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1.
Mol Cell Endocrinol ; 559: 111810, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36374835

RESUMO

Obesity is a modern pandemic with negative consequences in women's reproductive health. Women with overweight and obesity can develop mammary gland alterations that unable exclusive breastfeeding. Obesity associates with a disturbed lactating mammary gland endocrine environment including a decreased action of the hormone prolactin (PRL), the master regulator of lactation. The PRL receptor and the action of PRL are reduced in the mammary gland of lactating rodents fed an obesogenic diet and are contributing factors to impaired lactation in obesity. Also, treatment with PRL improves milk yield in women with lactation insufficiency. This review focuses on the impact of diet-induced obesity in the lactating mammary gland and how obesity impairs the lactogenic action of PRL. Although obesity alters lactation performance in humans and rodents, the responsible mechanisms have been mainly addressed in rodents.


Assuntos
Glândulas Mamárias Humanas , Feminino , Humanos , Animais , Prolactina , Lactação , Mama , Obesidade , Glândulas Mamárias Animais
2.
Rev. enferm. UERJ ; 30: e63381, jan. -dez. 2022.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1393338

RESUMO

Objetivo: discutir a ocorrência de contato pele a pele ao nascer e a amamentação na primeira hora de vida, bem como sua associação com a prevalência de aleitamento exclusivo na alta hospitalar. Método: estudo transversal, realizado com 157 puérperas e 160 recém-nascidos de uma maternidade pública do Rio de Janeiro. Os dados foram coletados de julho de 2020 a janeiro de 2021, por meio de questionário estruturado, com dados analisados pela estatística descritiva e regressão de Poisson com variância robusta. Resultados: dos recém-nascidos, 93,13% realizaram contato pele a pele e, destes, 74,67% permaneceram nesse contato por, no máximo, 10 minutos; 69,38% foram amamentados na primeira hora de vida, sendo esta prática significativamente associada (p=0,17) ao aleitamento exclusivo na alta hospitalar. Conclusão: os resultados encontrados reforçam a efetividade das recomendações das diretrizes nacionais e evidenciam a necessidade da manutenção das boas práticas de cuidado, importante compromisso com a qualidade assistencial materna e neonatal.


Objective: to discuss the occurrence of skin-to-skin contact at birth and breastfeeding in the first hour of life, as well as their association with the prevalence of exclusive breastfeeding at hospital discharge. Method: this cross-sectional study was conducted with 157 postpartum women and 160 newborns from a public maternity hospital in Rio de Janeiro. Data were collected from July 2020 to January 2021, through a structured questionnaire, and analyzed by descriptive statistics and Poisson regression with robust variance. Results: 93.13% of the newborns enjoyed skin-to-skin contact, which lasted a maximum of 10 minutes in 74.67% of cases; 69.38% were breastfed in the first hour of life, and this was significantly associated (p = 0.17) with exclusive breastfeeding at hospital discharge, which was 83.75% prevalent. Conclusion: the findings underline the effectiveness of the recommendations of Brazil's national guidelines and evidence the need to maintain good care practices, in an important commitment to quality maternal and neonatal care.


Objetivo: discutir la ocurrencia del contacto piel a piel al nacer y la lactancia materna en la primera hora de vida, así como su asociación con la prevalencia de lactancia materna exclusiva al alta hospitalaria. Método: Estudio transversal realizado junto a 157 puérperas y 160 recién nacidos de una maternidad pública de Río de Janeiro. Los datos fueron recolectados de julio de 2020 a enero de 2021, a través de un cuestionario estructurado, y analizados por estadística descriptiva y regresión de Poisson con varianza robusta. Resultados: el 93,13% de los recién nacidos tuvo contacto piel a piel y, entre estos, el 74,67% permaneció en ese contacto durante, como máximo, 10 minutos; el 69,38% fue amamantado en la primera hora de vida, y esta práctica se asoció significativamente (p=0,17) con la lactancia materna exclusiva en el alta hospitalaria. Conclusión: Los resultados encontrados refuerzan la efectividad de las recomendaciones de las guías nacionales y ponen en evidencia la necesidad de mantener buenas prácticas asistenciales, compromiso importante con la calidad de la atención materna y neonatal.

3.
Mult Scler ; : 13524585221129472, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36317497

RESUMO

OBJECTIVE: The objective of this study was to develop evidence-based recommendations on pregnancy management for persons with multiple sclerosis (MS). BACKGROUND: MS typically affects young women in their childbearing years. Increasing evidence is available to inform questions raised by MS patients and health professionals about pregnancy issues. METHODS: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and university databases (January 1975 through June 2021). The RAND/UCLA appropriateness method was developed to synthesise the scientific literature and expert opinions on healthcare topics; it was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence. RESULTS: A strong agreement was reached for all 104 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, locoregional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses and disease-modifying treatments. CONCLUSION: The 2022 recommendations of the French MS society should be helpful to harmonise counselling and treatment practice for pregnancy in persons with MS, allowing for better and individualised choices.

4.
Matern Child Nutr ; : e13443, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36330699

RESUMO

Breastfeeding is the most accessible and cost-effective activity available to public health and has been shown to be one of the most effective preventive measures mothers can take to protect their children's health. Despite the well-documented benefits, the UK has one of the lowest breastfeeding rates in the world. The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University. It provides an evidence-based process to help countries assess their breastfeeding status and readiness to scale up, and identifies concrete measures countries can take to sustainably increase breastfeeding rates, based on data-driven recommendations. BBF is grounded in the Breastfeeding Gear Model complex adaptive systems framework which is made up of eight simultaneous conditions that sustain breastfeeding. In 2018, a committee of multi-agency stakeholders implemented the BBF process in England, collecting evidence to score the 'gear' components of England's breastfeeding environment against 54 benchmarks. The Training and Programme Delivery gear received the highest score, attributable to existing learning outcomes for health professionals and practitioners, peer supporters and specialist services, although there is a need for greater coordination and integration. The lowest scores were given for Promotion and Coordination, Goals and Monitoring due to the lack of a dedicated national strategy for breastfeeding and poor sharing of localised strategies and programmes. The process generated clear recommendations highlighting the need for more robust routine infant feeding data collection and reporting, and the necessity for strengthening leadership, monitoring and oversight to scale up and sustain breastfeeding.

9.
Matern Child Nutr ; : e13449, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319613

RESUMO

This study aimed to investigate the impact of intrapartum and post-partum complications and newborn care practices on early initiation of breastfeeding (EIBF). Data for the study came from a prospective cohort study in Ethiopia that recruited and followed pregnant and post-partum women from 2019 to 2021. Resident enumerators conducted interviews at enrolment in 2019 and follow-ups at 6 weeks, 6 months and 1 year post-partum. The present analysis is based on data from the baseline survey and 6 weeks follow-up. Multivariable logistic regression was used to estimate the effects of newborn care practices and intrapartum and post- partum complications on EIBF (the proportion of newborns who initiated breastfeeding within the first hour of birth). Overall, 2660 mother-infant pairs were included in this analysis. After adjustment, EIBF was less likely among women who experienced intrapartum haemorrhage (adjusted odds ratio [AOR]: 0.76, 95% confidence interval [CI]: 0.59-0.97), malpresentation (AOR: 0.46, 95% CI: 0.30-0.72) and convulsions (AOR: 0.48, 95% CI: 0.34-0.66) during childbirth. Mother-newborn skin-to-skin contact increased the likelihood of EIBF (AOR: 1.47, 95% CI: 1.11-1.94). Women who experienced post-partum haemorrhage (AOR: 0.63, 95% CI: 0.47-0.84), retained placenta for more than 30 min (AOR: 0.36, 95% CI: 0.24-0.52) and convulsions after delivery (AOR: 0.57, 95% CI: 0.41-0.79) were less likely to initiate breastfeeding early. Also, women who had a caesarean birth (AOR: 0.28, 95% CI: 0.18-0.41), delivered outside of a healthcare facility (AOR: 0.70, 95% CI: 0.50-0.99) or had twin birth (AOR: 0.43, 95% CI: 0.22-0.85) were less likely to initiate breastfeeding early. Skin-to-skin contact should be encouraged whenever possible, and women with obstetric complications should be encouraged and supported to initiate breastfeeding early.

10.
Cell ; 185(23): 4280-4297.e12, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36323316

RESUMO

The gut microbiome has an important role in infant health and development. We characterized the fecal microbiome and metabolome of 222 young children in Dhaka, Bangladesh during the first two years of life. A distinct Bifidobacterium longum clade expanded with introduction of solid foods and harbored enzymes for utilizing both breast milk and solid food substrates. The clade was highly prevalent in Bangladesh, present globally (at lower prevalence), and correlated with many other gut taxa and metabolites, indicating an important role in gut ecology. We also found that the B. longum clades and associated metabolites were implicated in childhood diarrhea and early growth, including positive associations between growth measures and B. longum subsp. infantis, indolelactate and N-acetylglutamate. Our data demonstrate geographic, cultural, seasonal, and ecological heterogeneity that should be accounted for when identifying microbiome factors implicated in and potentially benefiting infant development.


Assuntos
Bifidobacterium longum , Lactente , Criança , Feminino , Humanos , Pré-Escolar , Bifidobacterium longum/metabolismo , Bifidobacterium/metabolismo , Desmame , Oligossacarídeos/metabolismo , Bangladesh , Leite Humano , Fezes/microbiologia
11.
Ginekol Pol ; 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36378127

RESUMO

Although the role of prolactin and cortisol in the human lactation process seems to be undisputed, the changes in postpartum serum concentrations in mothers make data interpretation difficult. To determine the factors that possibly influence these hormones, we examined a group of patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor period. The serum levels of cortisol and prolactin were assessed in these full-term pregnant women during admission to labor, in the third stage of labor, and on the second day postpartum. The prolactin and cortisol levels were also measured in the umbilical cord for the assessment of newborn babies. The results showed a significant relationship between maternal age and the level of prolactin measured before childbirth and fluctuations in cortisol level with respect to labor duration. In addition, we observed a strong correlation between the level of prolactin assessed before childbirth and the pH and base excess of the umbilical cord artery. Most importantly, a correlation was noted between breastfeeding within two hours after the labor and the level of cortisol measured after childbirth, which is worth mentioning to emphasize the significance of early maternal-neonatal skin-to-skin contact.

12.
Microorganisms ; 10(11)2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36363819

RESUMO

Human T lymphotropic virus 1 (HTLV-1) may be transmitted from mother to child and affects at least 5-10 million individuals worldwide, with severe consequences on health. Strategies to prevent transmission are important, as there is no treatment or vaccine. This systematic review aimed to identify interventions to prevent HTLV-1 mother-to-child transmission and to determine their effectiveness. Exclusive formula feeding, short-term breastfeeding, use of freeze-thaw milk, milk pasteurization, maternal and infant antiretroviral drugs, caesarean section, early clamping of umbilical cord, screening of milk donors and avoidance of cross-breastfeeding were identified as possible strategies. Avoidance of breastfeeding is an intervention that prevents 85% of transmissions. This strategy is recommended in Japan, Brazil, Colombia, Canada, Chile, Uruguay, the USA and some regions of French Guyana. Whilst breastfeeding for <3 months does not increase the risk of transmission compared to exclusive formula-feeding, concerns remain regarding the limited number of studies outside Japan, and the lack of information on women having higher risk of HTLV-1 transmission and on the ability of women to discontinue breastfeeding. Additional interventions are plausible, but data on their effectiveness are limited. The acceptance of interventions is high. These findings may guide healthcare professionals and support policymakers in implementing policies to avoid HTLV-1 mother-to-child transmission.

13.
Artigo em Inglês | MEDLINE | ID: mdl-36367052

RESUMO

AIM: The fall of a newborn baby to the hospital floor is a devastating experience for the family and staff caring for the mother and baby. The aim of this study was to report our experience in an ethnically diverse and socioeconomically disadvantaged community. METHODS: The study was a retrospective case series of all baby falls in the Counties Manukau Health (New Zealand) post-natal care wards, birthing suites and birthing units from 2015 to 2018. Information from the incident reporting system was used to identify the circumstances surrounding the fall. In addition, medical records of the mother and the baby were examined for the admission during which the fall occurred. RESULTS: There were 32 cases (rate 12.1/10 000 live births). Mothers of babies who fell were more likely to present late for antenatal care, to smoke and be obese. They were more likely to have delivered by caesarean. Falls were more likely to occur at night and around weekends. In most instances (84%) the mother fell asleep with baby on the bed while breastfeeding. There were no major injuries. CONCLUSIONS: The rate of baby falls is considerably greater than previous reports. Recommendations are made to reduce this occurrence. These can be incorporated into safe sleep education.

14.
Am J Health Promot ; : 8901171221138275, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36330772

RESUMO

PURPOSE: Perceived Social Support (PSS) can impact breastfeeding behaviors, and a lack of PSS potentially contributes to disparities in breastfeeding rates for African American women (AA). Objectives were to describe PSS at two timepoints and test associations between PSS and breastfeeding intensity for AA. METHODS: Data are from a feasibility trial of breastfeeding support among AA. The Hughes Breastfeeding Support Scale was used to measure PSS (Emotional, Informational, Tangible; total range = 30-120) in pregnancy (T1, n = 32) and early postpartum (T2, n = 31). Scale means were compared with t-tests. Associations between PSS at T1 and breastfeeding intensity (ie, quantitative measure of breastfeeding) were assessed with linear regression. RESULTS: Total PSS (mean ± SE) was high at both time points (T1 = 90.5 ± 4.8; T2 = 92.8 ± 3.1). At T2, older participants or those living with a partner had higher total PSS scores compared to those younger or living alone. Emotional PSS was significantly higher at T2 than T1 with no differences in tangible or informational PSS over time. Mixed-feeding, exclusive breastfeeding, and exclusive formula feeding was distributed at 39%, 32%, and 29%, respectively. Total PSS was not associated with breastfeeding intensity. CONCLUSION: Women reported high levels of social support, and emotional PSS increased over time in this small sample of AA. PSS and sources of PSS are understudied, especially among AA, and future studies should explore quantitative methods to assess PSS. The results of such assessments can then be used to design breastfeeding support interventions.

15.
Clin Anat ; 2022 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-36336971

RESUMO

Anatomy of the superior labial frenulum (SLF), at first glance, seems to be well established. However, existing studies on the SLF lack description of the incisivus labii superioris (ILS), which cannot be ignored when discussing the SLF. We believe that thorough understanding of the SLF necessitates the anatomical knowledge of the ILS. This study aimed to elucidate the anatomical relationship between the orbicularis oris (OO), ILS, and SLF. A total of 20 formalin fixed human cadaveric specimens were used for gross anatomical and/or histological observation. For histological observation, all specimens were stained with Masson-trichrome. The SLF was a mucosal fold between the gingival mucosa and alveolar mucosa with connective tissue deep to it. The connective tissue attached to the alveolar bone in the junction between the right and left ILS. Skeletal muscle fibers other than orbicularis oris was found in one specimen, which were considered the ILS. During a frenulectomy, removal of the connective tissue bundle is required to prevent recurrence of the high SLF insertion.

16.
Sci Total Environ ; 858(Pt 1): 159820, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36349623

RESUMO

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.

17.
J Family Med Prim Care ; 11(8): 4766-4772, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36353048

RESUMO

Background: Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health, there is a dearth of comprehensive studies covering all important aspects of infant care in an individual study. Objectives: To determine practices regarding infant feeding, infant sleep, use of pacifiers, and immunization, and to explore the association of these practices with mother's demographic data. Methods: A cross-sectional study was conducted using a self-administrated questionnaire distributed among mothers attending well-baby clinics in Primary Health Care Centers (PHCCs), Unaizah city, Qassim region, Saudi Arabia. By using the two-stage cluster sampling method, 50 women participated from each of the four selected PHCCs, leading to a total of 200 participants. The survey was conducted from December 2020 to February 2021. Data were analyzed using SPSS software. Results: A total of 124 (62%) respondents were between the ages of 26 and 35 years, 64% had a bachelor's degree, and 69.5% were housewives. Breastfeeding was practiced by 88% of women, 48% began infant weaning at 6 months of age, and 49% put their infant to sleep on their back. Up-to-date vaccination was reported for 188 (94%) infants. Infant pacifier use was reported by 58% of the respondents, and 82.5% of the participants had been offered formula milk for the newborn at the hospital. Vaginal delivery, absence of complications during pregnancy or labor, presence of a housemaid, and family income of more than 10,000 Saudi Riyals were significantly associated with better infant care practices. Conclusion: The study participants have good practices for certain infant care aspects such as immunization; however, improvement is needed for other practices, including weaning at the proper age, infant sleep position, and the use of pacifiers. Administrative measures are required to monitor the use of formula milk at hospitals and to enhance health education for mothers.

18.
Metabolites ; 12(11)2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36355152

RESUMO

Given the long-term advantages of exclusive breastfeeding to infants and their mothers, there is both an individual and public health benefit to its promotion and support. Data on the composition of human milk over the course of a full period of lactation for a single nursling is sparse, but data on human milk composition during tandem feeding (feeding children of different ages from different pregnancies) is almost entirely absent. This leaves an important knowledge gap that potentially endangers the ability of parents to make a fully informed choice on infant feeding. We compared the metataxonomic and metabolite fingerprints of human milk samples from 15 tandem feeding dyads to that collected from ten exclusively breastfeeding single nursling dyads where the nursling is under six months of age. Uniquely, our cohort also included three tandem feeding nursling dyads where each child showed a preferential side for feeding-allowing a direct comparison between human milk compositions for different aged nurslings. Across our analysis of volume, total fat, estimation of total microbial load, metabolite fingerprinting, and metataxonomics, we showed no statistically significant differences between tandem feeding and single nursling dyads. This included comparisons of preferential side nurslings of different ages. Together, our findings support the practice of tandem feeding of nurslings, even when feeding an infant under six months.

19.
J Hum Lact ; : 8903344221134273, 2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36384330

RESUMO

INTRODUCTION: Narcolepsy, a condition adversely affecting psychological, social, and cognitive function, is more prevalent in females of childbearing age than the general population. Modafinil and armodafinil are central nervous system stimulants approved for treatment of narcolepsy. Infant exposure to these agents through human milk has not been investigated. Poor quality medication safety information during lactation is associated with early cessation of breastfeeding and suboptimal healthcare for the breastfeeding family. MAIN ISSUE: In this case study, we measured the concentration of armodafinil (the most active form of modafinil) in human milk and infant plasma to quantify infant exposure. MANAGEMENT: The participant was a 30-year-old primipara with narcolepsy, taking modafinil (300 mg morning, 100 mg noon) while breastfeeding her 6-week-old infant despite the paucity of safety information. Armodafinil concentrations were measured in eight serial human milk samples collected over a 26-hr period and in single maternal and infant plasma samples using ultra performance liquid chromatography - tandem mass spectrometry. The average concentration of armodafinil in human milk was 1.96 mg/L; the relative infant dose was 4.85%; the theoretical infant dose was 0.294 mg/kg/day. Maternal and infant plasma concentrations of armodafinil were 12.02 mg/L and 0.19 mg/L, respectively. The participant continued to exclusively breastfeed the infant, who had normal growth and development. CONCLUSION: Based on these findings, relatively small amounts of armodafinil pass into human milk, with consequent limited infant exposure. Consideration can be given to the use of modafinil or armodafinil during breastfeeding, provided the infant is monitored. Further studies are needed to confirm these findings.

20.
Matern Child Nutr ; : e13453, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36394283

RESUMO

We estimated how micronutrient needs of young children, aged 6-24 months were covered by the standard (traditional) diets in Ghana and Benin, and the contributions of partial breastfeeding and national nutrition programs aimed at improving micronutrient status to overall micronutrient intakes. Estimates of micronutrient intake from standard diets were based on previous surveys, using the food composition table of West Africa (INFOOD). Recommended micronutrient intakes were based on World Health Organization recommendations. Children were grouped in three age groups (6-8, 9-12, and 13-24 months) to capture the changing dynamics of the complementary feeding period. As expected, from 6 months of age onwards, breastmilk didn't cover the micronutrient needs. The standard diets contributed only minimal to micronutrient intakes of children ranging from 0% to 37% of recommended intakes for Ca, Fe, Zn, vitamin A, vitamin D and iodine depending on the micronutrient considered. The contribution of mass (bio)-fortification programs to the coverage of micronutrient needs varied widely, depending on the staple food considered and the country, but overall did not allow to fill the gap in micronutrient needs of children except for vitamin A in some contexts. In contrast, consumption of voluntary fortified complementary food, especially formulated for the needs in this age groups, contributed substantially to overall micronutrient intake and could fill the gap for several micronutrients. The development of young child-targeted programs including micronutrient-dense foods, associated with interventions to increase the diet diversity and meal frequency, could significantly improve micronutrients intakes of children in both Ghana and Benin.

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