Nurses' attitudes towards breastfeeding among women with schizophrenia in southern Israel.

Breastfeeding is the best source of nutrition for infants. Approximately half of women with schizophrenia become mothers, yet the issue of breastfeeding is often overlooked by the health professional community. The aim of this study was to survey attitudes among registered nurses regarding breastfeeding by schizophrenic women. Cross-sectional descriptive design was used involving a sample of nurses (40 midwives, 37 psychiatric and 33 postpartum) in two medical centres in southern Israel. The validated semistructured questionnaire included sociodemographic and professional questions, personal and professional breastfeeding experience, attitudes and knowledge concerning schizophrenia and attitudes towards breastfeeding by schizophrenic women. The study results indicate that 70% of the respondents held positive attitudes towards breastfeeding in women with schizophrenia, although no significant differences were found between the different types of nurses. Multivariate analysis reveals that academic education was the only variable associated with positive attitudes, while negative feelings towards women with schizophrenia, and extensive knowledge regarding schizophrenia were negatively associated. This study can serve as a foundation for future research to further examine nurses' role in providing postpartum education and care for women with schizophrenia.

Effects of early breastfeeding on neonatal glucose levels of term infants born to women with gestational diabetes.

BACKGROUND: Infants born to diabetic women are at higher risk for hypoglycaemia related to hyperinsulinism in response to maternal hyperglycaemia during pregnancy. As such, recommendations to prevent neonatal hypoglycaemia include infant feeding in the early postpartum period. The present study aimed to examine the effect of early breastfeeding and type of nutrition used for the first feed (human milk or formula) on glucose levels in infants born to women with gestational diabetes. METHODS: The prospective pilot study of 84 infants born to gestational diabetic women examined the glycaemic levels of infants who were breastfed in the delivery room compared to glycaemic levels of those who were not. The study also compared the glycaemic levels of infants who breastfed with those who received formula for their first feed. RESULTS: Infants who were breastfed in the delivery room had a significantly lower rate of borderline hypoglycaemia than those who were not breastfed in the early postpartum period (10% versus 28%; Fisher's exact test., P = 0.05,). Likewise, infants breastfed in the delivery room had significantly higher mean blood glucose level compared to infants who were not breastfed in the delivery room (3.17 versus 2.86 mmol L(-1), P = 0.03). Additionally, breastfed infants had a significantly higher mean blood glucose level compared to those who were formula fed for their first feed (3.20 versus 2.68 mmol L(-1), P = 0.002). CONCLUSIONS: Early breastfeeding may facilitate glycaemic stability in infants born to women with gestational diabetes.

Multifetal pregnancy reduction and halakha.

The frequency of multifetal pregnancies has increased dramatically in recent years with the advent of assisted reproductive technologies. In an effort to ensure a successful outcome for both the fetus(es) and the mother, multifetal reduction is often medically recommended. Multifetal reduction may present a challenge to Orthodox Jewish law, as there is an apparent threat to the preservation of the fetuses lives. Yet, without medical intervention there is an increased risk of fetal and maternal morbidity and mortality. The issues involved in multifetal reduction have been thoroughly analyzed and recorded in Orthodox Jewish responsa, setting guidelines for rabbinic authorities to rule on the matter in specific cases based on the specific circumstances. The present article will analyze the medical procedure with respect to the halakhic literature published to date on the subject of multifetal reduction.

Relief of breast engorgement for the Sabbath-observant Jewish woman.

Relief of breast engorgement on the Sabbath is a challenge for the Sabbath-observant Jewish client. Many Sabbath laws limit the methods of care for the engorged breastfeeding woman. With a familiarity of the laws of the Sabbath, the health care provider can better address the needs of the engorged Sabbath-observant Jewish woman. In this article, interventions are proposed that mitigate or preclude violation of the Sabbath.