The Secret to Pain Free Breastfeeding

Breastfeeding Help And Baby Care For New Parents

The Breastfeeding Help Video Compilation By Australian International Board Certified Lactation Consultant Kate Hale is full of useful information about breastfeeding and how to manage low supply. It is very clear and concise in its content. It also has a lot handy tips for new mothers, including how to bath, massage and dress an infant. Learn how to care for a new-born, including how to deeply latch your baby and breastfeed without pain within minutes for a contented baby and an end to sore nipples. It is the only Dvd of which I am aware that is readily available to new mothers with an actual demonstration on how to correctly latch a baby on and off the breast using a couple of alternative feeding positions. Reading about breastfeeding in a book is nowhere near as useful as watching the Dvd. Read more here...

Breastfeeding Help And Baby Care For New Parents Summary


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Initiation and Maintenance of Breast Feeding

As noted above, breast-feeding a child is a somewhat predictable part of the life course for most women. That does not mean that initiation of nursing is routine and easy. Most populations also have cultural rules that women must follow during pregnancy to prepare for and ensure successful breast-feeding. These may include specific foods to eat or avoid, the wearing of special clothing and amulets, and other prescribed or restricted behaviors. Following birth, cultural practices relating to breast-feeding a child may include avoiding sexual relations, food restrictions, and performing ritual acts. Dana Raphael describes the tradition of the doula, a family member or friend whose primary role is to assist a new mother in breast-feeding her child (Raphael, 1973). Although the word itself is Greek and describes a person who assists women after childbirth (mothering the mother), the practice is found throughout the world, evidence that breast-feeding is not something that comes easily to...

Breast Feeding Practices in the West

In the United States, the number of mothers who chose to breast-feed their infants had declined by the middle part of the 20th century, with the decline being most rapid in the middle and upper classes, in association with the economic ability to purchase breast milk substitutes. By the end of World War II, most American women bottle-fed their babies (Raphael, 1973). One of the factors behind the decrease in breast-feeding was active promotion of infant formula by food and drug manufacturing companies. Initially, promotion efforts were aimed at educated women in industrialized nations, but as the birth rate began to fall in the early 1960s, manufacturers turned to developing nations for their markets. Outraged at what were viewed as unethical marketing practices resulting in commerciogenic malnutrition in infants of developing nations, advocacy groups in Europe and North America began what has been called the most successful international boycott in history against Nestl and other...

Breast Feeding During Illness

Many parents are concerned that breast-feeding has to stop if the mother gets ill. During most illnesses, including colds, flu, bacterial infections, and even surgical conditions, breast-feeding can and should continue. By the time you show symptoms of an illness, your baby has already been exposed to it. The best thing to do is to keep breast-feeding, because you have already started to produce antibodies. The baby will receive these antibodies through your milk, preventing infection of the baby. If you stop breast-feeding when cold or flu symptoms first appear, you actually reduce your baby's protection and increase the chance of the baby's getting sick. If you are unable to breast-feed your baby while you are ill, keep up your milk supply by expressing milk for your baby either by hand or using a pump. The milk can then be fed to the baby. You will usually need to stop breast-feeding only for a short period of time, even with serious illnesses. There are several infectious...

Breast feeding and Immunity to Infection

Additionally, cytokines and other growth factors in human milk contribute to the activation of the lactating infant's immune system, rendering breastfed infants less susceptible to diarrheal diseases, respiratory infections, otitis media, and other infections and may impart long-term protection against diarrhea. Breast feeding also reduces mortality from diarrhea and respiratory infections. However, human immunodeficiency virus (HIV) infection (and other viral infections) can be transmitted from a virus-positive mother to her child through breast milk, and breast-feeding is responsible for a significant proportion of childhood HIV infection.

Benefits of Breast Feeding

Breast feeding contributes to both maternal and infant nutrition and health through a number of important mechanisms. It provides a complete source of nutrition for the first 6 months of life for normal, full-term infants and provides one-half and one-third of energy needs for the second half of the first year and the second year of life, respectively. It also contributes significantly to protein and micro-nutrient requirements. Numerous studies have shown that during illness, whereas intake of complementary foods declines significantly, breast milk intake does not decrease. Because of the well-established superiority of breast milk over other infant feeding modes, women cannot ethically be randomized in infant feeding studies and as a result most data on the benefits of breast-feeding and the risks of not breast feeding are observational. However, the dose-response effect observed in such studies, even when donor breast milk is provided through a nasogastric tube to premature...

Breast Feeding Recommendations

Both the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend exclusive breast feeding for 6 months and continued breast feeding together with provision of safe, appropriate, and hygienically prepared complementary foods until 2 years of age or beyond. The American Academy of Pediatrics Section on Breastfeeding also recommends exclusive breast feeding for 6 months. Breast feeding is defined as exclusive if breast milk is the sole source of infant nutrition with no other liquids (including water) or food given, although medicinal and or vitamin drops are permitted. Partial or mixed breast-feeding is used to describe infants who are not exclusively breast-fed. In a comprehensive review, WHO provided the scientific underpinnings of the recommended duration of exclusive breast feeding and noted that infants who were exclusively breast fed for 6 months experienced less morbidity from gastrointestinal infection than those who were exclusively breast fed...

Global Breast Feeding Practices

The most comprehensive data on breast feeding come from the Demographic and Health Surveys conducted with support from the US Agency for International Development. These surveys are nationally representative and conducted throughout the developing world. In a number of countries, multiple surveys permit the analysis of trends. Overall, the data show that although the vast majority of women more than 90 in all countries initiate breast feeding, the duration of exclusive breast feeding is far less than the recommended 6 months (Table 2). In most countries, the duration of breast feeding is unchanged. Several countries are showing increases and in only one does there appear to be a decrease. However, concurrent with Table 2 Trends in breast feeding practices Table 2 Trends in breast feeding practices

Breast Feeding Initiatives

In response to concerns about the use of infant formula in environments where lack of breast feeding resulted in large numbers of infant who became severely ill or died, a grassroots global initiative took hold in the 1970s to promote international and national efforts to protect, promote, and support breast feeding. These efforts culminated in 1981 with the nearly unanimous adoption by the World Health Assembly (WHA) of the International Code of Marketing of Breast-Milk Substitutes. This document and subsequent relevant WHA resolutions, collectively known as the Code, provide guidelines for the marketing of breast milk substitutes, bottles, and teats. To ensure infant feeding decisions free from the influence of marketing pressures, the Code provides guidelines on a number of issues associated with increases in formula feeding, including direct promotion to the public, donations to health care institutions, free supplies to mothers, and the use of baby images on labels that glorify...

Breast Feeding Difficulties

If your baby cannot nurse or if you are having troubles with breast-feeding, it is important that you call your doctor as soon as possible. Refusal to breast-feed may be a sign of sickness that needs prompt attention. Try to avoid caffeine while you are breast-feeding, or at least reduce your intake. Caffeine tends to build up in babies because their bodies cannot get rid of it very easily. A morning cup of coffee is not likely to harm your baby, but too much caffeine can cause problems such as poor sleeping, nervousness, irritability, and poor feeding. Try using decaffeinated coffee and tea, and avoid colas and other carbonated drinks that have added caffeine. Sometimes breast-feeding babies react to certain foods eaten by their mothers. You may notice after you eat spicy or gas-producing foods that your baby cries, fusses, or nurses more often. Babies with colic often have similar symptoms. The best way to tell the difference between a food reaction and colic is by how long the...

Parental and Other Caretaker Roles

For the first 2 years of a child's life, mothers carry out much of the work of childcare (Gottlieb, 2000a). They breast-feed their infants frequently, engage in a lengthy bathing routine twice daily, and carry their babies on their backs for many hours each day, though they are frequently helped by female relatives in this task (Gottlieb, in press). The occasional father who enjoys the basic caretaking tasks of feeding, carrying, bathing, and clothing babies is much appreciated by his wife, and no one would think of making fun of such a helpful husband.

Skin Disorders Affecting The Nipple And Breast

Colonization of the nipples or the lactiferous ducts by Candida albicans may cause chronically sore nipples during or after lactation. The appearance of the nipple may be normal however, more commonly, scaling, fissuring, and erythema are present. Predisposing factors for candidal colonization include antibiotic use, vaginal candidiasis, mastitis, and nipple trauma occurring in the early lactation period. Definitive diagnosis may be made by fungal culture, but that should not be necessary. The nipples may be treated with topical antifungal creams.4 Vaginal candidiasis in the patient, as well as any clinically evident oral candidiasis in the infant, should also be treated.

Nipple retraction inversion

Congenital nipple inversion (of variable degree) occurs in up to one-fifth of all women. This is usually of no clinical significance unless it interferes with breast feeding. The woman may present because of the cosmetic deformity. However, two of the most common causes of nipple retraction are mammary duct ectasia and periductal mastitis. Clinically, this manifests as a transverse depression in the nipple which progresses to complete retraction (there may also be an associated nipple discharge). This process may be intermittent in its early stages and can be present in both breasts. Nipple retraction may also occur in patients with breast cancer. In the latter this is unilateral and there may be an associated breast lump, with or without a nipple discharge (often blood stained).

Childhood in Medieval and Early Modern Times

There were texts that stressed the importance of breastfeeding (and by inference pointed to the dangers of wet nurses), but the use of wet nurses was common among the upper classes. An English bishop wrote of the importance of cradles (which would prevent infant deaths resulting from suffocation in the parental bed). Some children's toys miniature figurines, for example have survived from the period.

Gender over the Life Cycle

The oquichcone-t or cihuacone-t usually becomes a boy (oquichpil) or girl (cihuapil) when weaned and walking. To wean her infant, the mother puts a bitter herb called chichicxihut on her nipples, usually in the sixth month of her next pregnancy. Nahua women usually conceive their next child a year after their last birth because they breast-feed their infants on demand, they observe 6 months of post-partum abstinence but appear to have 11 months of post-partum amenorrhea, and they do not practice other methods of birth control. Thus weaning frequently takes place when the infant is about 18 months old. The weaned infant passes from the sleeping mat of the mother to that of the father, where he or she remains until puberty. A boy remains an oquichpil and a girl remains a cihuapil until they reach puberty, the most dramatic transition following weaning. The stages beyond childhood are marked with terms for maiden (ichpo-ch) and bachelor or youth (telpo-ch), man (tacat) and woman...

Health Through the Life Cycle

Postpartum practices, including breast-feeding. Reaction to multiple births, birth defects, treatment of the healthy and unhealthy infant, and number and types of caretakers. Definitions of and duration of infancy. Special risks for one gender as compared with another. Special protections against or treatments of illness in infancy.

Sex Segregation of Labor

What sort of labor do adolescents provide, and how does it aid the family Research on the Hadza of Tanzania has shown that the adolescent boys provide food for their younger siblings, but also forage in order to improve their reputations as hunters (Blurton Jones, Hawkes, & O'Connell, 1997). That is, they practice kin altruism but also strive to advance their social standing and, ultimately, their mate value. Hadza adolescent girls often dig for roots while tending younger siblings. This is an inefficient foraging technique but it frees the mothers to forage more efficiently. In many preliterate cultures adolescents do not perform arduous labor. In the Kung of southern Africa, for example, adolescents are discouraged from working hard until about age 15 (Blurton Jones, Hawkes, & Draper, 1993). Evidently the optimal reproductive strategy in this forager society is extensive care of offspring, including prolonged breast-feeding. This line of research suggests that cultural and...

Pregnancy Weight Gain and Postpartum Risk of Obesity

Most women breast-feed their infants exclusively or partially for a relatively short time. There is little difference in weight loss between women who breast-feed and those who do not for periods up to 6 months postpartum. This is presumably due to the greater appetite and energy intake of women who are breast-feeding and perhaps to dieting on the part of non-breast-feeders. One study of women who breast-fed until 12 months postpartum did report a 2-kg greater weight loss compared to women who stopped breast feeding before 3 months. Even more weight was lost by those who breast-fed more often and gave longer feeds. especially vitamins, breast feeding women who choose to lose weight can do so by exercising and or reasonable restriction of energy intake. Exercising by jogging, biking, and aerobics for 45 minutes, four or five times per week for 12 weeks did not affect well-nourished mothers' ability to lactate or influence their milk composition. However, it is possible that severe...

Hypoallergenic milk formulae7

CMA in the first year of life is one of the most common problems faced by paediatricians. It is mediated by an immune mechanism, whereas cow's milk intolerance is due to non-immunological causes such as lactase deficiency. CMA may affect the gastrointestinal tract, respiratory tract, skin or blood, and systemic reactions, including anaphylaxis, may occur. Avoidance is the mainstay of treatment, and breast-feeding should be actively encouraged. Since intact cow's milk protein can pass into the breast milk, the lactating mother should avoid the excessive intake of milk products herself and take a calcium supplement. If breast-feeding is not feasible or if supplements are required, soya milk, hydrolysate or amino acid-based formulae may be used.

The Dietary Reference Intakes DRIs

We all need the same nutrients, but the amounts we need depend on our age, sex, and a few other factors. For example, women who are pregnant or breastfeeding need more of most nutrients. The Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences, a group of nutritional scientists from the United States and Canada, has established the Dietary Reference Intakes (DRIs), a set of recommendations for nutrient intake. The DRIs are age- and sex-specific. With the exception of fats and carbohydrates (whose requirements depend only on our calorie needs), a separate DRI is set for each of the known nutrients for each of10 different age groups. From the age of 9 years, males and females have separate DRIs, and additional DRIs are set for women who are pregnant or breastfeeding.

Hunger and Malnutrition in Lowincome Countries

Anthropological research on hunger and malnutrition indicates strong links between low household income and undernutrition, but it is evident that most of the malnutrition in low-income populations does not have one single cause. Research has suggested complex relationships between nutritional status and a wide variety of macro-level and micro-level factors, such as agricultural production, economic strategies, women's roles and time allocation, nature of local diet, food availability, intra-household allocation of food, breast-feeding, weaning practices, sanitation, and infections. Therefore, there are no easy solutions and strategies for preventing malnutrition and hunger programs to improve health need to address the various causes of malnutrition.

Physiological Cross Species and Evolutionary Perspective

See an entry for this activity in an encyclopedia. But as with similar life cycle phenomena such as pregnancy, childbirth, and puberty, breast-feeding for contemporary humans is never simply a biological phenomenon, but is typically embedded in a dense context of beliefs, values, and traditions. The physiological ability and requirement to nurse infants from mammary glands is, in fact, what defines us as mammals, members of the class Mammalia. Indeed, not all mammals have mammary glands (e.g., the monotremes who nurse their young, but do not have mammary glands) so this class might actually be better defined by noting that all members possess body hair, but it is mammary glands that catch our attention when we examine the characteristics of mammals. That, in itself, tells us something about the importance of breast-feeding to human observers who describe animal characteristics. Two hormones are involved in breast-feeding prolactin, which promotes milk production, and oxytocin, which...

The Five Themes of Human Childhood

Childhood is a reproductive and feeding adaptation. By the time the childhood growth stage begins at age three years the infant is weaned, meaning that all breast-feeding is finished. Weaning frees the mother from the demands of nursing and the inhibition of ovulation related to continuous nursing. This decreases the interbirth interval and increases reproductive fitness, as human women can reproduce successfully every three years or less, but ape females require four to seven years between successful pregnancies. A trade-off is that human children are still dependent on older individuals for feeding and protection because they do not have the permanent teeth, digestive systems, or motor skills to fend for themselves. The reproductive benefits are so great, however, that on balance childhood and child support social systems may have evolved as a means to provide dependent offspring with food and care while allowing the mother to reproduce new infants.

Population Groups at Risk of Vitamin K Deficiency

Highly effective however, a study in the United Kingdom in the 1990s suggested a possible link with childhood cancer. Despite little subsequent support for this contraindication, the adverse publicity led to a shift in practice toward oral dosing. An oral micel-lar preparation containing glycholate and lecithin has been developed that has improved absorption characteristics. Another approach toward the avoidance of late HDN is vitamin K supplementation of breastfeeding mothers since breast milk vitamin K levels can be increased substantially by dosage to the mother. Modern commercial formula feeds typically contain 50-125 mg phylloquinone l.

Food Intolerance and Allergy

Many studies have been done to address the usefulness of breast-feeding as a prophylactic treatment in preventing food allergies. The results have been mixed, with the edge given in favor of the benefits of breast-feeding. Many allergists are recommending exclusive breast-feeding for at least 6 months, particularly to infants with a family history of allergies. Some have recommended breast-feeding for even longer than 6 months because some studies have demonstrated that allergies to cow's milk can develop in infants exclusively breast-fed for 6 months. Others have suggested that if the infant's diet is well managed for the introduction of other foods early on, breast-feeding for beyond 6 months is not necessary. Little is known regarding the mechanism of prophylactic action of breast milk however, the presence of secretory IgA antibodies in breast milk may play a role. Some infants even after being fed breast milk develop food allergies. It is likely that transmission of protein...

Special Populations at Risk of Low Vitamin D Intakes and Low Status

Although breast-feeding is strongly recommended and lauded, the switching of infants from breast-milk to other beverages does not always include cows' milk or other calcium-rich drinks. In the southern US, this switching has led to a modest epidemic of rickets, which should not occur with our established knowledge about causation. Dark pigmentation reduces the efficiency of the skin to produce vitamin D and because many children with such skin coloration do not tolerate milk (lactose) well, they consume too little vitamin D and calcium. Supplementation and or alternate food sources should easily correct these nutrient deficits.

Delays in Secretory Activation

A delay in the onset of milk secretion is a problem for the initiation of breast-feeding in a significant See also Breast Feeding. Fatty Acids Omega-3 Polyunsaturated Omega-6 Polyunsaturated. Lactation Dietary Requirements. Lipids Chemistry and Classification. Pregnancy Energy Requirements and Metabolic Adaptations.

Cultural Construction of Gender

Bamileke believe that males and females differ in their anatomy and reproductive capacity, in their relative strength, and in their emotionality. In terms of reproduction, men contribute substance to the making of a new fetus (usually termed water, the same word used for semen, but occasionally termed blood). If the child is born in wedlock, it is said to physically resemble its father. Women likewise contribute substance (usually identified as blood but occasionally as water) to the new being, as well as actively forming the fetus through their transformational (cooking) skills during gestation. Women further form the child through breast-feeding. Women are responsible, through both inheritance of traits and child-rearing practices, for the personality of the child. Women are considered to be physically less strong than men, but to have greater endurance. Bamileke women are still expected to display considerable physical strength and fortitude, especially in their agricultural...

International Context International Promotion

Supporting bodies have explicit objectives to eradicate human suffering due to hunger and malnutrition and to promote well-being and sound standards of health for all peoples of the world. The focus of these groups has been mainly on developing countries, but developed countries have recently been considered. These organizations have played an important role in relation to nutrition policies in developing countries by (i) providing technical assistance in the formulation and implementation of policies, programs, and activities (ii) providing program and project funding (iii) collecting and disseminating data, such as the World Food Surveys conducted by FAO every decade since 1946, which have greatly influenced the ideas of nutritionists and development policymakers in estimating the extent and defining the causes of malnutrition and have shaped the technical assistance deemed to be appropriate (iv) organizing fora for debate on topics relevant to food and nutrition policy, such as the...

Components of Metabolic Rate

Differences in postprandial energy expenditure have been sought as an explanation for the propensity of some individuals and animals to obesity. Results are often conflicting because in any person, the response tends to vary from day to day and is readily influenced by changes in gastric emptying. A proportion of obese subjects have a reduced metabolic response to a meal this effect may depend on the degree of abdominal insulation since the response is reduced if volunteers are swathed in insulation to reduce abdominal heat loss, thereby increasing the temperature of the blood entering and leaving the liver. This seems to reduce the stimulus to body metabolism. Lactating mothers (and pregnant women) have a lower postprandial ther-mogenesis that returns to normal after they have stopped breast-feeding. Smoking and postprandial thermogenesis interact synergistically so the thermic output after a meal is enhanced. The small postprandial response during lactation is consistent with that...

Effect of maternal immunity on the child

Protection in the breastfed infant against Vibrio cholerae, Shigella and Campylobacter relates to the content in the mother's milk of secretory IgA antibodies against these pathogens. Protection against severe rotavirus diarrhea is also suggested as is protection against Helicobacter pylori infections. Studies have also shown that breastfeeding can prevent otitis media and this protection may relate to the fact that the milk secretory IgA may decrease nasopharvngial colonization with Haemophilus influenzae.

Dairy products and probiotics in childhood disease

3.2.1 Development of the intestinal microbiota in the first years of life - role of breast feeding, prebiotics and infant diet flora of mother, mode of birth, breast feeding, immune status of mother, diet, antibiotics flora of mother, mode of birth, breast feeding, immune status of mother, diet, antibiotics In the recent years three high quality randomised controlled trials (RCTs) have evaluated the effect of probiotics on the prevention of necrotising enterocolitis (Bin-Nun et al., 2005 Dani et al., 2002 Lin et al., 2005). Two of them evaluated supplemented formula, one breast feeding plus dissolved probiotics administered directly by spoon. investigated probiotics strains were L. rhamnosus GG and probiotic mixtures, one containing B. infantis plus Streptococcus thermophilus plus Bifidobacterium bifidum (ABC Dophilus, Solgar, Wyeth Consumer Healthcare), the other containing L. acidophilus plus B. infantis (both ATCC 1973) (Bin-Nun et al., 2005 Dani et al., 2002 Lin et al., 2005). The...

Emerging Issues in the Twenty First Century

Millions have died of AIDS, especially in sub-Saharan Africa, with devastating effects on people's livelihoods. For the individual, the disease raises nutrient requirements and reduces the immune system, increasing vulnerability to other diseases. A major issue is the transmission of HIV from mother to child during pregnancy, at birth, or with breastfeeding. For the household, HIV AIDS reduces the capacity to care for young children and infected household members and to work to ensure food security, resulting in deteriorating nutritional status. Women feel the impact most severely. Nutrition policy has to relate to prevention and nutritional care, which can significantly postpone illness and prolong life.

Complementary Feeding Period 624 Months

Breast feeding promotion Beyond 6 months of age, breast milk alone is not sufficient to sustain optimal growth and its contribution to energy and nutrient intake progressively declines. After the age of 12 months, breast fed children are not better nourished than non-breast fed children. However, prolonged breast feeding is very important and needs to be promoted because it improves child survival. The poor nutritional status of breast fed children older than 6 months of age is due to late introduction of an appropriately balanced diet. Family planning is an important intervention for promoting prolonged breast feeding because a new pregnancy can be a frequent cause of breast feeding cessation.

Functional Anatomy of Lactation

Ertaline Serotonin

Figure 2 Diagram of a mammary epithelial cell showing pathways for milk secretion described in the text. SV, secretory vesicle RER, rough endoplasmic reticulum BM, basement membrane N, nucleus PC, plasma cell FDA, fat-depleted adipocyte J, junctional complex containing the tight and adherens junctions GJ, gap junction ME, myoepithelial cell CLD, cytoplasmic lipid droplet MFG, milk fat globule. (Redrawn from Neville MC, Allen JC and Watters C (1983) The mechanisms of milk secretion. In Neville MC and Neifert MR (eds.) Lactation Physiology, Nutrition and Breast-Feeding, p. 50. New York Plenum Press.) Figure 2 Diagram of a mammary epithelial cell showing pathways for milk secretion described in the text. SV, secretory vesicle RER, rough endoplasmic reticulum BM, basement membrane N, nucleus PC, plasma cell FDA, fat-depleted adipocyte J, junctional complex containing the tight and adherens junctions GJ, gap junction ME, myoepithelial cell CLD, cytoplasmic lipid droplet MFG, milk fat...

The learning of flavour by the neonate

Particularly appealing to babies (Schaal, Soussignan and Marlier 2002) but it has also been shown that odours combined with thirty seconds of massage of one-day old babies condition them positively for that particular odour (Sullivan, Taborsky-Barba et al. 1991). In addition to the intrinsic appeal of human milk a baby can recognise the smell of its own mother's milk and is aware of changes in its flavour when nursing mothers eat either garlic (Menella and Beauchamp 1991), or vanilla (Menella and Beauchamp 1996) then in both cases there is a change in the sucking rate of the baby. Breast feeding in particular gives the benefit that the baby's diet is not monotonous since the foods eaten by the mother will affect the flavour of the milk and provide variety, it has been shown that mothers who consume specific flavours during breast feeding will enhance acceptance of those flavours in their child's diet at the time of weaning (Menella, Jagnow et al. 2001). Breast fed infants are also...

Memory and plasticity of olfactory function in early life 1841 Early postnatal shaping of odour preferences

The fact that human infants can be familiarised with a novel odorant by mere exposure, i.e. without any apparent reinforcement, has already been mentioned above (see page 416, Dimensions of olfactory stimulation discriminable to newborns). This form of passive acquisition seems to prepare more complex and more specific olfactory acquisitions. Thus, the repeated pairing of an initially neutral odorant with maternal contact leads to the progressive development of a preference. Delaunay-El Allam et al. (2006a) showed that the circumstantial odorisation of the maternal breast with a chamomile-scented salve induces the rapid formation of a significant preference for this odorant. This result corroborates a previous study by Schleidt and Genzel (1990) who also asked breastfeeding mothers to odorise their breasts (with rose essence) for the first two weeks following the birth of their infant. During preference tests carried out after 1 week and 2 weeks, these newborns displayed more...

Nutritional Value of Fish and Shellfish Introductory Remarks

When included in the diet of pregnant and breastfeeding women, DHA is thought to be beneficial to infant brain (learning ability) and eye (visual acuity) development. Scientists have found that women who ate fatty fish while pregnant gave birth to children with better visual development. Babies of mothers who had significant levels of DHA in their diet while breastfeeding experienced faster-than-normal eyesight development. Preliminary research also suggests that a diet rich in omega-3 fatty acids - and in DHA in particular - may help to decrease the chance of preterm birth, thus allowing the baby more time for growth and development.

Conclusions and future trends

Traits of intensity, noisiness clarity, complexity, rhythm tempo and variety. In the chemical senses, stimuli can have intensity, variety or complexity properties in common. Such amodal qualities may have strong influences on subsequent responsiveness. For example, early exposure to low intensity odour stimulations, which is typically the case in the amnion or milk, may be followed by a general trend of preferential responses to low intensity odorants. Otherwise, early experience of chemosensory variety has been shown to condition later acceptance of chemosensory novelty in animal infants (Kuo 1967). In rats, an effect of flavour variety experience on novelty acceptance could be ascertained in immature animals, but not in adult animals (Capretta el al. 1975), suggesting the existence of a sensitive period for the impact of chemosensory variety. Human cultures have fashioned distinct circumstances of early exposure to chemosensory variety breastfeeding in which infants are exposed to...

Hormonal Control of Secretory Activation

The decrease in progesterone around parturition is generally agreed to be required for the onset of milk secretion. In humans, it is known that removal of the placenta, the source of progesterone, is necessary for the initiation of milk secretion. In swine, timing of the increase in milk lactose correlates closely with timing of the decrease in plasma progesterone at parturition. Exogenous progesterone prevents lactose and lipid synthesis in mammary glands of pregnant rats and sheep after removal of their ovaries, the source of progesterone in these species. Progesterone also suppresses -casein expression in the rat mammary gland during pregnancy and the decrease in progesterone levels is linked to increased -casein synthesis at parturition. Receptors for progesterone are not detected in lactating mammary tissues, which explains why progesterone does not inhibit established lactation. It is likely that the decline in progesterone is insufficient to activate secretion and that the...

Other dairy products to improve infant health

Human breast milk is recognised as being the best functional food for infants due to its undisputed optimal health-promoting effects by specific and nonspecific factors, such as enhancement of the immature immunologic system of the newborn baby and strengthening of defence mechanisms against infective agents. Breastfeeding seems to protect from infections, the development of infant formulas or so called breast milk substitutes aim to provide an efficient and safe alternative diet for infants of those women who are not able to continue breastfeeding until six months of life. infant formula can be fed directly after birth when breastfeeding is not possible follow-on formulas are designed for children after the sixth month of life. Breast milk substitutes aim to mimic the composition of human breast milk concerning protein, fat and carbohydrate composition. The only carbohydrate of infant formulas is lactose, whereas follow-on formulas contain other carbohydrates, too. Protein sources...

Potential Importance of Phytoestrogens to Human Health Molecular Mechanisms of Action

Phytoestrogens can cause infertility in some animals and thus concerns have been raised over their consumption by human infants. The isoflavones found in a subterranean clover species (in Western Australia) have been identified as the agents responsible for an infertility syndrome in sheep. No reproductive abnormalities have been found in peripubertal rhesus monkeys or in people living in countries where soy consumption is high. Indeed, the finding that dietary isoflavones are excreted into breast milk by soy-consuming mothers suggests that in cultures in which consumption of soy products is the norm, breast-fed infants are exposed to high levels without any adverse effects. Isoflavone exposure soon after birth at a critical developmental period through breast feeding may protect against cancer and may be more important to the observation of lower cancer rates in populations in the Far East than adult dietary exposure to isoflavones. Although some controversy exists as to whether...

Maternal Alcohol Consumption

Consumption of alcohol is quite common among breast-feeding mothers as studies have shown ethanol to aid in the promotion of lactation. Establishing the harmful effects of alcohol consumption during lactation is therefore important. Newborn rats exposed to maternal alcohol only during the lactation period have also been shown to develop reduced insulin sensitivity despite having normal prenatal growth and development. In early postnatal life some important metabolic processes are still undergoing development. Therefore, it must be considered that early postnatal life is still a vulnerable period of growth and the developing metabolic processes may still be particularly susceptible to adverse effects induced by alcohol consumption by breast-feeding mothers.

Dietary Management Dietary Guidelines

The situation is similar for infant feeding. Brain lipids in the human infant are known to change with changing intakes of fatty acids. The needs of a newborn with Down's syndrome for the long-chain polyunsaturated fatty acids docosahexenoic acid and arachidonic acid have not been determined. Since breast milk contains the preformed dietary very long-chain fatty acids that seem to be essential for the development of the brain and the retina, it seems prudent to encourage breastfeeding.

Igemediated Food Allergies

Infants born to parents with histories of allergic disease are much more likely than other infants to develop food allergies. Prevention of the development of food allergies in such infants is quite difficult. The avoidance of commonly allergenic foods such as cows' milk, eggs, and peanuts primarily through breast feeding appears to delay but not prevent the development of food allergies.

Recommended Dietary Intakes

Breast-feeding is recommended for the first year of life. Although iron in breast milk is relatively low (0.35 mg l, or 0.27mg daily), it is well absorbed, possibly because of lactoferrin. Breast milk alone is assumed to be adequate for the first 6 months of infancy, with the addition of iron-rich foods in the next 6 months. When prepared formula is used, iron fortification of the formula is recommended.

Prevention of Obesity in Childhood

See also Adolescents Nutritional Problems. Appetite Psychobiological and Behavioral Aspects. Breast Feeding. Children Nutritional Requirements Nutritional Problems. Diabetes Mellitus Etiology and Epidemiology. Exercise Beneficial Effects. Food Choice, Influencing Factors. Nutritional Assessment Anthropometry Clinical Examination. Obesity Definition, Etiology and Assessment Fat Distribution Complications Prevention Treatment. Socio-economic Status. Weight Management Approaches.

Features of Marital Interaction Importance of the Marital Relationship

In cultures where a relationship other than the marital bond is viewed as primary, people may actively try to obstruct intimate interactions between a husband and wife. Thus, for instance, a traditional Hindu husband is warned not to look at his wife while she is eating, sneezing, yawning, breast-feeding, or relaxing comfortably, the idea being to encourage continued distance between spouses (Mace & Mace, 1959).

Development of bifidobacteria in the intestine and beneficial effects

Despite the variable results obtained in the numerous clinical trials, many scientists argue in favour of bifidobacteria for adjunct therapy. The main reason is the observation that bifidobacteria are the dominant commensal microbiota of most breast-fed babies, and the negative effects seen upon delayed colonization of bifidobacteria in pre-term babies (Westerbeek et al., 2006). The underlying assumption is that at least part of the protective effect of breast-feeding is linked to the presence of bifidobacteria.

Supplementation and Weaning

In the West, medical specialists and lactation consultants recommend that infants who are exclusively breastfed receive iron supplements at six months of age. Human milk is low in iron, so by the time the infant is that age, anemia may occur if breast-feeding is not supplemented. This is the age that is most commonly cited for supplementation in other cultures as well (e.g., Minturn & Hitchcock, 1966). Food supplements may include a gruel made from a common grain such as rice or millet, cow's or goat's milk, or finely ground meat. Just as there is variation in beliefs about breastfeeding, there is variation in beliefs about the timing and method of weaning. Commonly, an infant is weaned when the mother becomes aware of another pregnancy. Milk from a pregnant woman may be seen as dangerous for the nursing infant, or nursing may be seen as dangerous to the developing fetus. Women may choose to terminate breast-feeding in order to increase their fertility. In much of West Africa,...

Prevention of allergy

Experimental evidence indicates that the child can be sensitised in utero. It is sometimes advised that an atopic mother should avoid highly allergenic foods during pregnancy. However, there is concern that this might adversely affect the growth of the foetus. Avoidance of allergens during early infancy has been shown to reduce the development of allergy in at-risk infants. Among food allergens, cow's milk is an important allergen at this stage, and exclusive breastfeeding has been advocated. As protein ingested by the lactating mother can be secreted in the breast milk (a potential source of sensitisation), a maternal diet excluding allergenic foods during lactation has been advised. eHF may be used, if required, as a replacement or supplement to breast milk and by pregnant and lactating women if cow's milk is excluded from their diet. There are, however, problems designing suitable hydrolysates that are low in antigenicity and palatable in taste. In infants at risk of developing...

Dietary Management

Food intolerance There is much controversy surrounding the role of food in the development and onset of asthma. Evidence suggests that atopic or asthmatic parents, whose children have a high risk of developing asthma, should be advised to avoid smoking during pregnancy avoid cigarette smoke exposure after the child is born undertake house dust mite control strategies exclusively breast-feed their infants for 6 months and subsequently provide their child with a nutritious, balanced diet. In contrast, there is little to suggest that a low allergen diet for high-risk women during pregnancy is likely to reduce the risk of having an atopic child.

Modernization and Medicalization

Another aspect of medicalization can be glossed in the idiom of governmentality proposed by Michel Foucault. With the pervasive moves throughout the 19th century by the state, the law, and professional associations to increase standardization through the rational application of science to everyday life, medicine was integrated into an extensive network whose function was to regulate the health and moral behavior of entire populations. These disciplines of surveillance, population bio-politics as Foucault (1979) described it, function in two ways. First, everyday behaviors are normalized so that, for example, emotions and sexuality become targets of medical technology, with the result that reproduction of populations and even of the species are medicalized. Similarly, other activities, including breastfeeding, hygiene, exercise, deportment, and numerous other aspects of daily life are medicalized largely by means of public health initiatives and with the assistance of the popular media.

Public Health Consequences of Vitamin D Deficiency

The increase in rickets in the US is occurring primarily in African-American and Hispanic children who have gone off breast-feeding and are not getting sufficient calcium and vitamin D in their diets. This problem has been more common in the southern US despite greater availability of sunlight. In large part, rickets is an educational issue that requires input from both medical and public health professionals.

The role of carers in flavour learning by the child

The Department of Human Development and Family Studies at The Pennsylvania State University have shown another interesting consequence of bottle feeding on later food consumption (Fisher, Birch et al. 2000). In this case comparisons were made between toddlers which had either been breast fed or bottle fed earlier in life. One of the main conclusions of this work was that breast feeding in the first year showed benefits on food intake and feeding style which persisted into the toddler phase. However, a noteworthy aspect of this work was the conclusion that these benefits were indirectly derived from the mother-child relationship that developed during breast feeding and that this had more to do with the behaviour of the mother than the child those who breast fed their babies could not see how much milk they provided and they developed a relaxed attitude to the fact that their infant was getting enough to eat, the mothers who bottle fed their children were able to see how much the babies...

Implications of study design

Patients often do not have a good recall of events, leading to a form of information bias called recall bias. A good example of recall bias is a birth cohort study in which mothers were asked about the duration of breast feeding at 11 and 47 months of age (Huttly et al. 1990). At 47 months there was only 70 agreement with data obtained from the same mothers at 11 months. Although case series do not provide robust epidemiological data, they provide a window through which current clinical experience may be viewed. They often form the initial basis of many hypotheses that can subsequently be tested in more definitive studies where cases and control subjects are compared. Cohort studies are important in identifying risk factors for food allergy. This risk is usually quantified using odds ratios or relative risks. Confounding can still occur where a third factor may account for a perceived association between a particular exposure and an allergic outcome. Where such confounding...

Socialization of Boys and Girls

Not long ago, families favored boys over girls. A young bride wanted to produce a boy which would increase her own status. A friend told me how her mother had turned her face away, wept, and refused to nurse her first-born daughter in shame that she had not produced a son for her husband, until her aunts and other female relatives urged her to do so. When asked how many bacheh (child, although sometimes taken to mean boy) he has, a father may count only the boys. In my experience, when men recited the list of their ancestors and their lineage, they gave the names of males only. Females asked if I wanted them to list the women too, or just the men. Traditionally, mothers and others tended to male infants more than to female infants, breast-feeding them longer, and responding to their crying. Parents generally provided boys with more food, clothing, medical care, and education than

Introduction of Dietary Therapy

For regular infant formula or breast milk. In some clinics, only phenylalanine-free formula is given for a few days so that blood phenylalanine will quickly decrease to an acceptable level. A prescribed amount of breast milk or standard infant formula, however, should be shortly introduced into the diet. Whole protein is needed to meet phenylalanine requirements and prevent phenylalanine deficiency, which will lead to muscle protein catabolism and inadequate weight gain. For formula-fed infants, both standard infant formulas and PKU medical foods are used in prescribed amounts and are bottle fed. Breast-feeding of an infant with PKU is possible and, as with all infants, should be encouraged whenever possible. Mature breast milk contains approximately 46 mg 100ml-1of phenylalanine compared to approximately 59 mg 100 ml-1 in cows' milk protein-based formula and approximately 88 mg 100 ml-1 in soy-based formulas. Therefore, breast-fed infants may initially have slightly lower plasma...

Synthesis and distribution

IgA is found in species which emerged after the appearance of amphibia, although evidence has been presented that IgA-like molecules may exist in fish. In most higher vertebrates, the majority of IgA is synthesized by gastrointestinal lymphoid tissue, with smaller amounts synthesized at other mucosal sites such as the respiratory tract, salivary glands and reproductive tract. During lactation, mammary tissue contains substantial numbers of IgA-producing cells. The majority of these arc thought to migrate from the gut, thus protective IgA antibodies generated by the mother against gastrointestinal organisms in the environment may be transferred to the infant via breast feeding. An important species variation should be noted in addition to IgA, ungulates have even greater concentrations of IgGl antibodies in milk, due to the presence in mammary epithelium of a specific receptor which transports IgGl from blood to milk.

Limitations of Biological Treatments

Research on the use of antidepressant medication with children and adolescents remains sparse, and the few well-designed experiments that have been conducted have not shown that antidepressants are more effective than placebo. There also exists little research that has investigated the safety of these medications with pregnant women or women who are breast-feeding.

Long Term Effects of Infant Feeding

First, breast feeding is a complex behavior chosen by mothers. Women who choose to breast-feed are likely to differ in systematic ways from those who do not. The choice to breast feed and the duration of breast feeding may be related to other short- and long-term health behaviors that affect the ultimate health outcomes of interest. To isolate the effect of infant feeding, it must be assumed that other concurrent and subsequent exposures are not systematically related to feeding history, or such exposures must be taken into account in multivari-ate analysis. Unfortunately, most studies have insufficient data to adequately control statistically for these other behaviors, particularly since they are often unmeasured or poorly measured. Second, many studies use historical cohorts in which feeding method is recalled by the mother or based on limited records. While the decision to initiate breast feeding is likely to be accurately recalled, information about breast feeding duration and...

TABLE 1125 Causes of Jaundice in Neonates

Physiologic jaundice is due to the breakdown of fetal red blood cells, and bilirubin rises at a rate of less than 5 mg dL per 24 h, with a peak of 5 to 6 mg dL during the second to the fourth day of life, returning to < 2 mg dL by 5 to 7 days. Septic infants with hyperbilirubinemia also have other features of sepsis, such as vomiting, abdominal distention, respiratory distress, and poor feeding. Jaundice associated with breast-feeding is thought to be due to the presence of substances that inhibit glucuronyl transferase in breast milk it may start as early as the third to fourth day and reaches a peak of 10 to 27 mg dL by the third week of life. Cessation of breast-feeding causes rapid decline in 2 to 3 days.

Impact of Supplementation

See also Adolescents Nutritional Requirements. Breast Feeding. Lactation Physiology Dietary Requirements. Obesity Complications. Pregnancy Role of Placenta in Nutrient Transfer Nutrient Requirements Energy Requirements and Metabolic Adaptations Safe Diet for Pregnancy Dietary Guidelines and Safe Supplement Use Prevention of Neural Tube Defects Pre-eclampsia and Diet.

Everyday Feeding problems

Nutrient needs that are easily met in healthy children may be more difficult to achieve if children are offered, or accept, only a limited variety of foods or have poor appetites because of illness. Vegetarian diets for young children can provide adequate nutrition but some nutritional knowledge is advisable for those managing children on such diets. Plant proteins do not individually contain all the amino acids so mixing of protein sources is important for the provision of the amino acids needed for optimal nutrition and growth. Provided breast-feeding continues, or children take significant amounts of other milk or formula (cows' milk-based or soy-based infant formulas or, after 1 year, neat cows' milk), amino acid requirements can be met from milk or formula and little other protein is needed from plant or animal sources. WHO recommends that breast-feeding continues as part of a mixed diet into the second year of life. Milk in some form is recommended for young children. It...

Global Burden of Diarrhea and Epidemiological Trends

This is the period when the immune system is not yet fully matured and the maternal antibodies are reduced. In addition, they may receive contaminated foods to complement breast-feeding, and they begin to crawl, potentially to areas where they may have direct contact with human or animal feces.

Diet and Physical Activity Behaviors

Change, that could conceivably influence energy balance sufficiently to contribute to the prevention of weight gain and obesity. Behaviors that reduced the risk of obesity included regular physical activity, high dietary fiber intake, and possibly breast-feeding and low glycemic index diets. Behaviors that increased the risk of obesity included a high intake of energy-dense foods, a high intake of sugar-sweetened drinks and juices, time spent in sedentary behaviors, and possibly large portion sizes, a high intake of fast foods, and a restrained eating pattern.

Diet And Schizophrenia

Although there have been studies that have shown the importance of dietary essential fatty acids (EFAs) for healthy neurodevelopment (Crawford, 1993), until recently there had been no studies of infant feeding practices in relation to subsequent schizophrenia. It has been shown that the children of women pregnant during the Dutch famine (19441945) were significantly more likely to develop schizophrenia in later life (Susser & Lin, 1992). Although these women suffered multiple dietary deficiencies and not just PUFA, it is known that during early development infants require healthy amounts of AA and DHA to maintain normal brain development (Rogers, 1978 Rogan & Gladen 1993 Lucas et al., 1992). What the Dutch data do demonstrate is that dietary impairment in utero, presumably by affecting neurodevelopment of the fetus, can have substantial effects in adulthood. Two initial studies of breast feeding in schizophrenia, one by our group and one in Scotland (McCreadie, 1997), produced...

Biomedical Recommendations for Home Treatment

The World Health Organization (WHO) and other international agencies involved in the control and management of diarrheal diseases, dehydration prevention, and rehydration therapy have undertaken many programs and studies to determine the best medical, practical, feasible, and acceptable methods for preventing and treating diarrhea and dehydration. The general conclusions suggest that prevention of dehydration is the best home treatment procedure. However, most studies demonstrate that caregivers have difficulty in mixing the proper amounts of salts, sugars, and water, especially in making the mixture over-concentrated. This in itself can pose a danger for dehydration by pulling water into the intestine through osmosis and increasing diarrheal output. Traditional home preparations of fluids and foods are now encouraged, especially continued breast-feeding when applicable. If feeding, particularly fluids containing nutrients and calories, are continued throughout the diarrheal event,...

Nutrition and Health in the Urban World

Traditionally worked on both household and farm chores as part of an integrated family-production pattern. In urban areas, mere economic survival often obligates families to send children to work in factories at low wages, exposing them to occupational risk and interfering with their formal education. To the extent that urban mothers seek income-generating activities outside of the home, monetary resources may be bolstered by child-rearing and child-caring and meal provision can be disrupted. Breast-feeding is one form of meal provision, i.e., that for the infant, that can be influenced adversely by maternal work obligations. In general, less exclusive breast-feeding and shorter total lactation are seen in urban mothers as compared to their counterparts in the countryside.

Multination Health and Nutrition Surveys

During the past few decades, the Demographic and Health Surveys (DHS) have been conducted in many countries in all regions of the world. The DHS surveys are nationally representative surveys that include household and individual health and nutrition indicators. The surveys are large, typically 5000 to 30 000 households, and are conducted periodically, often at 5-year intervals. The data included in the survey vary slightly by country (Tables 1 and 2) but typically include as a minimum anthropometric measurements and hemoglobin concentration (prevalence of anemia) of children and women of reproductive age and breast-feeding and complementary feeding practices. One of the major strengths of the DHS surveys is that they use standard questionnaires that allow for

Preparation for Discharge

Approximately 1 week prior to discharge, preterm infants should be converted to the feeding regimen that will be used at home. Infants who have been fed expressed breast milk should demonstrate the ability to directly breast-feed and or to feed supplemented breast milk or formula from the bottle as needed to gain adequate weight. The infant who weighs less than 2500 g at discharge, especially those infants born at less than 30 weeks' gestation, may require the supplementation of some breast-milk feedings with post discharge formula powder or the feeding of a concentrated post discharge formula for some of the daily feedings.

Soft or Solid Food Energy Density of Diet and Protein and Energy Requirements

A child's diet during the period of diarrhea should not be drastically different from his or her normal healthy diet. Therefore, for children who are currently breast-feeding, they should continue to do so, and for children who are in the weaning period and have a mixed diet, they should continue to have a mixed diet of soft or solid food. If the child on a mixed diet is dehydrated, his or her soft and solid

Antibiotic Regimens for Endometritis

* Should not be given to breastfeeding mothers chlamydia infection is suspected, azithromycin 1 gram PO for one dose should be added to the regimen 3. Modifications in therapy may be necessary if there is no response to the initial antibiotic regimen after 48 to 72 hours. Approximately 20 percent of treatment failures are due to resistant organisms, such as enterococci which are not covered by cephalosporins or clindamycin plus gentamicin. The addition of ampicillin (2 g q4h) to the regimen can improve the response rate. Metronidazole (500 mg PO or IV q8h) may be more effective than clindamycin against Gram negative anaerobes but is generally not used in mothers who will be breastfeeding.

Implants and Plastic Surgery

There is still some question about whether it is safe to breast-feed if you have silicone breast implants, but there is no conclusive evidence that infants are harmed. The surgery for breast implants usually does not interfere with milk ducts or the nipples unless the incision was made around the edge of the areola. This surgery should not prevent successful nursing. Plastic surgery to reduce the size of breasts may interfere with breastfeeding, especially if the nipples were transplanted. If you have had plastic surgery on your breasts, it may be that the only way to find out whether or not you can productively breast-feed is by trying.

Delivery of the placenta

Acetaminophen codeine (Tylenol 3) 1-2 tab PO q3-4h prn OR Oxycodone acetaminophen (Percocet) 1 tab q6h prn pain. Milk of magnesia 30 mL PO q6h prn constipation. Docusate Sodium (Colace) 100 mg PO bid. Dulcolax suppository PR prn constipation. A and D cream or Lanolin prn if breast feeding. Breast binder or tight brazier and ice packs prn if not to breast feed. Labs Hemoglobin hematocrit in AM. Give rubella vaccine if titer < 1 10.

Rationale for Recommended Nutrient Intakes

In general, there is considerable uncertainty in establishing dietary nutrient recommendations for lactation due to high intra- and interindividual variability in breast milk volume output and in several specific nutrient concentrations in breast milk, and to temporal changes in milk volume and nutrient concentrations during the lactation period. The composition of breast milk is affected by several factors depending on the nutrient, such as stage of lactation, changes during nursing, diurnal rhythm, maternal diet, gestational age at birth, and parity. Moreover, the total amount of nutrients secreted into breast milk depends on the extent and duration of breast feeding. In addition, physiological adaptation to the increased nutrient lactation demands such as increased nutrient absorption and conservation, and use of maternal nutrient stores, which are quite specific for each nutrient and not easily quantified, contributes to the degree of uncertainty. Maternal age and maternal...

Miscellaneous Adverse Effects

In addition to the various dopamine-related side effects just described (extrapyramidal disorders, tardive dyskinesia, and NMS), the antipsychotics may cause a variety of other untoward effects, some of which are highlighted here. All antipsychotics may cause sedation and impair mental capacity to some degree 24 patients should be cautioned regarding activities requiring mental alertness, such as driving and operating heavy machinery. Photosensitivity may occur with the typical antipsychotics, especially the phenothiazines it is not a characteristic of the atypical agents, with the exception of risperidone. To varying degrees, all may lower the seizure threshold.24 Both typical and atypical agents are pregnancy category C with the exception of clozapine, which is category B none of these agents are recommended in breast-feeding women.24 Clozapine therapy carries the risk of agranulocytosis and is reserved for use in severely ill schizophrenics who have failed conventional treatment...

History Of Foods And Feeding Practice

Infant foods have evolved largely parallel to the development of food science and technology, and the implementation of food safety and food processing practices has dramatically influenced the availability of safe foods. Before 1800 about two-thirds of children died before 5 years of age, and that statistic has dramatically changed. Wet nurses (women hired to suckle others' children) were widely used when breast feeding was impossible. Otherwise, supplementary foods were of poor quality and unclean as a result, food was the most frequent cause of serious illness. A first major step was heat treatment of milk pasturization was first, followed by the development of sweetened condensed milk, which provided a much safer source of milk for infants than the raw or certified milk available previously. Early efforts to prepare foods specifically for infants and young children included meat juices and cereal gruels (Mellon's Food), malted milk (Horlick's Malted Milk), and sweetened condensed...

Paracellular Transport Pathway V

During pregnancy, with mastitis and after involution the tight junctions become leaky and allow components of the interstitial space, such as sodium and potassium, to pass unimpeded into the milk, a fact that is sometimes useful in diagnosing breast-feeding problems.

Regulation of Milk Synthesis Secretion and Ejection

Milk volume production is a primary indicator of lactational function the most precise methods for measuring the volume of milk produced involve weighing infants before and after each feed for 24 h or longer or using an isotope dilution technique with stable isotopes. Clinically, the amount of milk that can be expressed with a breast pump or the change in infant weight after a single feed can be used as a rough index. The volume of milk secreted by women exclusively breast-feeding a single infant at 6 months postpartum is remarkably constant at approximately 800 ml day in populations throughout the world. Mothers of twins, and occasionally even triplets, are able to produce volumes of milk sufficient for complete nutrition of their multiple infants, Figure 3 Changes in milk volume during weaning and in response to increased feeding frequency. (A) Milk volume transfer as a function of time postpartum. (B) Relation between feeding frequency (feeds day) and the milk volume. Data are from...

Infant Foods Infant Nutrition

Breast feeding is recognized as the preferred method for feeding very young infants, and breast milk should be the exclusive food for the first 4 to 6 months unless circumstances (mother unable to breast-feed, breast milk inade quate, etc) do not allow exclusive breast feeding. Any food other than breast milk that is introduced should supplement rather than replace breast feeding.

Milk Intolerance Lactose Intolerance

The majority of children can tolerate lactose during a diarrheal episode. A small proportion of children with diarrhea may not be able to digest lactose and are therefore not tolerant of milk- and lactose-containing formulas. This is more likely to occur among young children who only receive animal milk or formula in their diet and who have persistent diarrhea, and it rarely occurs in children on a diet of breast milk. In a lactose-intolerant child, milk- and lactose-containing formulas result in a significant increase in stool output. Stool output reduces dramatically when the milk- or lactose-containing formula is stopped. The warning signs of lactose intolerance include deterioration of the child's clinical condition, signs of dehydration, and an increase in the stool volume when milk feedings are given. However, only when the child is not gaining weight, eating less, and not fully alert is this a real cause for concern. This condition can be managed by continuing breast feeding....

Postreproductive Age 49 Years

See also Adolescents Nutritional Problems. Anemia Iron-Deficiency Anemia. Breast Feeding. Children Nutritional Problems. Dietary Surveys. Infants Feeding Problems. Infection Nutritional Interactions Nutritional Management in Adults. Lactation Dietary Requirements. Malnutrition Secondary, Diagnosis and Management. Nutritional Assessment Anthropometry Biochemical Indices Clinical Examination. Older People Nutrition-Related Problems. Pregnancy Nutrient Requirements. Supplementation Role of Micronutrient Supplementation Developing

Practical Aspects of Meeting the Nutrient Needs of Infants

Adequate amounts of breast milk meet the nutrient needs of most infants for the first 6 months of life. However, there is not universal agreement on the optimal duration of exclusive breast feeding and the precise timing or the order of introduction of complementary foods. Internationally, recommendations from most health agencies state that the ideal feeding of infants is exclusive breast feeding for the first 6 months of life with appropriate introduction of foods from 6 months onward including partial breast feeding through 2 years of age or beyond. When assessing intakes of infants fed marketed formulas, it must be kept in mind that intakes of most nutrients will exceed the new DRI values for AI given that these are based on the composition of human milk. In many cases, the greater concentration of nutrients in infant formula is appropriate due The March of Dimes report (2002) outlined three key recommendations for ensuring optimal nutrition of term-born infants through...

Gtm Loosing Weight

BF, breast feeding NA, not available. BF, breast feeding NA, not available. the time period during which the surveys took place, numerous demographic changes occurred that are negatively associated with breast-feeding, such as increased female employment and education and increased urbanization. When adjusted for these changes, highly significant improvements in breast feeding are seen in many countries, particularly those in which breast feeding promotion efforts have been most active.

Early Infancy

All newborns should be fed colostrum immediately after delivery. Because breast milk is the best food for infants, exclusive breast feeding is the best way to prevent undernutrition in this age group. Exclusive breast feeding also reduces the risk of diarrhea and other infections that can reduce appetite and absorption or increase nutrient losses. The advantages of breast feeding should be balanced with the risk of HIV transmission if the mother is known to be HIV positive. In early infancy, breast milk may not easily be replaced, and risks should be carefully assessed by program managers before recommending breast milk substitutes. Beyond exclusive breast feeding, there is a role for micronutrient supplementation for some high-risk children. For example, low birthweight infants can benefit from zinc, iron, and vitamin A supplementation. Where there is a risk of rickets, such as in areas where young infants do not get any exposure to sunlight or calcium intake is very low, vitamin D...

Microflora Research

In spite of the recent development of DNA based methods, microbiota development and characterization in the human host still rests largely on the culture-based assessment pioneered by Japanese researchers. The identification of different microbial species and strains has been dependent on microbial characterization, which is usually based on limited phenotypic properties and the metabolic activity of the microbes, for example, sugar fermentation profiles. There are several bacteria, however, that cannot be cultured and isolated or identified by the traditional methods. The culture technique as used in microbial assessments of feces is also hindered by the fact that microbes in the feces will mainly represent the microflora in the lumen of the sigmoid colon, while the composition of the intestinal microflora differs both along the GI tract and between the lumen and the mucosa. For more accurate information on the population elsewhere in the intestine, samples should be taken by...

Future Challenges

Cancer Epidemiology of Gastrointestinal Cancers Other Than Colorectal Cancers. Cholesterol Sources, Absorption, Function and Metabolism. Colon Disorders. Diarrheal Diseases. Food Allergies Etiology Diagnosis and Management. Lactose Intolerance. Microbiota of the Intestine Prebiotics.


Breast-feeding is beneficial for all women and their babies, and women who take medicine for epilepsy can breast-feed safely. If the mother was taking AEDs while she was pregnant, the amount of medication consumed by the baby through breast milk is significantly lower than the amount the baby was exposed to in the womb. Therefore, the benefits of breast-feeding usually outweigh the risks. Some AEDs have side effects, however. Phenobarbital or primidone may result in the baby's being overly sleepy, and if you must take these AEDs, you may have to bottle-feed instead. If your baby's pediatrician and your neurologist work together, however, you will probably be able to continue to breast-feed your baby by adjusting your AEDs. Learn as much as you can in advance about breast-feeding. There are several ways to conduct your own research Research has shown that it is good for women to breast-feed their babies for a least a few weeks. This will naturally wean the baby from the medication they...

Early Feeding

There is no consistent evidence that breast feeding protects children from later obesity. Any associations between breast feeding and a low prevalence of obesity may simply indicate that both obesity and a low prevalence of breast feeding are common in socioeconomically deprived communities. Furthermore, breast feeding is not a passive process but one that involves maternal emotions and close mother-child contact. The process of feeding and recognizing readiness to feed may teach a mother subtle subconscious understanding of her child's needs. Thus, the process of breast feeding may have positive influences on mothers' attitudes to child nurture attitudes that are less readily acquired through formula feeding. Likewise, studies of early weaning, although occasionally showing evidence of an association with later obesity, are certainly not consistent in finding relationships between weaning practices and later overweight. Early feeding studies can never be double-blind controlled, and...

High Risk Groups

Period of increased autonomy that is often associated with irregular meals, changed food habits, and periods of inactivity during leisure combined with physiological changes that promote increased fat deposition, particularly in females. Early adulthood usually correlates with a period of marked reduction in physical activity. In women this usually occurs between the ages of 15 and 19years but in men it may be as late as the early 30s. Excessive weight gain during pregnancy often results in retention of weight after delivery, particularly with early cessation of breast feeding. This pattern is often repeated after each pregnancy. In Western societies weight generally increases with age but it is not certain why menopausal women are particularly prone to rapid weight gain. The loss of the menstrual cycle does affect food intake and reduce metabolic rate slightly.

Latching On

There will be a tugging feeling when you first begin to nurse. If the latch on hurts, pinches, or produces pain, it may be incorrect. Break the latch on by slipping your finger into the corner of the baby's mouth, then reposition, and try again. This may take several tries. Breast-feeding should not be painful. Correct latching is important because it improves the flow of milk, prevents sore nipples, keeps the baby happy, stimulates a good milk supply, and helps prevent overly full (bloated) breasts. Talk with your pediatrician or a lactation specialist if you are having difficulties with latching on, or if you have pain while breast-feeding. Babies use their lips, gums, and tongues to get the milk to flow from the breast. This is known as suckling. Simply sucking on the nipple will not draw milk and may hurt the nipple. Listen for gulping sounds so you will know for certain that the baby is actually swallowing the milk. Also watch for slow, steady jaw movements. Most babies will...

The Let Down Reflex

Make sure your baby is in the proper position on your breast. Correct positioning is one of the most important factors in successful breast-feeding. 1. Smoking. Do not smoke while you are breast-feeding or around children. Secondhand smoke is dangerous to all children, but especially to newborns, because it increases the risk of SIDS.

Breast Care

By the third or fourth day of breast-feeding, your milk will become thicker and begin to resemble skim milk. Your breasts will also become firm. If your nipples leak, use a nursing pad or clean folded handkerchief squares inside your bra to catch the leaking milk. Be sure to change these often. Do not use plastic-lined pads because they prevent air from circulating around your nipples. Between feedings, gently pat your nipples dry. This helps prevent irritation. You may also want to apply a little expressed colostrum, human milk, or medical-grade modified lanolin on your nipples to prevent dryness. You may develop cracked or sore nipples if your baby is not positioned properly or does not latch on correctly. Reposition the baby frequently to prevent these problems, and make sure the baby's lips and gums are on the areola, not on the nipple.

Nipple discharge

Tests suggest underlying pathology (e.g. prominent red blood cell content, atypical or malignant cells), then the duct should be removed surgically (microdochectomy). In older women or those not intending to conceive and breast feed, if the duct cannot be identified or the discharge comes from several ducts, then subareolar central duct excision is undertaken through a circumareolar incision.

Infant Nutrition

The baby should steadily gain weight after the first week of life. During the first week, some infants lose several ounces of weight, but they should be back up to their birth weight by the end of the second week. Your pediatrician will weigh your baby at each visit. Keep in mind that the baby may breast-feed more often during growth spurts.


American Trypanosoma (T. cruzi) causes Chagas' disease. Three strains of African Trypanosoma cause sleeping sickness. Chagas' disease is usually transmitted by the reduviid (kissing) bug, but infection can also follow breast-feeding and blood transfusion, as has occurred in the United States. A nodular swelling, or chagoma, develops at the site of inoculation following a bite. The acute phase of the disease can last 2 to 3 months, and patients present with fever, headache, anorexia, conjunctivitis, and myocarditis. Infants can develop meningocephalitis, and heart involvement can lead to congestive heart failure and ventricular aneurysms. The organism can attack the myenteric plexus of the gastrointestinal tract, resulting in megacolon. Chronic infection can result in a cardiomyopathy. Laboratory abnormalities include anemia, leukocytosis, an elevated sedimentation rate, and electrocardiographic changes. During the acute phase, trypomastigotes can be seen on a peripheral smear or...

Multiple Births

It is possible to breast-feed twins at the same time by nursing one baby at each breast. You can hold one baby at each side using the football hold (described earlier), or you can cradle them both in front of you with their bodies crossing each other as they would have been in utero. Alternate the breast each baby uses at each feeding, or at least once a day. If this is It is also possible to breast-feed triplets, but most mothers supplement feedings with formula. Nurse two of the babies at a time and give formula to the third. At the next feeding, give the formula to a different baby. It is important that all three babies have an equal opportunity to breast-feed.

Returning to Work

Human milk has the same important benefits for older babies as it does for infants. Just because you are returning to work does not mean you have to stop breast-feeding. Knowing that you will be able to provide milk for your baby while you are away will help ease your transition back to work. Working women can manage breast-feeding in the following ways Extend maternity leave so there will be more time for breastfeeding to become well established. Breast-feed when you are with your baby. When you are away, the baby will receive formula or solids (if approximately 6 months of age). Be sure to select a childcare provider or center that supports breast-feeding, and can safely handle the milk and feedings per your instructions. Also, engage the support of your boss, human resources staff, occupational nurse, and coworkers. Assure them that pumping milk will not interfere with your work duties. Some babies lose interest in breast-feeding between 9 and 12 months of age, or after they learn...


Breast-feeding and diet Dietary risk in children refers to inadequate breast-feeding combined with low intakes of VA-rich foods from the household diet. A low dietary fat intake (e.g., < 5 of calories) may restrict absorption of pro-vitamin A carote-noids from vegetables and fruits and thus also predispose children to deficiency. intake' of 400-500 mg RAE has been set as a guide for infants in their first year, making infant VA intakes from breast milk marginal and, beyond infancy, marginally above an estimated deficient threshold thereafter (i.e., 210 mg RAE). Decrements in intake or concentration below this minimum increasingly place breast-fed children at risk, with greatest risk for those fully weaned and lacking a nutritious home diet. Studies in Asia and Africa show that breast-fed infants and toddlers are 65-90 less likely to have or develop xerophthalmia than non-breast-fed peers of the same age. Xe-rophthalmic children have been shown to begin weaning earlier (by month) and...

Management Treatment

Hypovitaminosis A is prevented by increasing intakes of preformed vitamin A or pro-vitamin A carotenoids to levels that maintain adequate status. This can be done through direct supplementation of targeted risk groups, food fortification, or a number of dietary approaches that protect breast-feeding and improve the quality of the home diet. See also Anemia Iron-Deficiency Anemia. Breast Feeding. Children Nutritional Requirements Nutritional Problems. Fruits and Vegetables. Malnutrition Primary, Causes Epidemiology and Prevention. Pregnancy Safe Diet for Pregnancy.

New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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