Fatores associados à introdução alimentar precoce em um município baiano / Factors associated with early food introduction in a municipality of baiano

Introdução: a introdução alimentar precoce é uma prática frequente no Brasil, envolta por diversos fatores de ordem social, cultural, econômica, familiar, emocional, bem como relacionados às condições de vida e assistência à saúde. Objetivo: identificar os principais fatores que se associam a introdução precoce de alimentos em crianças de zero a seis meses de vida, atendidas na Atenção Primária à Saúde de um município do Sudoeste da Bahia. Metodologia: estudo transversal, realizado com 75 mães e crianças atendidas na rede de saúde de Jequié, Bahia, no período de março a agosto de 2018. Empregou-se Regressão de Poisson com variância Robusta para avaliar a associação. Resultados: a prevalência da introdução alimentar precoce na população em estudo foi de 64%, sendo o leite de vaca, água/chá e fórmula infantil os alimentos mais prevalentes. Observou-se que a variável uso de chupeta (RP=1,21; IC95%= 1,02-1,43) apresentou associação positiva com a introdução alimentar precoce, enquanto que as variáveis uso de mamadeira (RP= 0,08; IC95%= 0,02-0,28) e orientações sobre amamentação (RP= 0,77; IC95%= 0,63-0,95) apresentaram associação negativa e inversa com o desfecho estudado. Conclusão: apesar da superioridade do leite materno sobre outras formas de nutrir as crianças menores de seis meses, os resultados deste estudo revelaram elevada prevalência de introdução alimentar precoce na população estudada e sua associação com o uso de chupetas. Sugere-se que ações de promoção e proteção da amamentação exclusiva aconteçam desde o pré-natal, evidenciando também os riscos da introdução alimentar precocemente.

Introduction: the early introduction of food is a frequent practice in Brazil, involved by several factors of social, cultural, economic, family, emotional, as well as related to living conditions and health care. Objective: to identify the main factors associated with the early introduction of food in children from zero to six months of life, attended in primary health care in a municipality in southwestern Bahia. Methodology: cross-sectional study, conducted with 75 mothers and children assisted in the health network of Jequié, Bahia, in the period from March to August 2018. Poisson Regression with Robust variance was employed to evaluate the association. Results: the prevalence of early food introduction in the study population was 64%, with cow's milk, water/tea and infant formula being the most prevalent foods. It was observed that the variable pacifier use (PR = 1.21; 95%CI = 1.02-1.43) showed a positive association with early feeding, while the variables bottle use (PR = 0.08; 95%CI = 0.02-0.28) and breastfeeding orientation (PR = 0.77; 95%CI = 0.63-0.95) showed a negative and inverse association with the studied outcome. Conclusion: despite the superiority of breast milk over other forms of feeding children under six months of age, the results of this study revealed a high prevalence of early introduction of food in the studied population and its association with the use of pacifiers. It is suggested that actions to promote and protect exclusive breastfeeding take place since the prenatal period, also highlighting the risks of introducing food early.

Correlates of exclusive breast feeding among nursing mothers attending child health clinic at a general hospital in Rivers State Nigeria

Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF) Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05. Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF. Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.

Perspectiva de mujeres mexicanas sobre lactancia materna asociada al cambio del modelo cultural / Mexican women breastfeeding perspective associated with the cultural model change / Perspectiva das mulheres mexicanas sobre a aleitamento materno associado ao câmbio do modelo cultural

RESUMEN Introducción: La lactancia materna es importante para el desarrollo saludable del recién nacido. A pesar de sus beneficios, la decisión de no amamantar se incrementa entre las mujeres de la Ciudad de México debido a la influencia de la globalización y del cambio de modelo cultural moderno al posmoderno. Objetivo: Comprender la perspectiva de las mujeres mexicanas sobre el ofrecer y abandonar la lactancia materna asociada al cambio del modelo cultural. Metodología: Se llevó a cabo un estudio cualitativo con enfoque exploratorio, descriptivo: participaron 12 diadas (madre-hijo lactante), residentes de la Ciudad de México, quienes ofrecieron y abandonaron la lactancia materna. Se realizaron entrevistas en profundidad. Los datos obtenidos se grabaron, transcribieron y codificaron para garantizar el rigor de la investigación. Resultados: Se reconocieron dos categorías que sustentan el por qué las mujeres brindan o abandonan la lactancia materna, vistas desde el modelo cultural. En el modelo moderno las mujeres consideran una convicción sentida el ofrecer lactancia materna, reconocen los beneficios de dicho alimento para su hijo; mientras que, en el modelo posmoderno, las mujeres tienen una convicción negativa de amamantar. Conclusiones: Al asociar la lactancia materna con modelos culturales, en el moderno se considera la lactancia como un deber, mientras que en el posmoderno un derecho. Al encontrarnos en transición entre ambos modelos, las mujeres están influenciadas por discursos y prácticas culturales que en ocasiones son contradictorias. Comprender estos fenómenos permitirá diseñar estrategias efectivas desde la enfermería para fomentar la lactancia materna.

ABSTRACT Introduction: Breastfeeding is an important activity for the healthy development of the newborn, but nevertheless the benefits, the decision of women to avoid breastfeeding is becoming more prevalent in Mexico City. Perhaps this decision is the result of the influence of the globalization process with its cultural model change from the modern to the postmodern. Objective: To better understand the perspective of Mexican women regarding breastfeeding or not breastfeeding and the relationship of this decision with the cultural model change. Methodology: This is a qualitative, descriptive, and exploratory study on 12 mothers in Mexico City, who decided to terminate breastfeeding their babies. In-Depth interviews were conducted. The gathered data were recorded, transcribed, and coded in order to procure rigour of research. Results: Two categories related to the cultural model that reflect why women breastfeed or not were identified. In the modern model, women consider breastfeeding as a solid conviction which has benefits to their babies, while in the postmodern model, women tend to have a negative image of breastfeeding. Conclusions: From the association of breastfeeding with the cultural models, in the modern model, women consider breastfeeding as a duty, while in the postmodern one, women consider breastfeeding as a right. Currently, we are in a transition between these possibly contradicting cultural models. Therefore, better understanding these phenomena can help nursing professionals design strategies which can foster a healthy decision on breastfeeding.

RESUMO Introdução: O aleitamento materno é importante para o desenvolvimento saudável do recém-nascido. Apesar de seus benefícios, a decisão de não amamentar aumenta entre as mulheres da Cidade do México devido à influência da globalização e da mudança do modelo cultural moderno para o pós-moderno. Objetivo: Compreender a perspectiva das mulheres mexicanas sobre a oferta e o abandono do aleitamento materno associado à mudança do modelo cultural. Metodologia: Realizou-se um estudo qualitativo com abordagem exploratória e descritiva: participaram 12 díades (mãe-filho em lactação), residentes na Cidade do México, que ofereceram e abandonaram a amamentação. Entrevistas em profundidade foram realizadas. Os dados obtidos foram gravados, transcritos e codificados para garantir o rigor da pesquisa. Resultados: Foram reconhecidas duas categorias que sustentam porque as mulheres oferecem ou abandonam a amamentação, visto a partir do modelo cultural. No modelo moderno, as mulheres consideram o fato da amamentação uma convicção sincera, reconhecem os benefícios dessa alimentação para o filho; enquanto no modelo pós-moderno as mulheres têm uma convicção negativa de amamentar. Conclusões: Ao associar o aleitamento materno aos modelos culturais, no moderno amamentar é considerado um dever, enquanto na pós-moderna um direito. Ao encontrarmos em transição entre os dois modelos, as mulheres são influenciadas por discursos e práticas culturais que às vezes são contraditórios. Compreender esses fenômenos permitirá o desenho de estratégias de enfermagem eficazes para promover o aleitamento materno.

A prospective study to evaluate the protective effect of breastfeeding on diarrheal morbidity in infants in rural Rajasthan

The benefits of breastfeeding on infant and child morbidity and mortality are well known since ages. Human milk protectsbreastfed infants against diarrhoeal disease by virtue to its various immunological properties. As diarrhoeal diseases are amajor cause of deaths among children aged 0-12 months, it is important to quantify the preventive effect of breastfeeding ondiarrhoea-specific morbidity and mortality. To assess the breast-feeding practices and its effect on incidence of diarrhoea ininfants in rural Rajasthan. A Prospective study was carried out in Achrol village, field practice area of National Institute ofMedical Science (NIMS) Hospital and Research Centre, Jaipur, over a period of one year. 246 infants were enrolled byconvenience sampling through house to house visits and followed-up on monthly basis to record information on feedingpractices and episodes of diarrhoea by interviewing their mothers. Descriptive statistics were presented as frequencies andpercentages and association between breastfeeding practices and incidence of diarrhoea was found using Chi-square test.48.8% of the infants studied were started on breast feeding between 1-6 hours while only 13% started breastfeeding withinan hour of birth. Majority (66.3%) of infants were denied colostrum feed and 92.68% infants were given pre lacteal feeds asis customary in the area. Among infants who were put on breastfeeding within 1 hour of their birth, 12.2% suffered fromdiarrhoeal where as infants who were started on breast feeding within 1-6 hours, 46.6% reported diarrhoeal episodes duringthe follow up period. This difference in diarrhoeal episodes based on initiation of breastfeeding was found to be statisticallysignificant (p< 0.05). There is enough evidence in favour of breast feeding (exclusive breast feeding for 6 months andcontinued breastfeeding up-to 2 years) as an effective tool against diarrhoeal morbidity in the studied infants.

Optimal feeding practices in Tamilnadu, breast feeding and complementary feeding: the reality

Background: Optimal feeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions. This study was done to evaluate feeding practices of infants in first two years of life.Methods: In this cross sectional study, 161 mothers with infants 6 mo to 24 mo of age, attending the well-baby clinic of this hospital were selected for study from April 2014 to March 2015 and interviewed using a structured questionnaire.Results: The prevalence of exclusive breastfeeding for 6 mo was 44% with a median duration of 4.9'1.8 mo. The proportion of infants who received continued breast feeding at 1 year of age (12-15 mo) was 67%. The median duration of any breast feeding was 13.6 mo by survival analysis. Early introduction of cow's milk and bottle feeding were associated with nonexclusive breast feeding under 6 mo and early termination of breast feeding.Conclusions: While rate of exclusive breast feeding was comparable to the state average (48%), there was a higher rate of introduction of cow's milk and bottle feeding which contributed to early termination of breastfeeding before one year of age. This study emphasis the fact that bottle feeding and inappropriate complementary feeding should be tackled to improve IYCF indicators in Tamilnadu.

A study on role of LATCH scoring in duration of exclusive breastfeeding in a rural tertiary care hospital, Puducherry: a prospective study

Background: Exclusive Breastfeeding (EBF) for 6 months is the optimal way of feeding infants. NFHS4 data shows 45.5% of children were exclusively breastfed at 6 months in Puducherry. The Global Nutrition Targets 2025 aims at increasing EBF rates in first 6 months up to at least 50%. The main objective is to find areas of needed intervention using LATCH scoring and to find factors responsible for fall in rates of EBF.Methods: A prospective study was conducted between November 2017 and April 2019 (1'years). Mothers were educated about breastfeeding. LATCH score assessed at 8 and 48 hours of life. At 48hours, score >8 indicates there is a high chance for EBF for next 6 months and score <8 indicates, mother is having difficulty in feeding and are intervened at this point. Data about EBF and reason for early weaning at 6 weeks and 6 months collected.Results: LATCH score at 8 hours was >8 in infants delivered via NVD: 50% as against 9.6% in babies delivered via LSCS. At 48 hours LATCH score improved in both groups: 60.8% in babies delivered via NVD, 38.3% in babies delivered via LSCS.' Compared to Primi-mothers, infants born to multigravida mothers had higher scores at 48 hours: 62.2% as against 31.1%. 84% were EBF at 6 weeks. 51% were EBF at 6 months. When mothers with LATCH score <8 at 48 hours were intervened, EBF rate at 6 weeks improved. Most common reason for early weaning at 6 weeks was maternal problems: 6.6% and at 6 months- due to influence of relatives: 27%.Conclusions: LATCH score helps in predicting breastfeeding duration as early as 48 hours of life. Low scores indicate, it requires intervention and identifies the areas of needed intervention. Counselling regarding EBF must include not only mothers but also relatives.

Role of mother’s education and antenatal counselling on breast feeding practices among women in coastal Karnataka: a community based cross sectional study

Background: Breastfeeding has been a universal practice. A number of factors influence the breastfeeding practices of the mothers. This study was conducted to assess the breast-feeding practices and its association with mother’s education and antenatal counselling.Methods: A community based cross sectional study was conducted among 167 mothers with infants who were residing in field practice area of a medical college. A pretested semi-structured validated questionnaire was administered to assess the breast-feeding practices followed. Towards the end of each interview the investigator observed the mothers as they breast fed their children to assess the appropriateness of positioning and attachment. Chi-square test and Fischer’s exact probability test were used to test the associations.Results: 19.8% of the mothers were illiterate. 64.1% had received antenatal counselling on breast feeding. 62.3% initiated breast feeding within one hour. Colostrum was discarded by 6% of the mothers and 28.7% gave pre-lacteal feeds. 72.3%, 86.1% and 77.3% of them practiced appropriate position of feeding, held their children in the appropriate position and had good attachment to the breast, respectively. Mother’s education had a statistically significant association with pre-lacteal feeds administration, exclusive breastfeeding and breast-feeding position. Antenatal breast-feeding counselling had a statistically significant association with appropriate positioning of the child, attachment and practicing burping.Conclusions: Breast feeding practices in the current study was far from satisfactory. Mother’s education and antenatal breast-feeding counselling had a major role in the feeding practices.

Infant feeding practices among parturient women in rural communities of Anambra State, Nigeria

Background: Infant feeding is an integral part of the reproductive process with important implications for the health of mothers and their babies. However, various practices exist in different communities. It is therefore pertinent to know the infant feeding practices among rural dwellers, as well as the factors that influence them.Methods: This study was a cross sectional survey. A total of 372 volunteering parturient women were recruited using a multi-stage stratified sampling technique. Ethical approval and respondents’ informed consent was obtained. A self-developed and validated questionnaire was used to collect data. Descriptive and inferential statistics was used to analyse data.Results: Findings revealed that majority (84.4%) of the respondents were aware of exclusive breastfeeding (EBF), but only about half (50.5%) ever practiced exclusive breastfeeding. Also, a significant percentage of the respondents introduced complimentary feeding to the baby immediately after birth while 29.3% of participants reported drinking palm wine which is mainly alcoholic to stimulate breast milk secretion. Occupation of parturient women was associated with the practice of EBF (p=0.002).Conclusions: Almost half of our studied parturient women do not engage in EBF. There is need for health care workers to strategically educate parturient women and their significant others on the numerous benefits of exclusive breast feeding.

Prevalence and determinants of exclusive breastfeeding among lactating mothers in an urban slum, West Tripura: a cross sectional study

Background: Exclusive breastfeeding is the optimal way to feed children during their first months of life, having important benefits for them and their mothers. Despite of all benefits, the practice of exclusive breastfeeding is quite low and information on influencing factors is limited especially from slum settlements. Objectives was to estimate the prevalence of exclusive breastfeeding and to find out the factors affecting exclusive breastfeeding among lactating mothers in an urban slum, West Tripura.Methods: A cross sectional study was conducted among 200 lactating mothers for a period of six months in an urban slum using structured interview schedule. Eligible mothers were selected by sample random sampling technique. Data has been analyzed by SPSS statistical software version 17.Results: Majority (43%) of the mothers was aged between 21-25 years and 89% were non working mothers. Among the participants, 55.5% were Hindu by religion, 60% belonged to nuclear family and 43.5% had studied up to primary level. The prevalence of exclusive breastfeeding rate among the study mothers were 60.5%. Only parity, place of delivery and number of antenatal check up were significantly associated with exclusive breastfeeding.Conclusions: Exclusive breast feeding (EBF) rate still needs to improve. Community level interventions like awareness programmes on exclusive breastfeeding, health education and behavior change communication among the target group is essential to improve the exclusive breastfeeding rate especially in slum settlements.

Clinical profile of hypernatremia in exclusively breast-fed neonates

Background: Neonatal hypernatremia is a potentially lethal condition. This study was planned to find out the predisposing factors and outcome of hypernatremia in breast feed late preterm and term neonates.Methods: In defined study period, neonates with serum sodium level >145mmol/L, who satisfies all the inclusion criteria are included in the study.' The data was collected using a proforma which included clinical symptoms, risk factors for neonatal hypernatremia in addition to laboratory data.Results: The results demonstrated hypernatremia in 63 neonates with mean age of presentation being 4.5 days, mean sodium level of 154.2 and average weight loss was 13.2%. Neonates admitted at older age >7days had higher sodium concentration with mean of 162.5mmol/L. Serum sodium levels correlates positively with percentage of weight loss and correlates negatively with birth weight and was statistically significant with p value <0.05. 41(65%) of mothers were primipara, 37(58%) had delivered by LSCS and 39(62%) had lactation issues postnatally. Most common presenting symptom was jaundice in 44(71%), followed by fever in 38(61%).Conclusions: Hypernatremic dehydration can be prevented by counselling about importance of breast feeding for the mothers starting from antenatal period, early initiation of breast feeding, addressing lactation issues and monitoring daily weight.

Infant and Young Child Feeding Practices among the Mothers in Urban Slums of Dibrugarh Town: A Cross Sectional Study

Introduction: Infant and young child feeding practices directlyaffect the nutritional status of children under two years of ageand ultimately, impact child survival. The present study wasundertaken to assess the prevalence of infant and young childfeeding practices and associated factors among the mothershaving children less than 24 months.Methodology: This cross sectional study was carried out inthe urban slums of Dibrugarh town, Assam, among childrenbetween 0 - 23 months. Sample size was calculated as 180.Infant and child feeding practices were collected byinterviewing mother by house to house visit on predesignedand pretested Performa.Results: Out of 180 children of 0-23 month, prevalenceinitiation of BF within 1 hour of birth was 84.4% (152).Prevalence of giving prelacteal feed and colostrums were 10%(18) and 86% (155) respectively. Exclusive breast feeding wasgiven to 70% (99) of the children, complementary feeding wasstarted in 80% (114) of the children at 6 months. Initiation ofbreast feeding within 1 hour of birth and giving colostrums weresignificantly associated with place and type of delivery andutilization of number of antenatal checkup. Giving prelactealfeed was associated with place of delivery and utilization ofantenatal check up by their mother. Exclusive breast feedingwas associated with sex of the child, mother’s educationalstatus and place of delivery. Boys were more likely to bestarted with complementary feeding at 6 months as comparedwith girls.

Should maternal anesthesia delay breastfeeding? A systematic review of the literature / Anestesia materna deve atrasar a amamentação? Revisão sistemática da literatura

Abstract Introduction: The importance and benefits of breastfeeding for the babies and mothers are well established and documented in the literature. However, it is frequent that lactating mothers need to undergo general or spinal anesthesia and, due to the lack of information, many of them interrupt breastfeeding after anesthesia. There are limited data available regarding anesthetics transfer to breast milk. This review aims to develop some considerations and recommendations based on available literature. Methods: A systematic search of the literature was conducted by using the following health science databases: Embase, Lilacs, Pubmed, Scopus, and Web of Science. The latest literature search was performed on April 6th, 2018. Additional literature search was made via the World Health Organization's website. We used the following terms for the search strategy: "Anesthesia" and "Breastfeeding", and their derivatives. Results: In this research, 599 registers were found, and 549 had been excluded by different reasons. Fifty manuscripts have been included, with different designs of studies: prospective trials, retrospective observational studies, reviews, case reports, randomized clinical trials, case-control, and website access. Small concentrations of the most anesthetic agents, are transferred to the breast milk; however, their administration seem to be safe for lactating mothers when administered as a single dose during anesthesia and this should not contraindicate the breastfeeding. On the other hand, high-doses, continuous or repeated administration of drugs increase the risk of adverse effects on neonates, and should be avoided. Few drugs, such as diazepam and meperidine, produce adverse effects on breastfed babies even in single doses. Dexmedetomidine seems to be safe if breastfeeding starts 24 h after discontinuation of the drug. Conclusions: Most of the anesthetic drugs are safe for nursing mothers and offer low risk to the breastfed neonates when administered in single-dose. However, high-dose and repeated administration of drugs significantly increase the risk of adverse effects on neonates. Moreover, diazepam and meperidine should be avoided in nursing women. Finally, anesthesiologists and pediatricians should consider individual risk/benefit, with special attention to premature neonates or babies with concurrent diseases since they are more susceptible to adverse effects.

Resumo Introdução: A importância e os benefícios do aleitamento materno para os bebês e para as mães estão bem estabelecidos e documentados na literatura. No entanto, é frequente que mães lactantes precisem se submeter à anestesia geral ou raquianestesia e, devido à falta de informações, muitas delas interrompem a amamentação após a anestesia. Existem poucos dados disponíveis sobre a transferência de anestésicos para o leite materno. O objetivo desta revisão foi desenvolver algumas considerações e recomendações com base na literatura disponível. Métodos: Uma busca sistemática da literatura realizada usando com os seguintes bancos de dados em ciências da saúde: Embase, Lilacs, Pubmed, Scopus e Web of Science. A pesquisa bibliográfica mais recente foi realizada em 6 de abril de 2018. Uma pesquisa bibliográfica adicional foi realizada através do site da Organização Mundial da Saúde. Usamos os seguintes termos para a estratégia de busca: "Anestesia" e "Aleitamento materno" e seus derivados. Resultados: Nesta pesquisa, 599 registros foram encontrados e 549 foram excluídos por diferentes razões. Foram incluídos 50 manuscritos, com diferentes modelos de estudo: estudos prospectivos, estudos observacionais retrospectivos, revisões, relatos de casos, ensaios clínicos randômicos, caso-controle e acesso a sites. Pequenas concentrações da maioria dos agentes anestésicos são transferidas para o leite materno; entretanto, sua administração parece ser segura para mães lactantes quando administrados em dose única durante a anestesia e isso não deve contraindicar o aleitamento materno. Por outro lado, altas doses, administração contínua ou repetida dos fármacos aumentam o risco de efeitos adversos em neonatos e devem ser evitados. Poucas drogas, como diazepam e meperidina, produzem efeitos adversos em bebês amamentados, mesmo quando administradas em doses únicas. Dexmedetomidina parece ser segura se a amamentação começar 24 horas após a interrupção do medicamento. Conclusões: A maioria dos anestésicos é segura para mães que amamentam e oferecem baixo risco para os recém-nascidos amamentados quando a administração é em dose única. No entanto, altas doses e repetidas administrações de drogas aumentam significativamente o risco de efeitos adversos em recém-nascidos. Além disso, diazepam e meperidina devem ser evitados em mulheres que amamentam. Finalmente, anestesiologistas e pediatras devem considerar o risco-benefício individual, com atenção especial para os recém-nascidos prematuros ou bebês com doenças concomitantes, pois são mais suscetíveis a efeitos adversos.

Clinical profile of neonates admitted with hypernatremia in NICU at tertiary hospital in Vadodara, Gujarat, India

Background: Neonatal hypernatremia is less common but significant' metabolic problem' with acute morbidity as well as long term consequences. Many causative' factors have been identified such' as inadequate breastfeeding, hot' weather with high' evaporative losses ,' infections etc. It is important to identify, anticipate and correct the condition before it leads to damaging consequences. The objective of the present study was evaluation of clinical profile, renal parameters and causative factors associated with hypernatremia in exclusively breast-fed infants.Methods: A retrospective review of' 30 new-borns less than 28 days of age admitted in' GMERS General hospital for hypernatremia was conducted. The study group included inborn and out born admissions. Records were reviewed, feeding history, severity of hypernatremia and altered renal parameters were analysed. The study period was from April 2018to June2018i.e summer months.Results: Total NICU admissions were 303 during these months' out of which 30 were diagnosed' with hypernatremia completely and discharged. Mean age of presentation was 8.4 days. Sodium levels ranged from 146-179 mmol/l. Mild hypernatremia was most common (56.7%), followed by moderate hypernatremia in 40%. All neonates were on' exclusive breast feeding. Majority of the affected neonates were term SGA followed by term AGA and preterm AGA. Renal parameters were altered in quarter of affected' infants.' Most common clinical feature noted was lethargy(70%), followed' by fever(53.3%),significant weight loss ,jaundice and dehydration. 29 patients were successfully discharged on breast milk feeding.Conclusions: Hypernatremia though rare, is common in young infants in summer months. It is preventable and treatable condition. It is important to anticipate, identify and treat such patients at the earliest. Treating physicians and nursing staff should be more vigilant for establishment of breast feeding in low birth weight infants. Exclusive breast feeding for first six months of life should always be promoted.

Factors associated with exclusive breastfeeding practice in a cohort of women from Cali, Colombia / Factores asociados con la práctica de lactancia exclusiva en una cohorte de mujeres de Cali, Colombia

Abstract Introduction: Breastfeeding promotion is one of the most effective strategies to prevent child malnutrition; it reduces costs to families, health services and society. In Colombia, exclusive breastfeeding is practiced only by 10% of women. Objective: To identify factors associated with the duration of exclusive breastfeeding. Methods: A cohort of 438 primiparous women was followed during 6 months by means of 8 home interviews, in order to determine the duration of exclusive breastfeeding. Individual, family and health service factors were studied; and survival analysis was carried out. Results: At 8 days, only a few more than half of the participants maintained exclusive breastfeeding; at month 6 of follow-up, this proportion was reduced to 1.4%. The duration of exclusive breastfeeding was determined by: initiation of breastfeeding in the first 4 hours after delivery (HR= 4.07, 95% CI: 0.96-16.67), self-perceived sureness for breastfeeding (HR= 1.28, 95% CI: 1.04 -1.58), positive opinion of the baby's father regarding breastfeeding (HR= 1.26, 95% CI: 1.01-1.57), and newborn weight (HR= 1.23, 95% CI: 1.00-1.53). Conclusion: There are factors before delivery and in the immediate puerperium that determine, partially, the duration of exclusive breastfeeding.

Resumen Introducción: La promoción de la lactancia es una de las estrategias más efectivas para evitar la desnutrición infantil; reduce costos a las familias, los servicios de salud y la sociedad. En Colombia solo 10% de las mujeres practican la lactancia materna exclusiva. Objetivo: Identificar factores asociados a la duración de la lactancia exclusiva. Métodos: Se siguió durante 6 meses a una cohorte de 438 mujeres primíparas mediante 8 entrevistas domiciliarias para determinar la duración de lactancia exclusiva. Se estudiaron factores individuales, familiares y de servicios de salud y se realizó análisis de sobrevida. Resultados: A los 8 días sólo un poco más de la mitad de participantes mantenía lactancia exclusiva; al mes 6 de seguimiento esta proporción se redujo a 1.4%. La duración de lactancia exclusiva estuvo determinada por: inicio de lactancia en las primeras 4 horas pos-parto (HR= 4.07; IC 95%: 0.96-16.67), seguridad auto-percibida para amamantar (HR= 1.28; IC 95%: 1.04-1.58), opinión positiva del padre del bebé frente a lactancia (HR= 1.26; IC 95%: 1.01-1.57) y peso de recién nacido (HR= 1.23; IC 95%: 1.00-1.53). Conclusión: Existen factores antes del parto y en el puerperio inmediato que determinan, parcialmente, la duración de la lactancia exclusiva.

Study regarding the feeding practice among mothers attending the immunisation clinic of a tertiary care centre

Background: The world health organization (WHO) recommends exclusive breast feeding (EBF) for the first six months of life while it is advised to provide adequate and safe complementary foods with breast feeding for up to two years and beyond.Methods: A hospital based cross sectional study was carried out in the immunisation clinic of IGIMS for a period of 6 months from January 2017 to June 2017.A total of 400 mothers were enrolled in the study. Children of Age group 0-12 months were included in the study. Sample size was collected by using convenient sampling from January to June 2017. All mothers who attended our immunization clinic for vaccination of their child and had children less than 12 months of age and who gave verbal consent were included in the study. Mothers were asked to stay after vaccination of their infants to look for any untoward effects of vaccination. Mothers were interviewed by using a semi structured questionnaire after getting a verbal consent from them, All data entry and analyses were carried out using Microsoft Excel and statistical software by descriptive statistics and presented as frequency and percentages.Results: The prevalence of exclusive breast feeding for up to 6 months of age was still low. Male child is having a higher percentage of immunization coverage of about 60%, where as the female child is having about 40%. 36% of the babies were started breastfeeding within one hour and colostrum was given to 40% of them, only 35% of them were on exclusive breast feeding.Conclusions: Use of expressed breast milk was low. The prevalence of EBF for up to 6 months of age was still low as per WHO recommendations. The mother's perception of “insufficient breast milk” was also the main reason for introducing other foods. We should make a strategy by making a guideline for promoting and educating about exclusive breastfeeding within the existing health care system such as the antenatal, after delivery and vaccination clinics.

The Infant Feeding Practices Among The Lactating Mothers Of Mansa Devi Area Located In Panchkula, Haryana.

Background: Malnutrition has been responsible for 60% of the 10.9 million deaths annually among children under five. 2/3 of these deaths are associated with inappropriate infant feeding practices. The nutritional status of slum children is even poorer than the rural average. Objective:To assess the infant feeding practices among the lactating mothers of Mansa Devi area located in Panchkula, Haryana. Methodology: Cross-sectional study among mothers of child up to one year of age was carried in Mansa Devi area located in Panchkula, Haryana. 76 mothers between 18 to 40 years were interviewed by predesigned and pretested questionnaire. Results and Conclusion: 92.1% infants were breast fed. 61.8% were exclusively breast fed. 10.5% infants had birth ghutti. Knowledge of breastfeeding (78.9%) , Colostrum (59.2%) and Complementary feeding (72.4%) was good due to Urban ASHA Worker (84.2%) awareness in area.

Hindering factors of infant feeding practices among the mothers of mid western part of Nepal

Background and Objectives: This study was aimed to provide baseline information on infant feeding knowledge, practices and hindering factors for proper feedings.Material and Methods: Among the 185 women with less than one year child coming on immunization clinic of health post of Chisapani Village Development Committee, infant feeding knowledge, practices were assessed by interviewing with semi structured questionnaire and focus group discussion.Results: Male children were more exclusively breastfed (33%) than female (27%) and exclusive breast feeding was lower in fifth and sixth month of age. All of them were aware that the baby should be fed only breast milk for 6 months, but the exclusive breastfeeding practice was found only in a very few mothers. Most of them had fed solid food after 3 months.Conclusion: Knowledge and practices on infant feeding do not go along despite the adequacy of knowledge due to the hindering factors like poverty, working mother, lack of support from family members and lack of support from the government infant. The gap between knowledge and practice can be lessened via informative activities on lactation management, endorsing policies and rights for mothers-infants relationship.

Study of breast feeding practices, problems and factors affecting exclusive breastfeeding in Barabanki District of Uttar Pradesh - A Hospital Based Study

Background: Breast feeding and colostrum is the first birthright of every newborn. It is the least expensive, safe, healthiest, natural feed that can be given very easily to any newborn baby for proper physiological growth and psychological development. Exclusive Breast feeding is a term used to define the process by which only breast milk is given to the new born till the first six months of life. Early initiation of breast feeding is very important in reducing infant morbidity and mortality. Rate of exclusive breast feeding is only 35% world-wide and complementary feeding is not started timely. Objective: To know the current situation of exclusive breast feeding, problems encountered by lactating mothers, factors affecting exclusive breast feeding and complementary feeding. Material and Method: This descriptive cross-sectional study was carried out on 200 mothers having children less than 2 years of age attending pediatrics OPD, Gynecology & obstetrics OPD and postpartum ward of Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh. The information about subjects’ demography and practices towards breast feeding were collected from the mother on structured proforma. Result: 200 lactating mothers were included in the study. Majority of mothers are from age group 24-29 years ie 105 (52.5%).out of 200 babies 110 are female and 90 are male and 20 (10%) lactating mothers initiated breastfeeding within 1 hours of delivery. Majority of mothers 102 (51%) initiated breastfeeding within 1-6 hours and only 46.5% babies were exclusive breastfed upto 6 months. 89% of mothers given colostrum to their babies. 47% of mothers given pre-lacteals to babies and formula milk (23%) was the common pre-lacteals followed by cow’s milk (11%). Only 49.3% children were started complementary feeding between 6-9 months. 45% do not encountered any problem during breastfeeding. 55% were having some problem during feeding. 20% mothers were having feeling of insufficient milk secretion followed by 12.5% not knowing about time and frequency of feeding. Conclusion: There were many demographic, social-economic factors and literacy of mother affecting exclusive breastfeeding. Breast feeding is almost universal in India but the rate of early initiation of breast feeding and exclusive breastfeeding are very low. Several factors can be attributed on the breast feeding practices. Social awareness programs, benefits of breast feeding and mass education of family regarding feeding practices should be started to promote exclusive breast feeding and complementary feeding.

A Study On Colostrum And Exclusive Breast Feeding Practices And Its Determinants In Rural Mothers Of Katihar, Bihar

Breastfeeding, also known as nursing, is the feeding of babies and young children with milk from a woman‘s east. Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks. Breastfeeding decreases the risk of respiratory tract infections and diarrhea. Other benefits include lower risks of asthma, food allergies, celiac disease, type 1 diabetes, and leukemia.Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood. Benefits for the mother include less blood loss following delivery, better uterus shrinkage, weight loss, and less postpartum depression. Long term benefits for the mother include decreased risk of east cancer, cardiovascular disease, and rheumatoid arthritis. Breastfeeding is less expensive than infant formula.Colostrum is the first east milk produced after birth and is important for promotion of health and prevention of infections of the newborn immediately after birth. Though the eastfeeding practices are well known to mothers but the necessity of colostrum feeding is still poorly understood especially by the mothers in rural areas due to various factors. World Health Organization (WHO), recommend eastfeeding exclusively for six months. After the introduction of foods at six months of age, recommendations include continued eastfeeding until at least one to two years of age.

Effect of Complementary Feeding Practices and Nutritional status of Children (6-23 months) in Tamang Community, Ambhanjyang VDC of Makwanpur

Background and Objectives: The aim of the paper was designed to know the relationship between complementary feeding, nutritional knowledge and behavior of mothers (IYCF practices) and nutritional status of children less than two years of age at Ambhanjyang Village Development Committee (VDC) of Makwanpur district.Material and Methods: The study was conducted in aforesaid VDC of Makwanpur districts with a total of 120 samples. The questionnaire used consisted of socio-demographic information, health profile, dietary behavior of the child such as amount of feeding, frequency of feeding, diversified food and attitude statements of mothers regarding nutritional knowledge. The nutritional status of the child was assessed on the basis of anthropometric measurements weight and height.Results: In this survey, 21.2 percent of the children were found to be moderately underweight while 5.8 percent of the children were severely underweight, 19.2 percent were moderately stunted while 15 percent were found severely stunted. Likewise, 10.8 percent of the children found moderately wasted and only 1 child was found to be severely wasted. No significant association was observed between various socio-economic factors, complementary feeding practices and nutritional status of a child.Conclusion: The prevalence of under nutrition, stunting and inadequate complementary feeding practices was observed in the study sample. Although no significant association was observed between various socio-demographic factors and nutritional status of a child, there is an immediate requirement of healthy knowledge and change in behavior of mothers of children about complementary feeding practices to prevent the deteriorating nutritional status of child.