Is Cesarean Section a Barrier to Early Initiation of Breastfeeding.

Cesarean section is considered as a barrier for early initiation of breastfeeding. We found that 65.2% of mothers initiated breastfeeding within 1 hour of delivery. We found that there is no significant difference between vaginal delivery and cesarean section in early initiation of breastfeeding, (P = 0.35). We were successful in overcoming this barrier by involving a lactation management counsellor in supporting mothers in early initiation of breastfeeding following cesarean section.

Initiation of lactation and establishing relactation in outpatients.

The present study was conducted to evaluate whether mothers with babies less than 6 weeks of age can be helped to initiate or establish lactation in outpatient department. One thousand mothers with babies less than 6 weeks of age who completed 10 days of follow-up in outpatient have been analyzed. Mothers who had either stopped breastfeeding or were not able to initiate breastfeeding were helped with establishing lactation at outpatient clinic. Sick babies and mothers having breast problem and systemic illness were excluded. 91.6% of mothers succeeded in establishing lactation within 10 days. 83.4% mothers achieved complete lactation and 8.2% of mothers achieved partial lactation in 10 days. However, 8.4% of mothers could not be helped in this study. They had to be hospitalized because of various reasons. It is possible to help majority of mothers with lactation difficulties at the outpatient when the baby is less than 6 weeks of age. Helping mothers with proper attachment at the breast appears to be crucial for success.

Chediak-Higashi syndrome.

A case of Chediak-Higashi syndrome is reported in a four-year-old boy who presented with recurrent chest infection, partial albinism, hyperpigmentation of the extremities and presence of giant granules in leucocytes and melanocytes in the skin. Parental consanguinity was present. Though uncommon, hyperpigmentation of sun exposed areas may be the initial symptom in Chediak-Higashi syndrome.

Follow-up study of survivors of severe protein energy manlnutrition.

OBJECTIVE: To evaluate the nutritional profile of survivors of severe protein energy malnutrition on follow-up at 1-3 years and 5-7 years. DESIGN: Prospective and Cross-sectional point prevalence. METHODS: Group I comprised 50 severely malnourished children dischared 5-7 years from nutritional rehabilitation center and Group II comprised 50 children discharged 1-3 years ago. The nutritional status of these 100 children was compared to the nutritional status of 35 siblings who had not suffered from severe malnutrition in their earlier life (Group III). RESULTS: All the malnourished children showed significant improvement in weight for age. More children in Group I had better height for age compared to Group II(p>0.05). Analysis of weight for height showed that study children has better nutritional status than their siblings who had not suffered from significant malnutrition. CONCLUSION: Significant improvement in nutritional status occurs with nutritional rehabilitation. However, improvement in height for age is more difficult to obtain. Interestingly, rehabilitated malnourished children on follow up had better nutritional status as compared to their siblings.

Breastfeeding practices in villages of central Karnataka.

OBJECTIVE: To asses the prevailing breastfeeding and infant feeding practices in rural areas. DESIGN: Stratified sampling method in a community based study. SUBJECTS: 1050 infants from 0-24 months of age. RESULTS: The timely first suckling rate was 0.3%. All the infants received prelacteal feeds. Colostrum was rejected by 29% of mothers. Delayed initiation of breastfeeding was common; 35% of babies were not breast-fed even at 48 h of birth. Exclusive breastfeeding was noted in 94% at 1 mo, 83.5% at 2 mo, 72.5% at 3 mo, 61.2% at 4 mo, 43.4% at 5 mo and 26.8% at 6 mo age. Timely complementary feeding rate was 57.3% among infants from 6 to 10 mo age. Continued breastfeeding rate was 99.7% at 1 year and 87.2% at 2 years. The bottle feeding rate was 49.4% among infants below 1 year age. The ever breast-fed rate was 97.0% and the median duration of breastfeeding was beyond 24 months. CONCLUSIONS: Bottle feeding is quite prevalent even in rural areas and the infant feeding practices are far from satisfactory.

Prevalence of urinary tract infection in severely malnourished preschool children.

Eighty eight severely malnourished preschool children (Grade III or Grade IV, IAP classification) were studied to find out the prevalence of urinary tract infection (UTI). Fifty three well nourished preschool children served as controls. Urine samples were collected by suprapubic aspiration in children below 3 years and in older children a clean catch midstream sample of urine was collected. The urine samples were subjected to direct microscopic examination, Gram's stain and culture. UTI was detected in 7 (8%) of the 88 malnourished children. Besides UTI, the other associated infections included respiratory tract infection (31.8%), diarrhea (27.2%) and tuberculous meningitis (12.7%).