Duration of Breastfeeding Interruption in Nuclear Medicine Procedures.

The recommendation for the duration of breastfeeding interruption after radiopharmaceutical administration has not been standardized and varies among the guidance documents and publications in the literature. Methods: A working group consisting of 3 staff physicians, 2 fellows, and 2 technologists was designated to update the institutional recommendations on breastfeeding interruption based on the review of the guidance documents and the literature. Results: Our institutional recommendations on the duration of breastfeeding interruption for 54 radiopharmaceuticals are presented in 4 summary tables. For completeness, we also include other radiopharmaceuticals with available information. Conclusion: The detailed recommendation summary on breastfeeding might be helpful to other centers.

Clinical Lactation Studies of Lithium: A Systematic Review.

Background: There is substantial evidence that postpartum prophylaxis with lithium lowers the rate of relapse in bipolar disorder. However, it is contraindicated during breastfeeding due to the high variability of the transfer into breast milk. Aims: We conducted a systematic review of the current evidence of studies assessing the transfer of lithium to lactating infants and short-term infant outcomes. Methods: An a priori protocol was designed based on PRISMA guidelines. Searches in PubMed and LactMed were conducted until September 2018. Studies assessing lithium pharmacokinetic parameters and short-term infant outcomes were included. Quality was assessed using a checklist based on international guidelines (i.e., FDA). Results: From 344 initial studies, 13 case reports/series with 39 mother-child dyads were included. Only 15% of studies complied with ≥50% of the items on the quality assessment checklist. Infants breastfeed a mean (SD) of 58.9 (83.3) days. Mean maternal lithium dose was 904 (293) mg/day, corresponding lithium plasma/serum concentration was 0.73(0.26) mEq/L, and breast milk concentration was 0.84(0.14) mEq/L. Mean infant lithium plasma/serum concentration was 0.23(0.26) mEq/L. Twenty-six (80%) infants had concentrations ≤0.30 mEq/L without adverse effects. Eight (20%) showed a transient adverse event (i.e., acute toxicity or thyroid alterations). All of them were also prenatally exposed to lithium monotherapy or polytherapy. Conclusion: The current evidence comes from studies with a degree of heterogeneity and of low-moderate quality. However, it identifies areas of improvement for future clinical lactation studies of lithium and provides support for some clinical recommendations.

Intervenciones de enfermería para prevenir trastornos nutricionales en niños de 0 a 2 años / Nursing interventions to preventing nutritional disorders in children less than two years age

En Colombia ocurre una transición nutricional; los profesionales de Enfermería participan en el diseño de intervenciones para prevenir trastornos nutricionales en la primera infancia; el objetivo es generar una guía de recomendaciones para intervenciones de Enfermería en la prevención de trastornos nutricionales en niños menores de dos años. Se adelantó una Investigación documental con fuentes de información de base secundaria; se realiza la aplicación de las 3 primeras etapas del proceso de Enfermería Basada en la Evidencia (EBE). Para la clasificación de la evidencia y elaboración de las recomendaciones se usó la herramienta Canadian Task Force on Preventive Health Care (CTFPHC). La evidencia disponible refiere que el impulsar el desarrollo de estrategias dirigidas a garantizar una nutrición óptima previa a la concepción tanto en hombres como mujeres garantiza una disminución en la presentación de malnutrición en la infancia. La aplicación de la EBE identifica la evidencia científica de calidad que permite la toma de decisiones y el desarrollo de acciones que pueden llevar a fortalecer el estado de salud de las poblaciones y disminuir los costos de atención en salud desde el enfoque preventivo.

Colombia lives a nutritional transition situation where nursing professionals play an important role through the construction of interventions to prevent early childhood nutritional disorders; The objective is to build a guide to recommendations for the generation of prevention interventions in nutritional disorders in children under two years of age from nursing care; A documentary research was developed with secondary-based sources of information; The first 3 stages of the evidence-based nursing (BSE) are implemented; The tool of the Canadian Task Force on Preventive Health Care (CTFPHC) was used for the classification of the evidence and the elaboration of the recommendations; The available evidence refers to the fact that promoting the development of strategies aimed at ensuring optimal nutrition prior to conception in both men and women ensures a decrease in the presence of malnutrition in childhood. The application of BSE identifies the scientific evidence of quality that allows decision-making and the development of actions that can lead to the strengthening of the health status of the populations and to reduce the costs of health care beginning with the preventive approach.

Factores que influyeron en el abandono precoz de la lactancia materna en lactantes de un Grupo Básico de Trabajo / Factors influencing in the precocious breastfeeding discontinuation in nursing infants of a Basic Group of Work

Introducción: son múltiples y variados los beneficios que ofrece la lactancia materna, entre ellos, la disminución de la mortalidad y la morbilidad infantil. Si embargo, sigue siendo un grave problema el abandono precoz de la lactancia materna en los lactantes, antes del tiempo recomendado. Objetivo: identificar los factores que influyeron en el abandono precoz de la lactancia materna en lactantes. Materiales y Métodos: se realizó un estudio descriptivo transversal, en un universo conformado por los 120 lactantes que no recibieron lactancia materna exclusiva hasta el sexto mes, pertenecientes al Grupo Básico de Trabajo 1, del Policlínico "José Martí Pérez", en Santiago de Cuba. El periodo comprendido fue desde enero a diciembre del 2014. Para la recolección de los datos se revisaron las historias clínicas de los lactantes y se elaboraron encuestas. Se procedió a la tabulación de los resultados los cuales quedaron recogidos en cuadros estadísticos. Resultados: predominaron e las madres multíparas en edades comprendidas entre 20 y 34 años de edad, para un 62,5 %. Un 27,5 % eran amas de casa, y un 25,8 % técnicos. El 65 % de las madres que participaron en el estudio tenían conocimientos sobre la lactancia materna, pero no recibieron suficiente apoyo de sus familiares. La mayoría de estos niños enfermaron, de ellos un 96,6 % padecieron enfermedades respiratorias agudas. La principal causa del abandono precoz fue la hipogalactia, con un 49,1 %. Conclusiones: se identificaron los factores que influyeron en el abandono precoz de la lactancia materna en lactantes (AU).

Introduction: there are several benefits offered by maternal breastfeeding, among them, the decrease of mortality and morbidity. Nevertheless, the precocious breastfeeding discontinuation - before the recommended time- is still a serious problem. Objective: to identify the factors influencing precocious breastfeeding discontinuation in nursing infants. Materials and Methods: a descriptive, cross-sectional study was carried out in a universe formed by 120 nursing infants who were not under exclusive maternal breastfeeding up to the their sixth month. They belonged to the Basic Group of Work 1, of the Polyclinic "José Martí Pérez", in Santiago de Cuba. The studied period was the one from January to December 2014. The clinical records of the nursing infants and surveys were used for data collection. The results were tabulated and gathered in statistical tables. Results: multiparous women aged 20-40 years predominated for a 62 %. 27.5 % of them were housewives, and 25.8 % were technicians. 65 % of the women who participated in the study had knowledge on the importance of maternal breastfeeding, but they did not have enough support from the part of their relatives. Most of the children got sick, and 96.6 % suffered acute respiratory diseases. The main cause of the precocious breastfeeding discontinuation was hypogalactia, with 49.1 % Conclusions: the factors influencing in the precocious maternal breastfeeding discontinuation were identified (AU).

Factores que influyeron en el abandono precoz de la lactancia materna en lactantes de un Grupo Básico de Trabajo / Factors influencing in the precocious breastfeeding discontinuation in nursing infants of a Basic Group of Work

Introducción: son múltiples y variados los beneficios que ofrece la lactancia materna, entre ellos, la disminución de la mortalidad y la morbilidad infantil. Si embargo, sigue siendo un grave problema el abandono precoz de la lactancia materna en los lactantes, antes del tiempo recomendado. Objetivo: identificar los factores que influyeron en el abandono precoz de la lactancia materna en lactantes. Materiales y Métodos: se realizó un estudio descriptivo transversal, en un universo conformado por los 120 lactantes que no recibieron lactancia materna exclusiva hasta el sexto mes, pertenecientes al Grupo Básico de Trabajo 1, del Policlínico "José Martí Pérez", en Santiago de Cuba. El periodo comprendido fue desde enero a diciembre del 2014. Para la recolección de los datos se revisaron las historias clínicas de los lactantes y se elaboraron encuestas. Se procedió a la tabulación de los resultados los cuales quedaron recogidos en cuadros estadísticos. Resultados: predominaron e las madres multíparas en edades comprendidas entre 20 y 34 años de edad, para un 62,5 %. Un 27,5 % eran amas de casa, y un 25,8 % técnicos. El 65 % de las madres que participaron en el estudio tenían conocimientos sobre la lactancia materna, pero no recibieron suficiente apoyo de sus familiares. La mayoría de estos niños enfermaron, de ellos un 96,6 % padecieron enfermedades respiratorias agudas. La principal causa del abandono precoz fue la hipogalactia, con un 49,1 %. Conclusiones: se identificaron los factores que influyeron en el abandono precoz de la lactancia materna en lactantes (AU).

Introduction: there are several benefits offered by maternal breastfeeding, among them, the decrease of mortality and morbidity. Nevertheless, the precocious breastfeeding discontinuation - before the recommended time- is still a serious problem. Objective: to identify the factors influencing precocious breastfeeding discontinuation in nursing infants. Materials and Methods: a descriptive, cross-sectional study was carried out in a universe formed by 120 nursing infants who were not under exclusive maternal breastfeeding up to the their sixth month. They belonged to the Basic Group of Work 1, of the Polyclinic "José Martí Pérez", in Santiago de Cuba. The studied period was the one from January to December 2014. The clinical records of the nursing infants and surveys were used for data collection. The results were tabulated and gathered in statistical tables. Results: multiparous women aged 20-40 years predominated for a 62 %. 27.5 % of them were housewives, and 25.8 % were technicians. 65 % of the women who participated in the study had knowledge on the importance of maternal breastfeeding, but they did not have enough support from the part of their relatives. Most of the children got sick, and 96.6 % suffered acute respiratory diseases. The main cause of the precocious breastfeeding discontinuation was hypogalactia, with 49.1 % Conclusions: the factors influencing in the precocious maternal breastfeeding discontinuation were identified (AU).