Impact of bottle feeding prohibition on exclusively breastfeeding.

OBJECTIVE: To compare the time of colostrum expression and quantity of breast milk between early postpartum women who practiced exclusively breastfeeding and who had combined breast and bottle feeding. MATERIAL AND METHOD: Seventy mothers who delivered term normal, singleton infants were voluntarily recruited during immediate postpartum period and allocated into two groups. Study group was 35 mothers who practiced exclusively breastfeeding and 35 mothers who practiced combined breast and bottle feeding were control group. Expression of colostrum at 12, 24, and 48 hours and quantity of breast milk at 48 hours after delivery were evaluated and compared between two groups. RESULTS: At 12 and 24 hours after delivery, 65.7% and 88.6% of study group had colostrum compared to 37.1% and 68.6% in control group, respectively. The difference was significantly higher in study group. However, at 48 hours after delivery, there was no statistical difference in both groups. Quantity of breast milk at 48 hours after delivery was 5 mL (2, 10) in the study group compared to 2 mL (0, 8) in the control group, which was significantly different. CONCLUSION: Exclusively breastfeeding since immediate postpartum significantly promote earlier expression of colostrum and higher quantity of breast milk.

Pregnancy induced hypertension in twin pregnancy.

OBJECTIVE: To compare the incidence, severity and pregnancy outcomes of pregnancy induced hypertension in twins and singleton gestations. MATERIAL AND METHOD: The cohort study enrolled 305 twins and 298 singleton gestations at Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand between January 1996 and December 2001. The rates of pregnancy induced hypertension and pregnancy outcomes were statistically analysed in both groups. P-value of< 0.05 was considered statistically significant. RESULTS: Pregnancy induced hypertension was found to at develop 18.36% in the twin gestations, compared with 5.03% in the singleton gestations (P < 0.05). Women with twin gestations had higher rates of pregnancy induced hypertension (RR 3.65, 95% CI 2.11-6.30, P<0.05) and occurred earlier than singleton gestations (35.86+/-2.50 VS 37.40+/-1.18 weeks, P<0.05). Twin gestations with pregnancy induced hypertension had significantly higher rate of cesarean delivery, low birthweight, NICU admission and perinatal death than singleton gestations with pregnancy induced hypertension (P< 0.05). Moreover the abruptio placenta, postpartum hemorrhage and perinatal mortality in twin gestations with pregnancy induced hypertension group were significantly higher than in normotensive group (P< 0.05). CONCLUSION: The incidence of pregnancy induced hypertension was significant higher and occurred earlier with greater adverse pregnancy outcomes among twin gestations than singleton gestations. Moreover, the rate of adverse maternal and perinatal outcomes in twin gestations with pregnancy induced hypertensive group was higher than in normotensive group.