Bejegyzés

A betegség soha nem jön jókor, de fokozott aggodalmat válthat ki, ha egy szoptató anya betegszik meg. Márpedig ez nem annyira ritka, mint gondolnánk, mivel a szoptatási időszak akár éveket is felölelhet, és ennyi idő alatt szinte lehetetlen, hogy elkerüljünk minden fertőzést.

Vannak, akik már a várandósságnak régóta ismert, krónikus betegséggel vágnak neki, hiszen egy jól karbantartott pajzsmirigy-, vagy cukorbetegség, illetve más hosszan tartó betegség nem akadálya az egészséges gyermek születésének.

Nem kell szenvedni

Akár akut, akár krónikus betegségről van szó, minden esetben felmerül a kérdés, hogy az édesanya az adott állapotban és kezelés mellett szoptathatja-e a kisbabáját. Szomorú tény, hogy az anya betegsége túl sokszor vet véget a szoptatási kapcsolatnak – a legtöbb esetben teljesen indokolatlanul.
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Valóban a mell lenne a legjobb HIV inhibítor? Az anyatej egyik eddig ismeretlen összetevője elpusztítja a HIV partikulumokat és a vírussal fertőzött sejteket, valamint gátolja a HIV átvitelét az egér és az emberi immunrendszerben egyaránt.

A gyermekkorban bekövetkező HIV fertőzés összefügésbe hozható a a betegség gyorsabb lefolyásával és a magasabb halálozási aránnyal. Az antiretrovirális terápia hiányában a HIV fertőzött gyermekeknek csak 65%-a éli meg az első és kevesebb mint a fele fogja ünnepelni a 2. születésnapját. A legtöbb HIV pozitív gyermek méhen belül, vagy szoptatás alatt fertőződik meg. A fejlett országokban az anya-gyermek HIV átvitel előfordulásának aránya rendkívül alacsony, mivel a nők antiretrovirális terápiában részesülnek a terhesség alatt, és tartózkodnak a szoptatástól.
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Heller MM, Fullerton-Stone H, Murase JE.
Int J Dermatol. 2012 Oct;51(10):1149-61.

Abstract

Breastfeeding is thought to be the most optimal form of infant nutrition. Nursing mothers are generally advised to continue breastfeeding until the infant is two years of age or beyond. Unfortunately, however, a majority of nursing mothers will discontinue breastfeeding much earlier than recommended. The most common reason for early discontinuation of breastfeeding is nipple pain. It is, therefore, essential that dermatologists know how to appropriately diagnose and effectively treat nipple pain associated with nipple dermatitis among nursing mothers. This review article provides a detailed discussion on the clinical features and management of various causes of nipple dermatitis during lactation, including problems with infant latch-on, congenital oral anomalies, plugged lactiferous ducts, atopic dermatitis, irritant contact dermatitis, allergic contact dermatitis, yeast infections, bacterial infections, herpes simplex virus, and Raynaud’s phenomenon of the nipple.
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Stage E, Mathiesen E, Emmersen P, Greisen G, Damm P.
Acta Paediatr. 2010 Feb 23. [Epub ahead of print]

Abstract

Aim:  As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity.

Methods: The records of an old cohort of 103 infants routinely admitted to the NSCU, and a new cohort (N = 102), offered rooming-in were assessed for neonatal morbidity.

Results: Eighty-four (82%) of the new cohort infants followed their mothers to the maternity ward; whereas 19 (18%) were transferred to the NSCU chiefly because of prematurity.
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Gordon G. Gallup Jr., R. Nathan Pipitone, Kelly J. Carrone and Kevin L. Leadholm
Med Hypotheses. 2010 Jan;74(1):174-6.

Summary

At the level of a mother’s basic biology, the decision to bottle feed unwittingly mimics conditions associated with the death of an infant. Child loss is a well documented trigger for depression particularly in mothers, and growing evidence shows that bottle feeding is a risk factor for postpartum depression.

The implications of this hypothesis for infant feeding practices, hospital procedures that lead to intermittent separation between mothers and infants during the immediate postpartum period, parallels between an increased desire to hold infants by mothers who bottle feed and responses to infant death among nonhuman primates, and the relationship between weaning and depression are discussed in the context of an emerging discipline known as evolutionary medicine.
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R. Shapiro, M. Hughes, A. Ogwu, D. Kitch, S. Lockman, C. Moffat, J. Makhema, S. Moyo, I. Thior, K. McIntosh, E. van Widenfelt, J. Leidner, K. Powis, A. Asmelash, E. Tumbare, S. Zwerski, U. Sharma, E. Handelsman, O. Jayeoba, E. Moko, S. Souda, E. Lubega, M. Akhtar, C. Wester, W. Snowden, M. Martinez-Tristani, L. Mazhani, M. Essex, The Mma Bana Study Team

5th IAS Conference on HIV Treatment, Pathogenesis and Prevention, Cape Town

Background: No randomized trial has previously compared highly active antiretroviral therapy (HAART) regimens in pregnancy or during breastfeeding.

Methods: HIV-infected pregnant women with CD4 ≥200 cells/mm3 randomized to co-formulated abacavir/zidovudine/lamivudine (Arm A) vs.
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Annette Langer-Gould, Stella M. Huang, Rohit Gupta, Amethyst D. Leimpeter, Eleni Greenwood, Kathleen B. Albers, Stephen K. Van Den Eeden, Lorene M. Nelson
Arch Neurol. 2009;66(8):958-963.

Abstract

Objective: To determine if exclusive breastfeeding protects against postpartum relapses of multiple sclerosis (MS) and, if so, whether this protection is related to prolonged lactational amenorrhea.

Design: We conducted structured interviews to assess clinical, menstrual, and breastfeeding history during each trimester and 2, 4, 6, 9, and 12 months postpartum and collected neurological examination findings from the treating physicians of women with MS. Hazards ratios (HRs) were adjusted for measures of disease severity and age.
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Rangmar Goelz, Eva Hihn, Klaus Hamprecht, Klaus Dietz, Gerhard Jahn, Christian Poets,
and Martin Elmlinger
Pediatr Res 65: 458–461, 2009

Preterm infants can inoculate virulent cytomegalovirus (CMV) through their mothers’ raw breast milk. Complete virus inactivation is achieved only by heat treatment, but the effect on growth factors has never been assessed systematically.

Neither long- nor short-time heating methods changed the concentration of EGF. Only short heating methods (5 s, 62–72°C) can preserve, almost completely, the concentrations of IGFs in human milk, whereas Holder-Pasteurization does not.

A cikk teljes szövege

Pediatric Research főoldal
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Chiara Riviello, Giorgio Mello, Lois G. Jovanovic
Endocr Pract. 2009 May-Jun;15(3):187-93.

Objective: To evaluate whether breastfeeding in women with type 1 diabetes mellitus is associated with a decreased insulin requirement.

Conclusions: Decreased need in total daily basal insulin is caused by increased glucose use during lactation. We recommend that the starting total daily basal insulin dosage for type 1 diabetic women who breastfeed be calculated as 0.21 units times the weight in kg per day. This regimen results in normoglycemia and minimizes the risk of severe hypoglycemia associated with lactation.

Az absztrakt teljes szövege

Az American Association of Clinical Endocrinologists honalpjának főoldala
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Elise Mok, Clarisse Multon, Lorraine Piguel, Emmanuelle Barroso, Valérie Goua, Patricia Christin, Marie-José Perez and Régis Hankard

PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1319-e1324

ABSTRACT

OBJECTIVE. The purpose of this work was to compare breastfeeding practices, perceptions, and infant weight change of prepregnant obese versus normal-weight mothers in the first 3 months postpartum.

PATIENTS AND METHODS. For the prospective case-control study, obese mothers (prepregnant BMI ≥ 30 kg/m2) were matched with normal-weight mothers (18.5 ≤ prepregnant BMI < 25 kg/m2) according to initial infant feeding, parity, maternal age, ethnicity, and education. Participants completed an oral questionnaire in the hospital and a telephone interview at 1 and 3 months postpartum.
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