Trends and disparities in breastfeeding initiation in France between 2010 and 2016: Results from the French National Perinatal Surveys.

Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department-level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed-effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby-Friendly Hospital Initiative designation. The 2010-2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers.

Neonatal Feeding Trajectories in Mothers With Bipolar Disorder Taking Lithium: Pharmacokinetic Data.

Purpose: Women who take lithium during pregnancy and continue after delivery may choose to breastfeed, formula feed, or mix these options. The aim of the study was to evaluate the neonatal lithium serum concentrations based on these three feeding trajectories. Methods: We followed 24 women with bipolar disorder treated with lithium monotherapy during late pregnancy and postpartum (8 per trajectory). Lithium serum concentrations were determined by an AVL 9180 electrolyte analyser with a 0.10 mEq/L detection limit and a 0.20 mEq/L limit of quantification (LoQ). Results: There was complete lithium placental passage at delivery, with a mean ratio of lithium concentration in the umbilical cord to maternal serum of 1.12 ± 0.17. The median times to LoQ were 6-8, 7-8, and 53-60 days for formula, mixed, and exclusive breastfeeding respectively. The generalized log-rank testing indicated that the median times to LoQ differ according to feeding trajectory (p = 0.037). According to the multivariate analysis-adjusted lithium serum concentrations at birth, times to LoQ are, on average, longer under exclusive breastfeeding (formula, p = 0.015; mixed, p = 0.012). No lithium accumulation was observed in infants under either exclusive or mixed breastfeeding. During the lactation follow-up, there was no acute growth or developmental delays in any neonate or infant. Indeed, lithium concentrations in the three trajectories declined in all cases. However, the time needed to reach the LoQ was much longer for those breastfeeding exclusively. Conclusions: In breastfeed infant no sustained accumulation of lithium and no adverse effects on development or growth were observed.

La lactancia materna y su influencia en el comportamiento de las infecciones respiratorias agudas / The breastfeeding and its influence on the behavior of acute respiratory infections

INTRODUCCION: la lactancia materna es reconocida como el mejor inductor de la maduración inmunológica de la etapa posnatal. La leche materna provee una nutrición completa para cualquier bebé desde el nacimiento hasta los 6 meses de vida. MÉTODOS: se estudiaron 80 transicionales, pertenecientes al Grupo Básico de Trabajo No. 2 del Policlínico Ana Betancourt, con el objetivo de identificar la frecuencia y variedad de las infecciones respiratorias agudas en relación con el tipo de lactancia recibida. Para la recolección de los datos se consideró la información reflejada en las consultas de puericultura realizadas, durante el primer año de vida, contempladas en las historias clínicas pediátricas (revisión documental). RESULTADOS: predominaron los niños lactados (83 por ciento), aunque de estos, solo el 25 por ciento se alimentó de forma exclusiva. La lactancia mixta, aunque mayoritaria (58 por ciento), predomina por debajo del cuarto mes de vida y el 17 por ciento de los casos fue lactado de manera artificial. Las infecciones respiratorias agudas fueron más frecuentes en niños que recibieron poco tiempo de lactancia mixta (19 por ciento), así como en los que se alimentaron de modo artificial (14 por ciento), con predominio en ellos de la mayor parte de las otitis medias y la totalidad de las neumonías. Solo en 3 de estos pacientes fue necesaria la hospitalización, y la evolución en todos los casos fue satisfactoria. CONCLUSIONES: predominó la variedad mixta de lactancia materna. Se comprobó una alta morbilidad por infecciones respiratorias agudas en los transicionales estudiados. Mientras más breve es el período de lactancia materna, mayor es el riesgo de infección y la severidad de estas. Las dos terceras partes de la otitis media y la totalidad de las neumonías ocurren en casos con lactancia materna mixta breve o artificial(AU)

INTRODUCCION: breastfeeding is recognized as the better inductor of the immunologic maturation of postnatal stage. Mother milk provides a complete nutrition for any baby from the birth to 6 months of life. METHODS: eighty transitional cases were studied from the No. 2 Basic Work Group of the Ana Betancourt Polyclinic to identify the frequency and variety of acute respiratory infections related to the type of breastfeeding received. To data collection authors considered the information achieved in the puericulture consultations during the first year of life, completed in the pediatric medical records (documentary review). RESULTS: there was predominance of breast-fed children (83 percent) although from these, only the 25 percent was feed in an exclusive way. Mixed lactation even so majority (58 percent) predominates under the fourth month of life and the 17 percent of cases was lactated in an artificial way. The acute respiratory infections were the most frequent in children with a short period of mixed lactation (19 percent), as well as in those lactated in an artificial way (14 percent) with predominance in them most of the otitis media and the total of pneumonia. Only in three of these patients it was necessary hospitalization and the course in all the cases was satisfactory. CONCLUSIONES: there was predominance of mixed breastfeeding. It was proved a high morbidity due to acute respiratory infections in study transitional cases. The more is brief the period of breastfeeding, greater is the infection risk and severity of these infections. The two third of otitis media and the total of pneumonias occur en cases with brief mixed breastfeeding or artificial(AU)

La lactancia materna y su influencia en el comportamiento de las infecciones respiratorias agudas / The breastfeeding and its influence on the behavior of acute respiratory infections

INTRODUCCION: la lactancia materna es reconocida como el mejor inductor de la maduración inmunológica de la etapa posnatal. La leche materna provee una nutrición completa para cualquier bebé desde el nacimiento hasta los 6 meses de vida. MÉTODOS: se estudiaron 80 transicionales, pertenecientes al Grupo Básico de Trabajo No. 2 del Policlínico Ana Betancourt, con el objetivo de identificar la frecuencia y variedad de las infecciones respiratorias agudas en relación con el tipo de lactancia recibida. Para la recolección de los datos se consideró la información reflejada en las consultas de puericultura realizadas, durante el primer año de vida, contempladas en las historias clínicas pediátricas (revisión documental). RESULTADOS: predominaron los niños lactados (83 por ciento), aunque de estos, solo el 25 por ciento se alimentó de forma exclusiva. La lactancia mixta, aunque mayoritaria (58 por ciento), predomina por debajo del cuarto mes de vida y el 17 por ciento de los casos fue lactado de manera artificial. Las infecciones respiratorias agudas fueron más frecuentes en niños que recibieron poco tiempo de lactancia mixta (19 por ciento), así como en los que se alimentaron de modo artificial (14 por ciento), con predominio en ellos de la mayor parte de las otitis medias y la totalidad de las neumonías. Solo en 3 de estos pacientes fue necesaria la hospitalización, y la evolución en todos los casos fue satisfactoria. CONCLUSIONES: predominó la variedad mixta de lactancia materna. Se comprobó una alta morbilidad por infecciones respiratorias agudas en los transicionales estudiados. Mientras más breve es el período de lactancia materna, mayor es el riesgo de infección y la severidad de estas. Las dos terceras partes de la otitis media y la totalidad de las neumonías ocurren en casos con lactancia materna mixta breve o artificial

INTRODUCCION: breastfeeding is recognized as the better inductor of the immunologic maturation of postnatal stage. Mother milk provides a complete nutrition for any baby from the birth to 6 months of life. METHODS: eighty transitional cases were studied from the No. 2 Basic Work Group of the Ana Betancourt Polyclinic to identify the frequency and variety of acute respiratory infections related to the type of breastfeeding received. To data collection authors considered the information achieved in the puericulture consultations during the first year of life, completed in the pediatric medical records (documentary review). RESULTS: there was predominance of breast-fed children (83 percent) although from these, only the 25 percent was feed in an exclusive way. Mixed lactation even so majority (58 percent) predominates under the fourth month of life and the 17 percent of cases was lactated in an artificial way. The acute respiratory infections were the most frequent in children with a short period of mixed lactation (19 percent), as well as in those lactated in an artificial way (14 percent) with predominance in them most of the otitis media and the total of pneumonia. Only in three of these patients it was necessary hospitalization and the course in all the cases was satisfactory. CONCLUSIONES: there was predominance of mixed breastfeeding. It was proved a high morbidity due to acute respiratory infections in study transitional cases. The more is brief the period of breastfeeding, greater is the infection risk and severity of these infections. The two third of otitis media and the total of pneumonias occur en cases with brief mixed breastfeeding or artificial