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An investigation of breast-feeding practices in a binational population.

Too few Mexican and Mexican-American mothers breast feed their babies. Results of a study of breast-feeding attitudes in Tijuana and San Diego point to the need for education, guidance, and support at the community level if more young mothers in this population are to give their newborns the advantages of breast feeding.

Adult↗

Transfer of carisoprodol to breast milk.

There is no published information on the transfer of the centrally acting muscle relaxant carisoprodol and its active metabolite meprobamate into breast milk. The objective of this study was to quantify the excretion of carisoprodol and meprobamate in human milk and estimate the dose received by breast-fed infants. The concentrations of carisoprodol and meprobamate were measured in breast milk on 4 consecutive days at steady-state conditions in one woman using carisoprodol 2100 mg/d. The average milk concentrations were 0.9 microg/mL for carisoprodol and 11.6 microg/mL for meprobamate. Based on the milk concentrations measured, the absolute dose ingested by an exclusively breast-fed infant could be estimated at 1.9 mg/kg per day, and the relative dose would be 4.1% of the weight-adjusted maternal dose. No adverse effects were observed in the infant, but the infant was partly fed with formula because of insufficient maternal milk production. Thus, the authors consider that at least during prolonged use, lactation is generally inadvisable until more clinical data are available.

Adult↗

Breast feeding, fertility and child health: a review of international issues.

Breast feeding is of central importance to child survival, growth and development, especially in non-industrialized countries. It also protects the mother against further pregnancy. In the light of the increase in the world's population, the implications of the decrease in breast feeding worldwide are serious. There is a direct association between child health and survival and breast feeding. In this paper, the contraceptive effect of breast feeding is reviewed. The emphasis is on families in non-industrialized societies. The importance of suckling frequency and duration, and the timing of introduction of supplementary foods to the baby, are discussed. Limitations of the method, and recommendations to maximize its effectiveness, are given. It is noted that protection of breast feeding both as a means of improving child health and of spacing births will require positive action at local and at governmental levels.

Adult↗

Infections during the postpartum period.

Postpartum infections are costly in terms of delayed mother-infant interaction; lactation difficulties; prolonged hospital stay or readmittance to the hospital and increased expense; and possible permanent injury or death. The nurse is in a unique position to identify the woman at risk, recognize early warning signs, and provide teaching and counseling for prevention and care. Shortened hospital stays challenge the nurse to develop, research, and discover funding for new interventions to provide care and teaching to minimize the effects of this problem.

Diagnosis, Differential↗

Secondary school students' attitudes and beliefs about breastfeeding.

The incidence and prevalence of breastfeeding has increased in the United States and Canada in the past decade, but in spite of its known benefits it is often abandoned before infants are two months of age. Society lacks the attitudes and knowledge necessary for breastfeeding success. A survey of the knowledge, beliefs and attitudes of 409 secondary school students in British Columbia, Canada, revealed misconceptions about the nature of breastfeeding. A high percentage felt it was unacceptable in social situations. The findings point to a need for the integration of information about breastfeeding into school health programs, biology, home economics/nutrition and family life/sexuality courses. Increased knowledge and discussion to foster positive attitudes could increase breastfeeding duration among parents in the future.

Adolescent↗

Extended breast-feeding and growth in rural China.

The relationship between duration of breast-feeding and growth has been investigated in a cross-sectional study of children living in an economically disadvantaged rural area of Hubei province, People's Republic of China. Data were analyzed from 2148 initially breast-fed children aged 12-47 months. Children who were breast-fed for longer than 12 months had significantly higher mean Z scores for weight-for-age, height-for-age, and weight-for height than children breast-fed for shorter periods. The positive association between duration of breast-feeding remained after adjusting the data for 11 potentially confounding factors, including age, sex, father's occupation, mother's education, recent infections, age of introduction of solids, and the variety of the weaning diet at 1 year. These results support the contention that mothers in developing countries should be encouraged to breast-feed their children for the first 2 years of life with the addition of good quality weaning foods from about 4-6 months.

Anthropometry↗

Ecological breastfeeding and child spacing.

Until the 2nd and 3rd decades of this century, breastfeeding was essential for infant survival. In that period, spacing of children was generally about 2 years. Later, improved modified cow's milk preparations became commercially available and were well tolerated by most infants. As a result, near cessation of ecological breastfeeding occurred toward the middle of the century. The decline in ecological breastfeeding was associated with early postpartum ovulation and shortened child-spacing of about 1 year. The endocrinology of breastfeeding is now known in considerable detail. Prolactin is secreted promptly in response to nipple stimulation and is a reliable marker of the endocrine alterations occurring postpartum. Success of lactation in suppression of ovulation was found to occur when infants sucked frequently and when only small amounts of selected foods were introduced gradually after the infants were about 6 months of age.

Amenorrhea↗

Users' understanding of the lactational amenorrhea method and the occurrence of pregnancy.

It is unknown whether a user's understanding of the Lactational Amenorrhea Method (LAM) is related to its successful use. A study of 876 LAM users in Pakistan and the Philippines collected information about women's understanding of LAM. The present analysis aims to determine: (1) the proportion of LAM users who understand the method, (2) whether any known factors can distinguish those who understand LAM from those who do not, and (3) whether an understanding of LAM is related to subsequent pregnancy. Over 75% of LAM users could consistently recite the LAM guidelines correctly for a full year postpartum. However, 38% of users failed to display, at least once, an understanding of LAM during the first year postpartum mainly by failing to abstain, to use another method or to explain their nonuse of another method when their LAM protection expired. LAM understanding generally could not be predicted by sociodemographic factors. The occurrence of pregnancy during the first year postpartum was not related to LAM understanding, regardless of how LAM understanding was defined, nor could it be predicted by any other measured characteristic of the users.

Adult↗

Long-Term Weight Trajectories in Infants Receiving Prolonged Breastfeeding: Impact of Formula Supplementation.

OBJECTIVE: This study compared weight trajectories in infants breastfed for at least 1 year, with or without formula supplementation. STUDY DESIGN: A retrospective cohort of 252 infants followed in well-baby clinics. All infants were breastfed &#x2265;12 months and received complementary foods at 4-6 months. Of these, 174 received no formula, and 78 received daily formula supplementation. Anthropometric data were collected from birth to 5 years of age. RESULTS: Among males, those breastfed without formula had significantly lower body weight between 13 and 18 months compared with those receiving formula (10.20 kg vs. 10.97 kg, p < 0.001). From 19 months onward, no significant weight differences were observed and trajectories converged through 5 years. CONCLUSION: Prolonged breastfeeding in male infants is associated with lower weight in early toddlerhood; however, differences resolve by age two. These findings suggest early variations may represent physiological patterns. Further controlled studies are needed.

Humans↗