The positive role of breastfeeding on infant health during the first 6 weeks: findings from a prospective observational study based on maternal reports.

This study aimed to report on adverse infant and maternal clinical outcomes, and investigate the relationship between infant feeding practice and such adverse clinical outcomes in infants during the first 6 weeks postpartum. From an eligible sample of 450 mother-term infant pairs recruited from the Coombe Women and Infants University Hospital in Dublin, 27.1% of infants (n=122) were maternally reported to have had an illness during the first 6 weeks that necessitated the provision of prescribed medication +/- general practitioner/paediatrician attendance +/- hospitalisation. Of these, 90 infants had > or =1 episode of infection +/- viral +/- gastro-intestinal-related condition. After adjustment, 'any' breastfeeding to 6 weeks was protective against such adverse infant outcomes (adjusted odds ratio [aOR] 0.44, P = 0.022). Attendance to the GP/paediatrician for > 1 visit (aOR 3.44, P = 0.000) and multiparity (aOR 1.76, P = 0.041) were also positively associated with such adverse infant outcomes. To decrease infant morbidity rates in Ireland, government investment in breastfeeding promotion, support and research should be a continued public health priority.

Maternal and infant nutritional supplementation practices in Ireland: implications for clinicians and policymakers.

This prospective Irish observational study examined maternal and infant nutritional supplement use. From an initial sample of 539 mothers recruited from the Coombe Women and Infants University Hospital in Dublin (during 2004-2006), 450 eligible mothers were followed up at 6 weeks and 6 months postpartum. Only 200 women (44.4%) complied with peri-conceptional folic acid at the recommended time with strong social patterning associated with its uptake. Almost 10% of the sample (n = 44) consumed a combined multivitamin and mineral supplement during pregnancy. A vitamin D-containing supplement was provided to only 5 (1.1%) and 15 (3.3%) infants at 6 weeks and 6 months, respectively. A national guideline that advises on adequate and safe use of both vitamin and multivitamin supplements during pregnancy with particular reference to vitamin A and D is warranted. Given the re-emergence of rickets in Ireland, and the reported morbidities associated with vitamin D insufficiency, promoting and monitoring compliance with 200 IU [5 microg] daily vitamin D supplements to all infants particularly those from higher risk groups from birth to 1 year, should be a public health priority.

Maternal health behaviours during pregnancy in an Irish obstetric population and their associations with socio-demographic and infant characteristics.

BACKGROUND/OBJECTIVES: To examine the prevalence and combined occurrence of peri-conceptional folic acid (FA) supplement use, smoking and alcohol consumption during pregnancy in a sample of women in Dublin, and determine the factors associated with these health behaviours. SUBJECTS/METHODS: A prospective observational study (2004-2006) involving the recruitment of 491 pregnant women from antenatal clinics in a Dublin maternity hospital, with postpartum follow-up of 450 eligible mothers. Data on FA use, maternal smoking and alcohol consumption patterns during pregnancy were collected from the antenatal patient-administered questionnaire, which was completed by participants, and returned to the investigator on the day of recruitment. RESULTS: The median gestational age of women at recruitment was 36 weeks. A combined 24.2% of mothers commenced FA at the recommended time, avoided alcohol consumption and smoking during pregnancy. In all, 35.3% of mothers reported to consuming alcohol, 20.9% smoked during pregnancy and 44.4% commenced FA at the recommended time. Mothers <25 years were more likely to have not taken FA at the recommended time (adjusted odds ratio (aOR): 4.0, 95% confidence interval (CI): 1.64-9.77) and were more likely to have smoked during pregnancy (aOR: 3.56, 95% CI: 1.32-9.57). Irish nationality positively predicted both alcohol consumption (aOR: 4.37, 95% CI: 1.88-10.15) and smoking (aOR: 10.92, 95% CI: 1.35-87.98) during pregnancy. CONCLUSIONS: Educational efforts are still necessary to convince women of Irish nationality, in particular, of the adverse effects of smoking and alcohol consumption on fetal outcome. Women <25 years should be specifically targeted in smoking cessation and FA promotional campaigns.

Subcapsular fluid entrapment in extracapsular cataract surgery.

We report five cases of sudden shallowing of the anterior chamber associated with irrigation under the iris. We suspect that irrigation in this context forces fluids through the zonules into the posterior chamber, where it becomes trapped, causing anterior chamber shallowing. In our cases, this phenomenon was most commonly associated with irrigation during cortex removal in cases in which the cornea was open (associated with corneal transplantation) and with zonular dehiscence.

The effect of dietary supplements of omega 3 polyunsaturated fatty acids on the fatty acid composition of platelets and plasma choline phosphoglycerides.

1. The effects of dietary supplements of omega 3 polyunsaturated fatty acids on the fatty acid composition of platelets and plasma choline phosphoglycerides were studied in vegans and in omnivores. 2. A supplement of 18:3 omega 3 led to an increase in 20:5 omega 3 but was less effective than one of 20:5 omega 3 + 22:6 omega 3.