS: There is a marked variability in breastfeeding support measures and in feeding practices of preterm infants in Spanish neonatal units.

Aleitamento Materno , Nutrição Enteral , Comportamento Alimentar , Leite Humano , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Padrões de Prática Médica , Espanha , Inquéritos e Questionários
J Hum Lact ; 30(3): 276-282, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24782488


The Baby-Friendly Initiative (BFI-Spain) was founded in 1995 by members of key professional associations (pediatricians, midwives, obstetricians, and nurses) and some mother-to-mother support groups. The United Nations International Children's Fund was instrumental in supporting the establishment of BFI-Spain as a not-for-profit organization. In 2007, the need for change was identified. A detailed analysis of BFI-Spain identified its main strengths, weaknesses, opportunities, and threats. A new strategic plan was devised that included the adoption of a staged accreditation system, a new website, expanding the initiative into the community, consolidating working teams to distribute tasks and responsibilities, and trying to involve the national health authorities. This article describes the analysis that was undertaken, the strategies implemented, and some of the outcomes observed 4 years later. The aim of the article is to support BFI teams in other countries who might be facing similar challenges.

J Hum Lact ; 28(3): 363-9, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22689708


BACKGROUND: Promotion and protection of breastfeeding is a public health objective. In April 2009, health authorities in the Madrid region in central Spain signed a collaboration agreement with The United Nations Children's Fund and created a breastfeeding committee. OBJECTIVE: To report the creation and implementation of a plan to promote and improve the quality of breastfeeding care in public hospitals in the region of Madrid, according to the Baby-Friendly Hospital Initiative (BFHI) standards. METHODS: The action plan included institutional commitment; creation of a breastfeeding committee in each hospital; outcome analyses, staff training, creation of educational materials; and dissemination of activities. The plan was adopted by the 19 non-BFHI-designated public maternity units in the Madrid region. Each hospital completed a modified version of the World Health Organization self-assessment questionnaire in 2009 (pre-intervention) and again in 2011. RESULTS: Thirteen maternity units (68.4%) established a breastfeeding committee, and 32 months after implementation of the plan, the other 6 hospitals have created one. Nine training courses have been carried out to train professional experts on breastfeeding as trainers. The 271 trainers provided 18-hour breastfeeding courses for 1423 professionals. In 2009, there was only 1 BFHI-accredited hospital. Currently, 52.6% of the other 19 hospitals have some level of accreditation, and 2 are fully accredited. CONCLUSIONS: An intervention to improve the quality of breastfeeding care based on an organized regional approach to the BFHI was useful for BFHI implementation.

Aleitamento Materno , Salas de Parto/normas , Promoção da Saúde/organização & administração , Cuidado do Lactente/normas , Assistência Perinatal/normas , Desenvolvimento de Programas/métodos , Acreditação , Aleitamento Materno/estatística & dados numéricos , Salas de Parto/organização & administração , Salas de Parto/estatística & dados numéricos , Feminino , Promoção da Saúde/métodos , Humanos , Cuidado do Lactente/métodos , Cuidado do Lactente/organização & administração , Recém-Nascido , Assistência Perinatal/métodos , Assistência Perinatal/organização & administração , Guias de Prática Clínica como Assunto , Gravidez , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Espanha , Nações Unidas , Organização Mundial da Saúde