When is industry going to accept the W.H.O. code on breast milk substitutes?
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Biomedical subjects
Publications and source records attributed to S Sjölin.
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30 children with acquired aplastic anaemia are presented. The mortality rate was 60%. The period of observation exceeded 8 years for patients. The importance of long control and the timely conclusion of therapy are emphasized. Prognostic criteria and alternatives to steroid therapy are discussed.
The parents of eight children who had died of malignant diseases were interviewed about their experiences concerning the medical and social care of the children. There was a great need for repeated and thorough information about the disease and the therapy to all in the family. The risk of isolation of the family could be diminished by active measures. There was a great need for continuity with only a few key people involved in the care. It proved important to recognize at an early stage the economical and social problems of the family and to help the family to solve them.
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A prospective study of the course of breast feeding was carried out in 75 randomly selected women. Weekly interviews were performed from the day after delivery until the termination of breast feeding, but in no case for longer than 6 months. In each case a detailed analysis was made of the factors leading to transient lactation crises or to complete cessation of breast feeding. A second group of 71 mothers, also randomly selected, was interviewed in retrospect only, 6 months after delivery, and served as controls. Twenty-four weeks after delivery 47% of the mothers in the weekly interview group were still breast feeding. The corresponding figure in the control group was 38%. In both groups only few mothers terminated lactation for medical reasons, while about one fourth stopped for some other reason and about one half because of a combination of factors. Brief case reports are presented to illustrate how varying the factors were that threatened breast feeding.
An attempt is made briefly to describe the present health problems of Swedish children. The report is based on data available in official statistics or collected from special studies. It is concluded that the general state of health of Swedish children is good when assessed by commonly used criteria. The mortality pattern is dominated by perinatal and accidental deaths, but also neoplasms are of importance. There are indications that genetic and handicapping disorders, and psychosocial maladjustment will receive more attention in the future.
The breast feeding rate has been declining steadily in Sweden since the 1930's up to the early 1970's. It is suggested that this was linked to the changing role of women, the development towards the nuclear family, the changing way of living, the influence of strict routines at the maternities and many other factors. A Committee was appointed in 1973 by the National Board of Health and Welfare, which initiated a number of breast feeding promoting activities: the editing of a Manual for health personnel, and booklets for mothers, the systematic arranging of workshops for key personnel in each county, stimulation to more flexible and breast feeding favouring maternity routines, backing of working groups of La Leche League-type, etc. Coinciding with these activities and probably a result of changed breast feeding attitudes among mothers, the breast feeding rate has increased considerably--at 2 months from an all time low of 31% in 1972 to 62% in 1976/77, and at 6 months from 6% to 20%.
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In 1972, 298 mothers representative of the city of Uppsala in general breast fed their babies for only a brief period of time despite a clear wish to continue--36% up to 8 weeks. The most common reason for terminating breast feeding was that the "milk dried up" (66%). More precise reasons commonly mentioned were anxiety of all kinds, lack of motivation, stress, tiredness and work outside the home. It was further found that mothers who enjoyed their breast feeding, were well educated, were older than 25 years and belonged to social class 1, tended to breast feed longest.
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