Bejegyzés

A 6-24 hónapos és idősebb csecsemők és kisgyermekek folytatólagos szoptatásának védelme, elősegítése és támogatása: kérdések, irányelvek, stratégiák, intézkedések

EGYÜTTES NYILATKOZAT a WABA (World Alliance for Breastfeeding Action – Szoptatási Világszövetség) Globális Szoptatási Partnereinek 2008. októberében Penangban megtartott VII. Találkozóján létrejött műhelymunka alapján

A nyilatkozattétel indoklása

A nemzetközileg elfogadott csecsemő- és kisgyermek-táplálási ajánlások hat hónapos korig kizárólagos szoptatást javasolnak, majd a szoptatás folytatását megfelelő kiegészítő táplálás mellett két éves korig vagy tovább. Az a táplálási gyakorlat, amely nincs összhangban ezzel az ajánlással (az optimálistól elmaradó szoptatás)1, felelőssé tehető az 5 éven aluli gyermekek haláleseteinek 12%-áért.2 Ezen meg­előzhető halálesetek majdnem negyede (23%-a) visszavezethető a 6-24+ hónapos korúak szoptatásá­nak hiányára.2

A szoptatási gyakorlat javítása komoly segítő tényező lehet a Millennium Fejlesztési Célok elérésében.
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Biomedical Ethics and Peer-to-Peer Milk Sharing

Karleen D. Gribble
Clinical Lactation, 2012, Vol. 3-3, 109-112

The facilitation of peer-to-peer milk sharing via the Internet has proven challenging to many health professionals and organizations. Biomedical ethics can be used to explore medical dilemmas and find reasoned, consistent, and defensible solutions to moral problems. The principles of biomedical ethics—autonomy, veracity, beneficence, nonmaleficence, confidentiality, and justice—are applied to peer-to-peer milk sharing in this article. Application of these principles provides guidance to assist lactation consultants to act ethically in their interactions with mothers and others around the peer sharing of milk.

A teljes cikk innen letölthető.
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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.

During the first 3 months of our intervention, the rate of early STS among healthy babies born by cesarean increased from 20% to 68%.
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Vital Signs: Hospital Practices to Support Breastfeeding – United States, 2007 and 2009

Centers for Disease Control and Prevention (CDC)
MMWR Morb Mortal Wkly Rep. 2011 Aug 5;60:1020-5.

Abstract

Background: Childhood obesity is a national epidemic in the United States. Increasing the proportion of mothers who breastfeed is one important public health strategy for preventing childhood obesity. The World Health Organization and United Nations Children’s Fund (UNICEF) Baby-Friendly Hospital Initiative specifies Ten Steps to Successful Breastfeeding that delineate evidence-based hospital practices to improve breastfeeding initiation, duration, and exclusivity.

Methods: In 2007 and 2009, CDC conducted a national survey of U.S. obstetric hospitals and birth centers. CDC analyzed these data to describe the prevalence of facilities using maternity care practices consistent with the Ten Steps to Successful Breastfeeding.
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Miért nem szoptat minden jó anya?

Ritka kivételektől eltekintve gyakorlatilag minden anya szoptatni akarja a gyermekét, 98%-uk erre testileg képes is és Magyarországon 90% el is kezdi a szoptatást. Tudjuk, hogy az anyatej a csecsemő tökéletes tápláléka és az anyák szándéka a közösségi nyomással is egybecseng: az anya szoptasson. A 3 hónapos csecsemők közül mégis már csak 58% szopik, a 6 hónaposan kizárólag szoptatottak aránya 36% körüli ( a “kizárólag szoptatás” fogalmát nem minden esetben a WHO definíció szerint használják, a csak folyadékpótlást kapó babákat sokszor beleszámolják – az anyák nem is mindig tudnak róla, hogy az újszülött mit kapott a kórházban). A jelenség más “nyugati” országokban is megfigyelhető.
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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.
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The Magic Number and Long-Term Milk Production

Nancy Mohrbacher
Clinical Lactation 2011 2(1):15-18

Abstract

Worry about milk production is the most common reason women wean earlier than planned. In many cases this worry is due to confusion about how milk production works. This article describes a teaching concept, termed the Magic Number. Clinicians can use this concept to provide mothers who are not exclusively breastfeeding on cue a clear, evidence-based understanding of how to keep their milk production stable over the long term.

With unrestricted access to the breast, most babies can easily adjust their mother’s milk production by simply changing their breastfeeding length and frequency. However, many mothers with milk-production issues are not exclusively breastfeeding.
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What Happens to Breastfeeding When Mothers Lie Back?

Clinical Applications of Biological Nurturing

Suzanne Colson
Clinical Lactation 2010 1(1):11-14

Abstract

Human neonates are born with an innate ability to find the breast, latch and feed. Unfortunately, some of these very reflexes can also hinder babies’ efforts to breastfeed depending on the mother’s posture. This article provides a brief overview on the mechanisms of biological nurturing (BN) and describes how practitioners can help mothers trigger innate feeding mechanisms so that they do not become barriers to breastfeeding.

From a survival standpoint, it makes evolutionary sense that neonates be born with a number of simple, innate movements enabling them to find the food source, latch on and feed.
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Factors predicting early discontinuation of exclusive breastfeeding in the first month of life

Vieira GO, Martins CC, Vieira TO, de Oliveira NF, Silva LR.
J Pediatr (Rio J). 2010 Sep-Oct;86(5):441-4.

Abstract

OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil.

METHODS: Cohort study with follow-up of 1,309 mother-child pairs selected from all maternities in the municipality. Data were collected in hospital and in home visits during the first month of life. Logistic regression analysis was used to examine the relationship between outcome and variables of interest.

RESULTS: Lack of prior breastfeeding experience (PR 1.24; 95%CI 1.75-1.43), cracked nipples (PR 1.25; 95%CI 1.09-1.43), use of fixed breastfeeding schedules (PR 1.42; 95%CI 1.09-1.84) and pacifier use (PR 1.53; 95%CI 1.34-1.76) were identified as factors predicting discontinuation of exclusive breastfeeding.
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Residency Curriculum Improves Breastfeeding Care

Feldman-Winter L, Barone L, Milcarek B, Hunter K, Meek J, Morton J, Williams T, Naylor A, Lawrence RA.
Pediatrics. 2010 Jul 5.

Abstract

Objectives Multiple studies have revealed inadequacies in breastfeeding education during residency, and results of recent studies have confirmed that attitudes of practicing pediatricians toward breastfeeding are deteriorating. In this we study evaluated whether a residency curriculum improved physician knowledge, practice patterns, and confidence in providing breastfeeding care and whether implementation of this curriculum was associated with increased breastfeeding rates in patients.

Subjects and Methods A prospective cohort of 417 residents was enrolled in a controlled trial of a novel curriculum developed by the American Academy of Pediatrics in conjunction with experts from the American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and Association of Pediatric Program Directors.
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