Nipple trauma in infants? Bednar aphthae.

INTRODUCTION: Bednar aphthae are infected wounds caused by trauma, localized to the hard palate in infants. They do not require specific treatment because they regress spontaneously in a few days. They often remain undiagnosed; other times, because of the pain they caused, they may worsen the nursing. CASE REPORT: We describe the clinical case of a healthy infant of 2 months, fed with formula, who has 2 aphthous lesions in the oral cavity associated with irritability and inconsolable crying during feeding. We excluded the influence of infectious factors or underlying diseases. The hypothesis of a traumatic factor was supported by the anatomical features of aphthae and then confirmed by the gradual resolution of lesions after some advices on breastfeeding. CONCLUSIONS: Our intent is to provide a photographic record of Bednar aphthae, which are quite common but often misdiagnosed also because of lacking of photographic material. Improved knowledge of this condition helps physicians in the differential diagnosis of a traumatic condition that is not as unusual as it seems in newborns.

Correlations between welfare initiatives and breastfeeding rates: a 10-year follow-up study.

AIM: To evaluate the prevalence of full breastfeeding during the first 6 months of age and to discover if training programs for health caregivers and welfare initiatives at the community level could improve breastfeeding rates. METHODS: Newborn babies with gestational age > or =36 weeks and birth weight > or =2500 g, discharged from the hospital within the first week of life, without any underlying pathologies, were enrolled in 3-month long sample periods between 1997 and 2006. A questionnaire was distributed to the mothers, to be completed and submitted before hospital discharge. Data were collected from phone interviews at 1, 3 and 6 months. RESULTS: Full breastfeeding rates at hospital discharge showed an oscillation between 69.9% and 87%. The rate decreased in the following months and reached very low levels at 6 months of age (< 24%), with the exception of the last sample period in 2006 (44.9%). CONCLUSION: A simple questionnaire, combined with standardized phone interviews, can be easily reproduced and may be used as an indicator for quality of neonatal care at hospital nurseries. A social and cultural change of the whole community towards breastfeeding promotion will result in increasing breastfeeding rates.