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2.
Nutr. hosp ; 36(4): 777-785, jul.-ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184700

RESUMO

Introduction: several investigations have identified breastfeeding as a protective factor for rapid infant weight gain and childhood obesity while other studies have found that this protective effect could be the result of confounding factors. Objectives: to assess the associations between lactation practices (breast-fed vs formula-fed infants) during the introduction of complementary food period, as well as the following: a) patterns of food intake; and b) trajectories of growth at six, nine and 12 months (z-score of weight, height and body mass index [BMI] and changes in these z-scores from six to 12 months). Methods: two hundred and three infants randomly selected from Spanish Primary Health Centres were measured. Parents recorded all infant's food consumption for three days (g/day). Linear regression models were applied. Results: breast-fed infants had a lower intake of cereals, fruit baby food, vegetables with meat/fish and a total intake of food compared to formula-fed infants at nine months of age. After adjusting for sex, parental education and total food intake, breastfed children continued to have lower intake of cereals (-5.82, 95% CI: -9.22, -2.43), and lower total food intake (-301.23, 95% CI: -348.50, -253.96). Breast-fed infants had a lower change in z-score of weight, height and BMI from six to 12 months of age and these differences remained when adjusting for all confounders. Conclusions: formula-fed infants during the complementary feeding period have a higher food intake and show higher rates of rapid infant weight gain compared to breast-fed infants. These differences in growth trajectories depending on breastfeeding maintenance and food intake during early life must be considered in adiposity risk evaluation


Introducción: varios estudios han identificado la lactancia materna como un factor protector frente a la ganancia rápida de peso y la obesidad infantil, mientras que otros estudios han encontrado que este efecto protector podría ser el resultado de la interferencia de factores de confusión. Objetivos: evaluar las asociaciones entre el tipo de lactancia (leche materna versus lactantes alimentados con fórmula) durante la introducción de la alimentación complementaria, así como: a) los patrones de ingesta de alimentos; y b) las trayectorias de crecimiento a los seis, nueve y 12 meses (z-score de peso, estatura e índice de masa corporal (IMC) y variaciones en estos z-score entre los seis y los 12 meses. Métodos: se midieron 203 neonatos seleccionados en centros de salud primaria españoles. Los padres registraron el consumo de alimentos de todos los bebés durante tres días (g/día). Se aplicaron modelos de regresión lineal. Resultados: los bebés alimentados con leche materna tuvieron una menor ingesta de cereales, alimentos para bebés a base de frutas, verduras con carne/pescado, así como una menor ingesta total de alimentos en comparación con los bebés alimentados con fórmula a los nueve meses de edad. Después de realizar el ajuste por sexo, educación de los padres y consumo total de alimentos, los niños alimentados con leche materna continuaron teniendo una menor ingesta de cereales (-5,82, IC 95%: -9,22, -2,43) y una ingesta total de alimentos más baja (-301,23, IC 95%: -348,50, -253,96). Los bebés alimentados al pecho tuvieron un menor incremento en la puntuación z-score de peso, talla e IMC entre los seis y los 12 meses de edad y estas diferencias se mantuvieron cuando se ajustaron para todos los factores de confusión. Conclusiones: los lactantes alimentados con fórmula durante el periodo de alimentación complementaria tienen una mayor ingesta de alimentos y muestran tasas más altas de ganancia de peso en comparación con los lactantes alimentados con leche materna. Estas diferencias en las trayectorias de crecimiento en función del mantenimiento de la lactancia materna y la ingesta de alimentos durante los primeros años de vida deben considerarse en la evaluación del riesgo de adiposidad


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Nutrição do Lactente/normas , Desenvolvimento Infantil , Aleitamento Materno/métodos , Alimentos Formulados/normas , Fórmulas Infantis , Estado Nutricional , Obesidade Pediátrica/prevenção & controle , Peso-Estatura , Índice de Massa Corporal , Modelos Lineares , Pais/educação , Adiposidade
3.
Enferm. clín. (Ed. impr.) ; 29(4): 207-215, jul.-ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182914

RESUMO

Objetivo: Conocer la experiencia personal y sentimientos de las mujeres primíparas que se vieron obligadas a abandonar la lactancia materna (LM) antes del tiempo previsto inicialmente por cada mujer, así como las causas del abandono y el papel de los profesionales sanitarios. Método: Estudio cualitativo fenomenológico mediante entrevista semiestructurada. Se realizó un muestreo opinático mediante informadores clave, hasta alcanzar la saturación de la información. Se realizó análisis de contenido cualitativo para generar códigos y asignar categorías. Resultados: Se entrevistaron 15 mujeres de 33,1 (DE 5,4) años. Se constató ambivalencia de sentimientos, considerando que la LM es una experiencia satisfactoria a la par que sacrificada y dolorosa. Las mujeres referían escasez de conocimientos. La inseguridad sobre la alimentación y el dolor físico fueron las causas más importantes para el abandono. Se evidenció además una dualidad de sentimientos entre la tranquilidad que supone la alimentación artificial, al saber que el niño está bien alimentado, y la sensación de culpabilidad por no haber mantenido la LM. Consideraron que los profesionales no realizan adecuadamente su labor de promoción de la LM, refiriendo numerosas ocasiones en las que los propios profesionales sanitarios efectuaron prácticas contrarias a su instauración y mantenimiento. Conclusiones: En el relato de las madres se constatan necesidades formativas y de soporte emocional insuficientemente cubiertas. Las enfermeras implicadas en la atención de estas mujeres deberían explorar sistemáticamente dichas necesidades


Objective: The aim of this study was to discover the personal experience and feelings of primiparous women who had to abandon breastfeeding (BF) before the expected time, as well as the causes of abandonment and the role of health professionals. Method: A qualitative study through semi-structured interview was carried out. A purposive sampling by key informants was conducted, until saturation of the information was reached. Qualitative content analysis was carried out to generate codes and assign categories. Results: We interviewed 15 women aged 33.1 (SD 5.4) years. Ambivalent feelings were found, while BF was considered a satisfying experience, it was also sacrificial and painful. They refer to a lack of knowledge, and insecurity about nourishing their infant and physical pain seem to be the most important reasons for giving up. There is also a duality of feelings between the peace of mind afforded by artificial feeding, knowing that their child is well nourished, and the feeling of guilt for not having maintained BF. They believe that professionals do not adequately perform their work to promote BF, referring to numerous occasions when health professionals themselves have performed practices contrary to its establishment and maintenance. Conclusions: In the mothers' account, emotional training and emotional support needs are insufficiently covered. Nursing professionals involved in the care of these women should systematically explore these needs


Assuntos
Humanos , Feminino , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Apoio Social , Comportamento Materno/psicologia , Desmame , Cuidados de Enfermagem , Aleitamento Materno/métodos , Análise Qualitativa
4.
Nutr. hosp ; 36(extr.3): 30-34, jul. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184445

RESUMO

Aunque los beneficios de la lactancia materna son claros y están bien documentados tanto para los recién nacidos como para las madres lactantes, las tasas de lactancia materna a nivel mundial en muchos casos no son óptimas. Existen múltiples mitos y errores en relación con la lactancia materna, como que no pueden consumirse determinados alimentos, que deben consumirse determinados alimentos para aumentar la producción láctea, que la composición de la leche materna en algunos casos no es adecuada, que la lactancia materna se asocia a más riesgo de caries… Por todo ello, el objetivo de este artículo es aclarar la realidad acerca de estos aspectos sobre la lactancia materna


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
Humanos , Recém-Nascido , Lactente , Aleitamento Materno/métodos , Nutrição em Saúde Pública , Conhecimentos, Atitudes e Prática em Saúde , Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente
5.
Nutr. hosp ; 36(3): 545-551, mayo-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184550

RESUMO

Objective: differences have been shown between males and females in terms of the prevalence of malnutrition in different parts of the world, which point to discrimination against females, including with respect to full breastfeeding. Therefore, the objective was to show that exclusive breastfeeding is less common for females in a population of medium-low and low socioeconomic strata. Methods: this was a cross-sectional analysis of a sample of 170 mother-infant dyads according to type of feeding (74 full breastfeeding, 57 partial breastfeeding and 39 human milk substitutes) at the Nuevo Hospital Civil de Guadalajara. Dependent variables according to type of feeding: full breastfeeding (exclusive and/or predominant), partial breastfeeding, and human milk substitutes. Independent variables: demographic data, schooling, occupation of mothers and/or parents, and family income. Kruskal-Wallis, Mann-Whitney U and Chi-square tests and odds ratio were used. Results: the probability of full breastfeeding was 3.8 times lower in females than in males. In a non-significant way, the likelihood of full breastfeeding was lower than that of partial breastfeeding, and full breastfeeding was lower than the combination of partial breastfeeding and human milk substitutes in females. Full breastfeeding and partial breastfeeding were lower than human milk substitutes, and partial breastfeeding was lower than human milk substitutes in females. Conclusion: there is a differentiated character in the privilege of full breastfeeding; it is four times lower in females than in males


Objetivo: se han observado diferencias entre niñas y varones en la prevalencia de desnutrición en diferentes partes del mundo, lo que apunta a la discriminación contra las niñas, incluso con respecto a la lactancia materna completa. El objetivo fue mostrar que la lactancia completa es menos común en las niñas en una población de estratos socioeconómicos medio-bajo y bajo. Métodos: se realizó un análisis transversal de una muestra de 170 díadas madre-lactante según el tipo de alimentación (74 de lactancia completa, 57 de lactancia parcial y 39 sucedáneos de la leche humana) en el Nuevo Hospital Civil de Guadalajara. Variables dependientes según el tipo de alimentación: lactancia completa (exclusiva y/o predominante), lactancia parcial y sucedáneos de leche humana. Variables independientes: datos demográficos, escolaridad, ocupación de madres y/o padres e ingresos familiares. Se utilizaron pruebas de Kruskal-Wallis, Mann-Whitney U y Chi-cuadrado y razón de momios. Resultados: la probabilidad de lactancia materna completa fue 3,8 veces menor en niñas que en varones. De manera no significativa, la probabilidad de lactancia completa fue menor que la de lactancia parcial y la frecuencia de lactancia completa fue menor que la combinación de lactancia parcial y sucedáneos de leche humana en niñas. La frecuencia de lactancia completa y lactancia parcial fue menor que los sucedáneos de leche humana y la lactancia parcial fue menos frecuente que los sucedáneos de leche humana en niñas. Conclusión: hay un carácter diferenciado en el privilegio de ofrecer lactancia materna completa. Es cuatro veces menor en las niñas que en varones


Assuntos
Humanos , Masculino , Feminino , Lactente , Aleitamento Materno/métodos , Transtornos da Nutrição Infantil/dietoterapia , Transtornos da Nutrição Infantil/diagnóstico , Desnutrição/epidemiologia , Gênero e Saúde , Igualdade de Gênero , México , Estudos Transversais
7.
MCN Am J Matern Child Nurs ; 44(3): 157-163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30882766

RESUMO

PURPOSE: The purpose of this study was to explore maternal child nurses' knowledge and beliefs about using pasteurized donor human milk (PDHM) to treat newborns with hypoglycemia. Pasteurized donor human milk has been used for decades in neonatal intensive care units, but its use is relatively new in the well-baby population. STUDY DESIGN AND METHODS: Focus groups of maternal child nurses were conducted to explore this topic. RESULTS: Six focus groups that included a total 20 nurses were held. Four themes were identified: 1) nurses presumed safety of PDHM but lacked knowledge, 2) nurses' role as patient-family advocate, 3) nurses' logistical concerns about implementation of PDHM, and 4) nurses lacked clarity on formal milk sharing versus PDHM. CLINICAL IMPLICATIONS: As the use of PDHM increases for well babies, nurses will need more education about PDHM, its safety profile, its use in breastfeeding support and protection of the infant microbiome, and how PDHM differs from informal milk sharing. Nurses play an important role in helping parents weigh risks and benefits of using PDHM or formula when supplementation is needed during the hospital stay. It is important that nurses feel confident in their own knowledge and ability to address parental concerns so they can advocate for their patients and support parental decision-making.


Assuntos
Hipoglicemia/dietoterapia , Fórmulas Infantis/estatística & dados numéricos , Leite Humano/metabolismo , Pasteurização , Aleitamento Materno/métodos , Competência Clínica , Grupos Focais/métodos , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Bancos de Leite/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Pesquisa Qualitativa
8.
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
9.
BMC Res Notes ; 12(1): 136, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30871623

RESUMO

OBJECTIVE: The study aimed at assessing skin-to-skin contact (SSC) during the postpartum stay and its determinant factors among mothers at public health institutions in Ethiopia. RESULT: A total of 384 mothers-indexed newborns admitted in postnatal wards were interviewed. The prevalence of mothers' SSC practice to their newborns with in the first 1 h during the postpartum stay was 28.1%. Mothers education (AOR = 18.23 [95% CI 5.26, 63.52]), and number of ANC visits (AOR = 8.55 [95% CI 1.05, 69.54]) were independently associated with SSC practice of mothers to their infants.


Assuntos
Aleitamento Materno/métodos , Instalações de Saúde/estatística & dados numéricos , Método Canguru/métodos , Mães/psicologia , Cuidado Pós-Natal/métodos , Saúde Pública/estatística & dados numéricos , Adulto , Aleitamento Materno/estatística & dados numéricos , Escolaridade , Etiópia , Feminino , Humanos , Recém-Nascido , Método Canguru/estatística & dados numéricos , Relações Mãe-Filho , Vigilância da População/métodos , Cuidado Pós-Natal/estatística & dados numéricos , Período Pós-Parto
10.
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
11.
Rev Bras Enferm ; 72(1): 3-8, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30916261

RESUMO

OBJECTIVE: To point out limits and possibilities involved in the teaching and learning process of undergraduate students from Health of a Federal Public Higher Education Institution on breastfeeding. METHOD: Instantaneous photography study carried out in undergraduate courses in the area of Health with professors and students involved in the teaching and learning process on breastfeeding. For data collection, the Focal Group technique was used with the students and the semi-structured interview with the professors. The speeches were submitted to the thematic content analysis of Bardin. RESULTS: It was identified the thematic category: Limits and possibilities for the teaching and learning process on breastfeeding, from two sub-categories: Structural limitations of the courses; and Advances and obstacles in the relationship between theory and practice. FINAL CONSIDERATIONS: Limits indicated as workload deficit and professor-centered teaching made progress in learning about breastfeeding difficult, and interdisciplinarity was a step forward in this process.


Assuntos
Pessoal Técnico de Saúde/educação , Aleitamento Materno/métodos , Currículo/normas , Estudantes/psicologia , Pessoal Técnico de Saúde/psicologia , Pessoal Técnico de Saúde/estatística & dados numéricos , Brasil , Aleitamento Materno/tendências , Coleta de Dados , Grupos Focais/métodos , Educação em Saúde/métodos , Educação em Saúde/tendências , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades/organização & administração , Universidades/estatística & dados numéricos
12.
Pediatr Clin North Am ; 66(2): 333-342, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30819340

RESUMO

This article covers several aspects of the clinical management of neonatal hypoglycemia that have recently evolved, reviewing the evidence informing these recommended changes in practice. Topics covered include use of buccal dextrose gel, rationale for avoiding the traditional "mini dextrose bolus," and benefits of direct breastfeeding for the treatment of asymptomatic hypoglycemia in at-risk newborns. The reasons for increasing use of more accurate point-of-care devices for measuring neonatal glucose concentrations are discussed, as well as the implications of different published opinions regarding the determination of readiness for discharge and the most important considerations when making this determination.


Assuntos
Hipoglicemia/terapia , Doenças do Recém-Nascido/terapia , Glicemia/análise , Aleitamento Materno/métodos , Nutrição Enteral/métodos , Glucose/uso terapêutico , Humanos , Recém-Nascido
13.
Pediatr Clin North Am ; 66(2): 353-367, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30819342

RESUMO

This review examines the continuum of care of opioid-exposed infants, including the assessment of the neonate, diagnosis of neonatal abstinence syndrome, management of the syndrome including nonpharmacologic and pharmacologic care, approach to breastfeeding, pediatric follow-up care, and integration of care of the mother-infant dyad.


Assuntos
Analgésicos Opioides/efeitos adversos , Síndrome de Abstinência Neonatal/diagnóstico , Transtornos Relacionados ao Uso de Opioides/terapia , Assistência ao Convalescente/métodos , Analgésicos Opioides/sangue , Aleitamento Materno/métodos , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Masculino , Mães , Síndrome de Abstinência Neonatal/terapia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/terapia
14.
Nurs Womens Health ; 23(2): 135-140, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30794770

RESUMO

In this article, I describe the effects of home interventions on latching difficulty that persisted for 27 days for a mother-neonate dyad. The neonate manifested latching difficulty immediately after cesarean birth, and it became worse when nipple shields, bottles, and pacifiers were introduced. Manual expression and an electric pump were implemented when the neonate started losing weight, resulting in reduced frequency of breastfeeding directly at the breast. Additionally, the neonate continued to have latching difficulty after frenotomy. The use of home-based interventions supported ongoing educational opportunities for optimal latch, and I recommend that this type of health education be consistent among health professionals.


Assuntos
Aleitamento Materno/métodos , Serviços de Assistência Domiciliar/tendências , Adulto , Anquiloglossia/complicações , Anquiloglossia/terapia , Feminino , Humanos , Recém-Nascido , Relações Mãe-Filho , Comportamento de Sucção/fisiologia , Resultado do Tratamento , Estados Unidos
15.
Health Policy Plan ; 34(2): 83-91, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30753437

RESUMO

There are important lessons learned from the 2014-16 Ebola virus disease outbreak in West Africa. However, there has not been a systematic documentation of nutrition lessons specifically. Therefore, this study sought to generate multiple stakeholder perspectives for understanding the nutrition challenges faced during the Ebola virus disease outbreak, as well as for consensus building around improved response strategies. Participatory workshops with 17 and 19 participants in Guinea and Sierra Leone, respectively, were conducted in February 2017. Workshops followed the Nominal Group Technique, which is a methodological approach for idea generation and consensus building among diverse participants. Those findings were triangulated with qualitative interview data from participants representing government, United Nations bodies, civil society, non-governmental organizations and local communities in both Guinea (n = 27) and Sierra Leone (n = 42). (1) Reduced health system access and utilization, Poor caretaking and infant and young child feeding practices, Implementation challenges during nutrition response, Household food insecurity and Changing breastfeeding practices were five nutrition challenges identified in both Guinea and Sierra Leone. (2) Between settings, 14 distinct and 11 shared organizational factors emerged as facilitators to this response. In Sierra Leone, participants identified the Use of Standard Operating Procedures and Psychosocial counselling, whereas in Guinea, Hygiene assistance was distinctly important. Political will, Increased funding, Food assistance and to a lesser extent, Enhanced coordination, were deemed 'most important' response factors. (3) The top nutrition lessons learned were diverse, reflecting those of nutrition policy, programme implementation, community activity and household behaviours. Disease outbreaks pose widespread nutrition challenges to populations in resource-constrained settings where global health security is not a guarantee. These findings should be considered for emergency nutrition preparedness and inform evidence-based priority setting in the post-Ebola virus context of Guinea and Sierra Leone.


Assuntos
Surtos de Doenças , Abastecimento de Alimentos , Doença pelo Vírus Ebola , Aleitamento Materno/métodos , Pré-Escolar , Consenso , Programas Governamentais/estatística & dados numéricos , Guiné , Acesso aos Serviços de Saúde/normas , Humanos , Lactente , Recém-Nascido , Política Nutricional , Organizações , Serra Leoa
16.
MCN Am J Matern Child Nurs ; 44(2): 80-85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807326

RESUMO

There is a growing Orthodox Jewish population in the United States and Canada. Many Orthodox Jewish families have a large number of children and choose to breastfeed. The Orthodox Jew observes Jewish laws and customs literally as dictated by the Torah. Orthodox Jews consult a rabbi or posek before making most major life decisions, including matters related to breastfeeding to ensure adherence to religious law. Cultural practices applicable to the Orthodox Jewish family related to the provision of human milk and breastfeeding when a sick newborn may require special care and continued hospitalization after the mother has been discharged are presented. Guidelines for preconception lactation counseling for families are provided to tailor nursing care to meet the individual needs of each Orthodox Jewish infant and family. Special considerations related to pumping schedule, use of mechanisms such as timers for breast pumps, and discussions with religious leader about the saving of colostrum and/or milk when an infant is critically ill will be addressed. To provide culturally sensitive and appropriate counseling related to the provision of human milk and breastfeeding, nurses need to be culturally aware of the specific needs of the Orthodox Jewish family. Clinical implications and suggestions are provided.


Assuntos
Aleitamento Materno/psicologia , Relações Familiares/psicologia , Fidelidade a Diretrizes/normas , Judaísmo/psicologia , Adulto , Aleitamento Materno/etnologia , Aleitamento Materno/métodos , Assistência à Saúde Culturalmente Competente/normas , Relações Familiares/etnologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Relações Mãe-Filho/etnologia , Relações Mãe-Filho/psicologia , Fatores de Risco
17.
MCN Am J Matern Child Nurs ; 44(2): 108-114, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807328

RESUMO

BACKGROUND: Treating pain during immunization should be a part of pediatric primary healthcare around the world, as untreated pain in children has short- and long-term consequences. Few studies of pharmacologic and nonpharmacologic methods of pain relief during immunization have been conducted in low- and middle-income countries. Finding pain-mitigating interventions that are low-cost, effective, and feasible across all settings, including with low-resourced settings could improve primary healthcare. PURPOSE: To evaluate the effectiveness of oral sucrose versus breastfeeding as methods of pain management during immunization of infants through 6 months of age. METHODS: A randomized controlled experimental design was used; 120 infants were randomly assigned to control, sucrose, or breastfeeding groups. Data were collected in an Egyptian primary health center. Outcome measures including pain (as per the FLACC pain scale), crying time, and heart rate were measured at three time points. RESULTS: There were significant differences in pain scores and crying duration during and after immunization (p < .001) for the breastfeeding group compared with the sucrose and control groups. IMPLICATIONS FOR PRACTICE: Health staff and parents need education and support in use of breastfeeding for pain management during immunization. More studies are needed to evaluate effectiveness of breastfeeding versus other pain management methods for managing infants' immunization-related pain.


Assuntos
Aleitamento Materno/métodos , Imunização/efeitos adversos , Manejo da Dor/normas , Dor/tratamento farmacológico , Sacarose/uso terapêutico , Análise de Variância , Egito , Feminino , Humanos , Lactente , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/métodos , Masculino , Dor/etiologia , Manejo da Dor/métodos , Medição da Dor/métodos , Sacarose/administração & dosagem
18.
Nurs Womens Health ; 23(2): 141-147, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30807741

RESUMO

Despite an emphasis on lactation and the availability of resources to support and sustain lactation, our community hospital's rates of exclusive breastfeeding remained less than the 50% to 70% benchmark recommended by The Joint Commission and the World Health Organization. Concluding that we had exhausted the majority of evidence-based best practices described in the literature, we sought to find a new way to provide an engaging, useful medium for nursing education and improvement of clinical nurses' skills related to breastfeeding. Here, we describe the simulation program we developed using the standardized patient model. Although our rates of exclusive breastfeeding remained unchanged after introducing the simulation program, the experience enabled us to identify inconsistent practices and knowledge gaps.


Assuntos
Aleitamento Materno/métodos , Simulação de Paciente , Padrões de Referência , Competência Clínica/normas , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/normas , Humanos , New Jersey
20.
BMC Pregnancy Childbirth ; 19(1): 48, 2019 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-30696411

RESUMO

BACKGROUND: The Parent Infant Feeding Initiative (PIFI) was a factorial, randomised controlled trial that aimed to prolong exclusive breastfeeding by targeting expecting fathers. One of the intervention strategies evaluated was a father-focused breastfeeding class facilitated by a male peer facilitator. The aim of this mixed-methods descriptive study was to 1) evaluate the feedback provided from participants of the class and 2) explore the motivations and experiences of volunteer male peer facilitators trained to deliver the class. METHODS: Father-focused breastfeeding antenatal (FFAB) classes were conducted in six Western Australian hospitals between August 2015 and December 2016. Following each peer facilitated FFAB class, expecting father participants completed an evaluation form to assess their satisfaction with the format, facilitation and content, in addition to whether their expectations and confidence to manage breastfeeding problems had changed. Feedback to open-ended questions was analysed using content analysis to identify learnings and suggestions for improvements. At the completion of PIFI, individual telephone interviews were undertaken with 14 peer facilitators to gain insight into their motivations for volunteering and experiences of conducting the classes. Transcripts from interviews were analysed using Braun and Clarke's six phases for thematic analysis. RESULTS: Participant evaluation forms were completed by 678 of the 697 father participants (98%). Overall satisfaction with class format, facilitation and content was high with 90% or more of fathers either strongly agreeing or agreeing with each positively-phrased evaluation item. Class participants enjoyed interacting with other fathers, appreciated validation of their role, were not always aware of the importance of breastfeeding or potential difficulties, valued the anticipatory guidance around what to expect in the early weeks of parenting and appreciated learning practical breastfeeding support strategies. Peer facilitators indicated they felt well prepared and supported to conduct FFAB classes. Analysis of interview transcripts revealed common experiences of the peer facilitators incorporating four themes: 'Highlights of being a facilitator', 'Challenges', 'Mourning the project completion' and 'Satisfaction with training and support'. CONCLUSION: Father-focused breastfeeding classes supported by volunteer male peer facilitators are a feasible and acceptable way of engaging fathers as breastfeeding supporters. TRIAL REGISTRATION: ACTRN12614000605695 . Registered 6 June 2014.


Assuntos
Aleitamento Materno/psicologia , Pai/psicologia , Educação em Saúde/métodos , Poder Familiar/psicologia , Grupo Associado , Adulto , Atitude Frente a Saúde , Aleitamento Materno/métodos , Humanos , Masculino , Pais/educação , Apoio Social , Austrália Ocidental , Adulto Jovem
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