健康催乳促进剖宫产患者母乳喂养的探讨

目的探讨健康催乳的施行对剖宫产母乳喂养的促进作用。方法将180例剖宫产术后可以母乳喂养的产妇分为实验组和对照组,比较两组剖宫产妇在医院7天内的母乳喂养情况。结果实验组采取有效的催乳措施促进母乳喂养获得成功。结论健康催乳是一种简单实用的护理技术,值得推广。

Nutritional management of newborn infants:Practical guidelines

The requirements of growth and organ development create a challenge in nutritional management of newborn infants,especially premature newborn and intestinal-failure infants.Since their feeding may increase the risk of necrotizing enterocolitis,some high-risk infants receive a small volume of feeding or parenteral nutrition (PN) without enteral feeding.This review summarizes the current research progress in the nutritional management of newborn infants.Searches of MEDLINE (1998-2007),Cochrane Central Register of Controlled Trials (The Cochrane Library,Issue 3,2007),abstracts and conference proceedings,references from relevant publications in the English language were performed,showing that breast milk is the preferred source of nutrients for enteral feeding of newborn infants.The number of nutrients found in human milk was recommended as a guideline in establishing the minimum and maximum levels in infant formulas.The fear of necrotizing enterocolitis and feeding intolerance are the major factors limiting the use of the enteral route as the primary means of nourishing premature infants.PN may help to meet many of the nutritional needs of these infants,but has significant detrimental side effects.Trophic feedings (small volume of feeding given at the same rate for at least 5 d) during PN are a strategy to enhance the feeding tolerance and decrease the side effects of PN and the time to achieve full feeding.Human milk is a key component of any strategy for enteral nutrition of all infants.However,the amounts of calcium,phosphorus,zinc and other nutrients are inadequate to meet the needs of the very low birth weight (VLBW) infants during growth.Therefore,safe and effective means to fortify human milk are essential to the care of VLBW infants.

Hepatitis B in pregnancy

Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.

Low level of galacto-oligosaccharide in infant formula stimulates growth of intestinal Bifidobacteria and Lactobacilli

AIM: To investigate the effect of a new infant formula supplemented with a low level (0.24 g/100 mL) of galacto-oligosaccharide (GOS) on intestinal micro-flora (Bif idobacteria, Lactobacilli and E. coli) and fermentation characteristics in term infants, compared with human milk and a standard infant formula without GOS. METHODS: Term infants (n = 371) were approached in this study in three hospitals of China. All infants started breast-feeding. Those who changed to formula-feeding within 4 wk after birth were randomly assigned to one of the two formula groups. Growth and stool characteristics, and side effects that occurred in recruited infants were recorded in a 3-mo follow-up period. Fecal samples were collected from a subpopulation of recruited infants for analysis of intestinal bacteria (culture technique), acetic acid (gas chromatography) and pH (indicator strip). RESULTS: After 3 mo, the intestinal Bifidobacteria, Lactobacilli , acetic acid and stool frequency were significantly increased, and fecal pH was decreased in infants fed with the GOS-formula or human milk, compared with those fed with the formula withoutGOS. No significant differences were observed between the GOS formula and human milk groups. Supplementation with GOS did not influence the incidence of crying, regurgitation and vomiting. CONCLUSION: A low level of GOS (0.24 g/100 mL) in infant formula can improve stool frequency, decrease fecal pH, and stimulate intestinal Bifidobacteria and Lactobacilli as in those fed with human milk.

An exploration of the breastfeeding behaviors of women aftercesarean section: A qualitative study

Objectives:To explore the factors affecting breastfeeding behaviors in women after cesarean section.Methods:This is a qualitative study that used a phenomenological approach.This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019.Information saturationwas used to determine sample size.Data were analyzed using a thematic content analysis method.Themes were developed based on the theory of planned behavior.Results:Thirteen(68.42%)had a planned cesarean section,and six(31.58%)cesarean sections were unplanned or emergent.Three major themes emerged:ambivalent attitude about breastfeeding,motivation to comply with the traditional cultural norms,and barriers and challenges.The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk,support from healthcare professionals,and responsibility for breastfeeding.The challenges for breastfeeding after cesarean sections included physical discomfort,knowledge and skills deficit of breastfeeding,lactation deficiency,and lack of knowledge and coping skills in managing their depressive mood after cesarean sections.There were a couple of neutral factors,such as the influences of family and peers.These factors could influence women either positively as facilitators or negatively as barriers.Conclusions:The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections.To promote women’s breastfeeding behaviors after cesarean sections,it is necessary to change women’s attitudes,belief systems,and the external environments and help them become more confident.

Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section:A randomized controlled trial

Objectives:To examine the efficacy of an intervention based on the theory of planned behavior(TPB)in improving breastfeeding behavior among women with cesarean sections(C-sections).Methods:This research was a randomized controlled trial.Women with planned elective C-sections were recruited to participate in a randomized controlled trial between June and September 2020.One hundred thirty-two women were divided randomly into the intervention(n=66)and control group(n=66)by systematic random sampling.In the intervention group,an intervention project was implemented after Keywords:Breastfeeding Cesarean section Intervention studies Theory of planned behavior the C-section to establish positive breastfeeding attitudes,cultivate supportive subjective norms,enhance perceived behavioral control,and strengthen breastfeeding intention to change behaviors.Those in the control group received routine pre-and post-delivery care.Exclusive breastfeeding rate and breast problem were collected at 5 days,2 weeks,and 1 month after C-section.The modified Breastfeeding Attrition Prediction Tool(BAPT)on the first day in the hospital,two weeks,and one month after C-section and Numerical Rating Scale(NRS)24 h postoperatively were used to compare the intervention effect between the two groups.Results:After the intervention,the intervention group had significantly higher exclusive breastfeeding rates than the control group at five days(86.4%vs.60.6%),two weeks(77.3%vs.57.6%),and one month(74.2%vs.50.0%)after the C-section.Besides,the intervention group was less likely to have sore nipples at five days(6.1%vs.18.2%in the control group,P<0.05)and two weeks(9.1%vs.12.1%in the control group,P<0.05).After two weeks of intervention,attitude scores(90.64±8.31 vs.87.20±8.15,P<0.05),subjective norm scores(88.07±24.65 vs.79.42±19.47,P<0.05)and behavior control scores in the intervention group were significantly higher than those in the control group.After one month of intervention,attitude scores(90.34±10.35 vs.84.22±10.51,P<0.05)and behavior control scores(43.13±5.02 vs.39.15±4.69,P<0.05)in the intervention group were significantly higher than those in the control group,which resulted in the higher breastfeeding intention in the intervention group.Conclusion:This study indicated that the TPB-based interventions effectively improved women's breastfeeding behaviors after C-sections.

Understanding South African mothers’challenges to adhere to exclusive breastfeeding at the workplace:A qualitative study

Objective:This study aimed to gain an in-depth understanding of the experience of South African working mothers in the adherence to exclusive breastfeeding when returning from maternity leave.Methods:The data of the study was collected using face-to-face semi-structured interviews.Eight breastfeeding mothers were purposefully selected from two primary health care clinics in Rustenburg,North West Province,South Africa.The data were coded,categorized,and clustered into themes using Giorgi’s phenomenological analysis.Ethical considerations and measures of trustworthiness were adhered to throughout the study.Results:The findings revealed three themes:a desire for working mothers to continue the adherence to exclusive breastfeeding,workplace support for breastfeeding mothers in the adherence to exclusive breastfeeding,and an unsuitable workplace environment for the adherence to exclusive breastfeeding.Six sub-themes were identified:the need to return to the workplace soon after baby’s birth,psychological responses in the adherence to exclusive breastfeeding,lack of support from employers and coworkers in the adherence to exclusive breastfeeding,lack of or partial implementation of breastfeeding policies in the workplace,the workplace not being supportive for mothers’having to express and the workplace not being supportive for mothers’having to store breastmilk.Conclusion:Based on the findings,South African government should revisit employment policies to support working mothers who need to continue with exclusive breastfeeding after returning from maternity leave.

A META-analysis of the association between breastfeeding and risk of infant hepatitis C virus infection

Objective: To investigate the association between breastfeeding and infant acquired infection of Hepatitis C Virus(HCV). Methods: To obtain studies eligible for META-analysis, China biological medicine discs(CBMD) and MEDLINE citations were surveyed. Criteria for enrollment of published studies for META-analysis were based on principle by Abdolmaleky HM[1]. Odd ratio(OR) was calculated and summarized by fixed effect model or random effects using RevMan software. The heterogeneity of ORs was assessed using an χ2 test of goodness of fit. The significance of the pooled OR was determined by the z-test. The strength of association was summarized usingOR. An OR>1.0 indicated a positive association between the risk factor and infants HCV infection. Results:After searching in Medline and CBMD, 120 articles were enrolled for further identification. Thirty-seven were of review on relative fields and were excluded. Abstracts of remaining articles were carefully read, and finally, only 6 articles met, the standards for enrollment criteria. After analysis of the factor concerned, no significant association was found between breastfeeding and infant HCV infection, with a pooled OR equal to 0.60(95%CI = 0.22-1.60), and proved not to be of risk factors on infant acquired infection of HCV. Conclusion: Breastfeeding dose not increase the risk of infant acquired infection of HCV.

A Comparative Study on Feeding Practice and Nutrition Status among 6-23 Months Age Children

To investigate the Infant and Young Child Feeding Practice and Nutrition status among 6-23 months age group children in nutrition intervention （national nutrition program） and non-intervention areas. Nutrition intervention has been proposed to reduce the risk of malnutrition. It was a comparative cross-sectional study. A total of 360 households, of which 180 were from the nutrition intervention area each with at least a child aged between 6-23 months were randomly selected. Statistical package for Social Scientists （SPSS/PC^＋） was used for data entry and analysis. Nutritional status that is weight-for-age, height-for-age and weight-for-height were computed using anthro software. T-test, chi-square and Pearson＇s correlation （p 〈 0.05） were administered to compare the two groups. There was a significant difference between the intervention and non intervention groups in relation to the incidence of initiation of breast feeding, prelacteal and exclusive breast feeding and complementary feeding （p 〈 0.05）. The prevalence of wasting （p = 0.004）, stunting （p = 0.015） and underweight （p = 0.003） was observed to be greater for non NNP area compared with the group of NNP area and association was found between those areas. In the study showed that the Infant and Young Child Feeding Practice and Nutritional status are better in nutrition intervention area.

Characterization and Technological Properties of Bifidobacterium Strains Isolated from Breast-fed Infants

Bifidobacteria represent the largest group of human intestinal bacteria. They have an important place in human health and represent the dominant group microflora of the newbom breast-fed. Following the behavior of strains of Bifidobacteria isolated from the breast-fed infants and from saline rehydration solution was considered in order to develop therapeutic fermented milk. Samples from newborn infants aged 10 months, or from a saline rehydration solution （Celia/Develop ORS） containing Bifidobacteria sold was used and isolated strains belonged to breve and longum species. Those strains showed preferences to neutral pH. They are mesophilic and tolerate high temperatures （42 ℃）. Glucose was commonly carbohydrate used in selective media for Bifidobacteria. Production of titratable acidity and therefore lowering the pH varies from one strain to another.

Effects of Probiotic Lactobacillus gasseri Strains of Breast-Fed Infant in a Murine Model

The ingestion of probiotic lactic acid bacteria has been evaluated and noted that it has an effect on the balance of desirable microbiota in the gastrointestinal tract. Lactobacillus gasseri demonstrates good survival in the gastrointestinal tract, and it has been associated with a variety of probiotic activities and roles, including the reduction of fecal mutagenic enzymes, the production of bacteriocins and the stimulation of macrophages immunomodulation. The aim of the study was to evaluate the effects of a pool of L. gasseri strains isolated from the feces of breastfed infants added in the human milk of healthy women. The milk was both pasteurized and unpasteurized, to verify the cell cytotoxicity of macrophages and to quantify the production of immunologic mediators such as IL-4, IL-6, IFN-γ, TNF-α, NO and oxygen intermediary compounds （H2O2）. The administration of raw human milk and pasteurized human milk to infants is a regular, encouraged practice in units of intensive therapy （UITs） and our present investigation verified the beneficial effect of addition of a pool of L. gasseri to pasteurized human milk （PHML）. Our results show that probiotic supplementation helped to maintain cell viability, reduced IL-6 and IFN-γ production and stimulated TNF-α, NO, H2O2, IL-4 production. Nevertheless, the results indicate that the addition of lactobacillus to human milk was not a determinant in the production of TNF-α. L. gasseri added to breast milk did not present a cytotoxic risk, and the addition ofL. gasseri to pasteurized milk of human milk bank would benefit newborns that depend on milk banks for the colonization of more desirable microbiota.

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.

Disadvantages of using pacifier in infants:a systematic review

Background and aim:Newborns with normal evolution have a biological inherited tendency for sucking.The satisfaction of this physiological necessity through excessive use of a pacifier and baby bottle in long time leads to multiple probable complications in children.Considering this important fact made the researchers to carry out the present study with the aim of systematic reviews of the disadvantages of the pacifier using on infants by using the texts studying and the writer experiences and the comments of the experts.Methods:All published studies in foreign databases during 2008-2018 were checked by using the key words of pacifier nutrition,non-exclusive nutrition,breastfeeding and human breast milk from Latin databases,such as CINHAL,PubMed,Web of Science and Scopus.Results:Fourteen studies were reviewed,aimed at analyzing the types of drawbacks to use of pacifier in infants.Finally,the types of drawbacks to using the pacifier were discussed in terms of the studies,frequency in the areas of oral and dental disorders,speech disorders,otitis media,sleep disorders,nutritional disorders and cognitive disorders.Conclusion:It seems that appropriate counseling about the way of breastfeeding should be used to replace the negative and false education of associates and informing the parents about the emotional needs of the child,as well as the emphasis on removing the pacifier from the age of one,is one of the things that can be effective in eliminating the factors involved in the aforementioned disorders.

Epidermal growth factor concentrations in human milk,cow's milk and cow's milk-based infant formulas

OBJECTIVE: Because maternal epidermal growth factor (EGF) may be an adaptive response to accelerate growth and maturation in premature infants, we compared the EGF content in fresh cow's milk and cow's milk-based infant formulas with full and preterm mother's milk. METHODS: EGF content of 57 human colostrum from mothers delivering prematurely and at term, 4 different fresh cow's milk and 8 different cow's milk-based infant formulas was determined by radioimmunoassay (RIA). RESULTS: Human milk from mothers of premature infants had a higher EGF content compared to that from mothers of term infants (28.2 +/- 10.3 nmol/L vs. 17.3 +/- 9.6 nmol/L). EGF content in human milk negatively correlated with gestational age and birth weight of neonates. EGF content in fresh cow's milk (13.8 - 18.2 nmol/L) was similar to that in human term milk. EGF levels in non-hydrolyzed protein formulas were much lower (5.6 - 8.6 nmol/L), and were undetectable in hydrolyzed protein formulas. CONCLUSION: The high EGF content in premature milk may represent a maternal compensatory mechanism to accelerate the growth and development of immature infants. Feeding infants with breast milk from their own mother should be advocated since there is lack of EGF in cow's milk-based infant formulas.