Orthodontic treatment during pregnancy, lactation, and postmenopausal period: a questionnaire development

Abstract This study aimed to develop and validate a self-administered questionnaire in Brazilian Portuguese to verify the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women, named "Considerations on Orthodontic Treatment during Pregnancy, Lactation, and Postmenopausal Periods." The development and validation of the questionnaire consisted of the following steps: a) item generation; b) item reduction; c) questionnaire design; and d) validity and reliability tests in a cross-sectional study with 258 orthodontists working in the field from different Brazilian states. A total of 60 orthodontists participated in test-retest over a mean period of 45 days. The preliminary questionnaire consisted of a total of 60 questions. After item reduction, 40 questions were selected for the final version of the questionnaire, with eight questions about pregnant women; six about lactating women; 18 about postmenopausal women, and eight about general knowledge in dentistry. Each item had three response options in the Likert scale format. Face and content validity analysis, reliability assessment through internal consistency (Cronbach's alpha and McDonald's omega), and test-retest reliability through the intraclass correlation coefficient (ICC) and Spearman's correlation coefficient were performed. Face and content validity indicated that the questionnaire was considered valid, objective, and easily understandable. The questionnaire had good internal consistency (Cronbach's alpha = 0.77; McDonald's omega = 0.78) and good test-retest reliability (ICC = 0.71; Spearman's correlation coefficient = 0.51). The questionnaire was considered valid and reliable to assess the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women.

Ingesta dietética y patrón alimentario de las mujeres en periodo de gestación y lactancia de los pueblos indígenas de Colombia. Problemática que requiere urgente atención

Objetivo: Analizar el patrón alimentario y el riesgo de deficiencia en la ingesta usual de energía y nutrientes de las mujeres gestantes y lactantes de algunos pueblos indígenas. Metodología: Estudio descriptivo transversal, con información del componente de ingesta dietética tomada del Estudio nacional de la situación alimentaria y nutricional de los pueblos indígenas de Colombia, realizado entre 2013 y 2019, que incluyó 1028 mujeres indígenas gestantes (319) y lactantes (709), de las regiones norte y sur del país. Resultados: Se encontró una proporción superior al 90 % (Desviación estándar = 0,04) de gestantes y lactantes con consumo inferior al recomendado de calorías (p= 0,038). Alrededor del 70 % de las gestantes y lactantes no consumió lácteos el día anterior a la encuesta, y 50 % no consumió frutas y verduras. Con respecto a los micronutrientes, se encontraron, en las gestantes y lactantes, altas prevalencias del riesgo de deficiencia en la ingesta de vitamina C (50,3 y 80,2 %), folatos (80,4 y 95,1 %), zinc (87,6 y 96,3 %), hierro (88,9 y 68,6 %) y calcio (87,5 y 98,5 %). Conclusión: El consumo de alimentos y nutrientes en las mujeres indígenas gestantes y lactantes es deficiente en nutrientes claves para mantener su estado de salud y proporcionar los nutrientes necesarios a su bebé, y su patrón alimentario se clasifica como no saludable.

Objective: To analyze the dietary pattern and deficiency risk in the usual energy and nutrient intake of pregnant and lactating women from some indigenous peoples. Methodology: Cross-sectional descriptive study, with information from the dietary intake component taken from the National Survey of the food and nutritional situation of indigenous peoples in Colombia, conducted between 2013 and 2019, which included 1,028 pregnant (319) and lactating (709) indigenous women from the northern and southern regions of the country. Results: A proportion higher than 90% (SD = 0.04) of pregnant and lactating women with lower than recommended calorie intake was found (p = 0.038). Around 70% of pregnant and lactating women had no any dairy products the day before the survey, and 50% did not eat fruits and vegetables. Regarding micronutrients, high prevalence of deficiency risk in the intake of vitamin C (50.3 and 80.2%), folate (80.4 and 95.1%), zinc (87.6 and 96.3%), iron (88.9 and 68.6%) and calcium (87.5 and 98.5%) was found in pregnant and lactating women. Conclusion: Food and nutrient intake in pregnant and lactating indigenous women is deficient in key nutrients to maintain their general health and provide the necessary nutrients to their babies. Their dietary pattern is considered unhealthy.

Objetivo: Analisar o padrão alimentar e o risco de deficiência na ingestão usual de energia e nutrientes das mulheres gestantes e lactantes de alguns povos indígenas. Metodologia: Estudo descritivo transversal, com informação do componente de ingesta dietética tirada do Estudo nacional da situação alimentar e nutricional dos povos indígenas da Colômbia, realizado entre 2013 e 2019, que incluiu 1028 mulheres indígenas gestantes (319) e lactantes (709) das regiões norte e sul do país. Resultados: Encontrou-se uma proporção superior a 90% (Desvio-padrão = 0,04) de gestantes e lactantes com consumo inferior ao recomendado em calorias (p = 0,038). Ao redor de 70% das gestantes e lactantes não consumiu lácteos no dia prévio à enquete, e 50% não consumiu frutas e verduras. No que se refere aos micronutrientes, acharam-se nas gestantes e lactantes altas prevalências de risco de deficiência na ingestão de vitamina C (50,3 e 80,2 %), folatos (80,4 e 95,1 %), zinco (87,6 e 96,3 %), ferro (88,9 e 68,6 %) e cálcio (87,5 e 98,5 %). Conclusão: O consumo de alimentos e nutrientes nas mulheres indígenas gestantes e lactantes é deficiente em nutrientes-chave para manter seu estado de saúde e proporcionar os nutrientes necessários para o bebê; seu padrão alimentar classifica-se como não saudável.

Mecanismos neuroendocrinos a la base de la asociación entre salud mental materna y lactancia / Neuroendocrine mechanisms underlying the association between maternal mental health and breastfeeding

La lactancia materna es fundamental para la salud del infante y se ve influida por diversos factores, entre ellos la salud mental materna. En particular, las madres que tienen síntomas depresivos tienen mayor riesgo de presentar dificultades de lactancia y de interrumpir tempranamente la lactancia exclusiva y la lactancia en general. Por otra parte, la lactancia materna actúa como un factor protector de la salud mental materna en algunas circunstancias, en tanto las dificultades de lactancia tienen un impacto negativo en la salud mental de la mujer. La presente revisión describe algunos de los mecanismos fisiológicos que subyacen al establecimiento y la mantención de la lactancia, asociados a la prolactina, la oxitocina, la dopamina y la serotonina, así como a la experiencia de la lactancia y la presencia de dificultades en esta área, y como estas interactúan con las dificultades emocionales de la madre. Se ofrece un modelo integrativo que considera aspectos hormonales y fisiológicos para comprender la asociación compleja y bidireccional entre el establecimiento de una lactancia exitosa y la salud mental materna.

Breastfeeding is essential for infant health and development. It is influenced by multiple factors, including maternal mental health. In particular, mothers who present depressive symptoms are at greater risk of presenting breastfeeding difficulties and presenting shorter exclusive breastfeeding and breastfeeding in general. On the other hand, breastfeeding acts as a protective factor for maternal mental health in some circumstances. Also, breastfeeding difficulties have a negative impact on womens mental health. This review describes some of the physiological mechanisms underlying the establishment and maintenance of lactation, associated with prolactin, oxytocin, dopamine, and serotonin. As well as how the lactation experience and the presence of difficulties in this area interact with the mothers emotional functioning. An integrative model is proposed, which considers hormonal and physiological aspects involved in the complex and bidirectional association between breastfeeding successful establishment and maternal mental health.

Consumo alimentario en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años. Centros de salud ciudad de La Paz - área urbana, 2018 / Food consumption in pregnant women, breastfeeding women and children from 0 to 5 years old. La Paz city health centers - urban area, 2018

OBJETIVO: Determinar el consumo de alimentos en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años, atendidos en Centros de Salud de Primer Nivel en la ciudad de La Paz en el mes de septiembre de 2018. MATERIAL Y MÉTODOS: Estudió transversal descriptivo correlacional en 126 mujeres embarazadas, 120 mujeres que dan de lactar, 105 niños de 0 a 5 meses y 117 niños de 6 a 60 meses, que asistieron a consulta en Centros de Salud. Se aplicó el método de Recordatorio de 24 Horas (R24H) para determinar el consumo de alimentos, método antropométrico para la evaluación nutricional. RESULTADOS: La ingesta promedio en mujeres embarazadas 1999 kcal y mujeres que dan de lactar 1943 Kcal, es menor a la recomendada; inadecuada en grasas, calcio y zinc; suficiente en proteínas, hidratos de carbono, vitaminas A y C; el hierro es deficiente en embarazadas. Los niveles de adecuación de la dieta en niños de 6 a 23 meses en calcio 88,3%, hierro 75%. De 24 a 60 meses en: calorías 86,3%, grasas 46,9% y zinc 50,6%. CONCLUSIONES: El consumo promedio observado en mujeres y niños es inferior a las recomendaciones nutricionales. El estado nutricional no corresponde al exceso o déficit en la ingesta. La ingesta deficiente de micronutrientes, es debida al consumo insuficiente de verduras y frutas.

Prevalência de aleitamento materno exclusivo e fatores associados em um município do extremo sul catarinense / Prevalence of exclusive breastfeeding and associated factors in a city of southern of Santa Catarina State, Brazil

Identificar a prevalência de aleitamento materno exclusivo e fatores relacionados durante os seis primeiros meses de vida do lactente. Trata-se de um estudo transversal realizado com 102 nutrizes residentes no município de Balneário Gaivota(SC) que efetivaram o pré-natal na rede pública ou privada e tiveram parto no ano de 2018. Os dados foram coletados por aplicação de questionário contemplando as variáveis sociodemográficas, gestacionais e pós-gestacionais. A prevalência de aleitamento materno exclusivo foi de 43,1%. Aqueles bebês que usavam mamadeira tiveram 45% menos probabilidade de ter recebido aleitamento materno exclusivo até os 6 meses de idade, e aqueles que receberam prescrição de fórmula infantil na alta hospitalar apresentaram 54% menos chance comparados aos seus pares. Os fatores relacionados ao aleitamento materno exclusivo são comportamentais e modificáveis, sendo necessária a orientação pelos profissionais de saúde durante a consulta pré-natal, puericultura e no acompanhamento do desenvolvimento infantil.

To identify the prevalence of exclusive breastfeeding and its related factors during the first six months of the infant's life. This is a cross-sectional study carried out with 102 nursing mothers residing in the city of Balneário Gaivota( SC) who performed prenatal care in the public or private network and gave birth in 2018. Data were collected by application of a questionnaire and included sociodemographic, gestational and post-gestational variables. The prevalence of exclusive breastfeeding was 43.1%. Those babies who used a bottle were 45% less likely to have been exclusively breastfed up to six months of age, and those who were prescribed infant formula at hospital discharge were 54% less likely compared to their peers. Factors related to exclusive breastfeeding are behavioral and modifiable, thus, guidance by health professionals is necessary during prenatal and childcare consultations and in the monitoring of child development.

Safety and Efficacy of a Combination of Amino Acids in Insufficient Lactating Mothers

Milk production of the mammary gland is mainly determined by the milk synthesis and proliferation abilities of mammary epithelial cells (MECs). The availability of amino acids is critical for the production of milk. Amino acids enhance milk protein synthesis and mammary gland development through the mechanistic target of rapamycin (mTOR) pathway. Taurine enhances lactation by increasing prolactin secretion. Vitamins such as Thiamine and Pyridoxine are essential for maintaining and growing maternal and child health. However, there is a paucity of data regarding the safety and efficacy of amino acids and vitamins combination in lactating mothers with insufficient lactation. Hence, a prospective study was conducted to assess the safety and efficacy of a novel amino acids and vitamins combination. The results showed that with the intervention of this combination, 62% of participants showed onset of lactation within 45 minutes to 2 hours. The study suggests clinicians should consider this novel combination to improve lactation in insufficient lactating mothers

A study of the influence of the level of transvaginal birth experience on the timing of postpartum lactation initiation / 中国实用护理杂志

Objective:To investigate the current status of women′s level of birth experience and lactation initiation time and explore the effect of level of birth experience on lactation initiation time.Methods:This was a cross-sectional study. A convenience sampling method was used to select 622 maternal cases attending the Affiliated Hospital of Jining Medical College from November, 2020 to January, 2021, and the distribution of their labor experience level and lactation initiation time was investigated by questionnaire and follow-up assessment.Results:There were 622 women with transvaginal deliveries who had lactation initiation times of more than 72 h in 241 cases (38.75%). The scores for each dimension of the Childbirth Experience Questionnaire (CEQ) were (49.63 ± 8.58)points, and the scores for each dimension of CEQ were perceived safety, professional support, involvement and self-efficacy in descending order. The results of the correlation analysis showed that there was a negative correlation between the scores on each dimension of CEQ and the total score and lactation initiation time ( r values were -0.436 to -0.146, all P<0.01). Stratified regression analysis showed that after controlling for age, number of births, gestational weeks of labour, illness during pregnancy and labour analgesia as the underlying variables affecting lactation initiation time, the scores for self-efficacy, involvement, perceived safety and professional support in the CEQ all affected lactation initiation time after delivery ( t values were -6.76 to -2.02, all P<0.05). Conclusions:The birth experience and lactation of women who deliver via vaginal birth need to be taken into account. The more negative the birth experience, the longer the lactation initiation time. The women′s involvement in the birth process, their own competence, perceived safety and level of professional support are all valid influencing indicators of lactation initiation time.

Cursos online sobre aleitamento materno como estratégia para melhoria da qualidade assistencial: revisão de escopo / Online courses on breastfeeding as a strategy to improve the quality of care: a scoping review / Cursos en línea sobre lactancia materna como estrategia para mejorar la calidad de la atención: una revisión de alcance

Objetivo: analisar a produção científica sobre cursos online sobre aleitamento materno como estratégia para melhoria da qualidade assistencial. Métodos: Revisão de escopo, baseada no método proposto pelo Joanna Briggs Institute.As bases eletrônicas de dados utilizadas foram: PubMed; LILACS; CINAHL; SCOPUS; Web of Science; BDENF e EMBASE, publicados de 2015 a 2020. Resultados: De um total de 961 resumos, 15 artigos foram selecionados e lidos na íntegra, com inclusão de 9. As publicações ocorreram entre 2011 e 2020, com amostras entre 54 a 26.009 participantes. Em apenas 5 estudos (55,6%) utilizou-se algum método de avaliação da aprendizagem e a estratégia mais usada foi a aplicação de pré e pós teste. Conclusão: A escassez de estudos a respeito de cursos online sobre aleitamento materno para melhoria da qualidade assistencial evidencia uma lacuna de conhecimento sobre o tema. Também se constatou a necessidade de melhorar a descrição metodológica dos estudos publicados.

Objective: to analyze the scientific production on online courses on breastfeeding as a strategy to improve the quality of care.Methods: a scoping review, based on the method proposed by the Joanna Briggs Institute.The electronic databases used were: PubMed; LILACS; CINAHL; SCOPUS; Web of Science; BDENF and EMBASE, published from 2015 to 2020. Results: 961 abstracts were read, 15 articles in full for the final inclusion of 9 articles. The publications occurred between 2011 and 2020, their samples ranged from 54 to 26009 participants. In only 5 studies (55.6%) some method of learning assessment was used and the most used strategy was the application of pre and post test. Conclusion: the scarcity of studies on online courses on breastfeeding as a strategy to improve the quality of care shows a gap in knowledge on the subject. It was also found the need to improve the methodological description of the published studies.

Objetivo: analizar la producción científica sobre cursos online en aleatoriedad materna como estrategia para mejorar la calidad asistencial. Métodos: Revisión de escopo, basada en el método propuesto por el Instituto Joanna Briggs.Las bases de datos electrónicas utilizadas fueron: PubMed; LILACS; CINAHL; SCOPUS; Web of Science; BDENF y EMBASE, publicadas desde 2015 hasta 2020. Resultados: Se leyeron 961 resúmenes, 15 artículos completos para la inclusión final de 9 artículos. Las publicaciones se produjeron entre 2011 y 2020, sus muestras oscilaron entre 54 y 26009 participantes. Sólo en 5 estudios (55,6%) se utilizó algún método de evaluación del aprendizaje y la estrategia más utilizada fue la aplicación de pre y postest. Conclusión: La escasez de estudios a propósito de los cursos online sobre el aleitamento materno como estrategia para la mejora de la calidad asistencial evidencia una laguna de conocimiento sobre el tema. También se constató la necesidad de mejorar la descripción metodológica de los estudios publicados.

Experiencia de lactancia humana frente a condiciones crónicas complejas / Human lactation experience facing complex chronic conditions

La alimentación es una actividad central de la vida de una familia. Es por lo que se enfatiza la primera forma de alimentación, que es la lactancia humana. En si misma posee beneficios ampliamente conocidos, más aún en bebés con condiciones de salud adversas. Se cree pertinente hacer foco en que estos bebés considerados frágiles por su condición de salud se benefician en aspectos por ejemplo en relación con el confort frente a las prácticas que muchas veces salvaguardan la vida, pero podrían dejar una experiencia de displacer. (Kerzner et al., 2015; Milano, Chatoor & Kerzner, 2019) Objetivo: conocer la experiencia de personas que pudieron o no amamantar a sus bebés con alguna condición crónica compleja o discapacidad. Y a su vez, profundizar acerca de los apoyos, facilitadores, limitaciones y/o dificultades en el camino de la lactancia. Metodología: Estudio observacional y transversal a través de encuestas voluntarias. Participaron personas mayores de edad con al menos un hijo de entre 0 a 15 años al momento de la encuesta con alguna condición médica. Resultados: Se destacan un total de 124 encuestados. La experiencia de lactancia fue muy variada: un 42,5% dificultosa, un 25,8% por el contrario la describió como placentera. Según los encuestados, un 41% refirió problemas de succión y el 26% refirió de deglución. A su vez surgió la falta de información en un 20% y un 9% refirió que les ofrecieron biberón sin antes probar con alguna forma de lactancia humana. Conclusión: Se cree fundamental poder visibilizar diferentes experiencias de lactancias tal y como plantean muchas familias el rol de fonoaudiólogos y puericultoras como agentes de salud más la información es de vital importancia. Este tipo de información, permite a los profesionales de salud tener en cuenta diferentes miradas y experiencias, esto visibiliza las problemáticas y jerarquiza el rol profesional de los agentes involucrados en la lactancia humana dentro del equipo interdisciplinario

Mealtime is a central activity in the life of a family. This is why the first form of feeding is emphasized, which is human lactation. It has widely known benefits, even more so in babies with adverse health conditions. It is believed pertinent to focus on the fact that these babies considered fragile due to their health condition benefit in aspects, for example, in relation to comfort compared to practices that often safeguard life but could leave an unpleasant experience. (Kerzner et al., 2015; Milano, Chatoor & Kerzner, 2019) Aim: Know the experience of people who could or could not breastfeed their babies with some condición crónica compleja or disability. And in turn, deepen about the supports, facilitators, limitations and / or difficulties in the path of breastfeeding. Methodology: Observational and cross-sectional study through voluntary surveys. People of legal age with at least one child between 0 and 15 years old at the time of the survey with some medical condition participated. Results: a total of 124 respondents stand out. The breastfeeding experience was very varied: 42.5% difficult, 25.8%, on the contrary, described it as pleasant. According to those surveyed, 41% reported sucking problems and 26% reported swallowing problems. In turn, the lack of information arose in 20% and 9% reported that they were offered a bottle without first trying some form of human breastfeeding. Conclusion: It is believed that it is essential to be able to visualize different breastfeeding experiences, as many families consider, the role of speech pathologists and childcare workers as health agents plus information is of vital importance. This type of information allows health professionals to take into account different views and experiences; this makes the problems visible and prioritizes the professional role of the agents involved in human lactation within the interdisciplinary team.

Autoeficácia e desfechos da amamentação em mães de bebês prematuros e a termo: um estudo longitudinal / Self-efficacy and breastfeeding outcomes in mothers of premature and term infants: a longitudinal study

RESUMO Objetivo Analisar a autoeficácia da amamentação, no período de 180 dias, em mães de recém-nascidos prematuros e a termo, e conhecer os fatores que influenciam na prática do aleitamento materno exclusivo no período de recomendação exclusiva. Método Coorte realizado com 44 puérperas de uma maternidade pública, entre janeiro e outubro de 2018. As puérperas foram divididas em dois grupos: Grupo Prematuro e Grupo Termo. A Breastfeeding Self-efficacy Scale foi aplicada no pós-parto imediato, além de um questionário elaborado pelos autores para coleta de variáveis sociodemográficas e obstétricas. O monitoramento da continuidade do aleitamento materno foi feito no 30º, 120º e 180º dia de vida do neonato, via telefone. Para a análise estatística entre os grupos foi utilizado o Statistical Package for the Social Sciences (SPSS). Resultados Não houve diferença na pontuação da autoeficácia, nas características obstétricas e socioeconômicas entre os grupos, exceto para a variável renda familiar, (menor no Grupo Prematuro - p=0,031). O tipo de dieta foi diferente no 30º dia pós parto (p=0,023), com maior adesão ao aleitamento materno exclusivo no Grupo Prematuro. Não foi encontrada associação entre a autoeficácia da amamentação e a prática do aleitamento materno exclusivo no período de 180 dias. Conclusão Nesta amostra, a autoeficácia da amamentação não teve relação com a prática do aleitamento materno exclusivo no período de 180 dias em ambos os grupos. O grupo de prematuros apresentou menor renda familiar e maior adesão ao aleitamento materno exclusivo no 30º dia pós parto.

ABSTRACT Purpose To analyze the breastfeeding self-efficacy in mothers of premature and full-term newborns, in the period of 180 days, and to know the social and obstetric factors that influence the practice of maintaining the exclusive breastfeeding in the period of exclusive recommendation. Methods Cohort with 44 mothers admitted to a public maternity hospital between January and October 2018. The mothers were divided into two groups: Premature and Full-term Groups. The Breastfeeding Self-efficacy Scale was applied in the immediate postpartum period, in addition to a questionnaire elaborated by the authors to collect sociodemographic and obstetric variables. The follow-up was done on the 30th, 120th and 180th days of the newborn's life, by telephone. For the statistical analysis between the groups, the Statistical Package for the Social Sciences (SPSS) was used. Results There was no difference in the self-efficacy score, nor in the obstetric and socioeconomic characteristics between the groups, except for family income (lower in the Premature Group - p = 0.031). The diet type was different on the 30th day after delivery (p = 0.023), with greater adherence to the exclusive breastfeeding in the Premature Group. No association was found between breastfeeding self-efficacy and exclusive breastfeeding practice in the 180-day period. Conclusion In this sample, the breastfeeding self-efficacy was not related to the exclusive breastfeeding practice in the period of 180 days, in both groups. The premature group showed lower family income and greater adherence to exclusive breastfeeding on the 30th day postpartum.

Video clip for learning the physiology of lactation: evaluation by the family support network for breastfeeding women / Videoclip para aprender la fisiología de la lactancia: evaluación realizada por la red de apoyo familiar para mujeres en lactancia / Videoclipe para aprendizagem da fisiologia da lactação: avaliação pela rede de apoio familiar às lactantes

ABSTRACT Objective: to evaluate the adequacy of using a care-educational technology with video clips for learning the physiology of lactation by the family support network for breastfeeding women. Method: a methodological study guided by the Knowledge Translation in Action Model. The collection procedure was carried out from July to September 2022 in the city of Santa Cruz do Sul, state of Rio Grande do Sul, Brazil. After the childcare consultation, each puerperal woman indicated one or more members of her support network to participate in the research. In face-to-face interviews, 52 participants answered the following instruments: Assistive Technology Assessment and Face Validation of Educational Technologies in Health. Normality of the variables was verified using the Kolmogorov-Smirnov test. The quantitative variables with normal distribution were described by mean and standard deviation. Face Validity Index and Cronbach's Alpha were calculated. Results: the video clip was evaluated as adequate (1.75) in all attributes: Interactivity (1.75), Objectivity (2.00), Relevance and efficacy (2.00) and Clarity (2.00). Face validity was excellent (0.969). Both instruments obtained Cronbach's Alpha values of 0.883 and 0.852, respectively, indicating reliability in this population. Conclusion: the video clip for learning the physiology of lactation is suitable for use by the family support network for breastfeeding mothers.

RESUMEN Objetivo: evaluar lo adecuado de utilizar una tecnología de atención-educativa del tipo videoclip para aprender la fisiología de la lactancia con la red de apoyo familiar para mujeres en lactancia. Método: estudio metodológico guiado por el Modelo de Traducción del Conocimiento en Acción. Los datos se recolectaron entre julio y septiembre de 2022 en la ciudad de Santa Cruz do Sul, estado do Río Grande do Sul, Brasil. Después de la consulta de puericultura, cada puérpera indicó al menos un integrante de su red de apoyo para que participara de la investigación. En sendas entrevistas presenciales, 52 participantes respondieron los siguientes instrumentos: Evaluación de Tecnología de Asistencia y Validación de la Apariencia de Tecnologías Educativas en Salud. La normalidad de las variables se verificó con la prueba de Kolmogorov-Smirnov. Las variables cuantitativas con distribución normal se describieron con valores medios y desviaciones estándar. Se calcularon el Índice de Validez de la Apariencia y el coeficiente Alpha de Cronbach. Resultados: el videoclip fue evaluado como adecuado (1,75) en todos los atributos: Interactividad (1,75), Objetividad (2,00), Relevancia y eficacia (2,00) y Claridad (2,00). La validez de la apariencia fue excelente (0,969). Ambos instrumentos obtuvieron coeficientes Alpha de Cronbach de 0,883 y 0,852 respectivamente, indicando confiabilidad en esta población. Conclusión: el videoclip para aprender la fisiología de la lactancia es adecuado para ser usado por la red de apoyo familiar para mujeres en lactancia.

RESUMO Objetivo: Avaliar a adequação do uso da tecnologia cuidativo-educacional, do tipo videoclipe, para aprendizagem da fisiologia da lactação pela rede de apoio familiar às lactantes. Método: Estudo metodológico, guiado pelo Modelo de Tradução do Conhecimento em Ação. A coleta foi desenvolvida na cidade de Santa Cruz do Sul, no Estado do Rio Grande do Sul, Brasil, no período de julho a setembro de 2022. Após a consulta de puericultura, a puérpera indicou um ou mais membros de sua rede de apoio para participar da pesquisa. Em entrevista presencial, 52 participantes responderam os instrumentos: Avaliação de Tecnologia Assistiva e Validação de Aparência de Tecnologias Educacionais em Saúde. A normalidade das variáveis foi verificada com o teste de Kolmogorov Smirnov. As variáveis quantitativas com distribuição normal foram descritas pela média e o desvio padrão. Foram calculados o Índice de Validade de Aparência e o Alpha de Cronbach. Resultados: O videoclipe foi avaliado como adequado (1,75) em todos os atributos interatividade (1,75), objetividade (2,00), relevância e eficácia (2,00) e clareza (2,00). A validade de aparência foi excelente (0,969). Ambos os instrumentos obtiveram Alpha de Cronbach, 0,883 e 0,852 respectivamente, apontando a confiabilidade nesta população. Conclusão: O videoclipe para aprendizagem da fisiologia da lactação está adequado ao uso pela rede de apoio familiar às lactantes.

Evaluation of last-year dental students' knowledge of prescription of analgesics and anti-bacterial agents for pregnant and lactating women

Oral health in pregnant and lactating women can affect maternal and child health. Dental treatments in this period should not have adverse effects on maternal and child health. This study was conducted to investigate the last-year dental students' knowledge of the prescription of analgesics and antibiotics for pregnant and lactating mothers in Isfahan city, Iran. Methods: A total of 104 last-year dental students of Khorasgan Islamic Azad University and Isfahan University of Medical Sciences were recruited in this descriptiveanalytical study. They completed a 16-item questionnaire on the prescription of analgesics and antibiotics for pregnant and lactating mothers. Data were analyzed by SPSS (Version 22) statistical software(t-test). Results: The total mean score of students' knowledge was 9.02±1.91. The highest level of knowledge about the safest analgesic (acetaminophen) was reported for the pregnant patients so that 100% of them had correct information in this regard. Further, the lowest level of knowledge was found for the use of dexamethasone during lactation, as only 10.6% of respondents were able to provide a correct response in this regard. Conclusion: The dental students had average knowledge about the prescription of antibiotics and analgesics for pregnant and lactating patients. To prevent the possible risks for these patients, further information should be provided to dental students

Effects of auricular thumbtack needle on lactation function and TDP-43/Btn1A1/XDH pathway in primiparous women with cesarean section / 中国针灸

OBJECTIVE@#To observe the effects of auricular thumbtack needle on breast feeding and lactation function in primiparous women with cesarean section, and to explore its mechanism of action from the perspective of lactation-related gene expression.@*METHODS@#One hundred cases of primiparous women with cesarean section were randomly divided into an observation group (50 cases, 3 cases dropped off) and a control group (50 cases, 2 cases were eliminated). The patients in the control group were treated with routine obstetric care. Based on the treatment of the control group, the patients in the observation group were treated with auricular thumbtack needle at Neifenmi (CO18), Xiong (AH10), Xiongzhui (AH11), Shenmen (TF4), and Jiaogan (AH6a), etc., with one side of auricular point selected, only once for a total of 3 d. The lactation initiation time, lactation adequacy rate at postpartum 72 h, exclusive breastfeeding rate at postpartum 42 d, and breastfeeding score after treatment were compared between the two groups. Real-time quantitative PCR and Western blot method were used to detect the mRNA and protein expression levels of TDP-43, Btn1A1 and XDH.@*RESULTS@#After treatment, the lactation initiation time in the observation group was earlier than that in the control group (P<0.01), and breastfeeding score in the observation group was higher than that in the control group (P<0.01). The lactation adequacy rate at postpartum 72 h was 63.8% (30/47) in the observation group, which was higher than 41.7% (20/48) in the control group (P<0.05). The exclusive breastfeeding rate at postpartum 42 d was 72.3% (34/47) in the observation group, which was higher than 47.9% (23/48) in the control group (P<0.05). The mRNA and protein expression levels of TDP-43 and Btn1A1 in breast milk in the observation group were higher than those in the control group (P<0.01), while there was no statistically significant difference in mRNA and protein expression of XDH in breast milk between the two groups (P>0.05).@*CONCLUSION@#The auricular thumbtack needle in addition to routine care could promote lactation initiation, improve lactation adequacy rate and exclusive breastfeeding rate in primiparous women with cesarean section, and the action mechanism may be related to up-regulation of TDP-43 and Btn1A1 expression.

Status and influencing factors of delayed onset of lactogenesis Ⅱ in mothers of preterm infants / 中华围产医学杂志

Objective:To investigate the incidence of delayed onset of lactogenesis Ⅱ (DOL Ⅱ) in mothers of preterm infants and its influencing factors.Methods:This retrospective cohort study involved women who delivered prematurely at the Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from September 2021 to March 2022. Demographic and perinatal data of the subjects were collected. According to lactation outcome on the third day after delivery, these women were divided into DOL Ⅱ and non-DOL Ⅱ groups. The two groups' differences in general conditions were compared, and the potential factors influencing DOL Ⅱ were also analyzed. Chi-square test, two independent samples t-test, Mann-Whitney U test, and logistic regression analysis were used for statistical analysis. Results:There were 286 mothers of premature infants enrolled in this study, and 73 (25.5%) of them experienced DOL Ⅱ. The other 213 cases without DOL Ⅱwere included as the non-DOL Ⅱ group. Univariate analysis showed significant differences between the DOL Ⅱ and non-DOL Ⅱ groups in the following aspects: the proportion of women with adverse pregnancy history [28.8% (21/73) vs 41.8% (89/213), χ2=3.89], the proportion of primiparas [60.3% (44/73) vs 38.0% (81/213), χ2=10.93], the incidence of hypertensive disorders of pregnancy [35.6% (26/73) vs 16.4% (35/213), χ2=11.92], the time to initiate breastfeeding after birth[5.0 h (3.0-7.0 h) vs 4.0 h (2.0-5.0 h), Z=－4.27], and the frequency of breastfeeding or pumping within 48 h after delivery [7.0 times (6.0-9.0 times) vs 9.0 times (7.0-11.0 times), Z=－3.62] (all P<0.05). Multivariate logistic regression showed that primipara ( OR=2.720, 95% CI: 1.485-4.982), hypertensive disorders of pregnancy ( OR=3.178, 95% CI: 1.609-6.274), the time to initiate breastfeeding ( OR=1.394, 95% CI: 1.211-1.604) and the frequency of breastfeeding/pumping within 48 h after delivery ( OR=0.861, 95% CI: 0.772-0.962) were independent influencing factors for DOL Ⅱ (all P<0.05). Conclusions:?The factors that influence the occurrence of DOL Ⅱ in preterm mothers are primipara hypertensive disorders of pregnancy, breastfeeding initiation time after delivery, and the frequency of breastfeeding or pumping within 48 h postpartum.

Radiación y medios de contraste en embarazo y lactancia: lo que el clínico necesita saber / Radiation and contrast media in pregnancy and lactation: what the clinician needs to know

Introducción: el uso de técnicas de imagenología es habitual e incluso indispensable en algunos procesos diagnósticos. Sin embargo, su indicación en mujeres embarazadas y en período de lactancia es controvertida. Objetivo: presentar una revisión narrativa sobre los riesgos asociados al uso de imágenes con radiación y medio de contraste en embarazo y periodo de lactancia, con énfasis en las recomendaciones y aplicaciones clínicas que el médico tratante debe tener presente al momento de su indicación. Métodos: se realizó una revisión bibliográfica de la literatura relevante sobre los riesgos y consideraciones especiales del uso de medios de contraste en el embarazo y lactancia. Resultados: los riesgos de la radiación ionizante sobre el feto varían de acuerdo al estadio del embarazo, por lo que la indicación del estudio debe ponderar los riesgos y beneficios. En las dosis clínicas en embarazo y lactancia, el uso de contraste yodado como basados en gadolinio no tienen efectos deletéreos en la salud de la madre ni la del feto. Sin embargo, las sociedades internacionales recomiendan limitar su uso. Conclusión: si bien la indicación de estudios de imagen que utilizan radiación ionizante en el embarazo y lactancia es seguro, el médico clínico debe conocer los posibles riesgos de la radiación ionizante en este grupo de pacientes. Respecto a los medios de contraste, el único efecto adverso reportado es la disfunción tiroidea transitoria en hijos de madres que recibieron medios de contraste yodado.

Introduction: the use of imaging techniques is essential in some diagnostic processes. However, its indication in pregnant and lac-tating women is controversial. Objective: To present a narrative review of the risks associated with using images with radiation and contrast media in pregnancy and lactation. Emphasis will be put on the recommendations and clinical applications that the physician must consider before its indication. Methods: a bibliographic review of the relevant literature on the risks and special considerations of contrast media in pregnancy and lactation was performed. Results: the risks of ionising radiation on the fetus vary according to the stage of pregnancy, so the indication of the study must balance the risks and benefits. The use of iodinated and gadolinium-based con-trast agents in clinical doses in pregnancy and lactation has no effects on the health of the mother or the fetus. However, international societies recommend limiting its use. Conclusion: Although the indication for imaging studies using ionising radiation in pregnancy and lactation is safe, the clinician must be aware of the possible risks of ionising radiation in this group of patients. The only adverse effect reported is transient thyroid dysfunction in children of mothers who received iodinated contrast media.

Imagenología en la patología mamaria durante el embarazo y la lactancia / Imaging of breast pathology during pregnancy and lactation

La patología mamaria durante el embarazo y la lactancia representa un desafío debido a que los cambios fisiológicos del tejido mamario durante este periodo pueden afectar la interpretación de los hallazgos clínicos e imagenológicos. El objetivo de esta revisión es conocer el diagnóstico diferencial de las enfermedades mamarias durante el embarazo y la lactancia. La mayoría de las patologías mamarias durante el embarazo y la lactancia son benignas y pueden ser clasificadas en tres categorías: 1) aquellas relacionadas con cambios fisiológicos, 2) enfermedades inflamatorias y 3) tumores benignos. Solo el 3% de los cánceres mamarios se desarrollan durante el embarazo. Los factores de mal pronóstico, como receptores hormonales negativos o HER2/neu positivo, en las mujeres embarazadas tienen una prevalencia similar a la observada en no embarazadas de la misma edad. El diagnóstico precoz es de crucial importancia pronóstica, por lo que es necesario mantener los esquemas de tamizaje recomendados. Es importante estar familiarizado con los cambios fisiológicos durante el embarazo y la lactancia, y conocer las patologías más prevalentes que afectan a las mujeres durante este periodo.

Breast pathology throughout pregnancy and lactation represents a challenge because the physiological changes of mammary tissue during this period may affect the interpretation of clinical and imaging findings. The objective of this presentation is to review the differential diagnosis of breast diseases during pregnancy and lactation. Most of breast pathology during pregnancy and lactation is benign and can be further classified into three categories: 1) those related to physiological changes, 2) inflammatory diseases, and 3) benign tumors. Only 3% of breast cancers will develop during pregnancy. Risk factors for worst prognosis, such as negative hormonal receptors or HER2/neu positive, in pregnant women have similar prevalence than in non-pregnant women of the same age. Early diagnose is of the outmost prognostic importance, therefore it`s important to maintain screening schedule as recommended. It is important to be familiarized with the physiological changes of the breast during pregnancy and lactation, and to know the most prevalent diseases affecting women during this period.

Manual Method vs Breast Pump for Breast Milk Expression in Mothers of Preterm Babies During First Postnatal Week: A Randomized Controlled Trial

Objectives: To compare breast milk volume between manual method and breast pump expression in mothers of preterm infants at different time point of first week. Design: Randomized controlled trial. Setting: Postpartum ward of Obstetrics department and tertiary level neonatal intensive care unit (NICU) in a single institution in Orissa between October, 2020 and May, 2021. Participants: Mothers who delivered before 34 completed weeks of gestation. Interventions: Manual breastmilk expression (ME) group using Marmet technique and breast pump milk expression (PE) group using pigeon manual breast pump, initiated milk expression within one hour of delivery. Outcome measures: Expressed breast milk (EBM) volume in mothers of preterm infants at different time point of first week, and cumulative milk volume. Results: Out of 170 mothers (83 PE and 87 ME group), 7-days milk volume data was available for 137 (71 ME and 66 PE) mothers. In per protocol analysis for 126 mothers (63 in each group), the median (IQR) EBM volume on day 2 and day 7 of ME and PE groups were similar [10 (5,20) vs 12 (5,28), P=0.10] and [280 (220-356) vs 280 (220-360), P=0.66]. The median (IQR) cumulative EBM volume over first 7 days in ME group was not significantly different from PE group [733 (593-995) vs 848.5 (571-1009)] P=0.55). A similar number of mothers in the PE and ME group [56 (88.9%) vs 58 (92%); P=0.14] provided exclusive breast milk for their neonates during the first week. Similar results were found on intention to treat analysis. Conclusion: EBM volume expressed was comparable between mothers expressing manually or with breast pump.

Preparación física para mujeres militares de la Fuerza Naval en período de poslactancia / Preparação física das mulheres militares da Força Naval no período pós-lactação / Physical preparation for military women of the Naval Force in post-lactation period

RESUMEN La preparación físico-militar incluye numerosos supuestos que regulan el apresto operacional del personal militar, establecen los estándares básicos para toda la vida activa. Dentro de las acciones de trabajo para mejorar o mantener la condición física, se deben tener presente las condiciones del militar, donde el entrenamiento del período poslactancia de las mujeres deben condicionarse a sus necesidades biológicas. En tal sentido, se planteó como propósito de la investigación implementar un plan de entrenamiento para mejorar la condición física de mujeres militares de la Fuerza Naval para el periodo de poslactancia. Bajo un muestreo intencional, se intervienen a siete mujeres (31-36 años) de la Fuerza Naval ecuatoriana, en proceso de lactancia, ellas son insertadas a un plan de ejercicios especializados para acondicionarlas físicamente. De aquí se genera un estudio en dos momentos de la preparación de su resistencia aeróbica, velocidad y potencia local muscular. Todas las pruebas de valoración presentaron un menor rendimiento medio en la primera valoración. Desde este resultado, se superan sus indicadores como parte del postest, test de velocidad: 17:56s-17:00s (p=0.018), test de Cooper: 16:38min-16:12min (p=0.712), Test de Abdominales: ≈36rep-≈41rep (p=0.000) y test de flexiones de codo: 25rep-30rep (p=0.000). Durante el proceso de intervención, no se presentaron lesiones ni otras dificultades que provoquen abandono del programa. El plan de intervención propuesto mejoró y acondicionó la preparación física en las mujeres militares de la Fuerza Naval ecuatoriana en estado de poslactancia; así mejoró significativamente las capacidades de velocidad y fuerza muscular local, lo cual acondicionó la capacidad de resistencia aeróbica.

RESUMO A preparação físico-militar inclui numerosos pressupostos que regulam a prontidão operacional do pessoal militar, estabelecem as normas básicas para toda a vida ativa. No âmbito das ações de trabalho para melhorar ou manter a condição física, devem ser tidas em conta as condições dos militares, onde a formação das mulheres no período pós-lactação deve ser condicionada às suas necessidades biológicas. Neste sentido, o objectivo da investigação era implementar um plano de formação para melhorar a condição física das mulheres militares na Força Naval para o período de pós-parto. Sob uma amostragem propositada, sete mulheres (31-36 anos) da Força Naval equatoriana, no processo de amamentação, foram envolvidas num plano de exercício especializado para as condicionar fisicamente. A partir disto, é gerado um estudo em dois momentos da preparação da sua resistência aeróbica, velocidade e potência muscular local. Todos os testes de avaliação mostraram um desempenho médio inferior na primeira avaliação. A partir deste resultado, os seus indicadores são excedidos como parte do teste de velocidade: 17:56s-17:00s (p=0,018), teste de Cooper: 16:38min-16:12min (p=0,712), teste abdominal: ≈36rep-≈41rep (p=0,000) e teste de flexão do cotovelo: 25rep-30rep (p=0,000). Durante o processo de intervenção, não houve feridos ou outras dificuldades que levassem ao abandono do programa. O plano de intervenção proposto melhorou e condicionou a preparação física das mulheres militares pós-lactação da Força Naval equatoriana; melhorou significativamente as capacidades de velocidade e força muscular local, o que condicionou a capacidade de resistência aeróbica.

ABSTRACT Physical-military preparation includes numerous assumptions that regulate the operational readiness of military personnel, establish the basic standards for all active life. Within the work actions to improve or maintain physical condition, the conditions of the military must be taken into account, where the training of the post- lactation period of women must be conditioned to their biological needs. In this sense, the purpose of the research was to implement a training plan to improve the physical condition of military women of the naval force for the post -lactation period. Under an intentional sampling, seven women (31-36 years old) of the Ecuadorian naval force, in the process of breastfeeding, are inserted into a specialized exercise plan to condition them physically. From here, a study is generated in two moments of the preparation of their aerobic endurance, speed and local muscle power. All the assessment tests presented a lower mean performance in the first assessment. From this result, their indicators are exceeded as part of the post -test, Speed Test: 17:56-17:00 (p=0.018), Cooper Test: 16:38-16:12 (p=0.712), Abdominal Test:≈ 36rep-≈ 41rep (p=0.000) and elbow flexion test: 25rep-30rep (p=0.000). During the intervention process, there were no injuries or other difficulties that caused abandonment of the program. The proposed intervention plan improved and conditioned the physical training of military women of the Ecuadorian naval force in a post -lactation state; thus, it significantly improved speed capabilities and local muscle strength, which conditioned aerobic endurance capacity.

Promoção e apoio ao aleitamento materno direcionados às puérperas na Rede Mãe Paranaense / Promotion and support of breastfeeding directed to mothers in the Rede Mãe Paranaense

Identificar as práticas de promoção e apoio ao aleitamento materno em maternidades de três Regionais de Saúde do Paraná, Brasil. Pesquisa transversal, com 1.270 puérperas, entre 2017 e 2018, utilizando um instrumento que contemplou o pré-natal, parto e pós-parto. Foi realizado o teste qui quadrado no programa XLSTAT Versão 2017. No pré-natal, 27,1% das gestantes receberam orientações sobre aleitamento, e 44,5% se prepararam para amamentação. O contato pele a pele ocorreu em 45,1%, com tempo de contato menor que 15 minutos (65,2%) e amamentação na primeira meia hora de vida em 61,8%. No alojamento conjunto, 88,6% receberam apoio e orientações, e 93,9% praticaram a livre demanda. Não houve orientações para persistir com a lactação (47,3%), ocorreu o uso de xícaras ou copos para oferta de leite materno em 38,1%, e 47,1% realizaram doação de leite materno. Foram identificados fatores que promovem o aleitamento materno, mas não de forma integral.

To identify the practices of promoting and supporting breastfeeding in maternity hospitals of three health regions of Paraná, Brazil. Cross-sectional study, with 1,270 puerperal women, between 2017 and 2018, using an instrument that included prenatal, delivery and postpartum care. The Chi-Square test was performed in the program XLSTAT, Version 2017. In prenatal care, 27.1% of pregnant women received guidance on breastfeeding and 44.5% prepared for breastfeeding. Skin-to-skin contact occurred in 45.1%, with contact time less than 15 minutes (65.2%) and breastfeeding in the first half hour of life in 61.8%. In the joint housing, 88.6% received support and guidance and 93.9% practiced free demand. There were no guidelines to persist with lactation (47.3%), there was the use of cups or cups to offer breast milk (38.1%), and 47.1% donated breast milk. Factors that promote breastfeeding were identified, but not in an integral way.

Assessing the Prevalence of Lactation Insuffi ciency with a View to Develop an Instructional Module to Promote Successful Lactation among Primipara Mothers in Chennai (Tamilnadu)

Breastfeeding is a traditional practice that comes ' naturally' to Indian mothers. This study sought to assess the prevalence of lactation insuffi ciency and to fi nd out the association between prevalence of lactation insuffi ciency among primipara mothers with selected background variables. This descriptive cross-sectional study was conducted in a selected maternity hospital of South India between May'ndash;July 2020. A total of 103 moth0ers in the post-natal wards were selected. Lactation insuffi ciency was assessed using LATCH scoring system. Data were analysed using descriptive and inferential statistics. Majority of the mothers (53, 52.48%) were in the age group 26-30 years; 56 (54.37%) studied higher secondary; 93 (90.29 %) received information on breastfeeding; 61 (59.23%) had least favourable and 42 (40.77%) had favourable LATCH scores. Chi square revealed no signifi cant association between lactation insuffi ciency and selected background variables among mothers. To conclude, there is a need to strengthen nurse-led lactation support to achieve successful breastfeeding practices.