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2.
Nutr Hosp ; 36(Spec No3): 30-34, 2019 Aug 27.
Artigo em Espanhol | MEDLINE | ID: mdl-31368334

RESUMO

Introduction: Although the benefits of breastfeeding are clear and well documented, for both newborns and nursing mothers, breastfeeding rates worldwide are not optimal in many cases. There are multiple myths and errors related to breastfeeding: that certain foods cannot be consumed during breastfeeding, that, however, certain foods must be consumed to increase milk production, that composition of breast milk is not adequate in some cases, that breastfeeding is associated with more risk of suffering caries… Therefore, the objective of this article is to clarify the reality about these aspects of breastfeeding.


Assuntos
Aleitamento Materno , Alimentos , Saúde do Lactente , Saúde Materna , Fatores Etários , Aleitamento Materno/efeitos adversos , Aleitamento Materno/psicologia , Suplementos Nutricionais , Ingestão de Energia , Feminino , Humanos , Recém-Nascido , Leite Humano/química , Necessidades Nutricionais
3.
Int Rev Psychiatry ; 31(3): 295-304, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31180257

RESUMO

The continuation of lithium while breastfeeding is a controversial topic, and clinical recommendations vary. A systematic review was completed of available data on lithium and breastfeeding to determine the degree of lithium exposure through breast milk and assess the potential risk to the infant. Databases, including PubMed MEDLINE, Embase, PsycINFO, Web of Science, Scopus, and Cochrane CENTRAL Register of Controlled Trials databases, were searched for articles on lithium and breastfeeding from the start dates of the databases through December 2018. Articles were included if the report included at least one maternal serum/plasma and/or breast milk lithium concentration and one infant serum/plasma lithium concentration. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Twelve articles, all case reports, were selected for inclusion out of 441 articles that were found and 230 that were reviewed from the search. Data are limited on the safety of lithium continuation while breastfeeding. Among the adverse effects reported, it is difficult to differentiate poor outcomes from factors affecting infant health, concomitant medications, and gestational lithium exposure. Recommendations on whether to continue lithium while breastfeeding must be personalized to the individual woman and her infant.


Assuntos
Aleitamento Materno/efeitos adversos , Lítio/toxicidade , Lítio/uso terapêutico , Leite Humano/química , Medição de Risco , Feminino , Humanos , Lactente , Lítio/sangue
5.
Acta Biochim Pol ; 66(2): 123-127, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31125391

RESUMO

The notion of 'civilization diseases' is used to describe certain ailments whose aetiology is difficult to explain based on the knowledge about the functioning of the body and its metabolism. Only studies at the cellular level, on biochemical changes shed light on the causes of some diseases described as civilization diseases (cancers, cardiovascular and respiratory diseases, obesity, psychomotor disorders in children and an increase in the frequency of malformations). The factors whose incontestable influence on the increase in the frequency of occurrence of various 'civilization diseases' has been proved are persistent organic pollutants, among others belonging to the group of organohalogen compounds. Among organohalogen pollutants one needs to distinguish organochlorine compounds, which have been used as pesticides, and pollution emitted by various industries such as dioxins and furans, polychlorinated biphenyls, and polybrominated organic compounds used as flame retardants and perfluoroalkylated substances, which are characterized by high chemical and thermal stability as well as high surface activity due to which they may be widely used as oleophobic and hydrophobic factors.


Assuntos
Exposição Ambiental/efeitos adversos , Neoplasias/etiologia , Obesidade/etiologia , Aleitamento Materno/efeitos adversos , Pré-Escolar , Dioxinas/efeitos adversos , Dioxinas/sangue , Feminino , Retardadores de Chama/efeitos adversos , Retardadores de Chama/análise , Furanos/efeitos adversos , Furanos/sangue , Humanos , Hidrocarbonetos Clorados/efeitos adversos , Hidrocarbonetos Clorados/análise , Lactente , Recém-Nascido , Masculino , Praguicidas/efeitos adversos , Praguicidas/análise , Bifenilos Policlorados/efeitos adversos , Bifenilos Policlorados/sangue
6.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30886111

RESUMO

This clinical report updates and replaces a 2008 clinical report from the American Academy of Pediatrics, which addressed the roles of maternal and early infant diet on the prevention of atopic disease, including atopic dermatitis, asthma, and food allergy. As with the previous report, the available data still limit the ability to draw firm conclusions about various aspects of atopy prevention through early dietary interventions. Current evidence does not support a role for maternal dietary restrictions during pregnancy or lactation. Although there is evidence that exclusive breastfeeding for 3 to 4 months decreases the incidence of eczema in the first 2 years of life, there are no short- or long-term advantages for exclusive breastfeeding beyond 3 to 4 months for prevention of atopic disease. The evidence now suggests that any duration of breastfeeding ≥3 to 4 months is protective against wheezing in the first 2 years of life, and some evidence suggests that longer duration of any breastfeeding protects against asthma even after 5 years of age. No conclusions can be made about the role of breastfeeding in either preventing or delaying the onset of specific food allergies. There is a lack of evidence that partially or extensively hydrolyzed formula prevents atopic disease. There is no evidence that delaying the introduction of allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months prevents atopic disease. There is now evidence that early introduction of peanuts may prevent peanut allergy.


Assuntos
Dieta , Intervenção Médica Precoce/métodos , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/prevenção & controle , Cuidado Pós-Natal/métodos , Aleitamento Materno/efeitos adversos , Aleitamento Materno/métodos , Criança , Pré-Escolar , Feminino , Alimentos Formulados , Humanos , Hipersensibilidade Imediata/dietoterapia , Hipersensibilidade Imediata/prevenção & controle , Lactente , Alimentos Infantis/efeitos adversos , Recém-Nascido , Masculino , Necessidades Nutricionais , Prognóstico , Medição de Risco , Fatores de Tempo
7.
MCN Am J Matern Child Nurs ; 44(3): 164-169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30855282

RESUMO

Investigation of the needs of same-sex mothers practicing lactation is limited in the nursing literature. The heteronormative structure of the healthcare system has stigmatized these postpartum women and minimized the level of nursing care provided. Case reports demonstrate that same-sex mothers value inclusivity and understanding of their healthcare needs that is missing in healthcare settings. Perinatal nurses must listen attentively and think critically about their words and actions to avoid inappropriate judgments when providing care to this population. Active engagement and ongoing competence education builds the foundation that will provide perinatal nurses the knowledge they need to best support the unique needs of same-sex mothers in their lactation experience.


Assuntos
Mães/psicologia , Minorias Sexuais e de Gênero/psicologia , Aleitamento Materno/efeitos adversos , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Competência Clínica/normas , Feminino , Humanos , Casamento/psicologia , Casamento/estatística & dados numéricos , Leite Humano/metabolismo , Mães/estatística & dados numéricos , Gravidez , Minorias Sexuais e de Gênero/estatística & dados numéricos
8.
Res Nurs Health ; 42(3): 176-188, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30835887

RESUMO

The majority of women experience pain during breastfeeding initiation with few strategies to manage breast and nipple pain. In fact, women cite breast and nipple pain as among the most common reasons for breastfeeding cessation. To address this important issue, we developed a breastfeeding self-management (BSM) intervention, based on the Individual and Family Self-Management Theory Framework. In this framework, self-management is conceptualized as a process in which women use knowledge, beliefs, and social facilitation to achieve breastfeeding goals. The purpose of this longitudinal pilot randomized controlled trial was to test the feasibility, acceptability, and preliminary efficacy of the BSM intervention with women initiating breastfeeding. Recruitment of 60 women intending to breastfeed occurred within 48 hr of delivery and women were randomized to either the intervention or usual care group. The BSM intervention group received BSM education modules that included information of how to manage breast and nipple pain and self-management support through biweekly texting from the study nurse, and were asked to complete a daily breastfeeding journal. Primary outcomes measured at baseline, 1, 2, and 6 weeks will be used to (a) evaluate feasibility, acceptability, and preliminary efficacy of the BSM intervention, and (b) assess the influence of protective and risk factors of breastfeeding pain (including individual genetic polymorphisms related to pain sensitivity) on process variables for self-management of breastfeeding and breastfeeding pain, and on proximal (breastfeeding pain severity and interference, breastfeeding frequency) and distal outcomes (breastfeeding exclusivity and duration and general well-being).


Assuntos
Aleitamento Materno/psicologia , Mães/educação , Mamilos , Cuidado Pós-Natal/métodos , Autogestão/educação , Adulto , Aleitamento Materno/efeitos adversos , Feminino , Humanos , Estudos Longitudinais , Satisfação do Paciente , Projetos Piloto , Autocuidado/métodos
9.
J Clin Pediatr Dent ; 43(2): 91-96, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30730796

RESUMO

PURPOSE: To assess the association between long-term breastfeeding and dental caries in children during the third year of life. STUDY DESIGN: This retrospective longitudinal study consisted of children who were followed-up by the Maternal and Child Public Oral Health Program. Information regarding socio-economic class, demographic status, daily frequency of sucrose intake, breastfeeding duration and oral hygiene were collected with the aid of a questionnaire. Information on dental caries in the children was collected from dental records. Negative binomial regression models were used to assess the association between breastfeeding duration and dental caries. RESULTS: We included a total of 325 children in the study. The incidence of dental caries was found to be 12.92%. Even after adjustments, children who were breastfed for a period ≥24 months were more likely to have dental caries, when compared with children who were not breastfed or were breastfed for less than 6 months. Children who had a higher frequency of sucrose intake and those with dental plaque were more likely to have dental caries. CONCLUSION: In this study, a greater incidence of dental caries was found in children who were breastfed for a period ≥ 24 months..


Assuntos
Aleitamento Materno , Cárie Dentária , Aleitamento Materno/efeitos adversos , Pré-Escolar , Cárie Dentária/etiologia , Sacarose na Dieta , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Prevalência , Estudos Retrospectivos , Fatores de Tempo
10.
Cad Saude Publica ; 35(2): e00041018, 2019 02 18.
Artigo em Português | MEDLINE | ID: mdl-30785486

RESUMO

This article sought to evaluate the conformity between recommendations regarding antidepressant use during breastfeeding found in drug package inserts with recommendations from science-based bibliographic sources. We evaluated the standard drug package inserts of 23 antidepressants with active registration in Brazil. The presence of contraindications of antidepressant use during breastfeeding was compared with information present in the Brazilian Ministry of Health technical manual, the book Medications and Mothers' Milk and on the databases LactMed, Micromedex and UpToDate. In most drug package inserts (62.5%), antidepressants are contraindicated during breastfeeding. Among bibliographical sources, that percentage varied between 0% and 25%. The study shows a low conformity between drug package inserts and bibliographical sources, alerting to the need for revising the content and presentation of information present in antidepressant drug package inserts in Brazil.


Assuntos
Antidepressivos/efeitos adversos , Aleitamento Materno/efeitos adversos , Indústria Farmacêutica/normas , Rotulagem de Medicamentos/normas , Medicina Baseada em Evidências , Antidepressivos/administração & dosagem , Brasil , Serviços de Informação sobre Medicamentos/normas , Monitoramento de Medicamentos , Feminino , Humanos , Lactação/metabolismo , Exposição Materna/efeitos adversos , Fatores de Risco
12.
MCN Am J Matern Child Nurs ; 44(2): 100-107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807327

RESUMO

BACKGROUND: The Centers for Disease Control and Prevention lists accidents (unintentional injuries) as the fifth leading cause of infant mortality. Data analysis from a multihospital system of inpatient family birth centers revealed fluctuations in newborn birth admission falls rates at times above the benchmark reported in the literature. PURPOSE: We describe a multipronged approach to address an identified safety concern. The aim of the project was to decrease the rate of newborn falls during birth hospitalization. Despite applying multiple interventions described in the literature, newborn falls were not eliminated. STUDY DESIGN AND METHODS: In this quality improvement project, a nursing leadership team was convened to review the literature, identify current and ideal states, obtain stakeholder input, identify contributing factors, and agree on standardized interventions to prevent newborn falls. The project received exempt status from the institutional review board. RESULTS: Since we started the project in 2016, there was a downward trend in newborn birth admission falls in 2017; however, based on our variable data over the last 5 years and small numbers of falls, it is difficult to conclude that any one strategy or combination of strategies has been successful. Because falls from bed with the new mother were the most common types of newborn falls, interventions were focused; however, our falls rate for newborns never fell below comparable rates in the literature. CLINICAL IMPLICATIONS: More data are needed on effective interventions that can reduce the rate of newborn falls, especially those from bed while with the new mother. A comprehensive approach based on analysis of events and review of existing evidence are necessary first steps.


Assuntos
Acidentes por Quedas/prevenção & controle , Doença Iatrogênica/prevenção & controle , Análise de Sistemas , Aleitamento Materno/efeitos adversos , Feminino , Humanos , Recém-Nascido , Masculino , Segurança do Paciente/normas , Avaliação de Programas e Projetos de Saúde/métodos , Melhoria de Qualidade/normas , Gestão de Riscos
14.
Eur J Pediatr ; 178(4): 541-550, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30707364

RESUMO

The aims of this study were to determine bisphenol A (BPA) levels in breast milk and urine specimens of healthy mother and exclusively breastfed infant pairs having no known BPA exposure, and also to examine the relationship between BPA levels and possible BPA exposure history. Forty mothers and their 1-2-month-old exclusively breastfeed infant were included in the study. The questionnaires about sociodemographic characteristics and possible BPA exposure history were filled out. Breast milk and urine samples were taken. BPA analyses of these samples were conducted using high-performance liquid chromatography coupled with mass spectrometry. All mother-infant pairs showed detectable BPA concentrations. The geometric means of BPA levels in breast milk, maternal urine, and infant urine were determined as 0.12 µg/L (0.03-0.59), 0.12 µg/L (0.03-0.73), and 0.13 µg/L (0.02-0.44), respectively. Infants whose mothers were consuming yoghurt in plastic containers had relatively higher urinary BPA levels (p = 0.00). Mothers consuming hot beverages in plastic glass showed higher breast milk BPA levels (p = 0.033). There were no statistical associations between BPA levels and the use of plastic materials and tools (p > 0.05).Conclusion: The measurable BPA concentrations in all breast milk specimens of healthy mothers may reflect possible exposure from dietary or non-dietary sources. Exclusively, breastfed healthy infants without any known BPA exposure may be exposed to BPA from their mothers through breastfeeding. What is Known: • Fetuses, neonates and infants are exposed to BPA from their mothers through placental transfer and breastfeeding. • Breast milk is considered a continuous low-level exposure to BPA. What is New: • BPA was detected in 100% of maternal urine, infant urine, and breast milk in healthy mother-infant pairs having no known BPA exposure. • The measurable amount of BPA in breast milk and infant urine may reflect possible BPA exposure of mother-infant pairs.


Assuntos
Compostos Benzidrílicos , Aleitamento Materno/efeitos adversos , Leite Humano/química , Fenóis , Adulto , Compostos Benzidrílicos/análise , Compostos Benzidrílicos/urina , Cromatografia Líquida de Alta Pressão , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fenóis/análise , Fenóis/urina , Plásticos/efeitos adversos , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Estatísticas não Paramétricas , Adulto Jovem
15.
Skin Res Technol ; 25(4): 461-468, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30623998

RESUMO

BACKGROUND: Nipple pain is the second most common reason for early weaning, exceeded only by the insufficient milk supply. Nipple fissures can bring other problems, acting also as a portal for bacteria and leading to mastitis. This work proposes the breast protector composite development using materials with tissue repair and moisturizing properties, aligned with a low-cost procedure, aiming not only to relieve pain, but also to heal the nipple fissures caused by breastfeeding. MATERIALS AND METHODS: For the dressings, production was used Natural Latex extracted from the rubber tree and glycerol. The Samples were evaluated chemically and physically by the techniques of Scanning Electron Microscopy, Fourier transform infrared spectroscopy, mechanical traction, and contact angle. The samples were also biologically evaluated by the hemolytic and cytotoxic activity assays. RESULTS: From the physical-chemical assays, the matrix with glycerol has high pore density; the natural latex and glycerol do not covalently interact, indicating that the glycerol can be released; the glycerol addition makes the matrix more elastic but fragile, and increase the wettability. From the biological assays, both materials showed no hemolytic effects; and the cytotoxicity results showed that glycerol did not present cytotoxicity in the fibroblasts, but show a dose-dependent influence in the keratinocytes. CONCLUSION: The material developed for application in breast fissures has mechanical properties similar to those found for materials for dermal applications, present high wettability and pore density. Furthermore, the material showed no cytolytic activity and the tests with skin cell cultures demonstrated the biocompatibility.


Assuntos
Bandagens/tendências , Aleitamento Materno/efeitos adversos , Mamilos/patologia , Dor/prevenção & controle , Bandagens/normas , Materiais Biocompatíveis/química , Crioprotetores/administração & dosagem , Crioprotetores/química , Feminino , Glicerol/administração & dosagem , Glicerol/química , Humanos , Látex/química , Teste de Materiais/métodos , Microscopia Eletrônica de Varredura , Mamilos/efeitos dos fármacos , Pele/efeitos dos fármacos , Pele/patologia , Espectroscopia de Infravermelho com Transformada de Fourier , Cicatrização/efeitos dos fármacos
16.
Clin Rheumatol ; 38(5): 1263-1270, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30635855

RESUMO

The sexual dimorphic prevalence of autoimmunity represents one of the most alluring observations among the mosaic of autoimmunity. Sex hormones are believed to be a mainstay of this asymmetry. The greater prevalence of autoimmunity among fertile women, disease onset/relapses during pregnancy, and postpartum are some of the points that support this theory. Undeniably, motherhood represents one of the most remarkable challenges for the immune system that not only has to allow for the conceptus but also deal with extraordinary hormonal alterations. Prolactin has a recognized immune-stimulatory effect, mainly inhibiting the negative selection of autoreactive B lymphocytes. In accordance, hyperprolactinemia has been associated with several autoimmune diseases, interfering with its pathogenesis and activity. During the pregnancy and lactation period, assorted autoimmune patients experience relapses, suggesting an active interference from increased levels of prolactin. This association was found to be significant in systemic lupus erythematosus, rheumatoid arthritis, and peripartum cardiomyopathy. Furthermore, treatment with bromocriptine has shown beneficial effects specially among systemic lupus erythematosus patients. In this review, we attempt to provide a critical overview of the link between prolactin, autoimmune diseases, and motherhood, emphasizing whether breastfeeding should be avoided among women, both with diagnosed disease or high risk for its development.


Assuntos
Autoimunidade , Aleitamento Materno/efeitos adversos , Hiperprolactinemia/etiologia , Prolactina/metabolismo , Artrite Reumatoide/imunologia , Bromocriptina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/tratamento farmacológico , Lactente , Saúde do Lactente , Recém-Nascido , Lúpus Eritematoso Sistêmico/imunologia , Leite Humano/imunologia , Escleroderma Sistêmico/imunologia
17.
Environ Sci Pollut Res Int ; 26(8): 7405-7427, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30687894

RESUMO

Breastfeeding is a gold standard of neonate nutrition because human milk contains a lot of essential compounds crucial for proper development of a child. However, milk is also a biofluid which can contain environmental pollution, which can have effects on immune system and consequently on the various body organs. Polychlorinated biphenyls are organic pollutants which have been detected in human milk. They have lipophilic properties, so they can penetrate to fatty milk and ultimately to neonate digestive track. Another problem of interest is the presence in milk of heavy metals-arsenic, lead, cadmium, and mercury-as these compounds can lead to disorders in production of cytokines, which are important immunomodulators. The toxicants cause stimulation or suppression of this compounds. This can lead to health problems in children as allergy, disorders in the endocrine system, end even neurodevelopment delay and disorder. Consequently, correlations between pollutants and bioactive components in milk should be investigated. This article provides an overview of environmental pollutants found in human milk as well as of the consequences of cytokine disorder correlated with presence of heavy metals. Graphical abstract.


Assuntos
Aleitamento Materno/efeitos adversos , Poluentes Ambientais/efeitos adversos , Poluição Ambiental/efeitos adversos , Exposição Materna/efeitos adversos , Metais Pesados/efeitos adversos , Leite Humano/química , Bifenilos Policlorados/efeitos adversos , Arsênico/efeitos adversos , Cádmio/efeitos adversos , Citocinas/biossíntese , Feminino , Humanos , Mercúrio/efeitos adversos , Mães
18.
MCN Am J Matern Child Nurs ; 44(2): 66-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30688667

RESUMO

PURPOSE: Breastfeeding-related pain is commonly experienced early in the postpartum period and is an important contributor to breastfeeding cessation, yet little is known about what this pain means to women and how it is experienced. The purpose of this study was to gain a better understanding of the phenomenon of breastfeeding-related pain, how women experience this pain, and the meaning it holds for them. STUDY DESIGN AND METHODS: Interpretive descriptive methods and inductive content analysis were used. Women were recruited using purposive sampling with a snowball approach. Data were collected via one-to-one interviews using a semistructured interview guide with postpartum women having experienced breastfeeding-related pain in the past 2 months. RESULTS: Fourteen postpartum women who met inclusion criteria were interviewed. They were predominantly Caucasian, well educated, and had greater than average Canadian annual household incomes. The dominant emerging discourse revealed three key themes: (a) interplay between breastfeeding pain and context, (b) action enablers and/or barriers, and (c) breastfeeding outcomes. CLINICAL IMPLICATIONS: Breastfeeding-related pain is an unpleasant sensory and affective experience for women during the postpartum period. Availability and accessibility of breastfeeding supports are essential to enable women to achieve their breastfeeding goals. Providing anticipatory guidance may help women to cope more effectively with their breastfeeding-related pain.


Assuntos
Aleitamento Materno/efeitos adversos , Mastodinia/complicações , Mães/psicologia , Adulto , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Canadá , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mastodinia/psicologia , Pesquisa Qualitativa
19.
BMC Pregnancy Childbirth ; 19(1): 15, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621615

RESUMO

BACKGROUND: WHO recommends that HIV infected women receive antiretroviral therapy (ART) minimally during pregnancy and breastfeeding ("Option B"), or ideally throughout their lives regardless of clinical stage ("Option B+") (Coovadia et al., Lancet 379:221-228, 2012). Although these recommendations were based on clinical trials demonstrating the efficacy of ART during pregnancy and breastfeeding, the population-level effectiveness of Option B+ is unknown, as are retention on ART beyond the immediate post-partum period, and the relative impact and cost-effectiveness of Option B+ compared to Option A (Centers for Disease Control and Prevention, Morb Mortal Wkly Rep 62:148-151, 2013; Ahmed et al., Curr Opin HIV AIDS 8:473-488, 2013). To address these issues, we conducted an impact evaluation of Zimbabwe's prevention of mother to child transmission programme conducted between 2011 and 2018 using serial, community-based cross-sectional serosurveys, which spanned changes in WHO recommendations. Here we describe the rationale for the design and analysis. METHODS/DESIGN: Our method is to survey mother-infant pairs residing in the catchment areas of 157 health facilities randomly selected from 5 of 10 provinces in Zimbabwe. We collect questionnaires, blood samples from mothers and babies for HIV antibody and viral load testing, and verbal autopsies for deceased mothers/babies. Using this approach, we collected data from two previous time points: 2012 (pre-Option A standard of care), 2014 (post-Option A / pre-Option B+) and will collect a third round of data in 2017-18 (post Option B+ implementation) to monitor population-level trends in mother-to-child transmission of HIV (MTCT) and HIV-free infant survival. In addition, we will collect detailed information on facility level factors that may influence service delivery and costs. DISCUSSION: Although the efficacy of antiretroviral therapy (ART) during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV (PMTCT) has been well-documented in randomized trials, little evidence exists on the population-level impact and cost-effectiveness of Option B+ or the influence of the facility on implementation (Siegfried et al., Cochrane Libr 7:CD003510, 2017). This study will provide essential data on these gaps and will provide estimates on retention in care among Option B+ clients after the breastfeeding period. TRIAL REGISTRATION: NCT03388398 Retrospectively registered January 3, 2018.


Assuntos
Infecções por HIV/transmissão , HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/virologia , Avaliação de Programas e Projetos de Saúde , Adulto , Aleitamento Materno/efeitos adversos , Estudos Transversais , Estudos de Avaliação como Assunto , Feminino , Infecções por HIV/virologia , Humanos , Recém-Nascido , Gravidez , Projetos de Pesquisa , Inquéritos e Questionários , Adulto Jovem , Zimbábue
20.
Midwifery ; 71: 71-76, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30690202

RESUMO

BACKGROUND: When compared with full-term birth (39 to <42 weeks), early-term birth (37 to <39 weeks) is associated with adverse neonatal outcomes that may impede breastfeeding. Breastfeeding provides numerous benefits to infants and could potentially offset the effects of early-term birth. However, the effect of early-term birth on any and exclusive breastfeeding duration among healthy normal weight infants is unclear. OBJECTIVES: The objective of this study was to examine the association between early-term birth and breastfeeding duration and exclusivity among healthy term infants. METHODS: Two prospective cohorts of 2704 healthy mother-infant pairs were recruited in Hong Kong in 2006-07 and 2011-12. Participants were followed prospectively for 12 months or until they stopped breastfeeding. RESULTS: Approximately one-third (32.8%) of the infants were born early-term. More than one-half of all participants had stopped breastfeeding by three months postpartum and approximately one-half of the infants were not being exclusively breastfed by two weeks postpartum. There was no significant difference in the odds of any (adjusted odds ratio [aOR] = 1.05; 95% 0.85, 1.31) or exclusive (aOR = 0.89; 95% 0.73, 1.08) breastfeeding at one-month postpartum between infants born early-term and at full-term. There was also no significant difference in the duration of any (adjusted hazard ratio [aHR] = 1.0; 95% 0.91, 1.10) or exclusive (aHR = 1.0; 95% 0.91, 1.09) breastfeeding between early-term and full-term infants. CONCLUSION: In this cohort, early-term birth was not associated with breastfeeding duration and exclusivity. This suggests that, in the absence of neonatal complications, early-term birth itself may not lead to a shorter duration of any or exclusive breastfeeding.


Assuntos
Aleitamento Materno/métodos , Resultado da Gravidez , Adulto , Aleitamento Materno/efeitos adversos , Aleitamento Materno/estatística & dados numéricos , Estudos de Coortes , Feminino , Idade Gestacional , Hong Kong/epidemiologia , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Nascimento a Termo , Fatores de Tempo
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