Bejegyzés

Greater Mortality and Morbidity in Extremely Preterm Infants Fed a Diet Containing Cow Milk Protein Products

Abrams SA1, Schanler RJ, Lee ML, Rechtman DJ.
Breastfeed Med. 2014 May 27.

Abstract

Background: Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit.

Subjects and Methods: EP infants <1,250 g birth weight received a diet consisting of either human milk fortified with a human milk protein-based fortifier (HM) (n=167) or a diet containing variable amounts of milk containing cow milk-based protein (CM) (n=93). Principal outcomes were mortality, necrotizing enterocolitis (NEC), growth, and duration of parenteral nutrition (PN).
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Results of research into the frequency of exclusive breastfeeding vary depending on the approach taken in the interview

Belo MM, Serva GB, Serva VB, Batista Filho M, Figueiroa JN, Caminha MF.
J Pediatr (Rio J). 2011 Jul-Aug;87(4):364-8.

Abstract

OBJECTIVE: To compare the frequency of exclusive breastfeeding using two different interview approaches.

METHODS: This was a cross-sectional study of 309 mothers of children aged 0 to 6 months, with a median age of 11 days. Mothers were interviewed at the Instituto de Medicina Integral Prof. Fernando Figueira during November and December of 2009. Two approaches to the interview were tested: firstly, the mother was asked if complementary foods had been given during the preceding 24 hours. Secondly, they were asked if at any point during the child’s life any other foods had been given.
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Valóban meg kell-e kezdeni a hozzátáplálást 6 hónapos kor előtt?

A La Leche Liga angliai szervezetének válasza a British Medical Journal című orvosi szaklapban 2011 januárjában megjelent cikkre, amely megkérdőjelezi a hozzátáplálás nem korábban, mint 6 hónapos korban való elkezdésére vonatkozó eddigi ajánlásokat

A La Leche Liga már több mint 50 éve nyújt információt és támogatást azoknak a szülőknek, akik szoptatni szeretnék gyermeküket. Munkája során osztja a WHO, az Egészségügyi Minisztérium és más mértékadó szervezetek azon nézeteit, miszerint a csecsemők optimális növekedését, fejlődését és egészségét az szolgálja legjobban, ha életük első 6 hónapjában kizárólag szopnak. Ezután pedig a szoptatást kiegészítve kapjanak a kisbabák megfelelő minőségű ételeket, hogy növekvő, változó táplálékigényüket kielégíthessék.
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Undeniable Benefits of Breastfeeding— Support for Evidence-Based International Guidelines

New Rochelle, NY, January 20, 2011 —A recent challenge to the well-established World Health Organization (WHO) breastfeeding guidelines is not supported by current research findings and unnecessarily questions the clear benefits of exclusive breastfeeding for at least the first 6 months of life. The Academy of Breastfeeding Medicine (ABM), a global physicians’ organization, supports the 2001 WHO recommendation for exclusive breastfeeding (not supplemented by formula or solid food) for six months after birth and emphasizes the proven health benefits of breastfeeding for both infants and mothers. ABM cautions against unsubstantiated, contradictory messages that create unnecessary confusion.

Ruth A. Lawrence, MD, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, a founder of ABM, and Editor-in-Chief of the journal Breastfeeding Medicine, challenges the opinions expressed by authors Mary Fewtrell and colleagues in the December 2010 issue of the British Medical Journal.
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Szakirodalmi összefoglaló és javaslat a glutén szoptatott csecsemők étrendjébe történő bevezetésével kapcsolatban

Háttér

Az elmúlt hónapokban az egészségügyi dolgozók (gyermekorvosok, védőnők) körében elter­jedt az a nézet, hogy a gluténtartalmú élelmiszereket 4 hónapos korban be kell vezetni a csecsemők étrendjébe, mert a glutén későbbi bevezetése fokozza a cöliákia kialakulásának kockázatát. Ez a javaslat a kutatási eredmények félreértelmezésén alapul, ellentmond az Egészségügyi Világszervezet és az európai egészségügyi szervezetek ajánlásának, és – a szilárd táplálékok túl korai bevezetése miatt – egészségügyi kockázatokat hordoz mind a szoptató anyákra, mind a szoptatott csecsemőkre nézve.

Az ESPGHAN ajánlása

Az Európai Gyermek Gasztroenterológiai, Hepatológiai és Táplálkozástudományi Társaság (ESPGHAN) 2008-ban kiadott állásfoglalásában (1) úgy fogalmaz, hogy az Egészségügyi Világszervezet által javasolt 6 hónapos korig tartó kizárólagos szoptatás kívánatos cél, vala­mint, hogy a kiegészítő táplálás semmiképpen se kezdődjön 17 hetes kor előtt és ne halasztód­jon 26 hetes kor utánra.
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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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Breast-feeding in relation to asthma, lung function, and sensitization in young schoolchildren

Kull I, Melen E, Alm J, Hallberg J, Svartengren M, van Hage M, Pershagen G, Wickman M, Bergström A.
J Allergy Clin Immunol. 2010 May;125(5):1013-9.

Abstract

Background The evidence from previous studies on beneficial effects of breast-feeding in relation to development of asthma is conflicting.

ObjectiveTo investigate the relation between breast-feeding and asthma and/or sensitization during the first 8 years of life.

Method In a birth cohort, children were followed up to 8 years by questionnaires at ages 2 months and 1, 2, 4, and 8 years to collect information on exposures and health effects. Determination of serum IgE antibodies to common inhalant and food allergens was performed at 4 and 8 years.
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European opinion on baby foods influenced by industry funding

Press release 23 December 2009

Health advocates predict a decline in breastfeeding if a new opinion of the European Food Safety Authority (EFSA) which is at variance with that of the World Health Organisation is translated into european legislation. The opinion which was issued on the 21st December (1) is a backward step and plays into the hands of the baby food industry which is trying to undermine moves to improve the 1996 EU baby food Directive. (2) It flies in the face of the global recommendation of the World Health Assembly, which was arrived at after a systematic review of over 3000 studies and is now policy in over 70 countries, including the UK.
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A prospective study of iron status in exclusively breastfed term infants up to 6 months of age

Shashi Raj, Mma Faridi, Usha Rusia and Om Singh

International Breastfeeding Journal 2008, 3:3

Abstract (provisional)

Background
Can exclusive breastfeeding until six months of age maintain optimum iron status in term babies? We evaluated iron status of exclusively breastfed term infants in relation to breast milk iron and lactoferrin.

Methods
In this prospective study in Delhi, India, during the period 2003-2004, normally delivered babies of non-anemic [(Hemoglobin (Hb) greater than or equal to 11 g/dl, n = 68] and anemic (Hb 7 – 10.9 g/dl, n = 61) mothers were followed until 6 months of age. Iron parameters were measured in the cord blood at 14 weeks and 6 months.
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Optimal duration of exclusive breastfeeding

KramerMS, Kakuma R.

Cochrane Database of Systematic Reviews – 2007. Update

Plain Language Summary

Exclusive breastfeeding for six months (versus three to four months) reduces gastrointestinal infection, does not impair growth, and helps the mother lose weight.

The results of two controlled trials and 18 other studies suggest that exclusive breastfeeding (no solids or liquids besides human milk, other than vitamins and medications) for six months has several advantages over exclusive breastfeeding for three to four months followed by mixed breastfeeding. These advantages include a lower risk of gastrointestinal infection, more rapid maternal weight loss after birth, and delayed return of menstrual periods.
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