Medicamentos, plantas, tóxicos, enfermedades y lactancia: una ayuda en español en Internet / Drugs, plants, toxins, diseases and breastfeeding: ana aid in Spanish on the Internet

Los beneficios de la lactancia materna, para el niño y la madre, su familia, el sistema sanitario y la sociedad en general, están muy bien documentados en múltiples publicaciones. Suprimir una lactancia sin un motivo de peso es una grave irresponsabilidad desde el punto de vista sanitario. Más del 90% de las mujeres pueden tener que tomar medicamentos o productos de fitoterapia durante el periodo de lactancia, lo que constituye un motivo clásico de cese de la lactancia, pese a no estar demostrado su peligro real más que en un pequeñísimo porcentaje de productos: fenindiona, amiodarona, derivados del ergot, antineoplásicos, y oduros y psicodrogas de abuso. Del mismo modo, sólo 6 enfermedades de la madre contraindican o hacen prácticamente imposible la lactancia. Con sentido común, unos conocimientos básicos de farmacología y pediatría y buenas guías (libros, revistas y páginas web), podemos asesorar a las mujeres que lactan, deben tomar remedios para alguna dolencia o sufren una enfermedad. Las madres huirán de informaciones erróneas, basadas sólo en prejuicios o en el Vademécum. Una página web(www.e-lactancia.org), en español y de sencillo manejo, nos ayudará a tomar decisiones acertadas antemás de 1.400 opciones diferentes implicadas en la lactancia materna

The benefits of breast feedingf or the infant, the mother, the family, the health care system and society in general are well documented in numerous scientific publications. The medical advice for weaning a child without a justified reason is an act of irresponsibility from an ethical point of view. Moret han 90% of women might need to take some type of medication while breastfeeding their babies at any time, this being a commonly alleged reason for weaning. However, only a few drugs have been shown to represent a real hazard: phenindione, amiodarone, ergot derivatives, antineoplastic agents, iodides and drugs of abuse. Seemingly, only six maternal diseases are considered to contraindicate breast feeding or make it nearly impossible. By exercising common sense, applying basic knowledge of Pharmacology and Pediatrics and using up dated guidelines (e.g. books, journals and web resources), we should be able to adequately advise those lactating mothers who require medication. Therefore, healthcare givers are committed to offering them proper assistance since mothers will ultimately reject misin formation or recommendations based on prejudice so rreleased by the industry, like that contained in the Physician's Desk Reference. A website, www.e-lactancia.org, an easy-touse resource in both Spanish and English, will help us make appropriate decisions concerning more than 1.400 options that a lactating mother may have to confront

[Breast feeding: knowledge, attitudes and sociocultural ambiguity]. / Lactancia materna: conocimientos, actitudes y ambigüedad sociocultural.

OBJECTIVES: Found sociocultural attitude with regard to breast-feeding (BF) between the sanitary (SP) and no sanitary personnel (NSP) of health centers. DESIGN: Descriptive, cross-sectional study. SETTING: 4 health centres and 3 hospitals of Valencia. PARTICIPANTS: 442 workers of these centres. INTERVENTION: Structured questionnaire. MAIN RESULTS: 88% of SP and 76% of NSP (p < 0.05) believed that BF has many advantages comparing with artificial-feeding in a developed country. SP said more advantages of BF than NSP (p < 0.0001). Most renowned advantages were immunological, affective relationship and comfort. Main inconveniences were dependence, work reasons, aesthetic nature and insecurity in the ingested amount. 56% of SP and 86% of NSP (p < 0.0001) believed milk's analysis necessary. 56% women and 38% men (p < 0.001) didn't see correct give BF in public. Men were more concerned than women (p < 0.05) for local problems of chest, aesthetic results, milk's quality and transmission of illnesses. CONCLUSIONS: It's necessary to support knowledge and re-evaluating the trust in the nutritious capacity of maternal milk between the personnel of health centers and hospitals. Generic ambiguity toward functions of feminine breast exists and public'BF isn't acceptable. It's necessary recover socioculturally the image of BF and keep in mind the existent ambiguity upon designing campaigns of promotion.

[Health examination of children from the Democratic Sahara Republic (North West Africa) on vacation in Spain]. / Examen de salud de niños de la República Arabe Saharaui Democrática (noroeste de Africa) de vacaciones en España.

OBJECTIVE: We present results of a global health evaluation of groups of children from the Democratic Sahara Republic who came to Spain for vacation. PATIENTS AND METHODS: Clinical and analytical tests of 242 Sahara children from refugee camps in Tindouf (Algeria) that were adopted temporarily by Spanish families between July 1993 and July 1997 are reported. We have used standard groups graphics from the World Health Organization. RESULTS: The results were as follows: sex, 53% girls; mean age, 11.1 +/- 1.6 years and age range, 7-16 years (mode 11). Sixty percent of the children had a weight lower than the 10th percentile and 28% less than the 3rd percentile. Fifty-one percent of the children had a height lower than the 10th percentile and 32% less than the 3rd percentile. The corporal mass was lower than the 10th percentile in 19% and less than the 3rd percentile in 8%. The mean hemoglobin was 12.7 +/- 1.2 gr/dl (17% Hb < 12), iron 66 +/- 32 micrograms/dl (23% Fe < 40), and ferritin 28 +/- 24 ngr/ml (26% Fe < 12). Between 1 and 3 intestinal parasites were found in 75% of the children. Isolated were: Entamoeba coli (38%), Blastocystis hominis (22%), Lamblia (18%), Endolimax nana (17%), Hymenolepis nana (11%), and Oxiuros (5%). Sixteen percent of the children had dental caries and 54% dental malocclusion. Ophthalmological problems were found in 28%, generally myopia. Mantoux > 9 mm was found in 5%. Other pathologies included: 5 kyphoscoliosis, 2 cardiopathies, 2 poliomyelitis sequels, 1 gastric ulcer, 1 epilepsy, 1 spherocytosis and 1 euthyroid goiter. Those with weight in p < 3 and/or functional murmur had Hb < 12 in 61% of the cases and Fe < 40 in 48%. CONCLUSIONS: Anamnesis is difficult because of ignorance of the pathological antecedents and date of birth. For physical exploration and collection of parasites they were extremely modest. Feeding and conditions of life would explain low weight and height percentiles, ferropenic anemia and intestinal parasite rates. It would be better to give anti-parasite drugs and systematic ferroprofilaxis as routine and perform blood tests only in those with weight p < 3.

[Medical responsibilities concerning maternal breast-feeding]. / Los cargos sanitarios ante la lactancia materna.

OBJECTIVE: The objective of this study was to determine the knowledge of high ranking officers in Servei-Valencià-Salut (SVS) about breast-feeding (BF) and national and international regulation related to it, in addition to determining what sanitary policies were undertaken by them to promote BF. PATIENTS AND METHODS: A survey was sent by mail to all high ranking officers (HO) of SVS and all pediatric chief staff services (PC) in our community. To analyze data between both groups a Chi square test and odds ratio in the qualitative variables and variance in the quantitative. RESULTS: Of the surveys sent, 100% were answered by the PC and 44% the HO. Breast-feeding was ranked as superior to artificial feeding by 100% of PC and 73% of HO (p < 0.05). Both groups believed in the necessity of carrying out policies to promote BF in developed countries. Only two PC seemed to know the 1981 OMS's code. All PC carried out policies of BF promotion in their area of influence, while in the HO the percentages varied from 64% to 0% according to their position in the health service organization. CONCLUSIONS: It is necessary to spread the knowledge of and to apply the OMS/UNICEF normatives and to involve al HO with real decision-making power in the development of sanitary policies.