Having Enough Milk to Sustain a Lactation Journey: A Call to Action.

The rates of human milk feeding are suboptimal worldwide. Recommendations for healthy, term mother-infant dyads include early breastfeeding initiation, frequent skin-to-skin contact, and frequent breastfeeding. The normal physiology of lactation can be affected by prenatal factors such as diabetes, obesity, and excessive gestational weight gain. Furthermore, birth-related factors such as early-term gestation, stressful labor, unscheduled cesarean birth, and postpartum hemorrhage can additionally disrupt recommended practices such as early initiation of breastfeeding and skin-to-skin contact. Given that the first 2 to 3 days postpartum are critical to achieving timely secretory activation and establishing an adequate volume of milk, a proactive approach to care can include building awareness of risk factors and development of protocols for the effective early initiation of lactation.

[The importance of breastfeeding for the infant]. / Bedeutung des Stillens für das Kind.

Breastmilk is natural nutrition for infants. In addition to nutrients, breast milk contains a variety of immunomodulatory, anti-inflammatory and antimicrobial substances that help to reduce short- and long-term morbidity risks and positively influence the child's cognitive and psychomotor development. Studies show that breastfed children are at a significantly lower risk for lower respiratory tract infections, otitis media, and gastroenteritis compared with non-breastfed children. Also, the risk for sudden infant death syndrome is significantly reduced by breastfeeding. Breastfeeding does not have an influence on the risk of allergies, neither in the overall population nor in children with a familial predisposition. However, breastfeeding promotes brain development, especially of the white matter, and is associated with improved intelligence by about 2 IQ points. Furthermore, studies show an inverse correlation between breastfeeding and the subsequent risk for obesity, and there is evidence for a risk reduction of type 2 diabetes mellitus. Breastfed infants can largely regulate their food intake. This can have a positive effect on later eating behavior and the risk for becoming overweight. In view of the positive health effects of breastfeeding, it is recommended that infants be breast-fed exclusively during the first few months of life and that complementary feeding should be started at the earliest from the beginning of the 5th month and no later than at the beginning of the 7th month. Complementary food should be offered in a suitable form and with consideration of the signals of the child. Overall, breastfeeding can make a significant contribution to promoting public health and thereby to reducing healthcare costs.

An email survey of midwives knowledge about CytoMegaloVirus (CMV) in Hannover and a skeletal framework for a proposed teaching program.

At present there is lack of information about CMV transmission given to midwives, general practitioners, neonatal pediatricians and nurses, with intrauterine transmission having profound consequences in terms of outcomes for the infected neonate. To identify one particular group of midwives knowledge about CMV, the research question surveyed midwives' knowledge of CMV. A quantitative electronic survey was the research method utilized in this study. To assess midwives knowledge about CMV, the first author emailed colleagues in Hannover and was in receipt of 40 completed questionnaires. Results showed that midwives have gaps in their knowledge about CMV and that an educational program is necessary to enlarge their understandings. Given the catastrophic consequences to the neonate of contracting congenital CMV, it is imperative that both health care professionals and women receive the educational message about prevention. In response an education program for lecturers has been proposed, which consists of eleven learning objectives.