[Breastfeeding in the "global strategy for infant and young child feeding"].
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Breast Feeding↗
Biomedical subjects
J Arena Ansotegui
Publications and source records attributed to J Arena Ansotegui.
[The responsibility of standards committees].
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Advisory Committees↗
[Iodine antiseptics are not harmless].
The use of iodine-containing antiseptics is still common in obstetrics and neonatology. Topical iodine given both to the mother before delivery and to the neonate causes iodine overload. The absorption of maternal iodine through the skin is so fast that iodine in the blood of the umbilical cord increases by 50% a few minutes before delivery. Iodine overload also occurs in the mother. Urinary and breast-milk iodine are increased more than 10-fold in the days after delivery if providone-iodine is used in episiotomy. The overload in the neonate is even higher if breast-fed. Particularly in iodine-deficient areas, this overload can produce thyroid blockade with undesirable effects in congenital hypothyroidism screening, raising the number of false positives and its consequences: parental anxiety and screening costs. The potential effects that this thyroid blockade can produce in the neonate are even more serious. Attention should be drawn to the undesirable effects of iodine antiseptics and their use in the perinatal period should be avoided.
Anti-Infective Agents, Local↗
[Congenital chylothorax].
OBJECTIVE: The aim of this study was to study the prenatal diagnosis, clinical manifestations and karyotype results in congenital chylothorax. PATIENTS AND METHODS: A retrospective survey of a 20 year period was carried out. The prenatal diagnosis, maneuvers following delivery, malformations and clinical outcome were studied. RESULTS: We found 10 cases of congenital chylothorax. Four were diagnosed by prenatal ultrasound with pleural effusion and no other signs of hydrops and six were diagnosed postnatally. Of the later, five had respiratory distress and one was diagnosed by radiological procedures. In all 10 cases, postnatal thoracocentesis was performed for diagnosis and therapy, five infants required mechanical ventilation and four parenteral nutrition. One patient died 72 hours after birth and three within 24 hours of birth. The clinical outcome of the rest was successful and were placed on a medium-chain triglyceride formula that was given orally. Of the eight karyotypes studied, six trisomy 21 were found. CONCLUSIONS: The prenatal diagnosis of pleural effusion permits prompt recognition of congenital chylothorax and allow for appropriate treatment upon birth. Medical therapy including pleural drainage and total parenteral nutrition and medium-chain triglyceride formula for oral feedings is successful in the majority of cases. Down's syndrome should be considered in fetuses or newborns with pleural effusion.
Chylothorax↗
[Iodine overload in newborn infants caused by the use of PVP-iodine for perineal preparation of the mother in vaginal delivery].
The high incidence of transient thyroid dysfunction in newborns from our hospital (0.6%), led us to investigate whether povidone perineal prep. during delivery and daily postpartum antisepsis, induced iodine overload in the newborn, and whether breast milk was the vehiccle. In a controlled randomized trial we used either povidone-iodine or clorhexidine in 36 mothers, and we investigated in them and in their newborns iodine levels and thyroid function. Iodine levels in cord blood, maternal urine and newborn urine were significantly higher in povidone treated group (p less than 0.001) up to the 4th postpartum day. These levels were also significantly higher in breast fed than in formula-fed babies within the group of povidone-iodine-treated mothers. Maternal prepartum urine iodine, and thyroid function in mothers and newborns were not significantly different in both groups.
Delivery, Obstetric↗