Szülés és szoptatás

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.

Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: Results of a cohort study.

Saxton A et al.
Midwifery. 2015 Jul 29. [Epub ahead of print]

Abstract

OBJECTIVE: to examine the effect of skin-to-skin contact and breast feeding within 30 minutes of birth, on the rate of primary postpartum haemorrhage (PPH) in a sample of women who were at mixed-risk of PPH.

DESIGN: retrospective cohort study.

SETTING: two obstetric units plus a freestanding birth centre in New South Wales (NSW) Australia.

PARTICIPANTS: after excluding women (n=3671) who did not have opportunity for skin to skin and breast feeding, I analysed birth records (n=7548) for the calendar years 2009 and 2010. Records were accessed via the electronic data base ObstetriX.

INTERVENTION: skin to skin contact and breast feeding within 30 minutes of birth.

Breastfeeding myths and mainstays for the obstetrician

Most ob/gyns are aware of the benefits of breastfeeding and the risks of not doing so. However, many do not appreciate the significant role that they play in supporting their patients’ breastfeeding efforts. Ob/gyns who are aware of some commonly held myths and who are familiar with strategies for breastfeeding can play a crucial role in a new mother’s breastfeeding success.

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.

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.

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.

Does breastfeeding induce spontaneous abortion?

Ishii H.
J Obstet Gynaecol Res. 2009 Oct;35(5):864-8.

Abstract

Aim: To verify the hypothesis that even if breastfeeding is continued during pregnancy, there are no harmful effects on pregnancy.

Methods: The outcomes of pregnancies in mothers who continued breastfeeding during pregnancy were studied. One hundred and ten pregnant women were recruited who had one full-term baby, no experience of premature birth or abortion, and who continued to breastfeed at diagnosis of pregnancy. Age and pregnancy history matched 774 pregnant women were selected as a control group. All of the control women stopped breastfeeding at least 3 months before becoming pregnant. We reviewed the outcome of each pregnancy retrospectively from patient records. Statistical analysis was conducted using the chi(2) test.

Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation.

Widström AM, Lilja G, Aaltomaa-Michalias P, Dahllöf A, Lintula M, Nissen E.
Acta Paediatr. 2011 Jan;100(1):79-85.

Abstract

Aim: The aim of this study was to provide a more detailed analysis of the infant’s behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep.

Excess weight loss in first-born breastfed newborns relates to maternal intrapartum fluid balance.

Chantry CJ, Nommsen-Rivers LA, Peerson JM, Cohen RJ, Dewey KG.
Pediatrics. 2011 Jan;127(1):e171-9.

Abstract

OBJECTIVES: The objectives were to describe weight loss in a multiethnic population of first-born, predominantly breastfed, term infants and to identify potentially modifiable risk factors for excess weight loss (EWL).

Excessive Weight Loss in Breastfed Infants During the Postpartum Hospitalization

Mulder PJ, Johnson TS, Baker LC.
J Obstet Gynecol Neonatal Nurs. 2010 Jan;39(1):15-26.

Abstract

OBJECTIVE: To examine differences in breastfeeding frequency, voids, and stools in infants with weight losses < or > or =7% during the postpartum hospitalization.

DESIGN: Secondary analysis of data from a primary psychometric study examining the Mother Infant Breastfeeding Progress Tool (MIBPT). Setting: A midwestern community hospital in a multicultural racially diverse community.

Associations of drugs routinely given in labour with breastfeeding at 48 hours: analysis of the Cardiff Births Survey

Jordan S, Emery S, Watkins A, Evans JD, Storey M, Morgan G.
BJOG. 2009 Nov;116(12):1622-9;

Abstract

Background Little is known about how breastfeeding rates are affected by drugs routinely administered in labour.

Objective To examine a large obstetric data set to investigate potentially modifiable associations between drugs routinely administered in labour and breastfeeding in healthy women and infants.

Design Retrospective cohort.

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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