Showing posts with label studies. Show all posts
Showing posts with label studies. Show all posts
Saturday, February 27, 2010
Infant Massage and Preemie Brain Development
Among the often-heard benefits of infant massage is its special benefits for preterm infants. But what does the research say about infant massage for preemies? For the first time, body massage has been shown to affect brain development in human infants, and tactile stimulation has been shown to influence visual development in these babies. A study published in the May 2009 Journal of Neuroscience finds that massage accelerates brain development and the maturation of visual functioning in preterm babies. The research team, working with a cohort of preterm Italian infants with a gestational age between 30 and 33 weeks, found that EEG maturation, as well as visual system development, was accelerated in the massaged infants, compared to their non-massaged control group. Larger studies will be needed to replicate these findings.
Saturday, June 6, 2009
Breastfeeding and Heart Disease
Women who breastfeed are at lower risk for heart disease later in life. Data from nearly 140,000 postmenopausal women (median age 63 years) were studied, as reported in the May 2009 edition of the journal “Obstetrics and Gynecology.” The study authors found that postmenopausal women with a single live birth who breastfed for 7-12 months were significantly less likely to develop cardiovascular disease than women who never breastfed. Among the women, increased duration of lactation was also associated with lower rates of hypertension, diabetes and hyperlipidemia. Access the study online at http://journals.lww.com/greenjournal/Abstract/2009/05000/Duration_of_Lactation_and_Risk_Factors_for.5.aspx.
Friday, May 22, 2009
Even Mildly Premature Infants at Risk for Severe RSV Infection
According to a research report presented earlier this month at the Pediatric Academic Societies (PAS) 2009 Annual Meeting in Baltimore, even mild prematurity increases the risk for severe RSV infection in infants. The team, from Kaiser Permanente's Division of Perinatal Research in California, conducted a retrospective study of over 100,000 infants with gestational age of at least 33 weeks. They found that even babies who were born nearly full-term (at 37 weeks) were at significantly increased risk for serious respiratory syncytial virus (RSV) infections that require medical attention, including hospitalization in some cases. While the team does not determine why even mildly premature infants born just two to three weeks early have such a high risk of RSV infection associated with morbidity. Placing mildly premature infants in an even more precarious position is the fact that RSV prevention with the drug pavlizumab is approved only for the extremely premature baby. For Medscape's coverage of this research and a Canadian registry under development to better understand the use of pavlizumab with preemies, click here. (Free registration is required to view this link.)
Thursday, March 19, 2009
Strong Evidence Base for Benefits of Breastfeeding
New Rochelle, NY, March 19, 2009—Breastfeeding offers irrefutable and long-lasting health benefits for both mother and baby, which are supported by a comprehensive body of scientific research, including original articles and reviews such as those in Breastfeeding Medicine, the peer-reviewed journal of the Academy of Breastfeeding Medicine. The Academy is a global organization of physicians dedicated to the promotion, protection, and support of breastfeeding through education, research, and advocacy ( www.bfmed.org).
According to leaders of the Academy, despite a sound scientific basis for the advantages of breastfeeding, dissenting opinions that aim to discredit breastfeeding, and question its relevance for women, receive exposure in the mass media such as the recent article in The Atlantic. Critics of breastfeeding do a disservice to new mothers around the world who seek the facts about the proven health benefits of breastfeeding as they often misrepresent the scientific findings and wrongly base global recommendations on the experiences and views of select groups of women.
Clinical and basic science research supports the role of breastfeeding in the development of a baby’s immune system and the presence of maternal antibodies protect infants against infection. Artificial feeding is also associated with increased risk of common disorders of early childhood such as ear infections, asthma, skin disorders, digestive problems, and respiratory tract infections. Studies have also linked artificial feeding to increased risk for obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. Mothers benefit as well, and a history of breastfeeding has been associated with a reduced risk of type 2 diabetes and of breast and ovarian cancer.
With this growing body of evidence, and increasing support among health and medical professionals, breastfeeding rates in the U.S. are in fact on the rise. “But we are reminded as articles like this arise that misinformation abounds. Our goal is to continue to educate healthcare professionals to support mothers who understand the singular importance of breastfeeding and choose to do so,” remarks Caroline J. Chantry, MD, President of the Academy.
“The Academy of Breastfeeding Medicine encourages all women to make an informed choice when faced with the question of how to feed their infants based on strong, well-referenced scientific information. The data are compelling, scientific, and reinforced constantly. Breastfeeding for the new mother may not always be easy, but it is important and rewarding for both mother and infant,” says Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine, from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry.
The Academy promotes the development and dissemination of clinical practice guidelines, and offers clinical protocols for the care of breastfeeding mothers and infants which are available on the Agency for Healthcare Research and Quality’s (AHRQ) National Guideline Clearinghouse website. The education of physicians and other healthcare professionals is the continuing goal of its Annual International Meeting; the 2009 Meeting will be held November 5-8 in Williamsburg, VA.
Breastfeeding Medicine is an authoritative, peer-reviewed, multidisciplinary journal published quarterly. The journal publishes original scientific articles, reviews, and case studies on a broad spectrum of topics in lactation medicine. It presents evidence-based research advances and explores the immediate and long-term outcomes of breastfeeding, including the epidemiologic, physiologic, and psychological benefits of breastfeeding. The Academy's complete position statement appears on the Academy website ( www.bfmed.org).
According to leaders of the Academy, despite a sound scientific basis for the advantages of breastfeeding, dissenting opinions that aim to discredit breastfeeding, and question its relevance for women, receive exposure in the mass media such as the recent article in The Atlantic. Critics of breastfeeding do a disservice to new mothers around the world who seek the facts about the proven health benefits of breastfeeding as they often misrepresent the scientific findings and wrongly base global recommendations on the experiences and views of select groups of women.
Clinical and basic science research supports the role of breastfeeding in the development of a baby’s immune system and the presence of maternal antibodies protect infants against infection. Artificial feeding is also associated with increased risk of common disorders of early childhood such as ear infections, asthma, skin disorders, digestive problems, and respiratory tract infections. Studies have also linked artificial feeding to increased risk for obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. Mothers benefit as well, and a history of breastfeeding has been associated with a reduced risk of type 2 diabetes and of breast and ovarian cancer.
With this growing body of evidence, and increasing support among health and medical professionals, breastfeeding rates in the U.S. are in fact on the rise. “But we are reminded as articles like this arise that misinformation abounds. Our goal is to continue to educate healthcare professionals to support mothers who understand the singular importance of breastfeeding and choose to do so,” remarks Caroline J. Chantry, MD, President of the Academy.
“The Academy of Breastfeeding Medicine encourages all women to make an informed choice when faced with the question of how to feed their infants based on strong, well-referenced scientific information. The data are compelling, scientific, and reinforced constantly. Breastfeeding for the new mother may not always be easy, but it is important and rewarding for both mother and infant,” says Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine, from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry.
The Academy promotes the development and dissemination of clinical practice guidelines, and offers clinical protocols for the care of breastfeeding mothers and infants which are available on the Agency for Healthcare Research and Quality’s (AHRQ) National Guideline Clearinghouse website. The education of physicians and other healthcare professionals is the continuing goal of its Annual International Meeting; the 2009 Meeting will be held November 5-8 in Williamsburg, VA.
Breastfeeding Medicine is an authoritative, peer-reviewed, multidisciplinary journal published quarterly. The journal publishes original scientific articles, reviews, and case studies on a broad spectrum of topics in lactation medicine. It presents evidence-based research advances and explores the immediate and long-term outcomes of breastfeeding, including the epidemiologic, physiologic, and psychological benefits of breastfeeding. The Academy's complete position statement appears on the Academy website ( www.bfmed.org).
Wednesday, March 18, 2009
Evidence Increases for Risks in Cesarean Surgery as National Rate Continues to Rise
WASHINGTON (March 18, 2009)— As research continues to mount for the risks of cesarean surgery, the Centers for Disease Control released new, staggering statistics today reporting that 31.8% of women endure birth by cesarean in the United States (2007). This announcement comes after the release of significant findings from the New England Journal of Medicine reinforcing that birth by cesarean surgery before 39 weeks of pregnancy causes increased complications in newborns.
Despite the latest advances in medical technology, health care providers cannot determine a baby’s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman’s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby’s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.
Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies in the NEJM study born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection (sepsis).
“Overuse of cesarean surgery complicates the otherwise natural process of birth,” says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, “Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.”
Spontaneous labor is almost always the best indication for a baby’s physical readiness for life outside of the womb. As one of the key steps to a healthy birth, Lamaze International recommends that women let labor begin on its own. Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth—both of which provide the best start for a baby’s growth and development.
Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE says, “Maternity care in the United States is at a crossroads. The most commonly used practices don’t align with the best evidence for a healthy birth.” The Milbank Report’s Evidence-Based Maternity Care: What It Is and What It Can Achieve reveals that several routine maternity care practices, including cesarean surgery, contradict best evidence and are overused in the United States.
Cesarean surgery—a major abdominal surgery—also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.
Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider. Lamaze International has developed tools to help women with these decisions, including the questions to ask and other reference material. Visit http://magazine.lamaze.org/ to learn more about the Lamaze during pregnancy, birth and beyond.
Despite the latest advances in medical technology, health care providers cannot determine a baby’s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman’s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby’s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.
Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies in the NEJM study born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection (sepsis).
“Overuse of cesarean surgery complicates the otherwise natural process of birth,” says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, “Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.”
Spontaneous labor is almost always the best indication for a baby’s physical readiness for life outside of the womb. As one of the key steps to a healthy birth, Lamaze International recommends that women let labor begin on its own. Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth—both of which provide the best start for a baby’s growth and development.
Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE says, “Maternity care in the United States is at a crossroads. The most commonly used practices don’t align with the best evidence for a healthy birth.” The Milbank Report’s Evidence-Based Maternity Care: What It Is and What It Can Achieve reveals that several routine maternity care practices, including cesarean surgery, contradict best evidence and are overused in the United States.
Cesarean surgery—a major abdominal surgery—also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.
Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider. Lamaze International has developed tools to help women with these decisions, including the questions to ask and other reference material. Visit http://magazine.lamaze.org/ to learn more about the Lamaze during pregnancy, birth and beyond.
Wednesday, February 11, 2009
Tuesday, January 27, 2009
Moms Who Breastfeed Less Likely to Neglect Child
MONDAY, Jan. 26 (HealthDay News) -- Mothers who breast-feed are less likely to neglect their children, Australian researchers report.
In their study, the scientists followed 7,223 Australian women and their children for 15 years and found that the longer a mother breast-fed her child, the lower the risk of neglect.
Mothers who breast-fed for less than four months were twice as likely to neglect their children as those who breast-fed four months or more. Women who didn't breast-feed were 3.8 times more likely to neglect their children as mothers who breast-fed for at least four months.
Even after they adjusted for other factors, such as socioeconomic status, substance abuse and depression, the researchers found a strong association between breast-feeding and motherly care.
The findings were published in the February issue of Pediatrics.
Previous research has suggested how breast-feeding may help form a strong mother-infant bond, study senior author Dr. Lane Strathearn, an assistant professor of pediatrics at Baylor College of Medicine and Texas Children's Hospital, said in a Baylor news release.
"Oxytocin is a critical hormone produced during breast-feeding that promotes and reinforces maternal behavior. Animal studies have shown that this hormone is critical for the initiation of maternal behaviors in animals," Strathearn said. "It may be that breast-feeding stimulates oxytocin production in the brain, helping to develop the attachment relationship of the mother and her baby. Or the factors that help shape the development of the oxytocin system in the brain may predispose to successful breast-feeding and nurturance of the baby."
"Promoting breast-feeding may be a simple and cost-effective way to strengthen the mother-infant relationship. Providing the economic and social support for new mothers to stay at home with their babies may help accomplish this goal. The simple fact that women have such limited maternity leave inhibits them from strengthening this relationship," Strathearn said.
"Maternal neglect represents a fundamental breakdown in the relationship between a mother and her child, as the mom fails to provide the physical and emotional caregiving that an infant requires for optimal development. Breast-feeding may be a natural way to support the mother-infant relationship, reducing the risk of neglect in the long term."
More information
The U.S. National Institute of Child Health and Human Development has more about breast-feeding.
SOURCE: Baylor College of Medicine, news release, Jan. 26, 2009
In their study, the scientists followed 7,223 Australian women and their children for 15 years and found that the longer a mother breast-fed her child, the lower the risk of neglect.
Mothers who breast-fed for less than four months were twice as likely to neglect their children as those who breast-fed four months or more. Women who didn't breast-feed were 3.8 times more likely to neglect their children as mothers who breast-fed for at least four months.
Even after they adjusted for other factors, such as socioeconomic status, substance abuse and depression, the researchers found a strong association between breast-feeding and motherly care.
The findings were published in the February issue of Pediatrics.
Previous research has suggested how breast-feeding may help form a strong mother-infant bond, study senior author Dr. Lane Strathearn, an assistant professor of pediatrics at Baylor College of Medicine and Texas Children's Hospital, said in a Baylor news release.
"Oxytocin is a critical hormone produced during breast-feeding that promotes and reinforces maternal behavior. Animal studies have shown that this hormone is critical for the initiation of maternal behaviors in animals," Strathearn said. "It may be that breast-feeding stimulates oxytocin production in the brain, helping to develop the attachment relationship of the mother and her baby. Or the factors that help shape the development of the oxytocin system in the brain may predispose to successful breast-feeding and nurturance of the baby."
"Promoting breast-feeding may be a simple and cost-effective way to strengthen the mother-infant relationship. Providing the economic and social support for new mothers to stay at home with their babies may help accomplish this goal. The simple fact that women have such limited maternity leave inhibits them from strengthening this relationship," Strathearn said.
"Maternal neglect represents a fundamental breakdown in the relationship between a mother and her child, as the mom fails to provide the physical and emotional caregiving that an infant requires for optimal development. Breast-feeding may be a natural way to support the mother-infant relationship, reducing the risk of neglect in the long term."
More information
The U.S. National Institute of Child Health and Human Development has more about breast-feeding.
SOURCE: Baylor College of Medicine, news release, Jan. 26, 2009
Saturday, January 3, 2009
Impact of Maternity Leave on Breastfeeding
A study published in the January 1st edition of the journal Pediatrics examines the relationship between breastfeeding and maternity leave before and after delivery among working mothers in Southern California. California is one of only five states in the US providing paid pregnancy leave that can be extended for infant bonding. In “Juggling Work and Breastfeeding: Effects of Maternity Leave and Occupational Characteristics,” the study authors assessed whether maternity leave and other occupational characteristics predicted the cessation of breastfeeding.
A maternity leave of less than six weeks or six to 12 weeks after delivery was associated with higher odds of failure to establish breastfeeding. The study authors concluded that, “postpartum maternity leave may have a positive effect on breastfeeding among full-time workers, particularly those who hold nonmanagerial positions, lack job flexibility, or experience psychosocial distress.”
To access the study online, go to http://pediatrics.aappublications.org/cgi/content/abstract/123/1/e38
A maternity leave of less than six weeks or six to 12 weeks after delivery was associated with higher odds of failure to establish breastfeeding. The study authors concluded that, “postpartum maternity leave may have a positive effect on breastfeeding among full-time workers, particularly those who hold nonmanagerial positions, lack job flexibility, or experience psychosocial distress.”
To access the study online, go to http://pediatrics.aappublications.org/cgi/content/abstract/123/1/e38
Saturday, November 1, 2008
Breastfed Baby May Mean Better Behaved Child
By Serena Gordon
HealthDay Reporter
Wednesday, October 29, 2008; 12:00 AM
WEDNESDAY, Oct. 29 (HealthDay News) -- Add yet another potential benefit to breast-feeding: Fewer behavioral problems in young children.
Parents of youngsters who were breast-fed as infants were less likely to report that their child had a behavior problem or psychiatric illness during the first five years of life, a new study found.
And the likelihood of mental health issues decreased in proportion to the duration of breast-feeding, meaning that a child who had been breast-fed for a year was less likely to have behavior problems than a child who had been breast-fed for just two months.
"This is an early finding, but it suggests that breast-feeding during infancy could have an effect on behavior during childhood," said the study's lead author, Dr. Katherine Hobbs Knutson, a resident in the department of psychiatry at Massachusetts General Hospital in Boston.
She was to present the findings Wednesday at the American Public Health Association's annual meeting, in San Diego.
Previous research has shown that breast milk offers numerous benefits for babies and that breast-feeding can benefit both mother and infant. Babies who are breast-fed are less likely to suffer from ear infections, diarrhea, pneumonia, wheezing, and bacterial and viral illnesses, according to the American Academy of Pediatrics (AAP). Research has also linked breast-feeding with a reduced risk of obesity, diabetes, sudden infant death syndrome (SIDS) and certain cancers, according to the AAP.
For mothers, breast-feeding helps the uterus quickly return to its pre-pregnancy shape and helps burn additional calories, which can help get rid of extra pregnancy weight, the AAP reports. Additionally, breast-feeding is believed to help nurture the mother-child bond.
The new study reviewed more than 100,000 interviews of parents and guardians of children between the ages of 10 months and 18 years who participated in the National Survey of Children's Health. Parents were asked about breast-feeding and about their child's behavior and mental health.
Examples of questions included: Are you currently concerned a lot, a little or not at all about how your child behaves? How he/she is learning pre-school or school skills? Has a doctor or health professional ever told you that your child has behavioral or conduct problems?
Parents of children who were breast-fed were 15 percent less likely to be concerned about their child's behavior, compared to formula-fed infants. And the breast-fed children were 37 percent less likely to have a medically diagnosed behavioral or conduct problem, according to the study.
And, Knutson said, the effect of breast-feeding appeared to be cumulative, with those who were breast-fed for a longer duration even less likely to have behavior problems.
She also said the study found "a correlation between breast-feeding and cognitive development." "These findings are certainly intriguing," said Dr. Debra Bogen, a pediatrician in the division of general academic pediatrics at the Children's Hospital of Pittsburgh. The study adds to the "overwhelming evidence that women should, if they can, offer breast milk to their babies," she added.
Both Bogen and Knutson said the nutritional composition of breast milk might have an effect on the way a baby's brain develops, and that better nutrition could explain the behavioral differences. But both experts felt it was too soon to know for sure the exact cause of the potentially protective effect.
More information
For more on the benefits of breast-feeding, visit the National Women's Health Information Center.
SOURCES: Katherine Hobbs Knutson, M.D., resident, department of psychiatry, Massachusetts General Hospital, Boston; Debra Bogen, M.D., pediatrician, division of general academic pediatrics, Children's Hospital of Pittsburgh; Oct. 29, 2008, presentation, American Public Health Association annual meeting, San Diego
HealthDay Reporter
Wednesday, October 29, 2008; 12:00 AM
WEDNESDAY, Oct. 29 (HealthDay News) -- Add yet another potential benefit to breast-feeding: Fewer behavioral problems in young children.
Parents of youngsters who were breast-fed as infants were less likely to report that their child had a behavior problem or psychiatric illness during the first five years of life, a new study found.
And the likelihood of mental health issues decreased in proportion to the duration of breast-feeding, meaning that a child who had been breast-fed for a year was less likely to have behavior problems than a child who had been breast-fed for just two months.
"This is an early finding, but it suggests that breast-feeding during infancy could have an effect on behavior during childhood," said the study's lead author, Dr. Katherine Hobbs Knutson, a resident in the department of psychiatry at Massachusetts General Hospital in Boston.
She was to present the findings Wednesday at the American Public Health Association's annual meeting, in San Diego.
Previous research has shown that breast milk offers numerous benefits for babies and that breast-feeding can benefit both mother and infant. Babies who are breast-fed are less likely to suffer from ear infections, diarrhea, pneumonia, wheezing, and bacterial and viral illnesses, according to the American Academy of Pediatrics (AAP). Research has also linked breast-feeding with a reduced risk of obesity, diabetes, sudden infant death syndrome (SIDS) and certain cancers, according to the AAP.
For mothers, breast-feeding helps the uterus quickly return to its pre-pregnancy shape and helps burn additional calories, which can help get rid of extra pregnancy weight, the AAP reports. Additionally, breast-feeding is believed to help nurture the mother-child bond.
The new study reviewed more than 100,000 interviews of parents and guardians of children between the ages of 10 months and 18 years who participated in the National Survey of Children's Health. Parents were asked about breast-feeding and about their child's behavior and mental health.
Examples of questions included: Are you currently concerned a lot, a little or not at all about how your child behaves? How he/she is learning pre-school or school skills? Has a doctor or health professional ever told you that your child has behavioral or conduct problems?
Parents of children who were breast-fed were 15 percent less likely to be concerned about their child's behavior, compared to formula-fed infants. And the breast-fed children were 37 percent less likely to have a medically diagnosed behavioral or conduct problem, according to the study.
And, Knutson said, the effect of breast-feeding appeared to be cumulative, with those who were breast-fed for a longer duration even less likely to have behavior problems.
She also said the study found "a correlation between breast-feeding and cognitive development." "These findings are certainly intriguing," said Dr. Debra Bogen, a pediatrician in the division of general academic pediatrics at the Children's Hospital of Pittsburgh. The study adds to the "overwhelming evidence that women should, if they can, offer breast milk to their babies," she added.
Both Bogen and Knutson said the nutritional composition of breast milk might have an effect on the way a baby's brain develops, and that better nutrition could explain the behavioral differences. But both experts felt it was too soon to know for sure the exact cause of the potentially protective effect.
More information
For more on the benefits of breast-feeding, visit the National Women's Health Information Center.
SOURCES: Katherine Hobbs Knutson, M.D., resident, department of psychiatry, Massachusetts General Hospital, Boston; Debra Bogen, M.D., pediatrician, division of general academic pediatrics, Children's Hospital of Pittsburgh; Oct. 29, 2008, presentation, American Public Health Association annual meeting, San Diego
Monday, July 7, 2008
UNICEF Features New Findings on Breastfeeding Support
UNICEF’s Baby Friendly Initiative website is featuring two new studies about the importance of providing quality breastfeeding support to new mothers. Published in the Journal of Advanced Nursing and the European Journal of Public Health, these studies take a closer look at interventions that make a positive difference for infants and families in the earliest days after birth – and far beyond. Go to http://www.babyfriendly.org.uk/page.asp?page=13
Saturday, June 14, 2008
Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers
Breastfeeding provides optimal nutrition for infants and is associated with decreased risk for infant and maternal morbidity and mortality (1); however, only four states (Alaska, Montana, Oregon, and Washington) have met all five (2) Healthy People 2010 targets for breastfeeding (3).* Maternity practices in hospitals and birth centers throughout the intrapartum period, such as ensuring mother-newborn skin-to-skin contact, keeping mother and newborn together, and not giving supplemental feedings to breastfed newborns unless medically indicated, can influence breastfeeding behaviors during a period critical to successful establishment of lactation (4--9). In 2007, to characterize maternity practices related to breastfeeding, CDC conducted the first national Maternity Practices in Infant Nutrition and Care (mPINC) Survey. This report summarizes results of that survey, which indicated that 1) a substantial proportion of facilities used maternity practices that are not evidence-based and are known to interfere with breastfeeding and 2) states in the southern United States generally had lower mPINC scores, including certain states previously determined to have the lowest 6-month breastfeeding rates.† These results highlight the need for U.S. hospitals and birth centers to implement changes in maternity practices that support breastfeeding.
Read more from the CDC (including statistics for each state) here
Read more from the CDC (including statistics for each state) here
Wednesday, June 11, 2008
Insurers Denying Coverage, Raising Premiums for Women After C-Section
Last week the New York Times reported on a trend in which some insurers have begun denying individual health coverage to women who have had c-section deliveries, on the basis that these women are likely to undergo the procedure in subsequent births. In these cases, a cesarean section is classified as a pre-existing condition, and some insurers are codifying a provision that excludes coverage for a certain period of time. Many insurers who do accept women with a prior c-section are charging higher premiums because of this history. As the Times reports, many ob/gyns do not deliver VBAC (vaginal birth after cesarean) patients for a host of reasons, including the rare but potentially fatal complication of uterine rupture. The report also notes the disparity in healthcare costs, with c-section deliveries costing patients and insurance companies significantly more than vaginal births.
For the Times story, go to http://www.nytimes.com/2008/06/01/health/01insure.html?_r=1&adxnnl=1&adxnnlx=1212329066-DLrBAsjKWs16k14Tzq/0kw&oref=slogin
For coverage of this issue from the International Cesarean Awareness Network (ICAN), go to http://www.ican-online.org/
For the Times story, go to http://www.nytimes.com/2008/06/01/health/01insure.html?_r=1&adxnnl=1&adxnnlx=1212329066-DLrBAsjKWs16k14Tzq/0kw&oref=slogin
For coverage of this issue from the International Cesarean Awareness Network (ICAN), go to http://www.ican-online.org/
Saturday, June 7, 2008
Prenatal Yoga May Result in Less Labor Pain, Shorter Labor
Chuntharapat, S., Petpichetchian, W., & Hatthakit, U. (2008). Yoga during pregnancy: Effects on maternal comfort, labor pain and birth outcomes. Complementary Therapies in Clinical Practice, 14(2), 105-115. [Abstract]
Summary: In this trial conducted in Thailand, nulliparous pregnant women without previous yoga experience were randomly assigned to practice prenatal yoga (n=37) or to usual care (n=37). The yoga group attended a series of six 1-hour yoga classes every two weeks in the final trimester and were given a booklet and audio tape for self-study, which they were encouraged to practice at least three times per week. Daily diaries kept by participants and weekly phone contact from researchers helped ensure compliance. Participants in both groups completed a prenatal questionnaire to assess anxiety and collect demographic data.
Once in labor, pain and comfort were assessed every 2 hours in the first stage of labor (for a maximum of three measurements) and again 2 hours postpartum using multiple pain-measurement instruments that have previously been validated for use in laboring women. The researchers controlled for maternal age, marital status, education level, religion, income, and maternal trait anxiety.
Data were available for 33 of 37 women assigned to each group but the researchers provide no explanation for this attrition. Although this omission limits the reliability of the study, the strength and consistency of the researchers' findings suggest that attrition probably did not significantly alter results. The experimental group (yoga group) had significantly less pain and more comfort than the control group at each of the three measurement intervals during labor and at the postpartum measurement. This finding was consistent and significant across all three pain main measurement instruments used.
The researchers do not present data about mode of birth. However, the length of the first stage of labor and total duration of labor were significantly shorter in the yoga group (mean length of first stage = 520 minutes in yoga group versus 660 minutes in control group; mean total time in labor 559 minutes in yoga group versus 684 minutes in control group). There were no differences in length of second stage of labor, pethidine usage or dose given, augmentation of labor, newborn weight, or Apgar scores. Epidural analgesia was not mentioned so presumably it was not available.
Significance for Normal Birth: This study provides evidence that regular yoga practice in the last 10-12 weeks of pregnancy improves maternal comfort in labor and may facilitate labor progress. The researchers offer several theories for these effects. First, yoga involves synchronization of breathing awareness and muscle relaxation which decrease tension and the perception of pain. Second, yoga movements, breathing, and chanting may increase circulating endorphins and serotonin, "raising the threshold of mind-body relationship to pain" (p. 112). Third, practicing yoga postures over time alters pain pathways through the parasympathetic nervous system, decreasing one's need to actively respond to unpleasant physical sensations.
Prenatal strategies that help women prepare emotionally and physically for labor may help reduce pain and suffering and optimize wellbeing in childbirth by providing coping skills and increasing self-confidence and a sense of mastery. More research is needed to confirm the findings of this study. However, yoga's many health benefits and the lack of evidence that yoga is harmful in pregnancy or birth provide justification for encouraging interested women to incorporate yoga into their preparations for childbirth.
Summary: In this trial conducted in Thailand, nulliparous pregnant women without previous yoga experience were randomly assigned to practice prenatal yoga (n=37) or to usual care (n=37). The yoga group attended a series of six 1-hour yoga classes every two weeks in the final trimester and were given a booklet and audio tape for self-study, which they were encouraged to practice at least three times per week. Daily diaries kept by participants and weekly phone contact from researchers helped ensure compliance. Participants in both groups completed a prenatal questionnaire to assess anxiety and collect demographic data.
Once in labor, pain and comfort were assessed every 2 hours in the first stage of labor (for a maximum of three measurements) and again 2 hours postpartum using multiple pain-measurement instruments that have previously been validated for use in laboring women. The researchers controlled for maternal age, marital status, education level, religion, income, and maternal trait anxiety.
Data were available for 33 of 37 women assigned to each group but the researchers provide no explanation for this attrition. Although this omission limits the reliability of the study, the strength and consistency of the researchers' findings suggest that attrition probably did not significantly alter results. The experimental group (yoga group) had significantly less pain and more comfort than the control group at each of the three measurement intervals during labor and at the postpartum measurement. This finding was consistent and significant across all three pain main measurement instruments used.
The researchers do not present data about mode of birth. However, the length of the first stage of labor and total duration of labor were significantly shorter in the yoga group (mean length of first stage = 520 minutes in yoga group versus 660 minutes in control group; mean total time in labor 559 minutes in yoga group versus 684 minutes in control group). There were no differences in length of second stage of labor, pethidine usage or dose given, augmentation of labor, newborn weight, or Apgar scores. Epidural analgesia was not mentioned so presumably it was not available.
Significance for Normal Birth: This study provides evidence that regular yoga practice in the last 10-12 weeks of pregnancy improves maternal comfort in labor and may facilitate labor progress. The researchers offer several theories for these effects. First, yoga involves synchronization of breathing awareness and muscle relaxation which decrease tension and the perception of pain. Second, yoga movements, breathing, and chanting may increase circulating endorphins and serotonin, "raising the threshold of mind-body relationship to pain" (p. 112). Third, practicing yoga postures over time alters pain pathways through the parasympathetic nervous system, decreasing one's need to actively respond to unpleasant physical sensations.
Prenatal strategies that help women prepare emotionally and physically for labor may help reduce pain and suffering and optimize wellbeing in childbirth by providing coping skills and increasing self-confidence and a sense of mastery. More research is needed to confirm the findings of this study. However, yoga's many health benefits and the lack of evidence that yoga is harmful in pregnancy or birth provide justification for encouraging interested women to incorporate yoga into their preparations for childbirth.
Friday, June 6, 2008
Is Iron Supplementation Necessary for Infants?
insightful information from Dr. Thomas Hale
http://www.ibreastfeeding.com/currentnewsletter.pdf
http://www.ibreastfeeding.com/currentnewsletter.pdf
Tuesday, May 27, 2008
ACNM Recommends Against Routinely Restricting Food & Drink During Labor
The American College of Nurse-Midwives has published a new Clinical Bulletin reviewing evidence on providing oral nutrition to women during labor. The guidelines recommend that drinking and eating during labor can provide women with the energy they need, and should not be routinely restricted. Currently, most American hospitals still have policies in place that restrict women’s oral intake during labor, and the debate over these policies has focused on concerns about possible detrimental effects of fasting on the labor process versus the risk of aspiration if general anesthesia becomes necessary. The new ACNM bulletin reviews recent randomized controlled trials, effects of fasting during labor, and risks of aspiration. They recommend that considerations must take into account the health status of the woman, the risk of surgical intervention and the system in which the woman is giving birth. To download the complete bulletin, go to http://www.midwife.org/siteFiles/news/ACNM_Clinical_Guidelines_on_Nutrition_in_Labor.pdf
Thursday, March 20, 2008
ILCA Releases Position on Breastfeeding and Work
The International Lactation Consultant Association (ILCA) announced today the release of its official position paper, "Position on Breastfeeding and Work," calling on employers, policymakers, and organizations that serve new families to improve the support that new mothers need to continue breastfeeding.
According to Rebecca Mannel, president of the ILCA Board of Directors, "The benefits of breastfeeding have been widely known for many years now, which has resulted in the majority of women now making the choice to breastfeed. Yet many mothers struggle to continue breastfeeding once they return to work. Some mothers quit within their first few weeks back at work because of challenges within the worksite itself such as no privacy or break time for expressing milk. Other mothers quit before they even return to work because they assume they cannot continue breastfeeding due to their job. ILCA believes that a woman’s right to work should not interfere with her additional right to provide optimal nutrition for her children."
According to Mannel, the steps to creating a supportive environment are simple and include allowing women to take needed breaks to regularly express milk every 2 or 3 hours, and a place to do so in privacy. Providing support and information to employees, along with information and access to International Board Certified Lactation Consultants (IBCLCs) if concerns arise, has also been proven to make a difference.
"The benefits to employers are significant," says Mannel. "The research is very clear that because breastfed infants are healthier, their mothers are not absent from work as often. The healthcare savings to the company and the savings from having workers stay at work can be significant to the business," she says. In addition, employee retention is higher as breastfeeding mothers who are supported in the workplace are more likely to return to their jobs after maternity leave ends.
Several studies of companies providing corporate lactation programs have confirmed the cost savings. For example, one company, CIGNA, studied the impact of their lactation program which enrolled 343 employees, and found the program saved their company $240,000 in healthcare costs, $62,000 savings in prescriptions annually, and an annual savings of $60,000 in lower employee absenteeism rates.
Mannel says that a growing number of companies are beginning to implement similar programs. Yet the practice is not widespread. Mannel believes that with greater education about the benefits, more employers will establish policies and practices that
allow breastfeeding employees to continue breastfeeding as long as they wish. Many state and national governments (including a dozen U.S. states) now provide laws that encourage or require employers to provide workplace accommodations for breastfeeding.
ILCA’s position on working and breastfeeding is available as a free download at their website at: http://www.ilca.org/BreasfeedingandWorkPP.pdf.
According to Rebecca Mannel, president of the ILCA Board of Directors, "The benefits of breastfeeding have been widely known for many years now, which has resulted in the majority of women now making the choice to breastfeed. Yet many mothers struggle to continue breastfeeding once they return to work. Some mothers quit within their first few weeks back at work because of challenges within the worksite itself such as no privacy or break time for expressing milk. Other mothers quit before they even return to work because they assume they cannot continue breastfeeding due to their job. ILCA believes that a woman’s right to work should not interfere with her additional right to provide optimal nutrition for her children."
According to Mannel, the steps to creating a supportive environment are simple and include allowing women to take needed breaks to regularly express milk every 2 or 3 hours, and a place to do so in privacy. Providing support and information to employees, along with information and access to International Board Certified Lactation Consultants (IBCLCs) if concerns arise, has also been proven to make a difference.
"The benefits to employers are significant," says Mannel. "The research is very clear that because breastfed infants are healthier, their mothers are not absent from work as often. The healthcare savings to the company and the savings from having workers stay at work can be significant to the business," she says. In addition, employee retention is higher as breastfeeding mothers who are supported in the workplace are more likely to return to their jobs after maternity leave ends.
Several studies of companies providing corporate lactation programs have confirmed the cost savings. For example, one company, CIGNA, studied the impact of their lactation program which enrolled 343 employees, and found the program saved their company $240,000 in healthcare costs, $62,000 savings in prescriptions annually, and an annual savings of $60,000 in lower employee absenteeism rates.
Mannel says that a growing number of companies are beginning to implement similar programs. Yet the practice is not widespread. Mannel believes that with greater education about the benefits, more employers will establish policies and practices that
allow breastfeeding employees to continue breastfeeding as long as they wish. Many state and national governments (including a dozen U.S. states) now provide laws that encourage or require employers to provide workplace accommodations for breastfeeding.
ILCA’s position on working and breastfeeding is available as a free download at their website at: http://www.ilca.org/BreasfeedingandWorkPP.pdf.
Wednesday, March 5, 2008
Planned Cesarean Surgery Is No Safer for Breech Births
Despite one study's conclusion that planned cesarean surgery results in superior outcomes for babies and equivalent outcomes for mothers, flaws in this research indicate otherwise. In "When Research is Flawed," obstetric research expert Henci Goer finds several problems in how the Hannah study—a randomized trial to compare planned cesarean surgery vs. planned vaginal birth for breech births—was conducted and its interpretations of the results.
Other studies, based on a good selection of patients, contradict these findings and report that with a good selection of patients, properly trained medical staff and careful management during labor, vaginal birth is safe for breech babies.
"When Research is Flawed," developed by the Lamaze Institute for Normal Birth, provides brief critiques of some of the most influential research studies published on topics that shape and affect policy and practice in maternal-child health care, such as breech birth. These research study critiques help childbirth professionals evaluate the quality of evidence and communicate that evidence to expectant parents, who may be misled or confused by information they receive from the media.
Read the complete critique on the Hannah study on breech birth, as well as critiques of studies on epidural analgesia, home birth, induction of labor and vaginal birth after cesarean (VBAC) at "When Research is Flawed" on the Research page of www.lamaze.org.
Other studies, based on a good selection of patients, contradict these findings and report that with a good selection of patients, properly trained medical staff and careful management during labor, vaginal birth is safe for breech babies.
"When Research is Flawed," developed by the Lamaze Institute for Normal Birth, provides brief critiques of some of the most influential research studies published on topics that shape and affect policy and practice in maternal-child health care, such as breech birth. These research study critiques help childbirth professionals evaluate the quality of evidence and communicate that evidence to expectant parents, who may be misled or confused by information they receive from the media.
Read the complete critique on the Hannah study on breech birth, as well as critiques of studies on epidural analgesia, home birth, induction of labor and vaginal birth after cesarean (VBAC) at "When Research is Flawed" on the Research page of www.lamaze.org.
Tuesday, February 26, 2008
One-Third of All United States Births are by Cesarean Section
According to a survey recently released by the US Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ), one-third of births in the United States were by cesarean section in the year 2005. That’s 1.3 million c-section births in 2005, up from the 800,000 c-section births nationwide in 1995. The report finds that vaginal deliveries among women who gave birth in hospitals declined by 3 percent between 1995 and 2005, and that vaginal births after cesareans (VBACs) dropped by 60 percent over the same decade. The report is based on data from AHRQ’S Healthcare Costs and Utilization Project. AHRQ analyst Anne Elixhauser has been quoted by Congressional Quarterly as saying that the cesarean increase is due, at least in part, to growing risk-aversion among obstetricians. To download the complete report as a PDF, go to http://www.hcup-us.ahrq.gov/reports/annualreport/HAR_2005.pdf
Tuesday, February 19, 2008
Coalition Responds to Findings on Baby Product Toxins
A coalition of public health and environmental NGOs is calling for a moratorium on Bisphenol A (BPA) in baby bottles, food and beverage containers, based on the results of a new study’s findings that the toxic chemical leaches from plastics when heated. The study, commissioned by Environmental Defense of Canada and researched in the lab of University of Missouri faculty, found that when new bottles are heated, those manufactured by Avent, Evenflo, Dr. Brown’s and Disney/First Years leached significant amounts of BPA. And recent animal research suggests that even BPA levels lower than these may disrupt normal child development. The synthetic sex hormone, which mimics estrogen and is used to make hard polycarbonate plastic, is used in the making of approximately 95 percent of all baby bottles on the US market. To date, nine states are considering legislation to restrict the use of BPA in children’s products: California, Connecticut, Hawaii, Maine, Maryland, Massachusetts, Minnesota, New York and Pennsylvania. To learn more and download the study, go to http://www.chej.org/BPA_Website.htm.
Tuesday, February 12, 2008
Subscribe to:
Posts (Atom)
