RESUMEN
OBJECTIVE: In-hospital formula supplementation places infants at risk for early breastfeeding cessation. The study's aim was to identify predictive and protective factors for in-hospital formula supplementation in individuals documented as wanting to exclusively breastfeed and residing in a geographic region with adverse social determinants of health and low breastfeeding rates. Additionally, we wished to determine if lactation consultation served as a protective factor against supplementation. METHODS: In this cross-sectional study, we retrospectively reviewed 500 randomly selected charts of newborns born in a 12 month period at a regional tertiary care hospital. We included healthy, full-term neonates having a recorded maternal decision to exclusively breastfeed. Maternal-newborn dyad characteristics were compared between those exclusively breastfeeding and those with in-hospital formula supplementation. RESULTS: Of the 500 charts, 70% of individuals desired to exclusively breastfeed. Overall, 41% of breastfed newborns were supplemented with formula before discharge, and 32% of women met with lactation consultants prior to supplementation. No statistically significant association was present between exclusive breastfeeding at discharge and meeting with a hospital lactation consultant (p = 0.55). When controlling for the confounders of maternal demographics and lactation consultation, significant associations with formula supplementation included Cesarean delivery (odd ratio: 2.08, 95% confidence interval: 1.04-4.16), primiparity (2.48, 1.27-4.87), and high school level of education (2.78, 1.33-5.78). CONCLUSIONS: Maternal characteristics of high school level educational, primiparity, and Caesarean delivery place individuals at risk for in-hospital formula supplementation in individuals wishing to exclusively breastfeed. Addressing barriers to exclusive breastfeeding is essential to enhance maternal and newborn health equity.
Asunto(s)
Lactancia Materna , Suplementos Dietéticos , Lactante , Embarazo , Recién Nacido , Humanos , Femenino , Estudios Retrospectivos , Estudios Transversales , Suplementos Dietéticos/efectos adversos , Hospitales , Fórmulas InfantilesRESUMEN
Small bowel obstruction is a common surgical emergency and frequent cause of hospitalization. Internal hernias account for less than 6% of all small bowel obstruction cases. Less frequently, hernias through the broad ligament of the uterus can occur and account for only 4-7% of total internal hernia cases. We report a case of a small bowel hernia through broad ligament of the uterus in a young female. Multiple diagnostic modalities suggested a ruptured ovarian cyst as the most probable cause for her abdominal pain. However, her symptoms were much more severe than an ovarian cyst would normally produce. Therefore, a diagnostic laparotomy was performed, which found a small intestine hernia through the left broad ligament of the uterus. The diagnosis of intestinal hernias, specifically through the broad ligament, is often delayed due to the infrequent occurrence, varied presentation, and difficulty of confirmation on computed tomography (CT) scan. Surgery is the gold standard for the diagnosis and treatment of internal hernias. This article draws attention toward a rare and potentially life-threatening cause of abdominal pain.
Asunto(s)
Ligamento Ancho , Hernia Abdominal , Obstrucción Intestinal , Quistes Ováricos , Neoplasias Ováricas , Dolor Abdominal/etiología , Femenino , Hernia Abdominal/complicaciones , Hernia Abdominal/diagnóstico , Hernia Abdominal/cirugía , Humanos , Hernia Interna , Obstrucción Intestinal/diagnóstico , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Quistes Ováricos/complicaciones , Quistes Ováricos/diagnóstico , Neoplasias Ováricas/complicaciones , ÚteroRESUMEN
Lessons learned from one hospital's COVID-19 experience.