Biomedical subjects

Lisa Helen Amir

Publications and source records attributed to Lisa Helen Amir.

10 recordsLinked to original sources

PubMed2006

Breastfeeding--managing 'supply' difficulties.

BACKGROUND: Many breastfeeding women have concerns about their milk supply; 'not enough milk' is the most common reason women give for stopping breastfeeding, however their concern is often unwarranted. OBJECTIVE: The article describes the process of history taking and examination of mother and infant to determine if the mother's milk supply is adequate, the causes of insufficient milk supply, and possible investigations and management. DISCUSSION: Insufficient milk supply may be secondary to maternal conditions such as postpartum haemorrhage or breast reduction surgery, or infant factors such as tongue-tie or ill health. In many cases, milk supply can be increased by frequent, regular milk removal. Medication to increase milk supply (galactogogues) such as domperidone, may also play a role. General practitioners can provide reassurance if milk supply is adequate, or can assist in resolving the problem if milk supply is low.

Breast Feeding↗

PubMed2006

Women's experience of lactational mastitis--I have never felt worse.

BACKGROUND: Mastitis is a common problem for breastfeeding women in the postpartum period. METHODS: Ninety-four breastfeeding women participating in a case control study of mastitis provided a free text comment about their experience of mastitis. Women were recruited from the emergency department, wards or breastfeeding clinics of the Mercy Hospital for Women and the Royal Women's Hospital, Melbourne, in 2002-2004. RESULTS: The main themes which emerged from the free text comments were: acute physical illness; negative emotions; life disrupted; to continue breastfeeding or not? A minor theme was 'support for mastitis research'. DISCUSSION: Women with mastitis often experience a rapid onset physical illness accompanied by strong negative feelings, which leads some women to consider stopping breastfeeding while others are determined to persevere. General practitioners need to provide emotional support for women with mastitis and acknowledge that breastfeeding may be difficult for new mothers.

Adult↗

PubMed2005

Breastfeeding and the introduction of solids in Australian infants: data from the 2001 National Health Survey.

OBJECTIVE: To present estimates on rates of breastfeeding and timing of introduction of solid foods to Australian children, 1998-2001. METHODS: Analysis of data from the 2001 Australian National Health Survey (NHS) using lifetable methods. Infant feeding questions were asked by personal interview in respect to 1,883 children aged under three years of age. RESULTS: At discharge from hospital, 83.3% of infants were breastfeeding, which is similar to estimates from the 1995 NHS. At 13 weeks postpartum, 64.3% were breastfeeding, 49.0% at 25 weeks and 24.9% were continuing to breastfeed at one year. At 25 weeks, 18.4% of infants were fully breastfed. Solid food was being offered regularly to 15.2% of infants at 13 weeks and 88.0% by 26 weeks. CONCLUSION: Fewer than 50% of infants are receiving breast milk at six months, which is considerably lower than the 80% figure recommended by the latest Dietary Guidelines for Children and Adolescents. Very few Australian infants are being exclusively breastfed for the recommended six months. Infant feeding practices in Australia appear to have remained unchanged between 1995 and 2001.

Australia↗

PubMed2005

Why do women stop breastfeeding? A closer look at 'not enough milk' among Israeli women in the Negev Region.

The aim of this study was to describe the breastfeeding experience of a sample of Israeli women. A random telephone survey of women, aged between 25 and 42, who had children under the age of 18 and were resident in the Negev Region of Israel (N=302) was conducted. Women had an average of three children each (range 1-11) and most breasted for less than three months. The most common reason given for not breastfeeding or breastfeeding less than three months was 'not enough milk' (90/205; 44%). A four-factor solution was extracted from a factor analysis of the reasons that women gave for stopping breastfeeding before three months or for not initiating breastfeeding. The four factors were: personal concerns (body image, tired, return to work); need help (wants husband to help, child unwell, didn't like breastfeeding), uncomfortable (nipple/breast pain, didn't like breastfeeding) and not confident (not enough milk). Women most frequently report that they stopped breastfeeding because they have insufficient milk, yet the lack of any consistent sociodemographic correlation indicates that this may be a universal way of expressing lack of confidence in breastfeeding.

Adult↗

PubMed2004

A failed RCT to determine if antibiotics prevent mastitis: Cracked nipples colonized with Staphylococcus aureus: A randomized treatment trial [ISRCTN65289389].

BACKGROUND: A small, non-blinded, RCT (randomised controlled trial) had reported that oral antibiotics reduced the incidence of mastitis in lactating women with Staphylococcus aureus (S. aureus)- colonized cracked nipples. We aimed to replicate the study with a more rigorous design and adequate sample size. METHODS: Our intention was to conduct a double-blind placebo-controlled trial to determine if an antibiotic (flucloxacillin) could prevent mastitis in lactating women with S. aureus-colonized cracked nipples. We planned to recruit two groups of 133 women with S. aureus-colonized cracked nipples. RESULTS: We spent over twelve months submitting applications to five hospital ethics committees and seven funding bodies, before commencing the trial. Recruitment to the trial was very slow and only ten women were randomized to the trial after twelve months, and therefore the trial was stopped early. CONCLUSIONS: In retrospect we should have conducted a feasibility study, which would have revealed the low number of women in these Melbourne hospitals (maternity wards and breastfeeding clinics) with damaged nipples. The appropriate use of antibiotics for breastfeeding women with cracked nipples still needs to be tested.

Journal Article↗

PubMed2003

Breast pain in lactating women--mastitis or something else?

BACKGROUND: Mastitis is a common problem for lactating women. However, medical practitioners may not recognise that there are also other causes of breast pain during lactation. OBJECTIVE: This article presents a case study that demonstrates several common causes of breast and nipple pain in a lactating woman. DISCUSSION: Once medical practitioners are aware of the presenting features of mastitis, candida infection and vasospasm, they will be able to conduct a careful history and examination and make the correct diagnosis.

Breast↗

PubMed2003

Does maternal smoking have a negative physiological effect on breastfeeding? The epidemiological evidence.

Women who smoke are less likely to breastfeed their children than nonsmokers. It is thought that nicotine has a negative effect on breastmilk supply by suppressing prolactin levels. The aim of this review was to assess the epidemiological evidence that maternal smoking has a negative physiological effect on breastfeeding. The following data sources were searched: The Cochrane Library, Medline, CINAHL, Current Contents, Psychinfo, Sociological Abstracts and the Lactation Resource Centre (Australian Breastfeeding Association) using the key words 'smoking' and 'breastfeeding' or 'infant feeding'. The Journal of Human Lactation and Birth were hand searched. Women who smoke are less likely to intend to breastfeed, less likely to initiate breastfeeding, and likely to breastfeed for a shorter duration than nonsmokers. Several studies have found a dose-response relationship between the number of cigarettes smoked each day and breastfeeding intention, initiation, and duration that persists after adjusting for confounding factors. In some population groups a high proportion of smokers breastfeed successfully. The association between maternal smoking and lack of breastfeeding is consistent across different study designs in a range of countries. Given that women who smoke are less likely to intend to breastfeed, however, it cannot be assumed that the relationship between smoking and duration of breastfeeding is a physiological one. If smoking had a consistent negative physiological effect on lactation, one would not expect to see such wide variations in breastfeeding rates among women who smoke. Therefore, it is likely that psychosocial factors are largely responsible for the lower rates of breastfeeding found in women who smoke compared with those who do not.

Adult↗

PubMed2002

Does maternal smoking have a negative physiological effect on breastfeeding? The epidemiological evidence.

BACKGROUND: Women who smoke are less likely to breastfeed their children than nonsmokers. It is thought that nicotine has a negative effect on breastmilk supply by suppressing prolactin levels. The aim of this review was to assess the epidemiological evidence that maternal smoking has a negative physiological effect on breastfeeding. METHODS: The following data sources were searched: The Cochrane Library, Medline, CINAHL, Current Contents, Psychinfo, Sociological Abstracts and the Lactation Resource Centre (Australian Breastfeeding Association) using the key words "smoking" and "breastfeeding" or "infant feeding." The Journal of Human Lactation and Birth were hand searched. RESULTS: Women who smoke are less likely to intend to breastfeed, less likely to initiate breastfeeding, and likely to breastfeed for a shorter duration than nonsmokers. Several studies have found a dose-response relationship between the number of cigarettes smoked each day and breastfeeding intention, initiation, and duration that persists after adjusting for confounding factors. In some population groups a high proportion of smokers breastfeed successfully. CONCLUSIONS: The association between maternal smoking and lack of breastfeeding is consistent across different study designs in a range of countries. Given that women who smoke are less likely to intend to breastfeed, however, it cannot be assumed that the relationship between smoking and duration of breastfeeding is a physiological one. If smoking had a consistent negative physiological effect on lactation, one would not expect to see such wide variations in breastfeeding rates among women who smoke. Therefore, it is likely that psychosocial factors are largely responsible for the lower rates of breastfeeding found in women who smoke compared with those who do not.

Adult↗

PubMed2002

The introduction of breast milk substitutes and solid foods: evidence from the 1995 National Health Survey.

OBJECTIVE: To report the introduction of breast milk substitutes and solid foods to Australian children between 1992 and 1995. METHODOLOGY: Analysis of data from the 1995 Australian National Health Survey. Infant feeding questions were asked by personal interview in respect to 3,252 children aged under four years of age. RESULTS: By the age of 26 weeks, the majority of children had been given infant formula (56.9%) and solid food (61.5%). More than one-quarter (27.1%) of children received cow's milk regularly during the first 12 months. Only 7% of children were given solids in the first 12 weeks of life. Soy milk was given to 14.2% of children aged less than four years. CONCLUSION: The majority of children in Australia are not being exclusively breastfed for six months as recommended by the World Health Organization (WHO). The intake of cow's milk before 12 months of age and the timing of introduction of solids needs to be monitored. Future surveys should collect more detail about type of infant formula so that the proportion of infants receiving soy-based formula and other formula can be assessed.

Animals↗

PubMedDate not supplied

Review of tongue-tie release at a tertiary maternity hospital.

OBJECTIVE: To review the first 12 months of assessment and release of lingual frenulum (frenotomy) at a breast-feeding clinic in a tertiary maternity hospital (August 2002 to end of July 2003) and to report on the breast-feeding outcomes and parental satisfaction. METHODS: A structured telephone interview was conducted with the mother at least 3 months after the assessment. Data were collected about the presenting problem and the effect of release of the tongue-tie (if performed). Parents were also asked about their satisfaction with the procedure and of problems following the release. RESULTS: Sixty-six babies were assessed in 12 months. If infants were assessed as: (i) having impaired lingual function (using the Hazelbaker assessment tool for lingual frenulum function); (ii) the frenulum visualized to be a thin membrane; and (iii) the parent(s) gave informed consent, the frenulum was released. Initial and follow-up data are available on 46 infants. Infants had a mean age of 18 days (range 3-98), 63% were male infants and most had difficulties with attachment to the breast. Frenotomy was performed on 35 infants and breast-feeding improved in 83%. Parents reported high levels of satisfaction with the frenotomy procedure and no complications were reported. CONCLUSION: Frenotomy is a safe and easy procedure. Infants with a significant tongue-tie that is interfering with breast-feeding have shown an improvement with breast-feeding following frenotomy.

Breast Feeding↗