In-Hospital Lactation Assessment

Verity Livingstone

Journal SOGC January 1996

Abstract

Obstetricians and family physicians play a privotal role in helping mothers to initiate lactation and to establish succesful breastfeeding in hospital. They can ensure that hospital policies and practices support breastfeeding, they can identify mothers and infants at risk for difficulties, and can offer early management advice.

This article outlines standardized in-hospital breast feeding protocols and assessments that can be used by health professionals on the wards.

A teljes cikk letölthető a Vancouver Breastfeeding Centre oldaláról.
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Breastfeeding Kinetics

A Problem-Solving Approach to Breastfeeding Difficulties

Verity Livingstone

Behavioral and Metabolic Aspects of Breastfeeding World Rev Nutr Diet. Basel, Karger, 1995, vol. 78. pp 28-54

Breatsfeeding has been recognized as the optimum way to nourish and nurture young children. It has proved to be the most cost-effective, health-promoting, and disease-preventing activity mothers can do because it is pivotal to infant growth, development, immunization and child spacing.

Over the last two decades, there has been an increase in the number of young mothers wishing to breastfeed, but despite teh widespread promotion of breastfeeding and the encouraging increase in its initiation rate, the number of mothers who exclusively breastfeed is < 30% in most industralized countries.
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Breast-feeding: matching supply with demand in human lactation

C. J. WILDEl, A. PRENTICE, M. PEAKER

Proceedings of the Nutrition Society (1995), 54, 401406

The potentially conflicting nutritional demands of parent and offspring during lactation may be considered across animal species in terms of cost-benefit analysis of parental investment. Based on Trivers’ (1974) kinship theory, Peaker (1989) proposed that parents invest in their young to an extent which increases survival of the present offspring, but not necessarily to an extent which would decrease the parent’s ability to invest in other offspring, including those not yet born. When the cost to the mother potentially compromises the parent’s ability to produce future offspring, then she may choose to discontinue that investment.
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Autocrine regulation of milk secretion by a protein in milk

Colin J. WILDE, Caroline V. P. ADDEY, Lynn M. BODDY and Malcolm PEAKER

Biochem. J. (1995) 305, 51-58

Abstract

Frequency or completeness of milk removal from the lactating mammary gland regulates the rate of milk secretion by a mechanism which is local, chemical and inhibitory in nature. Screening of goat’s milk proteins in rabbit mammary explant cultures identified a single whey protein of M(r) 7600 able to inhibit synthesis of milk constituents. The active whey protein, which we term FIL (Feedback inhibitor of Lactation), also decreased milk secretion temporarily when introduced into a mammary gland of lactating goats. FIL was synthesized by primary cultures of goat mammary epithelial cells, and was secreted vectorially together with other milk proteins.
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Prenatal Lactation Assessment

Verity Livingstone

Journal SOGC 1994 November

Abstract

Obstetricians and physicians play key roles in preparing pregnant women for breastfeeding. By performing a careful prenatal lactation assessment in the third trimester, maternal and infant risk factors for lactation and breastfeeding difficulties can be identified.

Anticipatory guidance and early intervention can help mothers to achive their breastfeeding goals and can help families to follow the recommended infant feeding guidelines. This article outlines a standardized prenatal assessment protocol that can be used by physicians in their offices.

A cikk teljes szövege letölthető a Vancouver Breastfeeding Centre oldaláról
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ABC of Breast Diseases: Congenital Problems and Aberrations of Normal Breast Development and Involution

J M Dixon, R E Mansel

BMJ 1994;309:797-800 (24 September)

A cikkben a következő témákról olvashat bővebben:

  • Congenital abnormalities
    – Extra nipples and breasts
    – Absence or hypoplasia of the breast
  • Breast development and involution
  • Aberrations of breast development
    – Juvenile or virginal hypertrophy
    – Fibroadenoma
  • Aberrations in early reproductive period
    – Pain and nodularity
  • Aberrations of involution
    – Cystic disease
    – Sclerosis
    – Duct ectasia
    – Epithelial hyperplasia
  • Causes of gynaecomastia

A cikk teljes szövege itt olvasható.
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Degree of breast emptying explains changes in the fat content, but not fatty acid composition, of human milk

SE Daly, A Di Rosso, RA Owens and PE Hartmann

Exp Physiol 1993;78;741-755

SUMMARY

We compared within and between breastfeed changes in milk fat to short-term rates of milk synthesis and degree of breast emptying (measured using the Computerized Breast Measurement system) over two 24 h periods for five lactating mothers. The fat content (f) of fore and hind milk samples increased more steeply as the breast was progressively emptied by the infant (degree of emptying, d, range 0-1; f = 21.59 + 9.38d + 70.99d2; P < 0,0001; r2 = 0.68; n = 154).

For the nine individual breasts, between 41-95% of the variance of the fat content of milk was explained by degree of breast emptying.
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Nursing Julia: My Supreme Challenge

Thanksgiving of 1991 was a special day for our family. Not only were we thankful for all our many blessings and for being able to share the day with family members we have not seen much of in recent years, but it was also our daughter Julia’s first birthday. A birthday is always a joyous occasion, but more so because Julia was born with a birth defect that is often fatal. There was, however, one more reason to celebrate that day. Julia had become a nursing baby only the day before. It was the culmination of more than five months of effort.
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Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media

Burris Duncan, John Ey, Catharine J. Holberg, Anne L. Wright, Fernando D. Martinez, Lynn M. Taussig
PEDIATRICS Vol. 91 No. 5 May 1993, pp. 867-872

Abstract

Objective. This study was designed to assess the relation of exclusive breast-feeding, independent of recognized risk factors, to acute and recurrent otitis media in the first 12 months of life.

Methods. Records of 1220 infants who used a health maintenance organization and who were followed during their first year of life as part of the Tucson Children’s Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy).
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The short-term synthesis and infant-regulated removal of milk in lactating women

SE Daly, RA Owens and PE Hartmann

Exp Physiol 1993;78;209-220

SUMMARY

We studied how short-term milk synthesis responds to milk removal by observing breast
volume before and after each breastfeed over 24 h periods within the homes of seven lactating mothers, using the Computerized Breast Measurement system. Short-term rates of milk synthesis varied markedly between the breasts of individual mothers, varied markedly between interfeed intervals for individual breasts and, for six of the thirteen breasts studied, were positively related to the degree to which the breast was emptied (r2 ranging from 0.32 to 0.95).

In addition, the infants rarely emptied the breasts of available milk (mean + S.D.
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