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Background: There is a high prevalence of vitamin D deficiency (VDD) in exclusively breast-fed infants in the absence of appropriate vitamin D supplementation. Objective: To evaluate the efficacy of two doses of maternal vitamin D supplementation on vitamin D levels of mother-infant pairs and to assess its effect on growth parameters (weight, length and head circumference) and bone mass of infants. Study design: Randomized controlled trial. Participants: Lactating mother-infant pairs (n=220). Intervention: Maternal oral vitamin D supplementation in two doses (group 1: 1,20,000 IU/month and group 2: 12,000 IU/month) for 12 months. Main outcomes: Maternal and infant serum 25OHD levels, and infants’ growth and bone mass. Results: There was high prevalence of VDD at baseline in mothers (94%) as well as infants (98.5%), which was reduced to 43.1% in (mothers) and 46.5% in infants after 12 months. Significantly higher median (IQR) serum 25OHD levels (ng/mL) were observed among mothers in group 1 compared to group 2 [46 (17-159) vs 18 (6-64); P<0.01] and in infants [36.5 (15-160) vs 17 (7-32); P<0.01]. No significant association was observed between growth parameters or bone mass and serum 25OHD levels of mother or infant between the two groups. Four mothers (3.6%) and two infants (1.8%) in group I had serum 25OHD>100 ng/mL, but without hypercalciuria or hypercalcemia. Conclusion: Bolus vitamin D supplementation in the dose of 1,20,000 IU/month was more efficacious in improving maternal and infant vitamin D status at 12 months, as compared to 12,000 IU/month.
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Pre-rupture of membranes prior labour initiation could complicate approximately 5% of pregnancies and could be associated with a high incidence of perinatal morbidity and mortality complications. The major complications could be chorioamnionitis and cord compression resulting in hypoxia. This study aimed to assess the health literacy of mothers on perinatal outcomes following prerupture of membranes at Thulamela B clinics of Vhembe district. A quantitative research approach with a cross-sectional descriptive design was used. The study population comprised a total of 210 lactating mothers within 6 weeks following delivery,irrespective of the mode of delivery were purposively selected. Data were collected by the researchers through self-administered questionnaires. The Statistical Package for Social Sciences (SPSS) version 25 was used for data analysis. The results are presented in the form of tables and graphs based on probability allowing judgment to be made on variables. Validity and reliability were ensured. Ethical clearance was obtained from the University of Venda Research Ethics Committee and permission to access health facilities from the Limpopo Province Department of Health. Findings revealed that limited and inadequate health literacy towards pre-rupture of membranes contributes to perinatal morbidity and mortality, with associated factors like poor antenatal care attendance, delayed health seeking, defaulting, and loss of follow-up. Recommendations emphasise the provision of preconception and antenatal care where health information on risks and danger signs of PROM to perinatal outcomes are given were made. (Afr J Reprod Health 2022; 26[7]: 90-101).
Subject(s)
Pregnancy Outcome , Health Literacy , Indicators of Morbidity and Mortality , Perinatal Care , Foods for Pregnant and Nursing Mothers , MembranesABSTRACT
Background: Anaemia in pregnancy and lactation period has detrimental effects on maternal and child health. Objective of this study was to assess knowledge of lactating mothers regarding anaemia and its preventive measures before and after educational intervention.Methods: The interventional study conducted in purposively selected lactating mothers attending the outpatient department of obstetrics and gynecology. Hospital ethical committee permission was obtained. After taking informed consent 100 lactating mothers were selected by systemic random sampling methods. Knowledge of lactating mothers regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Health education for 30 minutes was given to selected lactating mothers. Knowledge of pregnant women for the same was assessed after health education. Thus, collected data was analyzed using Epi info 7.Results: Awareness among lactating mothers regarding causes, signs and symptoms of anemia and dietary sources of iron was 41%, 26% and 5% respectively which was significantly increased to 73%, 56% and 42% respectively after health education. Awareness among lactating mothers regarding factors which inhibit and increase iron absorption was 31% and 22% respectively which was significantly increased to 80% and 65% respectively after health education. Out of 100 lactating mothers only 24% were aware regarding treatment of anemia.Conclusions: Lack of awareness among lactating mothers regarding anemia and its preventive measure should be addressed by health education during hospital visits.
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Background: Breast milk is optimum for a neonate as it is a natural food and the best gift a mother can give to her baby. Breast feeding is an art and skill which need to be learnt and mastered by mothers. As health care workers are the first line of contact for lactating mothers, this study was planned to assess their knowledge on breast feeding.Methods: Hospital based cross-sectional study was performed among health care workers at Yenepoya Medical College and Hospital of Mangalore. 100 health care workers consisting of 60 medical interns and 40 staff nurses were enrolled in the study. Health care workers were given a questionnaire that sought responses pertaining to the knowledge on breastfeeding and its techniques. The data were analyzed using Microsoft Access and Excel software.Results: The present study showed 92% of medical interns and 95% of nursing staff had correct knowledge about initiation of breastfeeding. Knowledge on contents of colostrums and its advantage was more among medical interns (85%) as compared to nursing staffs (30%). Knowledge on prelacteal feeds was good among medical interns as compared to nurses. Both medical interns and nursing have poor knowledge on breastfeeding during maternal illness. Knowledge on correct feeding position and good breast attachment was good among nursing staffs.Conclusions: Study showed there is some substantial knowledge gap on breastfeeding among health care workers. Enhancing their knowledge on breastfeeding and the problems associated with it will be useful for the nurturing mothers as well as themselves.
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Background: Antenatal care and supplementary nutrition are evidence-based strategies to improve neonatal outcomes and birth weight, and are currently provided free of cost by the government in every village through the ICDS. This study aims to assess the utilization of Anganwadi services by pregnant and lactating mothers in a rural area and the various barriers to utilization of Anganwadi services.Methods: A hospital-based, cross-sectional study was conducted among pregnant women (more than 28 weeks gestation) and lactating mothers (up to 6 months after delivery) availing maternal and child health services at a maternity hospital in a rural area of Ramnagara district in South Karnataka, using a pre-tested questionnaire.Results: Awareness regarding Anganwadi services available for pregnant and lactating mothers like IFA, calcium and deworming tablets, TT and health check-ups was found to be poor. While more than half of the women had received health education from Anganwadi teacher, important topics like dangers signs, birth preparedness and essential antenatal care were not discussed.Conclusions: Utilization of health care services at the Anganwadi was poor among the subjects. Supplementary nutrition was not utilized by 54% of pregnant women and 43% of lactating mothers. Those who had been visited by Anganwadi teacher at home and those who received nutrition education by the Anganwadi teacher had significantly higher consumption of supplementary nutrition. The common barriers to utilization were lack of awareness of services and perception of poor quality and hygiene of the supplementary nutrition.
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Background: Chronic periodontitis is a multifactorial disease which has several promoting effect on general health and when the lactating mothers are affected the cytokines associated with it is secreted in milk that had a severe effect on the health of the infant. Interleukin-6 is an anti-inflammatory and pro-inflammatory cytokine with extensive range as a biological mediator in chronic inflammation of periodontal disease; its elevation had an effect on infant growth. The purpose of the present study was to assess the effect of interleukin-6 in human milk on infant’s growth. Materials and methods: A comparative study includes lactating mothers with age range 30-40 years and their infants with age range 3-12 months. The study group includes mothers with chronic periodontitis and the control group includes 45 mothers with healthy periodontium. Milk interleukin-6 is measured in lactating mothers by using the enzyme-linked immune sorbent assay (ELISA). Infant growth was recorded according to CDC growth charts and National Health and Nutrition Examination Surveys in 2007. Results: The results show mothers with chronic periodontitis have a higher level of milk IL6 than mothers with healthy periodontium; the result was statistically highly significant, even though the result of the effect of milk IL6 on infant’s growth wasn’t significant statistically. Conclusion: Mothers with chronic periodontitis have a higher level of milk IL6 than mothers with healthy periodontium. High level of proinflammatory milk IL6 will effect infant growth and result in retardation of normal infant growth like underweight, overweight and short stature infants. High level of milk interleukin 6 in mothers with chronic periodontitis could influence negatively on their infant’s growth.
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Objective: To investigate the diet of lactating mothers, breast milk components and the growth of infants in Changchun City, Jilin Province and explore the relationships between the nutritional status of breast milk and the growth of infants, and to provide the theoretical basis for the development of the infant health.Methods: A total of 138 healthy nursing mothers were selected. Within 40-45 d after the delivery, face-to-face investigations were conducted to obtain the basic information of the subjects and the growth and development information of the infants. The 24-hour dietary review method was adopted to investigate the dietary status of the lactating mothers, the standard food pictures were provided to estimate the dietary variety and the quantities of the subjects. Golden key maternal nutrition expert system software was applied to analyze the energy and nutrients of dietary intake, and they were compared with Dietary Guidelines of Pregnant, Lactating Women and 0-6 Years Old Children in China (2007) and Chinese Dietary Reference Intake of Nutrients (2013);the diet intake level of the lactating mothers was evaluated. The breast milk was collected and the infant growth and development indicators were measured. The compositions of breast milk were analyzed by milk composition analyzer. The relationships between the lactating mother's diet, the breast milk composition and the infant growth and development were analyzed.Results: The average energy intake of the lactating mothers was (1 698.7±406.23) kcal·d-1, and the energy proportions of proteins, lipids, and carbohydrates were 14.06%, 33.83%, and 52.09%, respectively. The average energy content of breast milk was (61.18±13.04) kcal·100g-1, the average protein content was (0.94±0.19) g·100g-1, the average lipid content was (3.55±1.27) g·100g-1, and the average lactose content was (6.38±0.82) g·100g-1. The dietary protein intake was associated with the protein content of breast milk (r=0.203,P=0.017).When the influence of feeding patterns, energy of breast milk, infant gender, and age were controlled, the partial correlation analysis result showed that the breast milk composition had no correlations with the increases in body lengths and weights of the infants (P>0.05).Conclusion: There are insufficience and imbalance in the general dietary intakes in the lactating mothers. The dietary protein intake of lactating mothers may influence the protein content of breast milk. The lipid and carbohydrate contents in milk have no significant correlations with the dietary nutrients of the lactating mothers. The breast milk compositions of lactating mothers have no effects on the growth and development of infants.
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El yodo es un elemento esencial para la síntesis de hormonas tiroideas (HT), necesarias para el desarrollo del cerebro. Los grupos más vulnerables a la deficiencia de yodo (DY) son las embarazadas, mujeres lactantes y niños menores de dos años. La ingesta de yodo y el estado nutricional del yodo en la madre lactante, está fuertemente relacionada con la secreción del micronutriente en leche materna (LM). Como la mayor parte del yodo absorbido por el organismo es excretada en orina, la mediana de concentración de yodo urinario (CYU), es el mejor indicador bioquímico empleado para evaluar la situación nutricional del yodo en mujeres lactantes y niños menores de dos años. Con base en la CYU en escolares de la mayoría de los países de Latinoamérica, la ingesta de yodo resultó adecuada. Sin embargo, la suficiencia de yodo en escolares no siempre se corresponde con una adecuada ingesta de yodo en mujeres lactantes. Se ha dedicado escasa atención a las consecuencias adversas de la DY durante la lactancia. En esta corta revisión, se examina la importancia del estado nutricional del yodo en la mujer lactante y se recomienda instaurar su vigilancia y monitoreo a través del análisis de yodo en orina, implementar medidas de intervención apropiadas a fin de contribuir a garantizar un óptimo estado de salud y nutrición en la madre y prevenir la aparición de trastornos por DY en lactantes y niños pequeños.
Iodine is an essential component of thyroid hormones (TH). TH are necessary for brain development. The most susceptible groups to iodine deficiency (ID) are pregnant and lactating women and children under two years of age. Maternal nutritional status and iodine intake strongly affect the amount of this nutrient secreted in breast milk (BM). Most of the iodine absorbed by the body is eventually excreted in the urine. For this reason, the median urinary iodine concentration (UIC) is the best indicator to assess the iodine nutritional status of lactating women and children less than two years of age. With base on the UIC in most of Latin American school-aged children, iodine intake was normal. However, iodine sufficiency in school age children not always corresponds with an adequate intake in lactating mothers. Little attention has been paid to the adverse consequences of ID during lactation. The objective of this short review was to examine the importance of iodine nutritional status in lactating women. We recommend to establish surveillance and monitoring of iodine status in lactating women through urine iodine levels, to implement measures to help promote an optimal health and nutrition of the mother to prevent iodine deficiency disorders (IDD) of infants and young children.
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@#Aflatoxin M1 (AFM1) is a secondary metabolite in the breast milk of lactating mothers who consume foodstuffs infected by the fungi Aspergillus flavus and Aspergillus Parasiticus. The concentration of AFM1 in breast milk of lactating mothers is of major public health concern, because it can negatively affect the health of their babies. The major objective of this study was to assess the AFM1 concentration in the breast milk of lactating mothers in Papua New Guinea (PNG). This was a prospective cross-sectional study carried out between 2011 and 2015 in three of the four Regions in PNG: the National Capital District (NCD) in the Southern Region; Eastern Highlands (EHP) and Western Highlands (WHP) provinces in the Highlands Region; and East New Britain (ENB) and Manus provinces in the Islands Region. The Susu Mama, Well-Baby and Paediatric clinics in the General Hospitals in each of the selected provinces in the three regions were the primary sites for this study. A solid phase competitive Enzyme-Linked Immunosorbent Assay (ELISA 96 Microwell plates) was used for the quantification of AFM1 in breast milk from consented lactating mothers. A total of 874 lactating mothers and their babies participated in this study. The mean age of the mothers was 28.0 ±5.5 years. The age range of all the babies was 2 to 6 weeks. 76.1% (665/874) of all breast milk samples analyzed had detectable levels of AFM1. The concentration of AFM1 was above 10.00ppt in 89 (10.2%) of the 874 breast milk samples (which, according to the Australia / New Zealand / Austria safe cut-off limits for AFM1, makes them unsafe for consumption by the babies). The mean AFM1 concentration in the breast milk samples from lactating mothers in EHP (7.99ppt) was higher than that in the samples from the other 4 provinces in the present study. AFM1 concentration was above 10.00ppt in 14 (4.6%) of the 300 breast milk samples from NCD, in 62 (31.0%) of the 200 samples from EHP, in 10 (4.5%) of the 220 samples from ENB and in 3 (3.0%) of the 100 samples from WHP. In order to reduce the AFM1 concentrations in breast milk of lactating mothers, basic nutrition education, aggressive advocacy, social mobilization, awareness campaigns, including communication with all relevant target groups and the relevant policy makers are urgently required.
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Objective:To analyze the levels of arachidonic acid (AA)and docosahexaenoic acid (DHA)in the breast milk of lactating mothers in Changchun City of Jilin Province, and to explore their influence factors. Methods:The lactating mother’s basic information was collected with questionnaire, and the breast milk of lactating mothers on postpartum 22-25 d was obtained and the 3-day 24-hour dietary recall method was used to investigate the dietary intake information of 514 healthy lactating mothers.The Food Composition Table of China 2009 was used to calculate the intakes of five kinds of polyunsaturated fatty acids (PUFAs) in diet of lactating mothers and the gold key nutrition expert system software for corresponding nutrient analysis was used to calculate the amount of various kinds of foods in the lactating mothers’daily diet.The levels of AA and DHA in breast milk were determined with gas chromatography and the linear regression was used to analyze the related factors of AA and DHA levels in breast milk.Results:①The average concentration of AA in breast milk of 514 lactating mothers was (0.08±0.04)g·100 g-1,and the average concentration of DHA was (0.05±0.04)g·100 g-1. ②The single factor correlation analysis results showed that the oil intake was both positively correlated with AA and DHA levels in milk of lactating mothers (r= 0.360,r=0.354,P<0.001),while the intakes of linoleic acid (LA), alpha linolenic acid (ALA),eicosapentaenoic acid (EPA),DHA,dairy and meats and seafood in diet were both negatively correlated with AA (r= -0.321,r=-0.280,r=-0.255,r=-0.299,r=-0.196 ,r=-0.306,P<0.05)and DHA (r=-0.315,r=-0.279,r=-0.175,r=-0.189,r=-0.248,r=-0.142,P<0.05).③The linear regression analysis results showed regression equation that dairy intake (β=-0.265)and EPA intake (β=-0.144)were both negatively correlated with the level of AA (P=0.009),and dairy intake was also negatively correlated with the level of DHA (β=-0.233,P<0.001).Conclusion:The AA and DHA levels in breast milk of lactating mothers didn’t increase with the increasing of intake of milk or dairy products in the study.Moreover there is a competitive relationship between n-6 and n-3 series polyunsaturated fatty acids in the process of metabolism.
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Background: Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine status of breast-fed infants depends on iodine in breast milk and also number of feeding in 24 hours. Iodine deficiency and iodine excess both have bad impact on infant’s health. Objective: To measure the iodine in breast milk and to evaluate iodine status of their breast-fed infants. Materials and method: This observational analytical study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic container free from any chemical contamination. Urinary iodine was used as indicator for assessing iodine status. All statistical analyses were done by using SPSS (statistical programme for social science) 12 version software package for Windows. Results: The median (range) urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 μg/L (61.50-530.00) and 225.75 μg/L (100.50-526.00) respectively. The median (range) breast-milk iodine concentration was 157 μg/L (54.50-431.50) which was more than three times of recommended minimum concentration (50 μg/L). Only 2 (4%) lactating mothers had mild biochemical iodine deficiency (UIE, 50-99 μg/L). There was no biochemical iodine deficiency of breast-fed infants. Iodine in breast milk of lactating mothers was positively correlated with their urinary iodine excretion (p<0.01). Infant’s urinary iodine was positively correlated with iodine concentration in breast milk (p<0.01) and with urinary iodine of lactating mothers (p<0.01). Conclusion: Lactating mothers and their breast-fed infants in this study were iodine sufficient. If iodine content of breast-milk is within normal range, 10-12 numbers of feeding in 24 hours for infants is enough to get sufficient iodine from their mother’s milk.
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Background & objectives: Vitamin D deficiency with a resurgence of rickets and tetany are increasingly being reported in young infants from temperate regions, African Americans and also from India. The data on vitamin D status of healthy term breastfed Indian infants and mothers are scant. Therefore, we undertook this study to determine the prevalence of vitamin D deficiency and insufficiency [serum 25 hydroxyvitamin D (25OHD) ≤ 15 ng/ml and 15-20 ng/ml, respectively] among healthy term breastfed 3 month old infants and their mothers, evaluate for clinical and radiological rickets in those infants having 25OHD < 10 ng/ml, and check for seasonal variation and predictors of infants’ vitamin D status. Methods: A total of 98 infants aged 2.5 to 3.5 months, born at term with appropriate weight and their mothers were enrolled; 47 in winter (November- January) and 51 in summer (April-June). Details of infants’ feeding, vitamin D supplementation, sunlight exposure and mothers’ calcium and vitamin D intake were recorded. Serum calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone were estimated. Results: Vitamin D deficiency was found in 66.7 per cent of infants and 81.1 per cent of mothers; and insufficiency in an additional 19.8 per cent of infants and 11.6 per cent of mothers. Radiological rickets was present in 30.3 per cent of infants with 25OHD < 10 ng/ml. 25OHD did not show seasonal variation in infants but maternal concentrations were higher in summer [11.3 (2.5 - 31) ng/ml] compared to winter [5.9 (2.5-25) ng/ml, P=0.003]. Intake of vitamin supplement, sunlight exposure and mother’s 25OHD were predictors of infants’ 25OHD levels. Interpretation & conclusions: Prevalence of vitamin D deficiency and insufficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants with 25OHD < 10 ng/ml in this study. Studies with large sample need to be done in different parts of the country to confirm these findings.
Subject(s)
Adult , Breast Feeding , Female , Humans , India/epidemiology , Infant , Prevalence , Seasons , Vitamin D Deficiency/epidemiologyABSTRACT
Objetivou-se levantar e categorizar trabalhos científicos sobre a influência da rede social da lactante no contexto da amamentação. Para isto, realizou-se uma revisão bibliográfica nas principais bases de dados em saúde (MEDLINE, LILACS, SciELO), utilizando como palavras chaves os descritores: aleitamento materno, desmame e família (e suas versões em inglês e espanhol). Foram consultados também livros, teses, dissertações, publicações em órgãos internacionais e nacionais (OMS, UNICEF, Ministério da Saúde). Pode-se observar que os atores que compõem a rede social da nutriz são capazes de exercer interferência na decisão de amamentar, através de diferentes âmbitos, tais como o incentivo/apoio à iniciativa; o repasse de conhecimentos e valores culturais; a tradição familiar e o cultivo do desinteresse/desestímulo e da pressão exercida sobre a lactante em relação à forma de alimentar a criança. Destarte, pode-se inferir sobre a necessidade de implementação de novas práticas de saúde no que tange à forma de cuidado a este grupo populacional. Vale ressaltar a importância de que os profissionais se capacitem para uma escuta sensível sobre o significado da lactação desde o olhar da nutriz. Por fim, destaca-se o papel importante da rede social da lactante, principalmente a família, para o sucesso da amamentação.
The objective was to raise and classify scientific works on the influence of the social net of lactating mothers in the context of the breastfeeding. A bibliographical review was done in the main databases (MEDLINE, LILACS, SciELO), using as keywords: breastfeeding, weaning and family (and their versions in English and Spanish). Books, thesis, dissertations, and publications in international and national institutions were consulted (WHO, UNICEF, Ministry of Health). It could be observed that the actors that compose the social net of the lactating mothers can interfere in the decision of breastfeeding, through different extents, such as the encouragement/support to the initiative; reviewing the knowledge and cultural values; family tradition; and the cultivation of the indifference/discourage and the pressure exercised on the lactating mothers in relation to the form of feeding the child. In this way, it can infer on the need of the implementation of new health practices regarding to the care of this group. It is worth to highlight, the importance of the professionals to be qualified for the sensitive listening on the meaning of the nursing under the glance of the lactating mothers . Finally, it stands out the importance role of the social net of the lactating mothers, especially the family, for a successful breastfeeding.