Tag Archive for: Állásfoglalások, ajánlások

BREAST CANCER, PREGNANCY AND BREASTFEEDING

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This document was developed by the Breast Disease Committee and approved by
Executive and Council of the Society of Obstetricians and Gynaecologists of Canada.

SOGC Clinical Practice Guidelines, No. 111, February 2002

Abstract

Objective: The primary objective of this guideline is to provide Canadian physicians up-to-date, accurate information and recommendations regarding:
i) impact of pregnancy and lactation on risk of breast cancer;
ii) prognosis of breast cancer diagnosed during pregnancy and lactation;
iii) risk of recurrence of breast cancer with the occurrence of subsequent pregnancies;
iv) feasibility of breastfeeding and its impact on the prognosis of women with breast cancer.

Options: This guideline reviews evidence on whether pregnancy and breastfeeding change the lifetime risk for breast cancer in women, and whether breast cancer diagnosed during pregnancy or during lactation has a different prognosis.
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Breast-Feeding and Vaccination

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Neither inactivated nor live vaccines administered to a lactating woman affect the safety of breast-feeding for mothers or infants. Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine. Limited data indicate that breast-feeding can enhance the response to certain vaccine antigens (123). Breast-fed infants should be vaccinated according to routine recommended schedules (124–126).

Although live vaccines multiply within the mother’s body, the majority have not been demonstrated to be excreted in human milk. Although rubella vaccine virus might be excreted in human milk, the virus usually does not infect the infant. If infection does occur, it is well-tolerated because the viruses are attenuated (127).
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Complementary Feeding

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  • Report of the global consultation convened jointly by the Department of Child and Adolescent Health and Development and the Department of Nutrition for Health and Development Geneva, 10-13 December 2001

    • and

  • Summary of guiding principles for complementary feeding of the breastfed child

A teljes dokumentum a WHO oldalán található.
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ILCA: Position on Breastfeeding, Breastmilk and Environmental Contaminants

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Concern continues to be appropriate regarding environmental contaminants that find their way into the breast milk of lactating mothers. Dioxins produced during industrial processes and persistent organic pollutants (POPs), such as organochlorine pesticides and olychlorinated biphenyls (PCBs), are of great concern due to their long half-lives in the
body and their contribution to the body burden of contaminants in mothers and babies. Such substances are toxic to the nervous and immune system of the developing fetus. The number of environmental chemicals is in the thousands, with many new ones being added each year. Exposure may be geographical, occupational, or accidental.

Researchers and health authorities may use breast milk sampling as a measure of community-wide contamination because it is a rapid, sensitive, and less invasive method than drawing blood or obtaining a fat biopsy.
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The Transfer of Drugs and Other Chemicals Into Human Milk

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AMERICAN ACADEMY OF PEDIATRICS Committee on Drugs

PEDIATRICS Vol. 108 No. 3 September 2001

ABSTRACT.

The American Academy of Pediatrics places emphasis on increasing breastfeeding in the United States. A common reason for the cessation of breastfeeding is the use of medication by the nursing mother and advice by her physician to stop nursing. Such advice may not be warranted. This statement is intended to supply the pediatrician, obstetrician, and family physician with data, if known, concerning the excretion of drugs into human milk. Most drugs likely to be prescribed to the nursing mother should have no effect on milk supply or on infant well-being.
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American Academy of Family Physicians (AAFP) – Breastfeeding (Position Paper)

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Introduction

The American Academy of Family Physicians (AAFP) has long supported breastfeeding. All family physicians, whether or not they provide maternity care, have a unique role in the promotion of breastfeeding. Family physicians understand the advantages of family-centered care and are well positioned to provide breastfeeding support in that context. Because they provide comprehensive care to the whole family, family physicians have an opportunity to provide breastfeeding education and support throughout the life cycle to all members of the family.

Family physicians may provide prenatal care and labor support, deliver the infant, help in the prompt initiation and continuation of breastfeeding, and continue caring for the baby and family.
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ILCA: Position Paper on Infant Feeding

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The International Lactation Consultant Association(ILCA) affirms the right of all women to breastfeed their infants, of all infants to receive human milk, and of all men and women to assist mothers in protecting these rights. Many unnecessary obstacles stand in the way of women who wish to breastfeed. ILCA seeks to draw attention to key findings of recent research and the clinical implications of those findings. References noted below include research with a variety of methodologies ranging from carefully controlled clinical trials to small descriptive studies. ILCA’s recommendations are based on rigorous published research wherever possible and on collected experience and wisdom where gaps in research-based knowledge exist.
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ILCA: Position on Infant Feeding in Emergencies

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Increasingly over the last several years, mothers and infants have been affected by a variety of emergency situations world-wide

  • Armed conflicts displace millions of families and cut them off from their usual food supplies. There are some 50 million refugees around the word. Eighty percent of them are women and children.
  • Natural disasters also create short or long-term refugees and make access to food very difficult for sufficient time to endanger the most vulnerable of those affected – the ill, the elderly and young children. Crop failures, earthquakes, floods, hurricanes, tidal waves, typhoons and volcanic eruptions can destroy a country’s infrastructure and the livelihoods of those who weren’t killed outright.

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Breastfeeding and Maternal Tuberculosis

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Az egészségügyi dolgozók gyakran kerülnek olyan helyzetbe, hogy tanácsot kell adniuk, vajon biztonságos-e egy tuberculosisban szenvedő édesanya esetében a szoptatás. Korábban ilyen esetben a csecsemőt elkülönítették az anyától, legalábbis arra az időre, amíg az anya fertőzőképes volt. Az elkülönítés a szoptatást és a baba gondozását lehetetlenné tette az édesanya számára, a csecsemőt pedig – a mesterséges táplálás következtében – a fertőzések és az alultápláltság kockázatának tette ki. Ezek az intézkedések ma már nem javasoltak.

A teljes cikk a WHO oldalán olvasható.
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Breastfeeding and the Use of Human Milk

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AMERICAN ACADEMY OF PEDIATRICS
Work Group on Breastfeeding
PEDIATRICS Vol. 100 No. 6 December 1997, pp. 1035-1039

Abstract

This policy statement on breastfeeding replaces the previous policy statement of the American Academy of Pediatrics, reflecting the considerable advances that have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, in the mechanisms underlying these benefits, and in the practice of breastfeeding. This document summarizes the benefits of breastfeeding to the infant, the mother, and the nation, and sets forth principles to guide the pediatrician and other health care providers in the initiation and maintenance of breastfeeding. The policy statement also delineates the various ways in which pediatricians can promote, protect, and support breastfeeding, not only in their individual practices but also in the hospital, medical school, community, and nation.
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