Bababarát kórház

Optimizing Support for Breastfeeding as Part of Obstetric Practice

ACOG Committee Opinion No. 658., February 2016

ABSTRACT: Although most women in the United States initiate breastfeeding, more than one half wean earlier than they desire. As reproductive health experts and advocates for women’s health who work in conjunction with other obstetric and pediatric health care providers, obstetrician–gynecologists are uniquely positioned to enable women to achieve their infant feeding goals. The American College of Obstetricians and Gynecologists recommends exclusive breastfeeding for the first 6 months of life, with continued breastfeeding as complementary foods are introduced through the infant’s first year of life, or longer as mutually desired by the woman and her infant. Because lactation is an integral part of reproductive physiology, all obstetrician–gynecologists and other obstetric care providers should develop and maintain knowledge and skills in anticipatory guidance, physical assessment and support for normal breastfeeding physiology, and management of common complications of lactation.

Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review

Pérez-Escamilla R et al
Matern Child Nutr. 2016 Jul;12(3):402-17.

Abstract

The Baby-friendly Hospital Initiative (BFHI) is a key component of the World Health Organization/United Nations Children's Fund Global Strategy for Infant and Young Child Feeding. The primary aim of this narrative systematic review was to examine the impact of BFHI implementation on breastfeeding and child health outcomes worldwide and in the United States.

A korai bőrkontaktus támogatása 10 lépésben - gyakorlati útmutató családoknak, szakembereknek

A korai kötődés, azaz bonding – már a születés, szülés előtt, illetve a szül(et)és pillanatában megkezdődik. Elengedhetetlen, hogy a gyermek és az anya elválasztását meggátoljuk az élet első pillanataiban, óráiban, napjaiban. A korai kapcsolat támogatása alapvető fontosságú minden gyermeknél, de ennél is lényegesebb a koraszülötteknél és császármetszéssel világrajötteknél, traumatizált anyáknál. A szül(et)éssel egyaránt megváltoznak mind a gyermek, mind az anya neuropszichológiai mechanizmusai. A bőrkontaktus elősegíti a szülővé válást, az újszülött adaptálódását, a természetes, egészséges bio-pszicho-szociális, spirituális folyamatok kibontakozását, megvalósul a kolonizáció, immunológiai, fiziológiai szempontból is az ideális kezdetet kapja meg a kisbaba.

Midwives׳ experiences with mother-infant skin-to-skin contact after a caesarean section: 'Fighting an uphill battle'.

Zwedberg S, Blomquist J, Sigerstad E.
Midwifery. 2015 Jan;31(1):215-20.

Abstract

OBJECTIVE: to explore midwives׳ experiences and perceptions of skin-to-skin contact between mothers and their healthy full-term infants immediately and during the first day after caesarean section.

DESIGN: qualitative interviews with semi-structured questions.

SETTING AND PARTICIPANTS: eight midwives at three different hospitals in Stockholm participated in the study. All participants provided care for mothers and their newborn infants after caesarean birth.

Early skin-to-skin contact for mothers and their healthy newborn infants (2012)

Moore ER, Anderson GC, Bergman N, Dowswell T.
Cochrane Database Syst Rev. 2012 May

Abstract

BACKGROUND: Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, head covered with a dry cap and a warm blanket across the back, prone on the mother's bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically 'sensitive period' for programming future physiology and behavior.

OBJECTIVES: To assess the effects of early SSC on breastfeeding, physiological adaptation, and behavior in healthy mother-newborn dyads.

Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations.

Nyqvist KH et al.
J Hum Lact. 2013 Aug;29(3):300-9.

Abstract

In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care.

Császár után

Egy éve dolgozom az egészségügyben. Egy év alatt annyit tanultam, mint azelőtt összesen. Többek között azt, milyen fontos néha csak ülni valahol, és nem csinálni semmit. Ilyen helyzet, amikor anya és baba először találkoznak.

Eddig bába és szülész ismerőseimtől hallottam arról, mekkora művészet valahol csak ott lenni, nem is szólni, szinte észrevétlenül belesimulni a környezetbe, csak annyira látszani, hogy az anya biztonságérzete meglegyen. Sokan erre képtelenek, úgy érzik, tenni kell valamit, különben miért is lennének ott. Vagy tenni kell valamit a fizetésükért/fizetségükért. Vagy azért, hogy bebizonyítsák: itt szükség van a szaktudásukra. Vagy azért, hogy végre történjen már valami. Pedig néha fontos, hogy úgy legyünk az anya mellett, mintha ott sem lennénk.

The Baby-Friendly Initiative: Protecting, promoting and supporting breastfeeding

CM Pound, SL Unger; Canadian Paediatric Society, Nutrition and Gastroenterology Committee
Paediatr Child Health 2012;17(6):317-21

Abstract

Breastfeeding confers extensive and well-established benefits and is recognized as an extremely effective preventative health measure for both mothers and babies. Except in very few specific medical situations, breastfeeding should be universally encouraged for all mothers and infants. To improve worldwide breastfeeding initiation and duration rates, the WHO and UNICEF launched the Baby-Friendly Initiative (BFI) in 1991. The goal was to protect, promote and support breastfeeding by adherence to the WHO’s “Ten Steps to Successful Breastfeeding”. Since then, more than 20,000 hospitals in 156 countries have achieved Baby-Friendly status, with a resultant increase in both breastfeeding initiation and duration. Still, only 500 hospitals are currently designated Baby-Friendly in industrialized countries, including 37 health centres or health authorities in Canada. Health care practitioners have a unique and influential role in promoting and supporting breastfeeding. Provincial and territorial government leadership is essential to ensuring implementation of the BFI in all health care facilities delivering services to families with young children.

Early Skin-to-Skin After Cesarean to Improve Breastfeeding

Hung KJ, Berg O.
MCN Am J Matern Child Nurs. 2011 Sep-Oct;36(5):318-24.

Abstract

This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) and during recovery, was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital. The nursing role is key for the intervention, but the program involves the entire perinatal team, including the obstetricians, pediatricians, and anesthesiologists.

Improving the "Bottom-Line"

Financial Justification for the Hospital-Based Lactation Consultant Role

Shannon Francis-Clegg, Deanne T. Francis
Intermountain Healthcare Lactation Standardization Project (2007)
Clinical Lactation, 2011, Vol. 2(1), 19-25

Abstract

Intermountain Healthcare’s Lactation Standards Team conducted a year-long indepth study to evaluate their current lactation services for staffing, patient satisfaction, patient and staff education, reimbursement patterns, cost of care and lactation-failure readmissions. The attempt was to evaluate and then standardize the lactation services within their 23-hospital system and create staffing recommendations to support optimal lactation care and support. This article represents a brief summary of recommendations based on this study. Individual portions of the project with detailed process and final results/data will be submitted for future publication.

Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

Stage E, Mathiesen E, Emmersen P, Greisen G, Damm P.
Acta Paediatr. 2010 Feb 23. [Epub ahead of print]

Abstract

Aim:  As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity.

Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, et al.

Health Technol Assess 2009;13(40).

Objectives: To evaluate the effectiveness and costeffectiveness of interventions that promote or inhibit breastfeeding or feeding with breastmilk for infants admitted to neonatal units, and to identify an agenda for future research.

Implementing and revitalizing the Baby-Friendly Hospital Initiative

Randa Saadeh and Carmen Casanovas
Food Nutr Bull. 2009 Jun;30(2 Suppl):S225-9.

Abstract

The Baby-Friendly Hospital Initiative (BFHI) was launched in the 1990s by the World Health Organization (WHO) and UNICEF as a global effort with hospitals, health services, and parents to ensure babies are breastfed for the best start in life. It is one of the Operational Targets of the Global Strategy for Infant and Young Child Feeding endorsed in 2002 by the Fifty-Fifth World Health Assembly and the UNICEF Executive Board.

Early contact versus separation: effects on mother-infant interaction one year later.

Bystrova K et al.
Birth. 2009 Jun;36(2):97-109.

Abstract

BACKGROUND: A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long-term effects on mother-infant interaction of practices used in the delivery and maternity wards, including practices relating to mother-infant closeness versus separation.

Hospital Practices and Women’s Likelihood of Fulfilling Their Intention to Exclusively Breastfeed

Eugene Declercq, Miriam Labbok, Carol Sakala, MaryAnn O'Hara

Am J Public Health. 2009 Mar 19. [Epub ahead of print]

Objectives. We sought to assess whether breastfeeding-related hospital practices reported by mothers were associated with achievement of their intentions to exclusively breastfeed.

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