Bejegyzés

Visszafelé sült el az együttalvást tiltó ajánlás

Nincs olyan új szülő, aki ne hallotta volna a figyelmeztetést: Soha ne aludjon együtt a kisbabájával!

Az állami és helyi egészségügyi szervek Massachusettsben és szerte az Egyesült Államokban az egyik legfontosabb feladatuknak tekintik ennek az üzenetnek a közvetítését azóta, hogy az Amerikai Gyermekgyógyászati Akadémia (AAP) 2011-ben hivatalos ajánlásában megfogalmazta. Dollármilliókat költöttek a hirdetésére és még több milliót arra, hogy kiságyakkal lássák el a szegény családokat.

Egyes helyeken ijesztő reklámokkal támogatták az üzenet megértését: a képen egy csecsemő felnőtt ágyban fekszik egy húsvágó bárd mellett, és a szöveg szerint: „Ha a kisbabád veled alszik, az ugyanennyire veszélyes lehet.” Vagy egy másik: „A kisbabának a kiságyban a helye, nem egy koporsóban.”

Félremagyarázott tanulmányok

A széles körben elterjedt javaslattal az a probléma, hogy az AAP mindössze négy tanulmányra alapozta az ajánlását.
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Bringing the Parent Back into Decisions about Nighttime Care

Wendy Middlemiss
Clinical Lactation, 2013, Vol 4-2, 71-76

Abstract

New parents often have many questions and concerns about how to help their children grow strong and healthy. Unfortunately, when it comes to nighttime care, healthcare providers often tell parents what to do rather than discussing options. Healthcare providers might give parents specific advice about how to handle nighttime wakings, for example, without inquiring about parents’ beliefs and preferences. When healthcare providers simply tell parents what to do, parents may choose to ignore the advice if it is not consistent with their beliefs and preferences. When parents and healthcare providers do not communicate, parents do not get the information they need to cope with some of the more challenging aspects of infancy, including nighttime waking.
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Breastfeeding and Dental Caries: Looking at the Evidence

Valerie Lavigne
Clinical Lactation, 2013, Vol. 4-1, 12-16.

Abstract

Dental caries and prolonged breastfeeding still trigger much debate among professionals and parents. Some mothers are still being told to discontinue breastfeeding their toddlers because of cavities in the mouth. Parents often feel very discouraged and upset when they are forced to stop breastfeeding their toddlers. Dental caries is one of the most common chronic diseases in childhood, and is a disease of multifactorial etiology. This paper reviews the literature on dental caries and breastfeeding. This review revealed that there was no conclusive evidence that prolonged breastfeeding increased the risk of early childhood cavities.
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Cortisol regulation in 12-month-old human infants: associations with the infants’ early history of breastfeeding and co-sleeping

Beijers R, Riksen-Walraven JM, de Weerth C.
Stress. 2012 Nov 1.

Abstract

Experiences during early life are suggested to affect the physiological systems underlying stress responses, including the hypothalamic pituitary adrenal axis (HPA-axis). While stressful early experiences have been associated with dysregulated HPA-axis functioning, positive early experiences, i.e. high maternal caregiving quality, contribute to more optimal HPA-axis functioning. Influences of other early caregiving factors, however, are less well documented. The goal of this study was to examine whether breastfeeding and co-sleeping during the first six months of life was associated with infant cortisol regulation, i.e. cortisol reactivity and recovery, to a stressor at 12 months of age.
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Should Neonates Sleep Alone?

Morgan BE, Horn AR, Bergman NJ.
Biol Psychiatry. 2011 Nov 1;70(9):817-25.

Abstract

BACKGROUND: Maternal-neonate separation (MNS) in mammals is a model for studying the effects of stress on the development and function of physiological systems. In contrast, for humans, MNS is a Western norm and standard medical practice. However, the physiological impact of this is unknown. The physiological stress-response is orchestrated by the autonomic nervous system and heart rate variability (HRV) is a means of quantifying autonomic nervous system activity. Heart rate variability is influenced by level of arousal, which can be accurately quantified during sleep. Sleep is also essential for optimal early brain development.
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The Effect of Feeding Method on Sleep Duration, Maternal Well-being, and Postpartum Depression

Kathleen Kendall–Tackett, Zhen Cong, Thomas W. Hale
Clinical Lactation, Volume 2, Issue 2, 2011

Abstract

When a breastfeeding mother is depressed – or even at risk for depression – she is often advised to supplement with formula so that she can get more sleep. Results of recent studies suggest, however, that exclusively breastfeeding mothers actually get more sleep than their mixed- or formula-feeding counterparts. The present study examines the relationship between feeding method, maternal well-being, and postpartum depression in a sample of 6,410 mothers of infants 0-12 months of age.

Our findings revealed that women who were breastfeeding reported significantly more hours of sleep, better physical health, more energy, and lower rates of depression than mixed- or formula-feeding mothers.
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Mother–Infant Sleep Locations and Nighttime Feeding Behavior

Kathleen Kendall–Tackett, Zhen Cong, Thomas W. Hale
Clinical Lactation, Volume 1, Fall 2010

Abstract

The controversy around mother–infant bedsharing continues to grow. In order to make sound policy recommendations, policy makers need current data on where infants sleep and how families handle nighttime feedings. The present study is a survey of 4,789 mothers of infants 0–12 months of age in the U.S. The findings indicate that almost 60% of mothers bedshare and that this occurs throughout the first year. These findings also indicate that 25% of mothers are falling asleep with their infants in dangerous sleep locations, such as chairs, sofas or recliners.
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Relationship Between Bed Sharing and Breastfeeding: Longitudinal, Population-Based Analysis.

Blair PS, Heron J, Fleming PJ.
Pediatrics. 2010 Oct 18. [Epub ahead of print]

Abstract

Objectives: This is an investigation into the longitudinal patterns of bed sharing, the characteristics associated with those patterns, and the relationship with breastfeeding.

Methods: The study used prospective, population-based data from the United Kingdom to investigate nocturnal bed sharing at 5 time points from birth to 4 years of age. Of 14 062 live births, 7447 (53%) had data available for all time points.

Results: Latent class analysis identified 4 mutually exclusive groups, broadly described as nonsharers (66%), early bed sharers (only in infancy) (13%), late bed sharers (after the first year) (15%), and constant bed sharers (throughout the 4 years) (6%).
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Maternal emotional availability at bedtime predicts infant sleep quality

Teti DM, Kim BR, Mayer G, Countermine M.
J Fam Psychol. 2010 Jun;24(3):307-15.

Abstract

In the present study, linkages were examined between parental behaviors (maternal practices) at bedtime, emotional availability of mothering at bedtime, and infant sleep quality in a cross-sectional sample of families with infants between 1 and 24 months of age.

Observations of maternal behaviors and maternal emotional availability were conducted independently by 2 sets of trained observers who were blind to data being coded by the other. With infant age statistically controlled, specific maternal behaviors at bedtime were unrelated to infant sleep disruptions at bedtime and during the night.
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Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England

Peter S Blair, Peter Sidebotham, Carol Evason-Coombe, Margaret Edmonds, Ellen M A Heckstall-Smith, Peter Fleming
BMJ 2009;339:b3666

Abstract

Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child).

Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups.

Setting South west region of England (population 4.9 million, 184 800 births).
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