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1.
Asclepio ; 74(1): 1-14, jun. 2022.
Artigo em Espanhol | IBECS | ID: ibc-203280

RESUMO

This article analyzes the relationship between infant mortality and milk consumption in the Province of Santiago during 1930-1962. The process studied begins with the Pasteurization Law, which by sanitizing milk reduced the number of children with gastrointestinal diseases and indeed mortality, and ends with the inauguration of milk distribution programs. It is argued that the scarcity and insufficient hygiene of this product, added to the cultural and housing conditions that surrounded the children, are explanatory factors for the high mortality of infants, while recognizing the State as a fundamental promoter of public policies to correct the demographic catastrophe. The research, supported by newspapers, medical journals, degree theses, statistical yearbooks, and government documents, concludes that the set of laws, regulations and state programs produced a set of changes among State actors, reflected in practices and approval discourses and rejection of the importance of sanitizing milk, which, ultimately, did not prevent a considerable decrease in the number of children who died for food reasons


Este artículo analiza la relación entre la mortalidad en la infancia y el consumo de leche en la Provincia de Santiago durante 1930-1962. El proceso estudiado comienza con la Ley de Pasteurización que al higienizar la leche redujo las cifras de niños con enfermedades gastrointestinales y en efecto la mortalidad, y finaliza con la inauguración de los programas de distribución de leche. Se argumenta que la escasez y la higiene insuficiente de ese producto sumadas a las condiciones culturales y habitacionales que rodeaban a los niños son factores explicativos de la mortalidad alta de infantes, a la vez que reconoce en el Estado un promotor fundamental de políticas públicas para subsanar la catástrofe demográfica. La investigación, sustentada en periódicos, revistas médicas, tesis de titulación, anuarios estadísticos, y documentos gubernamentales, concluye que el conjunto de leyes, reglamentos y programas estatales produjo un conjunto de cambios entre los actores del Estado, reflejados en prácticas y discursos de aprobación y rechazo hacia la importancia de higienizar la leche que, en última instancia, no impidieron una disminución considerable de niños muertos por razones alimentarias.


Assuntos
Lactente , Ciências da Saúde , Mortalidade da Criança/história , Aleitamento Materno/história , Nutrição da Criança , Política Pública/história , Política de Saúde
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48792

RESUMO

Observa Infância é uma iniciativa de divulgação científica para levar ao conhecimento da sociedade dados e informações sobre a saúde de crianças de até 5 anos.


Assuntos
Aleitamento Materno , Promoção da Saúde , Fórmulas Infantis/legislação & jurisprudência , Brasil , Atenção Primária à Saúde , Mortalidade Infantil
3.
BMJ Open ; 12(5): e051004, 2022 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-35584874

RESUMO

OBJECTIVES: Late initiation of breast feeding (LIBF) is associated with increased neonatal mortality and morbidity. This study aimed to assess the association between intrapartum, early postpartum and neonatal factors, and LIBF in Bangladesh. DESIGN, SETTING AND PARTICIPANTS: In this analysis, we used data from the mothers participating in a cluster-randomised controlled trial (Rang-Din Nutrition Study) conducted in rural northwest Bangladesh. Mothers (n=3594) were interviewed about the time of initiation of breast feeding, and peripartum maternal and neonatal complications within the first 72 hours of delivery. LIBF was defined as initiation of breast feeding 1 hour after birth. Factors associated with LIBF were identified by multivariable logistic regression analysis. MAIN OUTCOME MEASURES: Prevalence and associated factors of LIBF. RESULTS: The prevalence of LIBF was 18.5%. Factors significantly associated with LIBF in multivariable logistic regression were assisted vaginal delivery (adjusted OR (AOR) 2.17, 95% CI 1.44 to 3.27); delivery by caesarean section (AOR 9.67, 95% CI 7.21 to 12.96); maternal health problems during childbirth (AOR 1.61, 95% CI 1.30 to 2.00); preterm newborns (AOR 1.39, 95% CI 1.09 to 1.78); newborns moved slowly immediately after birth (AOR 1.43, 95% CI 1.05 to 1.94); and sick newborns (AOR 1.60, 95% CI 1.12 to 2.29). CONCLUSIONS: Findings from this study suggest that to reduce LIBF, peripartum maternal and neonatal complications should be prevented and treated. TRIAL REGISTRATION NUMBER: NCT01715038.


Assuntos
Aleitamento Materno , Cesárea , Bangladesh/epidemiologia , Feminino , Humanos , Recém-Nascido , Mães , Período Periparto , Gravidez
4.
J Health Popul Nutr ; 41(1): 16, 2022 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505386

RESUMO

BACKGROUND: The purpose of the project was to improve newborn health in neonatal care units in a low resource area with high neonatal mortality, predominantly by better nutrition and educational exchange of health care workers. METHOD: A fourfold program to make human milk production and distribution feasible and desirable. 1 Education to enlighten health care workers and parents to the excellence of human milk. 2 Lactation counselling to address the various challenges of breastfeeding. 3 Improving infants´ general condition. 4 Infrastructure alterations in the hospital. A collaboration between hospitals in India and Norway. RESULTS: The number of infants receiving human milk increased pronouncedly. Systematic, professional lactation counselling, the establishment of a milk bank, and empowerment of nurses was perceived as the most important factors. CONCLUSIONS: It is possible to greatly improve nutrition and the quality of newborn care in low/middle income settings by optimising human resources. Viable improvements can be obtained by long-term health partnership, by involving all hierarchal levels and applying locally developed customized methods.


Assuntos
Aleitamento Materno , Saúde do Lactente , Feminino , Hospitais , Humanos , Renda , Lactente , Recém-Nascido , Pobreza
5.
Artigo em Inglês | MEDLINE | ID: mdl-35253935

RESUMO

BACKGROUND: Early initiation of breast feeding (EIBF) reduces the risk of neonatal mortality. However, only 45% of newborns are breast-fed within the first hour after birth and prelacteal feeding (PLF) is widely prevalent in low- and middle-income countries (LMICs). OBJECTIVE: To assess within- and between-country disparities in EIBF and PLF practices by household wealth and place of birth and to investigate the national-level correlation between these feeding indicators in LMICs. METHODS: Data from Demographic Health Surveys and Multiple Indicator Cluster Surveys (2010-2019) in 76 LMICs were used to investigate within-country disparities in EIBF, any PLF, milk-based prelacteal feeding (MPLF), and water-based prelacteal feeding (WPLF) by wealth quintiles and place of childbirth (institutional [private or public sector] or in-home) for children under two years. We examined the between-country Pearson's correlation between EIBF and types of PLF, later adjusted for per capita gross domestic product (GDP). RESULTS: No clear wealth-related differences were found for EIBF and WPLF; however, any PLF and MPLF were significantly higher in children belonging to the richest 20% of households but are also prevalent among lower income groups. Prevalence of any PLF was higher among institutional births in all LMICs, but especially for MPLF in private sector deliveries in East Asia & the Pacific, Eastern Europe & Central Asia, and Latin America & the Caribbean. WPLF was more common in all African regions. EIBF was inversely correlated with any PLF (r = -0.59, 95% CI -0.72, -0.42), MPLF (r = -0.41, 95% CI -0.58, -0.21) and WPLF (r = -0.34, 95% CI -0.53, -0.13). Adjustment for log-GDP did not affect the magnitude and direction of the results. CONCLUSION: Clear prorich disparities exist in the prevalence of PLF, especially MPLF. Children born in private sector facilities are more likely to receive MPLF. EIBF is negatively associated with PLF practices in LMICs. The promotion of better early feeding practices is urgent to achieve the Sustainable Development Goal to reduce neonatal mortality to 12 deaths per 1000 live births.

6.
Biomed Res Int ; 2022: 5533668, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35265715

RESUMO

Background: Early initiation of breastfeeding (EIBF) is a costless practice with numerous neonates' survival benefits. Thus, any disparity results in an unacceptably high neonatal death rate but socioeconomic disparities on EIBF have not been well explored in Ethiopia. Therefore, this study is aimed at assessing the socioeconomic inequalities of EIBF in Ethiopia from 2000 to 2016. Methods: The Ethiopian demographic and health survey data and the World Health Organization's Health Equity Assessment Toolkit were used to investigate the inequalities in EIBF across the wealth quintile, education, residence, and subnational region. Difference, ratio, slope index inequality (SII), relative index inequality (RII), and population attributable risk (PAR) were used as equity summary measures. Results: In Ethiopia, EIBF practice was 47.4% in 2000, 66.2% in 2005, 51.5% in 2011, and 73.3% in 2016. Wealth-related inequality was observed in the 2000, 2005, and 2011 survey years with SII of -7.1%, -8.8%, and 8.7%, respectively, whereas educational-related inequality was observed in 2005 and 2011 with SII of -11.7% and 6.5%, respectively. However, significant change in wealth-, education-, and residence-related inequalities was detected in 2011. Regional inequality on EIBF was observed in all survey years with a difference of 35.7%, 38.0%, 29.1%, and 48.5% in the 2000, 2005, 2011, and 2016 survey years, respectively. But a significant change in regional inequality was noted in 2016 with a PAR of 17.2%. Conclusions: In Ethiopia, the wealth-, residence-, and educational-related inequalities of EIBF increased significantly between the years 2000 and 2011. However, regional inequality persistently increased from 2000 to 2016. Overall, one-sixth of the national level EIBF was decreased due to regional disparity in 2016. The northern regions of Ethiopia (Tigray, Afar, and Amhara) poorly performed compared to the peer regions. Therefore, interventions targeting them would significantly improve the national level of EIBF.


Assuntos
Aleitamento Materno , Mortalidade Infantil , Escolaridade , Etiópia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Recém-Nascido , Fatores Socioeconômicos
7.
Am J Epidemiol ; 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35292797

RESUMO

Sudden Unexpected Infant Death (SUID) disproportionately affects non-Hispanic Black (NHB) and American Indian/Alaskan Native (AI/AN) infants, who have lower rates of breastfeeding than other groups. No existing literature investigates if breastfeeding explains disparities in SUID rates. Using 13,077,880 live birth certificates and 11,942 linked SUID death certificates from 2015-2018, we calculated odds ratios and adjusted risk differences (AdjRD) of SUID by not-breastfeeding across 5 racial/ethnic strata in the United States. We analyzed mediation by not-breastfeeding in the race/ethnicity-SUID association. The overall SUID rate was 0.91/1,000 live births. NHB and AI/AN infants had the highest disparity in SUID relative to non-Hispanic White (NHW) infants. Overall not-breastfeeding was associated with SUID, adjusted Odds Ratio (aOR) 1.14 (95% Confidence Interval [CI]: 1.10, 1.19), the AdjRD was 0.12/1,000 live births. The aOR of not-breastfeeding for SUID was 1.07 (95% CI: 1.00, 1.14) in NHB infants, and 1.29 (95% CI: 1.14, 1.46) in Hispanic infants. Breastfeeding minimally explained the higher SUID risk in NHB infants (2.3% mediated) and the lower risk in Hispanic infants (2.1% mediated) relative to NHW infants. Competing risks likely explain the lower aOR seen in NHB infants of not-breastfeeding on SUID, suggesting that social/structural determinants must be addressed to reduce racial disparities in SUID.

8.
BMJ Open ; 12(1): e053196, 2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-35017244

RESUMO

OBJECTIVES: This study analysed the association between breast feeding (BF) and birth interval (BI) (both succeeding and preceding) with neonatal mortality (NM), infant mortality (IM) and under-5 mortality (U5M). DESIGN: This cross-sectional study used data from the Pakistan Demographic and Health Survey 2017-2018. SETTINGS: All provinces, Islamabad and Federally Administered Tribal Areas were included in the analysis. PARTICIPANTS: A total of 12 769 children born to ever-married multiparous women aged 30-49 years who gave live birth within 5 years preceding the interview. Multiple births are not included. DATA ANALYSIS: Multivariate logistic regression analysis was used. RESULTS: We found that BF was associated with nearly 98% lower risk of NM (OR 0.015; 95% CI: 0.01 to 0.03; p<0.001), 96% lower risk of IM (OR 0.038; 95% CI: 0.02 to 0.06; p<0.001) and 94% lower risk of U5M (OR 0.050; 95% CI: 0.03 to 0.08; p<0.001). Compared with optimal preceding birth interval (PBI) (36+ months), short PBI (<18 months) was associated with around six times higher risk of NM (OR 5.661; 95% CI: 2.78 to 11.53; p<0.001), over five times risk of IM (OR 4.704; 95% CI: 2.70 to 8.19; p<0.001) and over five times risk of U5M (OR 4.745; 95% CI: 2.79 to 8.07; p<0.001). Disaggregating the data by child's gender, place of residence and mother's occupational status showed that being ever breast fed was associated with a smaller risk of NM, IM and U5M in all three disaggregations. However, the risk of smaller PBI <18 months was generally more pronounced in female children (NM and U5M) or when the children lived in rural areas (NM, IM and U5M). PBI <18 months was associated with greater risk of NM and IM, and smaller risk of U5M when mothers did a paid job. CONCLUSION: This study's significance lies in the fact that it has found BF and BI to be consistent protective factors against NM, IM and U5M. Given Pakistan's economic constraints, optimal BF and BI are the most cost-effective interventions to reduce child mortality.


Assuntos
Aleitamento Materno , Mortalidade da Criança , Adulto , Intervalo entre Nascimentos , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Pessoa de Meia-Idade , Paquistão/epidemiologia , Fatores de Risco , População Rural , Fatores Socioeconômicos
9.
J Health Popul Nutr ; 41(1): 1, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34980283

RESUMO

BACKGROUND: Despite significant economic growth and development, undernutrition among children remains a major public health challenge for low- and middle-income countries in the twenty-first century. In Millennium Development Goals, India committed halving the prevalence of underweight children by 2015. This study aimed to explain the geographical variation in child malnutrition level and understand the socio-biomedical predictors of child nutrition in India. METHODS: We used the data from India's National Family Health Survey 2015-2016. The survey provided estimates of stunting, wasting, and underweight at the national, state, and district level to measure nutritional status of under-five children. Level of stunting, wasting and underweight at the district level are considered as outcome variables. We have used variance inflation factor to check the multicollinearity between potential predictors of nutrition. In this study, we performed spatial analysis using ArcGIS and multiple linear regression analysis using Stata version 15. RESULTS: Five states (Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Meghalaya) had very high prevalence of stunting (40% and above). High prevalence of wasting was documented in Jharkhand, Madhya Pradesh, Chhattisgarh, and Karnataka (23 to 29%). Jharkhand, Madhya Pradesh, Maharashtra, and Chhattisgarh had the highest proportion of underweight children in the country. We found that electricity and clean fuel use in the household, use of iodized salt, and level of exclusive breastfeeding had significantly negative influence on the stunting level in the districts. The use of iodized salt has similar effect on the wasting status of under-five children in the districts (b: - 0.27, p < 0.10). Further, underweight level had a negative association with clean fuel use for cooking (b: - 0.17, p < 0.01), use of iodized salt (b: - 0.36, p < 0.10), breastfeeding within one hour (b: - 0.18, p < 0.10), semisolid/solid food within 6-8 months (b: - 0.11, p < 0.05) and Gross Domestic Product of the districts (b: - 0.53, p < 0.10). CONCLUSION: In the study, a variety of factors including electricity and clean fuel use in the household, use of iodized salt, level of exclusive breastfeeding, breastfeeding within one hour, semisolid/solid food within 6-8 months and Gross Domestic Product of the districts have a significant association with nutritional status of children.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Criança , Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Humanos , Índia/epidemiologia , Lactente , Desnutrição/epidemiologia , Estado Nutricional , Prevalência , Magreza/epidemiologia
10.
J Nutr ; 152(4): 1149-1158, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34982817

RESUMO

BACKGROUND: There is uncertainty about whether children with moderate wasting should receive supplementary feeding. OBJECTIVES: We examined whether supplementary feeding compared with counseling alone in children with moderate wasting prevented progression to severe acute malnutrition (SAM) or death. METHODS: This was a retrospective, dual-cohort study in which 1791 children with moderate wasting were drawn from 2 prior randomized controlled trials that took place in the same location in rural Sierra Leone. A total of 1077 children received supplementary feeding, whereas 714 children received counseling alone. Children in both cohorts were followed for ≥24 wk from enrollment. The primary outcome was time to SAM or death using Kaplan-Meier analysis. Secondary outcomes included time to death as well as proportions of children with healthy midupper arm circumference (MUAC), moderate wasting, SAM, or death at 6, 12, and 24 wk from enrollment. RESULTS: Children who received supplementary feeding were less likely to develop SAM or die across the entire follow-up period (HR: 0.53; 95% CI: 0.44, 0.65; P < 0.001). Time to event for death alone also revealed a lower risk for children who received supplementary feeding (HR: 0.52; 95% CI: 0.28, 0.94; P = 0.03). Children who received supplementary feeding were more likely to have a healthy MUAC at 6 wk (RR: 2.0; 95% CI: 1.7, 2.2) and 12 wk (RR: 1.3; 95% CI: 1.2, 1.5), were less likely to develop SAM at 6 (RR: 0.7; 95% CI: 0.6, 0.9), 12 (RR: 0.5; 95% CI: 0.3, 0.8), and 24 wk (RR: 0.2; 95% CI: 0.1, 0.5), and had higher rates of gain in weight and MUAC at 6 and 12 wk. CONCLUSIONS: Supplementary feeding of children with moderate wasting reduces risk of SAM and death across 24 wk of follow-up.


Assuntos
Desnutrição , Desnutrição Aguda Grave , Criança , Estudos de Coortes , Aconselhamento , Humanos , Lactente , Desnutrição/epidemiologia , Desnutrição/prevenção & controle , Estudos Retrospectivos , Serra Leoa/epidemiologia
11.
Am J Clin Nutr ; 115(2): 407-421, 2022 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-34677583

RESUMO

BACKGROUND: Infants are at a high risk of acquiring fatal infections, and their treatment relies on functioning antibiotics. Antibiotic resistance genes (ARGs) are present in high numbers in antibiotic-naive infants' gut microbiomes, and infant mortality caused by resistant infections is high. The role of antibiotics in shaping the infant resistome has been studied, but there is limited knowledge on other factors that affect the antibiotic resistance burden of the infant gut. OBJECTIVES: Our objectives were to determine the impact of early exposure to formula on the ARG load in neonates and infants born either preterm or full term. Our hypotheses were that diet causes a selective pressure that influences the microbial community of the infant gut, and formula exposure would increase the abundance of taxa that carry ARGs. METHODS: Cross-sectionally sampled gut metagenomes of 46 neonates were used to build a generalized linear model to determine the impact of diet on ARG loads in neonates. The model was cross-validated using neonate metagenomes gathered from public databases using our custom statistical pipeline for cross-validation. RESULTS: Formula-fed neonates had higher relative abundances of opportunistic pathogens such as Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Klebsiella oxytoca, and Clostridioides difficile. The relative abundance of ARGs carried by gut bacteria was 69% higher in the formula-receiving group (fold change, 1.69; 95% CI: 1.12-2.55; P = 0.013; n = 180) compared to exclusively human milk-fed infants. The formula-fed infants also had significantly less typical infant bacteria, such as Bifidobacteria, that have potential health benefits. CONCLUSIONS: The novel finding that formula exposure is correlated with a higher neonatal ARG burden lays the foundation that clinicians should consider feeding mode in addition to antibiotic use during the first months of life to minimize the proliferation of antibiotic-resistant gut bacteria in infants.


Assuntos
Proteínas de Bactérias/metabolismo , Resistência Microbiana a Medicamentos/genética , Microbioma Gastrointestinal/genética , Fórmulas Infantis/microbiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Estudos Transversais , Fezes/microbiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Modelos Lineares , Masculino
12.
Nutr Hosp ; 39(1): 211-216, 2022 Feb 09.
Artigo em Espanhol | MEDLINE | ID: mdl-34781689

RESUMO

INTRODUCTION: Introduction: the current continuity of publications on abandoned children during the Spanish Enlightenment, from the same perspectives of social control that were established at the end of the 20th century, undermines the efforts of some Enlightenment scholars to find artificial nutrition alternatives to breastfeeding through wet nurses. Aim: to analyse the nutritional trials carried out by Joaquín Xavier Úriz (1747-1829) in the Pamplona foundling home. Method: review, analysis and interpretation of his work "Causas prácticas de la muerte de los niños expósitos en sus primeros años", published in 1801. Results: after justifying its necessity, setting out objectives, and designing a controlled experiment, he carried out two trials with infants, one with healthy children using rice water supplements to the wet-nurse's milk and the other with sick children using mixed goat and wet-nurse breastfeeding. Both were initially conducted with one and two subjects, respectively, to be extended after good results to a larger, non-randomised sample (12 subjects in the case of sick children). Although the initial results were inconclusive, a decrease in subsequent infant mortality was noted. Conclusions: the trials are based on the application of a more appreciable scientific method than in didactic texts by more relevant authors, as in the case of Iberti. The prevailing utilitarianism does not hide the value given to the life of the foundling over any other, Úriz being a clear example of the exceptions to the predominantly punitive approach of historiography. The subsequent decline in infant mortality suggests the possibility of a successful cause-effect of the trials.


INTRODUCCIÓN: Introducción: la continuidad actual de publicaciones sobre la infancia abandonada durante la Ilustración española, desde las mismas perspectivas del control social que se establecieron a finales del siglo XX, desvirtúa el esfuerzo de algunos ilustrados por encontrar alternativas de nutrición artificial a la lactancia mediante nodrizas. Objetivo: analizar los ensayos nutricionales efectuados por Joaquín Xavier Úriz (1747-1829) en la inclusa de Pamplona. Método: revisión, análisis e interpretación de su obra "Causas prácticas de la muerte de los niños expósitos en sus primeros años", publicada en 1801. Resultados: tras justificar su necesidad, plantear objetivos y diseñar un experimento controlado, realizó dos ensayos con lactantes, uno con niños sanos mediante suplementos de agua de arroz a la leche de nodriza y otro con niños enfermos mediante lactancia mixta de cabra y nodriza. Ambos se realizaron inicialmente con uno y dos sujetos, respectivamente, para ampliarlo tras buenos resultados a una muestra mayor no aleatorizada (12 sujetos en el caso de los enfermos). Aunque los resultados iniciales no fueron concluyentes, se constata un descenso de la mortalidad lactante posterior. Conclusiones: los ensayos responden a la aplicación de un método científico más apreciable que el observado en textos didácticos de autores más relevantes, como es el caso de Iberti. El utilitarismo imperante no oculta el valor dado a la vida del expósito sobre cualquier otro, siendo Úriz un claro ejemplo de las excepciones al enfoque predominantemente punitivo de la historiografía. El descenso posterior de la mortalidad del lactante sugiere la posibilidad de una exitosa causa-efecto de los ensayos.


Assuntos
Aleitamento Materno , Lactação , Feminino , Humanos , Masculino , Espanha
13.
J Biosoc Sci ; 54(2): 199-216, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33678208

RESUMO

Early initiation of breastfeeding (EIBF) is considered one of the most cost-effective interventions for infant survival and well-being. This study aimed to examine the variations in, and determinants of, early initiation of breastfeeding among women in high and low neonatal mortality rate (NMR) settings in India using data from the fourth round of the National Family Health Survey conducted in 2015-16. At 35%, EIBF was found to be disproportionately low in the high NMR group of states compared with 52% in the low NMR group, with the national average being 44%. The chance of EIBF significantly increased if childbirth was vaginal, delivery took place in a health institution, the mother received breastfeeding advice and the birth was a planned one in both high and low NMR settings. In the high NMR group of states, the probability of initiating breastfeeding immediately after birth improved to a great extent if childbirth was assisted by a trained person and if the mother was exposed to any type of mass media. There is an urgent need to increase the access of mothers to breastfeeding advice during pregnancy and to increase their exposure to mass media, particularly in high NMR states. In addition, achieving universal access to institutional deliveries and deliveries assisted by a skilled birth attendant, especially in high NMR settings, and promoting early breastfeeding, especially in the case of Caesarean deliveries, would further improve the level of EIBF in the country as a whole. These interventions can potentially increase the prevalence of early initiation of breastfeeding and help India attain the neonatal mortality rate target of Sustainable Development Goal 3.


Assuntos
Aleitamento Materno , Mães , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Gravidez , Fatores de Tempo
14.
Matern Child Nutr ; 18 Suppl 1: e13229, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34523803

RESUMO

South Asia has made significant progress in reducing child undernutrition. The prevalence of stunting declined by one third between 2000 and 2019; as a result, in 2019, there were 34 million fewer stunted children than in 2000, indicating that progress for child nutrition is possible and is happening at scale. However, no country in South Asia is on track for all nutrition targets of Sustainable Development Goal 2, and the region has the highest prevalence of stunting (33.2%) and wasting (14.8%) in the world. Nepal, the best performing country in the region, narrowly missed the Millennium Development Goal (MDG) target to half the prevalence of child underweight between 1990 and 2015 and achieved the fastest recorded reduction in stunting prevalence in the world between 2001 and 2011. In 2019, UNICEF Nepal completed a series of papers to examine Nepal's progress on maternal and child nutrition during the MDG era. The series explores the trends, distribution and disparities in stunting, micronutrient deficiencies and feeding practices in children under 5 years and anaemia in adolescents and women. Besides, it reviews national micronutrient programmes (vitamin A supplementation, iron and folic acid supplementation and universal salt iodization) and Nepal's first Multi-Sector Nutrition Plan, to illuminate the success factors and enduring challenges in the policy and programme landscape for nutrition. This overview paper summarizes the evidence from these analyses and examines the implications for the direction of future advocacy, policy and programme actions to improve maternal and child nutrition in Nepal and other similar contexts.


Assuntos
Transtornos da Nutrição Infantil , Estado Nutricional , Adolescente , Anemia/epidemiologia , Criança , Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Nepal/epidemiologia , Nações Unidas
15.
JPEN J Parenter Enteral Nutr ; 46(3): 572-582, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34190351

RESUMO

BACKGROUND: Treatment of antenatal corticosteroids (ACSs) to women at risk of preterm labor can decrease neonatal mortality and morbidity. However, effect of ACS exposure on enteral feeding and body growth of preterm infants remains elusive. METHODS: This retrospective study collected information of eligible singleton infants born between 22+0 and 36+6 weeks' gestation from 2017 to 2019. Logistic regression and multivariate linear regression were adopted to examine the associations of the ACS exposure with various outcomes of enteral feeding and growth considering potential confounders. Stratified analysis was performed based on gestational age (GA) (<34 vs ≥34 weeks). RESULTS: Of the 1694 preterm infants included, 1222 (72.1%) were exposed to ACSs. Infants with ACS exposure had a higher incidence of feeding intolerance (odds ratio 1.51; 95% CI, 1.05 to 2.20; P = .03), slower advancement of enteral feeding (ß coefficient -0.86; 95% CI, -1.48 to -0.25; P = .01), and lower delta body-weight z-scores (ß coefficient-0.13; 95% CI, -0.18 to -0.08; P < .001). Unlike in infants with GA <34 weeks, ACS exposure was associated with slower advancement of enteral feeding, longer time to regain birth weight, and lower delta body-weight z-scores in the ones with GA ≥34 weeks. CONCLUSION: ACS exposure is associated with poorer enteral feeding process and body growth in our study population, which is more prominent in late preterm infants. A multicenter prospective study and mechanistic studies using animal models are required.


Assuntos
Nutrição Enteral , Recém-Nascido Prematuro , Corticosteroides/uso terapêutico , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Prospectivos , Estudos Retrospectivos
16.
Cult. cuid ; 26(62): 1-17, 1er cuatrim. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-CR-174

RESUMO

The objective of this historical investigation is to discover if the Institution called "LaGota de Leche" existed in Toledo. Methodology by means of the heuristic method, the historicalpress is analyzed and other primary archival sources are reviewed. Results, although its creationwas tedious and its operation was subject to criticism, its benefits were soon seen through thematernal and child health indicators. The institution between 1906 and 1966, was present in boththe urban and rural areas of Toledo. Since the creation the mother received health care throughoutthe gestational period; she acquired habits on child hygiene and obtained health education toestablish adequate breastfeeding. Conclusion La Gota de Leche Toledana was a School ofChildcare and Maternology, a fact that allowed to carry out prevention, care and educationactivities throughout the gestational period. Thus, the results obtained were extremelysatisfactory, since it was possible to reduce infant mortality during the first half of the 20thcentury, through the improvement of maternal and child health indicators


El objetivo de esta investigación histórica es descubrir sí en Toledo existió la Institucióndenominada «La Gota de Leche». Metodología por medio del método heurístico se analiza laprensa histórica y se revisan otras fuentes primarias archivísticas. Resultados, aunque su creaciónfue tediosa y su funcionamiento estuvo sujeto a críticas, sus beneficios pronto se dejaron ver, através de los indicadores salud materno-infantil. La institución entre 1906 y 1966, estuvo presentetanto en el ámbito urbano como rural de Toledo. Desde la creación la madre recibía atenciónsanitaria durante todo el periodo gestacional; adquiría hábitos sobre higiene infantil y obteníaeducación sanitaria para establecer una lactancia materna adecuada. Conclusión La Gota de LecheToledana fue una Escuela de Puericultura y Maternología, hecho que permitió llevar a caboactividades de prevención, asistencia y educación durante todo el periodo gestacional. De modoque los resultados obtenidos fuero sumamente satisfactorios, pues se logró reducir la mortalidadinfantil durante la primera mitad del siglo XX, a través de la mejoría de los indicadores de la saludmaterno-infantil.


O objetivo desta investigação histórica é descobrir se a Instituição chamada "La Gota deLeche" existia em Toledo. Metodologia por meio do método heurístico, a imprensa histórica éanalisada e outras fontes arquivísticas primárias são revisadas. Resultados, embora sua criaçãotenha sido tediosa e seu funcionamento sujeito a críticas, seus benefícios logo foram percebidosatravés dos indicadores de saúde materno-infantil. A instituição entre 1906 e 1966, esteve presentetanto na zona urbana como rural de Toledo. Desde a criação a mãe recebeu cuidados de saúdedurante todo o período gestacional; adquiriu hábitos de higiene infantil e obteve educação emsaúde para estabelecer o aleitamento materno adequado. Conclusão La Gota de Leche Toledanafoi uma Escola de Puericultura e Maternologia, fato que possibilitou a realização de atividades de123Cultura de los Cuidados. 1º Cuatrimestre 2022. Año XXVI. nº 62prevenção, cuidado e educação durante todo o período gestacional. Assim, os resultados obtidosforam extremamente satisfatórios, uma vez que foi possível reduzir a mortalidade infantil durantea primeira metade do século 20, por meio da melhoria dos indicadores de saúde materno-infantil.


Assuntos
Humanos , História do Século XX , História da Enfermagem , Aleitamento Materno/história , Mortalidade Infantil/história , Espanha
17.
Breastfeed Med ; 17(2): 182-188, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34919408

RESUMO

Justification: Breastfeeding provides the best infant food, and closeness to the mother is crucial for successful breastfeeding. However, sharing parents' beds and sleeping on the stomach poses a high risk for sudden infant death syndrome (SIDS). There is little information on these practices regarding the Spanish population. Objective: To explore breastfeeding and bed-sharing practices in the study population Materials and Methods: A cross sectional observational study was conducted through an anonymous telephone survey with a representative random sample of babies born in the Health Area of La Marina Baixa, Alicante, between 2018 and 2019. A previous-day strategy was implemented to determine the feeding and bed-sharing variables. Results: The total breastfeeding and formula-feeding rates were 47.0% and 52.9%, respectively. The overall bed-sharing rate was 66.5%. The breastfeeding rate was 86.4% with bed-sharing and 13.6% without bed-sharing. The rate of prone sleeping position in children younger than 6 months of age was 9.3-3.5% with breastfeeding and 5.8% with formula feeding. Lower frequencies of tobacco, alcohol, and nonsupine sleeping positions were observed among mothers who practiced breastfeeding and bed-sharing. Conclusions: We found a close relationship between breastfeeding and bed-sharing and a lower frequency of SIDS risk factors associated with both practices. Families should be informed about the risk factors associated with SIDS to encourage safe bed-sharing while avoiding recommendations that discourage breastfeeding.


Assuntos
Morte Súbita do Lactente , Aleitamento Materno , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Cuidado do Lactente , Decúbito Ventral , Fatores de Risco , Sono , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Morte Súbita do Lactente/prevenção & controle
18.
PLoS Negl Trop Dis ; 16(3): e0010080, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35271571

RESUMO

BACKGROUND: Breast-feeding holds considerable potential to reduce infant mortality. Feeding choices, already complex, take on additional complexity against a backdrop of the risk of transmissible Ebola Virus. This review describes the factors that influence infant feeding and attitudes of pregnant women, mothers, family members and health practitioners, policy makers and providers (midwives) concerning infant feeding when there is a risk of Mother-to-Child (MTC) transmission of Ebola Virus Disease (EVD). METHODOLOGY: A systematic review of qualitative studies identified through rigorous searches of thirteen online databases and additional citation searches of included studies was undertaken. Search terms included breast-feeding, breast-feeding, infant feeding; Ebola; and qualitative, interview(s) and findings. Independent extraction of data by two reviewers using predefined extraction forms. Studies were assessed using the CASP Qualitative checklist. PRINCIPAL FINDINGS: 5219 references were screened. 38 references related specifically to Ebola, and five papers met the inclusion criteria with data gathered from two settings: Guinea and Sierra Leone. The EVD outbreak had a significant impact on beliefs, attitudes, and resources to support infant feeding practices negatively affecting the nutritional status of children. The evidence from these studies highlight the need for guidance and appropriate psychosocial support need to be available to mothers who display symptoms and become infected and to front-line staff who are giving advice. Communities need to be engaged because stigma and fear may hinder uptake of appropriate interventions. The EVD outbreak caused multi-level system disruption akin to that seen following a natural disaster, meaning that logistics and coordination are critical and need adequate resourcing. Food production and distribution, and malnutrition screening are also disrupted and thereby compounding compromised nutritional status. The limited number of relevant studies highlights the need for further primary research, particularly in translation of messages to local settings. CONCLUSIONS: An EVD outbreak causes multi-level disruption that negatively impacts infant feeding and child care practices. Negative impacts have multiple causes and successful planning for Ebola outbreaks requires that nutrition of infants and young children is a priority. Lessons from the Ebola pandemic have wider applicability to other pandemic contexts including Covid-19.


Assuntos
COVID-19 , Ebolavirus , Doença pelo Vírus Ebola , Atitude , Pré-Escolar , Surtos de Doenças , Feminino , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Serra Leoa/epidemiologia
19.
Int Breastfeed J ; 16(1): 91, 2021 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-34876163

RESUMO

BACKGROUND: Breastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa. METHODS: This study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox). RESULTS: Early initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d' Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively. CONCLUSIONS: The findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.


Assuntos
Aleitamento Materno , Mortalidade da Criança , Criança , Cognição , Feminino , Humanos , Lactente , Mortalidade Infantil , Masculino , Parto , Gravidez
20.
Rev Bras Ginecol Obstet ; 43(10): 728-735, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34784628

RESUMO

OBJECTIVE: The role of breast milk in the physical and mental health of infants and in the prevention of infant death is widely known. The benefits of breastfeeding for mothers and infants have been proven, but several factors can affect breastfeeding. Childbirth is one of the most influential factors. The present study aimed to investigate the effect of the type of delivery (natural childbirth and cesarean section) on breastfeeding based on the latch, audible swallowing, type of nipple, comfort, hold (LATCH) scoring system. METHODS: The present cross-sectional observational study was performed using the census method among women who referred to Afzalipour Hospital for delivery in May 2020; the breastfeeding pattern was completed by observation and the in-case information, by LATCH checklist. Data were analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 19.0, analysis of variance (ANOVA), and the Chi-squared statistical test. RESULTS: Out of a total of 254 deliveries (127 natural childbirths and 127 cesarean deliveries), there was no statistically significant difference between the 2 study groups in terms of age, maternal employment status, and infant weight, but there was a statistically significant relationship between the type of delivery, the maternal level of schooling, and the appearance, pulse, grimace, activity, and respiration (Apgar) score in the first minute. The mean score of breastfeeding patterns among the natural childbirth group (9.33) was higher than that of the cesarean section group (7.21). CONCLUSION: The type of delivery affects the mother's performance during breastfeeding, and mothers submitted to cesarean sections need more support and help in breastfeeding.


OBJETIVO: É sabido o papel do leite materno na saúde física e mental dos bebês e na prevenção da mortalidade infantil. Os benefícios da amamentação para mães e bebês foram comprovados, mas vários fatores podem afetar a amamentação. O parto é um dos fatores mais influentes. Este estudo teve como objetivo investigar o efeito do tipo de parto (parto Natural e cesariana) na amamentação com base no sistema de pontuação agarramento, deglutição audível, tipo de mamilo, conforto, segurar (latch, audible swallowing, type of nipple, comfort, hold, LATCH, em inglês). MéTODOS: Este estudo transversal e observacional foi realizado pelo método do censo entre mulheres que buscaram atendimento no Hospital Afzalipour para parto em maio de 2020; o padrão de amamentação foi completado por observação e in-case, pela lista de verificação do LATCH. Os dados foram analisados usando o programa Statistical Package for the Social Sciences (IBM SPSS for Windows, IBM Corp., Armonk, NY, Estados Unidos), versão 19.0, análise de variância (analysis of variance, ANOVA, em inglês) e o teste estatístico do qui-quadrado. RESULTADOS: De um total de 254 partos (127 parto naturais e 127 cesarianas), não houve diferença estatisticamente significativa entre os dois grupos de estudo em termos de idade, situação laboral materna e peso do bebê, mas houve uma relação estatisticamente significativa entre os tipo de parto, a escolaridade materna e o índice de aparência, frequência cardíaca, irritabilidade reflexa, tônus muscular, e respiração appearance, pulse, grimace, activity, and respiration, (Apgar), no primeiro minuto. A pontuação média do padrão de amamentação no grupo do parto natural (9,33) foi maior do que a do grupo da cesariana (7,21). CONCLUSãO: O tipo de parto afeta desempenho da mãe durante a amamentação, e as mães submetidas a cesariana necessitam de mais apoio e ajuda na amamentação.


Assuntos
Aleitamento Materno , Mães , Cesárea , Estudos Transversais , Feminino , Humanos , Lactente , Leite Humano , Gravidez
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