Tag Archive for: A szoptatás támogatása, segítségnyújtás

Initial Management of Breastfeeding

Keith Sinusas, M.D. and Amy Gagliardi, M.A., I.B.C.L.C.

Am Fam Physician 2001;64:981-8,991-2.

Breast milk is widely accepted as the ideal source of nutrition for infants. In order to ensure success in breastfeeding, it is important that it be initiated as early as possible during the neonatal period. This is facilitated by skin-to-skin contact between the mother and infant immediately following birth. When possible, the infant should be allowed to root and latch on spontaneously within the first hour of life. Many common nursery routines such as weighing the infant, administration of vitamin K and application of ocular antibiotics can be safely delayed until after the initial breastfeeding.
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Maternity care practices: implications for breastfeeding

DiGirolamo AM, Grummer-Strawn LM, Fein S.
Birth. 2001 Jun;28(2):94-100.

Abstract

BACKGROUND: Many United States mothers never breastfeed their infants or do so for very short periods. The Baby-Friendly Hospital Initiative was developed to help make breastfeeding the norm in birthing environments, and consists of specific recommendations for maternity care practices. The objective of the current study was to assess the impact of the type and number of Baby-Friendly practices experienced on breastfeeding.

METHODS: A longitudinal mail survey (1993-1994) was administered to women prenatally through 12 months postpartum. The study focused on the 1085 women with prenatal intentions to breastfeed for more than 2 months who initiated breastfeeding, using data from the prenatal and neonatal periods.
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Breastfeeding determinants and a suggested framework for action in Europe.

Abstract

This is a background paper for the EURODIET initiative. A number of international initiatives and documents were identified, such as the Baby-Friendly Hospital Initiative, the International Code of Marketing of Breast Milk Substitutes and a number of consensus reports from professional groups, that propose ways forward for breastfeeding promotion. These point at a range of initiatives on different levels. The determinants for successful breastfeeding have to be identified. They can be categorised into five groups; socio-demographic, psycho-social, health care related, community- and policy attributes. A framework for future breastfeeding promoting efforts on European level is suggested, within which these determinants are considered.
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Promotion of Breastfeeding Intervention Trial (PROBIT): A Randomized Trial in the Republic of Belarus

Michael S. Kramer et al.
JAMA. 2001;285:413-420.

Abstract

Context Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries.

Objective To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants.

Design The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996–December 1997 with a 1-year follow-up.

Setting Thirty-one maternity hospitals and polyclinics in the Republic of Belarus.

Participants A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up.
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Promoting and Supporting Breast-Feeding

Jay Moreland, Jennifer Coombs

Am Fam Physician 2000;61:2093-100,2103-4.

The family physician can significantly influence a mother’s decision to breast-feed. Prenatal support, hospital management and subsequent pediatric and maternal visits are all-important components of breast-feeding promotion. Prenatal encouragement increases breast-feeding rates and identifies potential problem areas. Hospital practices should focus on rooming-in, early and frequent breast-feeding, skilled support and avoidance of artificial nipples, pacifiers and formula. Infant follow-up should be two to four days postdischarge, with liberal use of referral and support groups, including lactation consultants and peer counselors.

Breast-feeding is the best form of nutrition for infants.1,2 Family physicians can have a significant impact on the initiation and maintenance of breast-feeding, if they have sufficient knowledge of breast-feeding benefits and the necessary clinical management skills or habits.
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Postpartum Breastfeeding Assessments

Verity Livingstone

Journal SOGC February 1996

Abstract

Despite a high initiation rate of breastfeeding in hospital, most mothers stop breastfeeding within a few weeks, “The window of professional unavailability” and lack of breastfeeding management skills among health professionals are partly to blame. This article, the third in a series, reviews the physiology of ongoing lactation, and outlines a protocol for post-partum breastfeeding that can be incorporated into routine postpartum management.

It reviews the early detection of infants at risk for breastfeeding difficulties and insufficient milk intake. It outlines topics for discussion and anticipatory guidance at age appropriate intervals including breastfeeding and sexuality, introduction of solids, and child led weaning.
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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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A diagnostic approach to breastfeeding problems

Verity Livingstone

The Canadian Journal of Pediatrics February 1990

One-third of breastfeeding mothers stop within the first two months because they cannot solve their infant feeding difficulties, not because they wish to stop breastfeeding. This early weaning rate is unacceptably high, according to current infant feeding recommendations. The World Health Organization suggests that weaning should not occur until the second year, yet less than 10% of infants in Canada are receiving breast milk by one year.

Breastfeeding problems include: infant failure to thrive, early supplementation due to inadequate milk supply, infant distress, or maternal discomfort and distress. The etiology or underlying cause(s) should be carefully identified before appropriate management is instituted and preventive measures taken.
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The Family Physician’s Role in Preventing Early Termination of Breastfeeding

Verity Livingstone
Can Fam Physician 1986;32:2162-2169

Summary

Despite the high rate of breastfeeding among mothers as they leave the hospital, early termination of breastfeeding continues to be a problem. A new mother needs considerable education, support and, often, early intervention, not only to initiate breastfeeding successfully, but also to prevent breastfeeding problems occuring and to continue breastfeeding successfully for several months. Knowledgeable health-care providers are the key to promoting and protecting breastfeeding, yet in the community, many of these mothers, lacking the support of such knowledgeable advisers, often terminate early.

Family physicians are in a key position to help teh nursing dyad.
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