Women's breast-feeding behavior and its influencing factors in shanghai in the late 1980's

Objectives: To analyze women’s breast-feeding behavior and its influencing factors.Design: A cohort study.Setting: In 2 districts of Shanghai.Subjects: 7 826 couples from August 1987 to August 1988 within 15 months of marriage and having a baby.Methods: From the Luwan and Hongkou Districts’ marriage registration departments out of 15 933 newly married registered couples, 7 911 eligible couples were selected by randomization. Home visits were paid twice at the 3rd and 15th month after marriage. Questions about general status, contracep-tion, births and breast-feeding, etc. were asked. A total of 7 826 couples completed questionnaires was analyzed.Results: 71. 6% of couples had a baby after marriage. The breast-feeding rate at the end of 2nd week after birth was 70.7%. The main reason of artificial feeding was insufficient or no breast milk,which constituted 82. 8% of the total. Logistic regression analysis showed that the factors affecting women’s breast-feeding behavior were wife’s age at marriage, education, ownership of working unit,fertility intention, some personal character and satisfaction with her husband. Infant’s body weight at birth, premature and abnormal birth were also influencing factors.Conclusion: In order to increase the breast-feeding rate, it is important to provide IEC of breast-feeding, to reduce premature births and births of low body weight and increase chances of breast-feed-ing while in hospital.

PRESENT SITUATION OF BREAST-FEEDING AND COMPLEMENTARY FEEDING AND THEIR INFLUENCE ON GROWTH OF CHILDREN UNDER 36 MONTHS IN WESTERN CHINA

Objective To find out the present situation of complementary feeding, breast-feeding and children nutrition, and further explore the relationship between them. Methods Random sampling was adopted and 7302 pairs or mothers and their children under 36 months were investigated by means or questionnaires. Results Breast- feeding rate was 96. 8%,but exclusive breast-feeding rate was only 37.6%. Breast-feeding rate over 12 months was 34.7%,breast-feeding rate over 24 months was only 15. 8%. Timely sucking rate was 8.4%, 19. 2% of children had too early complementary feeding, 26.8% had too late,and 43.1% had appropriate feeding. To the children over 6 months, the feeding rates or meat and eggs per week were 36.3% and 49.3%,respectively. The stunting-rate was 24.0%, underweight-rate 22.1%,and wasting-rate 8.9%. The incidence rate of iron deficiency anemia (IDA) was 23.3%. Multivariable analysis showed that growth of children was associated with diet diversity,intake frequency of eggs and meat, too early complementary feeding,prolonged breast-feeding and diarrhea, etc. Conclusion In rural areas of western China,breast-feeding has been fundamentally popularized,however,the unfit complementary feeding and malnutrition of children under 36 months are common and serious,important complementary feeding recommen- dations and good hygiene condition are strongly needed.

Factors Influencing Breast-Feeding Among Women in China

Although a well-established association between breast-feeding and a range of positive health outcomes in children has been demonstrated, less attention has been paid under China circumstance, especially what factors will influence breast-feeding behavior among Chinese women from empirical perspective has not been explored yet. In this paper, survival analysis with duration model is applied to find out the main determinants. The well-known China Health and Nutrition Survey （CHNS） dataset fits for this study since it has plenty information about breast-feeding and children. Family income, age, education level, and maternity leave are found to he the main determinants which have significant effects on the breast-feeding behavior, also the gender of infant plays an important role which is for Chinese-specific cases. The opportunity cost for women with higher education level and higher income, especially in urban areas is so high that they have to shorten the duration of breastfeeding their children. The probability of breast-feeding her child is decreasing with the aging of mother.

Otoacoustic Emissions and Evoked Potentials in Infants after Breast-Feeding Jaundice——Hearing Dysfunction in Breast-Feeding Jaundice

We study hearing in a group of infants with Breast-feeding jaundice (BFJ) by means of Transient-evoked otoacoustic emissions (T-EOE) and Brainstem auditory evoked potentials (BAEP) searching for relationship between bilirubin serum levels and auditory dysfunction. Eleven infants born at-term with BFJ were selected for the study. We studied also 11 control age- and gender matched healthy at-term infants without signs of jaundice. T-EOAE studies were performed between 5-7 days after birth, and 3 months later. BAEP studies were performed once. BFJ group infants exhibited lower amplitudes in T-EOE than infants in the control group. These differences disappear at the 3-month evaluation. In BAEP, we observed a significant latency delay of waves I and V in Breast-feeding jaundice group infants. All infants in both groups demonstrated reproducible wave V response at 30 decibels. No significant correlation values were observed between bilirubin serum levels and T-EOE and BAEP variables. Our data suggest that BFJ can result in transient peripheral and central auditory dysfunction. Dysfunction is reversible after treatment of infants with BFJ.

Hospitals Promoting Breast-feeding

CHINESE mothers used to be satisfied enough if they could deliver their babies at a hospital, although there the newborn would be kept away from them in infant rooms for days after birth. "The new mother was not allowed to hold her baby in her arms and breastfeed it until at least 24 hours after delivery, as it was thought she needed

Is infliximab safe to use while breastfeeding?

Inflammatory bowel disease (IBD) often affects women around the age of conception and pregnancy. Most drugs used to treat IBD are safe in pregnancy, but physicians must consider the clinical implications of certain treatment regimens in young, fertile females. We report an informative case of a pregnant patient with IBD who underwent treatment with infliximab during her pregnancy and while nursing her infant. Serum and breast milk infliximab levels were monitored throughout this time period. This case report suggests that targeted monoclonal antibodies and other biologic agents can be used with caution in pregnant and breastfeeding patients.

Characteristics of allergic colitis in breast-fed infants in the absence of cow's milk allergy

AIM: To investigate the characteristics of mucosal le-sions and their relation to laboratory data and long-term follow up in breast-fed infants with allergic colitis. METHODS: In this study 31 breast-fed infants were prospectively evaluated (mean age, 17.4 wk) whose rectal bleeding had not ceased after a maternal elimi-nation diet for cow's milk. Thirty-four age-matched and breast-fed infants (mean age, 16.9 wk) with no rectal bleeding were enrolled for laboratory testing as con-trols. Laboratory findings, colonoscopic and histological characteristics were prospectively evaluated in infants with rectal bleeding. Long-term follow-up with differ-ent nutritional regimes (L-amino-acid based formula or breastfeeding) was also included. RESULTS: Iron deficiency, peripheral eosinophilia andthrombocytosis were significantly higher in patients with allergic colitis in comparison to controls (8.4±3.2 μmol/L vs 13.7±4.7 μmol/L, P<0.001; 0.67±0.49 G/L vs 0.33±0.17 G/L, P<0.001; 474±123 G/L vs 376±89 G/L, P<0.001, respectively). At colonosco-py, lymphonodular hyperplasia or aphthous ulceration were present in 83% of patients. Twenty-two patients were given L-amino acid-based formula and 8 contin-ued the previous feeding. Time to cessation of rectal bleeding was shorter in the special formula feeding group (mean, 1.4 wk; range, 0.5-3 wk) when com-pared with the breast-feeding group (mean, 5.3 wk; range, 2-9 wk). Nevertheless, none of the patients ex-hibited rectal bleeding at the 3-mo visit irrespective of the type of feeding. Peripheral eosinophilia and cessa-tion of rectal bleeding after administration of elemental formula correlated with a higher density of mucosal eosinophils. CONCLUSION: Infant hematochezia, after cow's milk allergy exclusion, is generally a benign and probably self-limiting disorder despite marked mucosal abnor-mality. Formula feeding results in shorter time to cessa-tion of rectal bleeding; however, breast-feeding should not be discouraged in long-lasting hematochezia.

Pregnancy related issues in inflammatory bowel disease: Evidence base and patients' perspective

Inflammatory bowel disease (IBD) affects women of childbearing age and can influence fertility, pregnancy and decisions regarding breastfeeding. Women with IBD need to consider the possible course of disease during pregnancy, the benefits and risks associated with medications required for disease management during pregnancy and breastfeeding and the effects of mode of delivery on their disease. When indicated, aminosalicylates and thiopurines can be safely used during pregnancy. Infliximab and Adalimumab are considered probably safe during the first two trimesters. During the third trimester the placenta can be crossed and caution should be applied. Methotrexate is associated with severe teratogenicity due to its folate antagonism and is strictly contraindicated. Women with IBD tend to deliver earlier than healthy women, but can have a vaginal delivery in most cases. Caesarean sections are generally recommended for women with active perianal disease or after ileo-anal pouch surgery. While the impact of disease activity and medication has been addressed in several studies, there are minimal studies evaluating patients' perspective on these issues. Women's attitudes may influence their decision to have children and can positively or negatively influence the chance of conceiving, and their beliefs regarding therapies may impact on the course of their disease during pregnancy and/or breastfeeding. This review article outlines the impact of IBD and its treatment on pregnancy, and examines the available data on patients' views on this subject.

Pharmacological role of efflux transporters: Clinical implications for medication use during breastfeeding

The World Health Organisation recommends exclusive breastfeeding for the first six months of an infant’s life and in combination with solid food thereafter. This recommendation was introduced based on research showing numerous health benefits of breastfeeding for both the mother and the infant. However, there is always concern regarding the transfer of medications from mother to their breastfed baby via milk. Pharma-cokinetic properties of a drug are usually used to pre-dict its transferability into breast milk. Although most drugs are compatible with breastfeeding, cases of toxic drug exposure have been reported. This is thought to be due to active transport mechanisms whereby effux transporter proteins expressed in the epithelial cells of the mammary gland actively secrete drugs into milk. An example of such effux transporters including the breast cancer resistance protein which is strongly induced during lactation and this could result in contamination of milk with the substrates of this transporter which may place the suckling infant at risk of toxicity. Furthermore, there is little known about the substrate specifcity of most effux transporters as we have highlighted in this review. There also exists some degree of contradiction between in vivo and in vitro studies which makes it difficult to conclusively predict outcomes and drug-drug interactions.

How Infant Mortality Was Reduced in the Early Twentieth Century in Osaka

In 1983, the Vice Secretary-General of United Nations Children＇s Fund （UNICEF）, Karl Knutsson, visited Japan and remarked that the method of reducing the Japanese infant mortality rate （IMR） was a model for every country. In the early twentieth century, Osaka and at the time of UNICEF＇s plan in the 1980s, diarrhea was the cause of most babies＇ deaths, so we consider infant nutrition to be the central issue. The average IMR was 155.4 in rural areas in Japan, and IMR in Osaka city was 231.6 during 1906 to 1910. IMR in Osaka city might have been influenced by somewhat negative urban factors, which we can call the ＂urban penalty＂. Dr. Hiroshi Maruyama discovered the a-index in 1938. The a-index represents infant mortality number divided by neonatal mortality number. After all, Maruyama set one month after birth as a boundary to divide endogenous and exogenous. The a-index shows a qualitative measure of infant mortality. Post neonatal mortality was increased due to acquired diseases such as diarrhea, pneumonia, and beriberi. This shows that the effect of the urban penalty was raising the a-index. The a-index of the industrial zones shows that bad maternal conditions affected endogenous factors. Most mothers suffered from a deficiency of breast-feeding capability.

Microbiological safety of expressed breast milk for preterm admitted to neonatal unit in China

Objective To determine the degrees and types of bacterial contamination in home-expressed mother's milk for preterm admitted to neonatal unit in China. Methods The present paper was a descriptive study enrolled a total of 75 human breast milk samples from February 2nd to March 1st 2015. The primary outcome was microbiological features of breast milk samples collected at home. A sample of more than 104 colony-forming units/mL is considered as the significantly bacterial contaminated breast milk. Results Among the milk samples obtained from the mothers of 75 neonatal babies,69. 3% had substantial bacterial growth. This high contamination rate could be due to the Chinese tradition of avoiding bathing for one month after childbirth.Conclusion Un-processed breast milk expressed by mothers in home was not safe for high risk preterm babies. Health care needs to pay attention to the risk of that in China. Good hygienic practice and strict process control for breast expression,including collection,transportation and storage should be developed for Chinese mothers of hospitalized preterm infants.