Breastfeeding,
how...
Dewey KG,
Cohen RJ, Rivera LL, Brown KH.
Effects of age of introduction of complementary foods
on iron status of breast-fed infants in Honduras,
American Journal of Clinical Nutrition, 67(5):
878-84, 1998.
To evaluate the effect of the introduction
of complementary foods before six months of age, this
study randomly assigned 164 four-month-old infants to
one of two groups. One group continued with breast milk
exclusively until six months of age, while the other
introduced complementary foods (fortified with iron)
in addition to breast milk. The analysis showed that
a higher risk of anemia and iron deficiency was associated
with birth weights lower than 2500g, while no infant
with a birth weight over 3000g experienced an iron deficiency
before the sixth month. It was concluded that the risk
of iron deficiency is lowest in infants with birth weights
over 3000g who are exclusively breastfed for the first
six months of life.
Brandt KA,
Andrews CM, Kvale J. Mother-Infant interaction and
breastfeeding outcome 6 weeks after birth. Journal
of Obstetric and Gynecological Neonatal Nursing, 27(2):
169-74, 1998.
This study explored the relationships
between early post partum mother-infant interaction
and breastfeeding six weeks post partum. 42 Latin women
were studied. All were recruited in the third trimester
of pregnancy, were 18 years or older and primiparas.
They all wanted to breastfeed for eight weeks or more,
had planned to give birth in a hospital, carried their
infants to term, had vaginal, complication-free births
and left the hospital with their children. The mother-infant
pairs were studied between 28 and 90 hours post partum
(in their homes) according to the Barnard's Test (Barnard's
Nursing Child Assessment Feeding Scale- NCAFS.) At six
weeks post partum, a phone conversation confirmed the
breast-feeding situation. The results showed that the
pairs who continued nursing at six weeks post partum
had achieved significantly higher point totals on the
Barnard's Test immediately post partum. In the same
way lower values on this test were predictors of early
weaning and difficulties with mother-infant interactions.
Dewey KG.
Cross-cultural patterns of growth and nutritional
status of breast-fed infants, American Journal
of Clinical Nutrition, 67(1): 10-7, 1998.
This study evaluated growth patterns
and iron levels in breastfed infants during their first
year of life. Four populations were analyzed: 1) a group
of infants of high socioeconomic status in California
(DARLING Study), 2) infants with normal birth weight
from low-income families in Honduras, 3) full-term,
low birth weight infants from Honduras, and 4) infants
from Ghana. It was found that when breastfeeding was
continued during the first full year of life and efforts
were made to secure adequate complementary foods after
the sixth month of age, the incidence of weight deficits
could most probably be attributed to prenatal factors
and maternal nutritional state. Differences in iron
among the populations studied reflected variations in
birth weight as well as the use of fortified foods.
Concha G,
Vogler G, Nermell B, Vather M. Low-level arsenic
excretion in breast milk of native Andean women exposed
to high levels of arsenic in the drinking water,
International Archives of Occupational and Environmental
Health, 71(1): 42-6, 1998.
The objectives of this study were
to analyze the arsenic concentration present in the
breast milk of native Andean women living in the Northeast
zone of Argentina, where high levels of arsenic are
present in the drinking water (around 200µg/l)
and to evaluate the early exposure of their infants
to this arsenic. The study included 10 breastfeeding
mothers and two breastfeeding infants. The arsenic concentrations
in samples of drinking water, breast milk, blood and
urine were measured. The arsenic concentration detected
in maternal blood (total arsenic) and urine (metabolites
of inorganic arsenic) were high, averaging 10 and 320µg/l
respectively.
Considering the high levels of arsenic present in maternal
blood, the levels found in breast milk samples were
low (17 µg|l}, as were levels of metabolites found
in urine of the two infants (47 µg/l). The lower
arsenic concentration detected in the mothers' milk
and in the urine of nursing infants whose mothers had
high levels in their blood indicated that inorganic
arsenic is not excreted in breast milk in significant
quantities. It is therefore recommended to nurse for
long periods in these areas.
Prentice A.
Calcium requirements of breast-feeding mothers,
Nutrition Review, 56(4 Pt 1): 124-7, 1998.
In a randomized, placebo-controled
study the benefits of calcium supplementation during
six months of exclusive breast-feeding and the weaning
period was studied in breastfeeding mothers with a daily
intake of fewer than 800mg of calcium, as compared to
a group of new mothers who were not breastfeeding. Supplementation
of 1000mg/day of calcium did not have an impact of the
calcium concentration of breast milk nor did it change
maternal bone mineralization. This study confirmed the
findings of three previous studies which found that
extra calcium intake by mothers is not necessary during
breastfeeding.
Thorley V.
Inverted nipple with fatty plaques on areola and
nipple, Breastfeed Review, 5(2): 43-4, 1997.
A patient was found to have inverted
nipples in a prenatal consultation. The right areola
and nipple were covered with fatty plaques that made
it difficult to observe the diameter of the nipple.
Both nipples were successfully everted in the first
consultation using an inverted hypodermic syringe. The
extreme of the syringe was cut with a needle after the
piston had been totally introduced, so as to produce
a suction in place of an ejection. The mother continued
the treatment and exhibited good nipple protrusion in
her postnatal follow up.
O'Rourke K,
Howard Grabman L, Seoane G. Impact of community organization
of women on perinatal outcomes in rural Bolivia,
Rev Panam Salud Publica, 3(1): 9-14, 1998.
The goal of this community intervention
was to improve post partum maternal health in a rural
zone of Bolivia with remote possibilities for medical
attention. It was based on the creation and sustaining
of women's groups and on providing tools for the identification
and prioritizing problems in ensuring safe births. The
impact was evaluated, considering the perinatal mortality
and obstetric behavior of 409 women before and after
the intervention. Perinatal mortality fell from 117
to 43.8 births; the proportion of mothers who initiated
breastfeeding during the first day of their child's
life was also significantly higher. This study demonstrated
that community organization can provide adequate maternal
health care in remote areas.
Young KT,
Davis K, Schoen C, Parker S. Listening to parents:
A national survey of parents with young children.
Archives of Pediatric and Adolescent Medicine, 152(3):
255-62, 1998.
This study documented the experiences
of 2017 pairs of parents with children between birth
and three years of age. It focused on the children's
upbringing and pediatric care. Among other aspects,
breastfeeding and adequate interpretation of the child's
needs were much more probable if a doctor stimulated
the parents to do so. It was concluded that pediatric
interventions could have a positive effect on parental
behavior and that it is necessary to consider creative
forms for re-planning the function of health services.
Righard L.
Are breastfeeding problems related to incorrect breastfeeding
technique and the use of pacifiers and bottles?
Birth, 25(1): 40-4, 1998.
Because the common tales of painful
nipples and insufficient milk of the 1960s and 70s interfered
with prolonged breastfeeding, the author investigated
the relationship among breastfeeding problems, maternal
behavior, and pacifier use. 25 healthy mother-infant
pairs with breastfeeding problems were observed between
August, 1987 and July, 1989 in Malmo General Hospital,
Sweden. The infants ranged in age from 1 to 17 weeks.
40 problem-free, mother-infant pairs served as a control
group. In many cases, the problems were related to incorrect
techniques with the differences in technique between
the two groups statistically significant (p>0.0001.)
Few infants continued breastfeeding after introduction
of the bottle. Pacifier use was more common in infants
with breastfeedidng problems and in some cases was associated
with a defective suckling. The author concluded that
these problems can be prevented with the adoption of
hospital routines that do not interfere with the initiation
of breastfeeding and that discourage extensive pacifier
use.
van Unnik
GA, van Roosmalen J. Lactation-induced amenorrhea
as birth control method. Ned Tijdschr Geneeskd,
142(2): 60-2, 1998.
A recent World Health Organization
document reviewed the clinical evidence and epidemiology
for the medical choice of a good contraceptive method.
The lactation-induced amenorrhea (LAM) method has been
demonstrated to be safe and effective. Worldwide, this
method is the most important form of fertility regulation
for the first six months post partum. When a few important
conditions are met (frequency of nursing, no supplementary
foods, use of the method before the return of menstruation)
it can be used as a reliable method during the first
post partum year.
Zhou G, Ru
WP, Zhang J. Current situation and analysis on the
infection of Salmonella typhimurium in Henan
province, Chung Hua Liu Hsing Ping Hsueh Tsa
Chih, 17(5): 268-71, 1996.
This report discussed the situation
of hospital infections of Salmonella typhimurium
and the characteristics of food contamination in the
province of Henan in recent years. One of the measures
planned to control the hospital infection is the establishment
of the "Baby Friendly Hospital Initiative"
which encourages the establishment and continuation
of breastfeeding.
Roger IS,
Emmett PM, Golding J. The incidence and duration
of breastfeeding, Early Human Development, 49
Suppl: S45-74, 1997.
Information obtained from different
sources in various countries showed distinct trends
for initiation and duration of breastfeeding. In populations
in developing countries mothers living in rural areas
were generally more inclined to breastfeed than those
living in urban areas. Women with higher levels of education
and higher social status tended to breastfeed less.
In contrast, in industrialized countries mothers with
higher educational levels and higher social status were
more likely to breastfeed. Evidence exists that the
delay in the initiation of breastfeeding, a lack of
professional support, contradictory advice from professionals,
and the presence of free samples of formula (with or
without a request from the mother) can make failures
more common. While breastfeeding is almost universal
in some developing nations the early use of complementary
foods is quite common. In some countries, particularly
in Asia, it is common for infants not to receive maternal
colostrum, with the initiation of breastfeeding delayed
until after 24 hours of life.
Ineichen B,
Pierce M, Lawrenson R J. Teenage mothers as breastfeeders:
attitudes and behavior, Adolescence, 20(5):
505-9, 1997.
Repeated studies demonstrate that
adolescent mothers are less inclined to breastfeed their
babies. This study contacted a group of 55 young mothers
and future mothers. Only around half of them had talked
with their doctors about breastfeeding. This tended
to occur with older mothers. Their partners or their
own adolescent mothers frequently influenced their decision,
often in a hostile manner. A stronger effort is needed
to promote breastfeeding among adolescent future mothers.
Dye TD, Wojtowycz MA, Aubry RH, Quade J, Kilburn H.
Unintended pregnancy and breast-feeding behavior, American
Journal of Public Health, 87(10): 1709-11, 1997.
This study analyzed the effects
of unwanted pregnancy on breast-feeding practices. 33,735
women who became mothers between January 1, 1995 and
July 31, 1996 in the central region of New York were
asked about their intentions to become pregnant and
their plans for breastfeeding. Those women who were
not trying to or did not want to become pregnant were
significantly less inclined to breastfeed than those
who had planned their pregnancies. It was concluded
that it is very important to promote breastfeeding among
women with unwanted pregnancies to improve their health
status and increase the possibility that they will breastfeed
their children.
Scott J, Binns
CW, Aroni RA. The influence of reported paternal
attitudes on the decision to breastfed, Journal
of Paediatrics and Child Health, 33(4): 305-7, 1997.
The object of this study was to
identify factors that influence mothers' decisions to
breastfeed. Before the end of their maternity leave
period 556 mothers participated via an auto-administered
questionnaire. 83.8% of the women was breastfeeding
at the time. The paternal preference for breastfeeding
was the principal factor influencing the mothers to
breastfeed (OR=10.18). The authors advise including
both parents in the discussion about infant feeding.
Hatloy AO,
Oshaug A. Human milk: an invisible food resource,
Journal of Human Lactation 13(4): 299-305, 1997.
Breast-milk is an invaluable food
resource in sub-Sahara Africa. In this analysis, the
value of one liter of breast milk was put at US $1.
The incorporation of the total breast milk value into
the Gross National Product (GMP) of each country could
increase the GMP more than 5% for Mali and close to
2% for Senegal, for example. The incorporation of breast
milk value into the GMP is proposed to highlight its
nutritional and economic importance.
Hughes R.
Promoting breastfeeding in rural communities: breast
is best and bottle is a last resort, Australian
Journal of Rural Health, 4(4): 242-7 1996.
"Breast is best and the bottle
is a good second option" was a common axiom in
Australia until recently. A better, more accurate recommendation
is that breast milk is a superior nourishment for the
first six months of life and that artificially fed infants
run a greater risk of infection. This idea was difficult
to promote because it was believed that, according to
the axiom, the bottle was the second best option. To
revise the breast-feeding promotional campaign, professionals
in rural Australia adopted a better axiom: "Breast
is best and the bottle is the last resort".
Davies Adetugbo
AA, Adetugbo K. Effect of early complementary feeding
on nutritional status in term infants in rural Nigeria,
Nut Health 12(1): 25-31 1997.
In developing countries breastfeeding
is common, but complementary foods are frequently introduced
very early. This study sought to determine the effect
of early complementary feeding on the nutritional status
of 82 infants from three to four months of age, 42 of
whom had complementary foods introduced before two months
of age. The results showed that weight-for-age was significantly
lower in the group with early introduction of complementary
foods (p=0.004). Low weight was also more significantly
associated with this group (p=0.0292). There was a 14.3%
greater incidence of severe low weight among the infants
with early introduction of complementary foods as opposed
to those who had been exclusively breastfed (p=0.0259).
The authors recommend the promotion of exclusive breastfeeding
and adequate weaning habits as well as monitoring growth
in these rural communities.
Prepared
by International Baby Food Action Network-IBFAN
editors Fernando Vallone
Nancy-Jo Peck
Copies of Breastfeeding Briefs
will be sent upon request to GIFA, Avenue de
la Paix 11,
1202 Geneva, Switzerland, fax +41 22 798 4443, e-mail
: philipec@iprolink.ch
or to UNICEF country offices.
It is available also in French, Spanish and Portuguese.
A contribution of SFr. 10.- for a subscription to
industrialized countries is gratefully accepted. It
can be sent by international money order or international
postal order to no. 12-17653-5.
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