Breastfeeding as a Fundamental Islamic Human Right.

The argument inherent in this paper is that the religious beliefs and values system deeply shape Muslims' breastfeeding culture and that mapping the religious ideals of Islam is essential given the potential inroads it offers toward enhanced neonatal, prenatal and pediatric practices, as well as the mitigation of malpractice or cultural inhibitors. This paper discusses the Muslim religious, moral and spiritual understanding of breastfeeding as a basic natural right while exploring the peculiar perspectives of Islamic law and ethics on the matter, in an effort to present a relevant coherent overview. This research shows that for Muslims, breastfeeding is intertwined with Islam's system of beliefs and values and hence continues to play a vital role in improving health education and increasing rates of exclusive breastfeeding. Further empirical studies on Muslims' perception and practices of breastfeeding shall highlight the extent to which Muslims adhere to religious and spiritual teachings, the response to cultural, secular and liberal models of child upbringing, and how a Muslim religious discourse may further support and celebrate human lactation and breastfeeding as a basic right.

Protecting Breastfeeding From Conflicts of Interest.

In order to maximize profits from sales of breastmilk substitutes, manufacturers use a whole gamut of strategies to interfere with the effective implementation of policies that protect, promote, and support breastfeeding (e.g., the International Code of Marketing of Breastmilk Substitutes with its subsequent World Health Assembly resolutions and the Global Strategy on Infant and Young Child Feeding). Their strategies create, among other problems, personal and institutional conflicts of interest. Effective Conflict of Interest policies are therefore needed for ensuring that governments, international organizations, non-governmental organizations, and health professionals can protect their independence, integrity, and credibility in order to work in the best interests of children. Conflicts of interest are discussed by Dr Lida Lhotska and Dr Judith Richter, who have been actively involved in these issues internationally. Lida Lhotska holds a BSc in Biology and a PhD in Anthropology. Her international work spans over 25 years. She headed the Infant Feeding and Care team for UNICEF and subsequently joined the IBFAN-Geneva Infant Feeding Association team, always focusing on advancing the protection of breastfeeding through legal and other policy measures. Judith Richter has a multidisciplinary background combining knowledge in the humanities with health sciences (PhD Social Sciences; MA Development Studies; MSc Pharmaceutical Sciences). Her work as a freelance researcher for United Nations agencies, governments, and civil society organizations and networks has centered on safeguarding their capacity to hold transnational corporations accountable. In her interview, Judith Richter explains why conflict of interest regulation matters to health professionals working in the field of lactation. (MA = Maryse Arendt; LL = Lida Lhotska; JR = Judith Richter).

Ethical Issues Arising from Marijuana Use by Nursing Mothers in a Changing Legal and Cultural Context.

In the early 2000s, several states legalized marijuana for medicinal uses. Since then, more and more states have either decriminalized or legalized marijuana use for medical or recreational purposes. Federal law has remained unchanged. The state-level decriminalization of marijuana and the concomitant de-stigmatizing and mainstreaming is likely to lead to greater use among the general population, including among nursing mothers. Marijuana is already one of the most widely used illicit substances among lactating women. There exist few studies demonstrating the effects of marijuana in breast milk on nursing babies. In the present context of a changing legal landscape, shifting cultural beliefs, and the absence of clear professional guidelines, healthcare professionals are faced with ethical questions around how best to support nursing mothers and their babies when marijuana use is a factor. This paper first presents an overview of the law, science, and professional guidelines as they relate to marijuana and breastfeeding. Then, I offer an assessment of the relevant ethical issues providers and their patients may need to navigate.

Do Infant Formula Giveaways Undermine or Support Women's Choices?

Eliminating formula giveaways ("banning the bag") has been embraced as a way to reduce the influence of formula marketing in hospitals and to increase breastfeeding rates among new mothers, but the policy raises ethical concerns in the mind of some, notably because it denies a useful benefit to mothers who have trouble affording formula. Hospital policies to promote breastfeeding, including banning the bag, should be sensitive to the economic and other costs associated with breastfeeding and should be consciously designed to make breastfeeding easier and not just to make formula feeding more difficult. We recommend that hospitals evaluate the negative impacts of banning the bag on their patient population in order to ensure that families are not being negatively affected.

A critical review of human milk sharing using an intersectional feminist framework: Implications for practice.

OBJECTIVE: Driven by a growing body of research demonstrating the health benefits of human milk over substitute feeding preparations, the demand for human milk donations in North America is rapidly increasing. In the context of an increasingly institutionalized and commercialized human milk market, informal peer-to-peer milk sharing networks are commonplace. Race, class, gender and sexual orientation are intersecting aspects of identity and power that influence participation in breastfeeding and the domain of milk exchange. Using an intersectional feminist framework, we critically review studies of participation in milk sharing to examine the identities and socio-political circumstances of milk sharing participants. DESIGN, SETTING AND PARTICIPANTS: We use an intersectional feminist framework to conduct a critical review of the evidence pertaining to human milk sharing participants in North America. The search strategy included relevant databases (Pubmed, CINAHL) and hand-searches of key journals. We include research studies with participants in the United States and Canada and where participants milk shared as recipients or donors. FINDINGS: Of those studies that examine socio-political identities such as race and class, participants are largely white and high-income. Many studies did not examine socio-political identities, and none examine sexual orientation. Themes we identify in this review include: (1) Socio-political identities; (2) Milk sharing supports parental health; (3) Socio-political influences; (4) Resistance against institutionalization. IMPLICATIONS FOR PRACTICE: Maternity care providers can advocate for improved access to breastfeeding support and pasteurized human donor milk to address inequities. Maternity care providers can bring consciousness of intersecting socio-political identities to discussions with families about milk-sharing.

Should we talk about the 'benefits' of breastfeeding? The significance of the default in representations of infant feeding.

Breastfeeding advocates have criticised the phrase 'breast is best' as mistakenly representing breastfeeding as a departure from the norm rather than the default for infant feeding. Breastfeeding mothers have an interest in representing breastfeeding as the default, for example, to counteract criticism of breastfeeding outside the home. This connects to an increasing trend to frame feeding babies formula as harmful, which can be seen in research papers, public policy and information presented to parents and prospective parents. (1) Whether we frame infant-feeding decisions in terms of harming or benefit, protection or risk matters because these distinctions are generally morally significant and thus (2) holding that those who decide to use formula 'harm', 'risk harm' to their babies or describing formula feeding as 'dangerous' is likely to contribute to guilt associated with formula feeding and thus to undermine the well-being of vulnerable women. It may undermine attempts to improve breastfeeding rates by leading women to reject information about health outcomes surrounding infant-feeding decisions. However, (3) these distinctions do not apply easily to infant-feeding decisions, in part because of difficulties in determining whether we should treat breastfeeding as the normative baseline for infant feeding. I show that neither the descriptive 'facts of the matter' nor moral or pragmatic considerations provide an easy answer before discussing how to respond to these considerations.

"Fantástica fábrica de leite": problematizando o discurso de apoio à amamentação / "A fantastic milk factory": problematising the discourse in support of breastfeeding / "Fantástica fábrica de leche": problematizando el discurso de apoyo a la lactancia materna

A amamentação, é foco de discursos das políticas direcionadas à gestante. O pré - natal tem como principal objetivo a diminuição da morbidade e da mortalidade materna e infantil. Este artigo busca problematizar as políticas de apoio à mulher durante a gravidez no contexto de uma instituição filantrópica que oferece o serviço. Trata-se de uma pesquisa-intervenção, sendo realizadas oficinas com as gestantes. Nas discussões apontamos as falas trazidas por essas mulheres sobre como se sentiam e os discursos dos profissionais de saúde relatados por elas. Para análise, embasamo-nos nas reflexões foucaultianas para debater como esse discurso se conecta às políticas públicas direcionadas a elas e como delas se distancia. Conclui-se que os discursos atuam gerando determinados modelos relacionados a amamentação e à função como mãe. O controle do corpo, a influência da mídia e o julgamento social estão presentes nos atendimentos e produzem referência de como devem ser mães. (AU)

Breastfeeding is a focus of policy discourses directed at pregnant women. Pre-natal care has as principal objective the protection of both mother and child and aims at reducing their morbidity and mortality rates. This paper seeks to problematise assistance policies directed at pregnant women by a philanthropic institution providing pre-natal assistance. An intervention-research was carried out and two workshops were organised with pregnant women. In the discussions with the participants, we focused on their testimonials as to how they felt and their accounts of the discourses of health professionals. The analysis was based on a Foucauldian scaffolding to assess how women's discourse is connected to current public policies directed at them and how this discourse is also disconnected from them. We conclude that the discourses generate specific models of breastfeeding and bolster women's role as a mother. The control of the body, the influence of the media and judgmental social attitudes permeate care practices for pregnant women and generate a prescriptive normative reference for mothering. (AU)

Los cuidados con la lactancia materna, tanto durante el prenatal o el pos-parto, son focos de discursos de las acciones direccionadas a la mujer y forman parte de los cuidados médicos e sociales , según orientación del Ministerio de Salud, teniendo como principal justificación la disminución de la morbilidad y de la mortalidad del lactante y la madre. Este artículo busca problematizar las políticas de apoyo a la mujer durante el ciclo del embarazo, parto y puerperio en el contexto de una institución filantrópica que ofrece el servicio de asistencia prenatal. Para realizar el estudio, se ha optado por la investigación e intervención, siendo realizados talleres, previamente programados con las gestantes. En las discusiones con las participantes, apuntamos las conversaciones traídas por esas mujeres acerca de cómo se sentían y los discursos de los profesionales de salud según lo relatado por ellas. Para el análisis, nos basamos en las reflexiones de Foucault para debatir como el discurso presentado por las gestantes se articula a las políticas públicas dirigidas a ellas en ese momento y cómo de ellas se aleja. Se concluye que los discursos actúan generando determinados modelos relacionados con la lactancia materna y en el papel cómo madre. El control del cuerpo, la influencia de los medios y el juicio social atraviesan las prácticas de atención de las gestantes y producen referencia de cómo deben ser madres. (AU)

[First year of life. Human milk and human milk substitutes]. / Primer año de vida. Leche humana y sucedáneos de la leche humana.

The nutritional improvement of mothers and their children is one of the most cost-effective tools to achieve optimal human growth and development. The World Health Organization recommends offering «exclusive breastfeeding for the first six months, and then begin the introduction of safe and nutritious food while breastfeeding continues until the second year of life.¼ Since the second half of the 20th century to date extraordinary progress in the manufacturing and formulation of substitutes for human milk has been accomplished, these being partial or complete substitutes for human milk, whether or not suitable for this purpose. Whole (cow´s) milk is not an adequate substitute for human milk during the first six months of life because of its great nutritional disparity and excess solutes with potential deleterious effects in infants. Therefore, it is an ethical responsibility of health professional to educate and advise parents and caregivers on the proper and timely use of human milk substitutes available in our country.

Should Providers Discuss Breastfeeding With Women Living With HIV in High-Income Countries? An Ethical Analysis.

As men and women with human immunodeficiency virus (HIV) are living longer, healthier lives and having children, many questions regarding reproduction in the context of HIV arise. One question is whether breastfeeding is an option for mothers living with HIV. The established recommendation is that women living with HIV in high-income countries avoid breastfeeding. However, some women may still choose to breastfeed for a variety of personal, social, or cultural reasons. Nonmaleficence ("do no harm") must be weighed against maternal autonomy. We propose that providers caring for women in this situation are ethically justified in discussing breastfeeding as a reasonable, though inferior, option. Providers should pursue a shared decision-making approach, engaging in open conversations to learn about the mother's preferences and values, providing education about risks and benefits of various feeding options, and together with the mother formulating a plan to ensure the best possible outcome for the mother and baby.

Intervención educativa sobre lactancia materna en los primeros seis meses de vida / Educational intervention in breastfeeding in the first six months of life

Introducción: la utilización de la leche humana como alimento en el primer semestre de vida no alcanza aún los resultados que se esperan.Objetivo: determinar el efecto de una intervención educativa sobre la lactancia materna en los primeros 6 meses en dos grupos de niños.Métodos: se realizó un estudio analítico y prospectivo de grupos y controles después de una intervención educativa en las gestantes, en el Policlínico Luis Augusto Turcios Lima, de San José de las Lajas. Se conformaron dos grupos homogéneos de 67 madres y sus hijos, uno capacitado; y otro control, no capacitado. Se exploraron: tiempo de lactancia, causas de abandono, morbilidad, pesos y tallas al nacer, a los 3 y 6 meses. La información se procesó por el paquete estadístico Microstat. Se utilizó la dócima X2. Si existían diferencias significativas se aplicó la dócima de comparación múltiple de Duncan.Resultados: las madres capacitadas lactaron de forma exclusiva mayoritariamente de 4 a 6 meses, y las no capacitadas de 1 a 3. En el grupo control hubo mayor frecuencia de procesos mórbidos, ingresos y utilización de antibióticos. En el grupo de estudio se alcanzaron los mejores percentiles de pesos para la edad y pesos para la talla.Conclusiones: la intervención educativa resulta efectiva; se alcanzan mejores tiempos de lactancia materna exclusiva, menor morbilidad y mayores percentiles de peso y talla para la edad, en el grupo intervenido(AU)

Introduction: use of human milk as food in the first six months of life does not reach the expected results yet.Objective: to determine the effect of an educational intervention on breastfeeding in the first six months of life in two groups of children.Methods: prospective, analytical case-control study was conducted after an educational intervention involving pregnant women from Luis Augusto Turcios Lima polyclinics in San José de las Lajas. Two homogeneous groups of 67 mothers and their children, one trained and the other untrained control, were created. The study variables were length of breastfeeding, causes of breastfeeding cessation, morbidity, weight and size at birth after 3 and 6 months. Microstat statistical package allowed processing the whole information. Statistic X2 was used. In case of significant differences, then Duncan's multiple comparison statistic was applied.Results: the mothers in the trained group exclusively breastfed their infants mostly for 4 to 6 months whereas the untrained ones did it for 1 to 3 months. In the control group, morbid processes, hospitalizations and use of antibiotics were more common. The study group reached the best percentiles of weight-to-age and weight-to-height.Conclusions: the educational intervention proved to be effective since longer length of exclusive breastfeeding, less morbidity and higher percentiles of weight and height for age were reached in the study group(AU)

Intervención educativa sobre lactancia materna en los primeros seis meses de vida / Educational intervention in breastfeeding in the first six months of life

INTRODUCCIÓN: la utilización de la leche humana como alimento en el primer semestre de vida no alcanza aún los resultados que se esperan. OBJETIVO: determinar el efecto de una intervención educativa sobre la lactancia materna en los primeros 6 meses en dos grupos de niños. MÉTODOS: se realizó un estudio analítico y prospectivo de grupos y controles después de una intervención educativa en las gestantes, en el Policlínico "Luis Augusto Turcios Lima", de San José de las Lajas. Se conformaron dos grupos homogéneos de 67 madres y sus hijos, uno capacitado; y otro control, no capacitado. Se exploraron: tiempo de lactancia, causas de abandono, morbilidad, pesos y tallas al nacer, a los 3 y 6 meses. La información se procesó por el paquete estadístico Microstat. Se utilizó la dócima X2. Si existían diferencias significativas se aplicó la dócima de comparación múltiple de Duncan. RESULTADOS: las madres capacitadas lactaron de forma exclusiva mayoritariamente de 4 a 6 meses, y las no capacitadas de 1 a 3. En el grupo control hubo mayor frecuencia de procesos mórbidos, ingresos y utilización de antibióticos. En el grupo de estudio se alcanzaron los mejores percentiles de pesos para la edad y pesos para la talla. CONCLUSIONES: la intervención educativa resulta efectiva; se alcanzan mejores tiempos de lactancia materna exclusiva, menor morbilidad y mayores percentiles de peso y talla para la edad, en el grupo intervenido.

INTRODUCTION: use of human milk as food in the first six months of life does not reach the expected results yet. OBJECTIVE: to determine the effect of an educational intervention on breastfeeding in the first six months of life in two groups of children. METHODS: prospective, analytical case-control study was conducted after an educational intervention involving pregnant women from "Luis Augusto Turcios Lima" polyclinics in San José de las Lajas. Two homogeneous groups of 67 mothers and their children, one trained and the other untrained control, were created. The study variables were length of breastfeeding, causes of breastfeeding cessation, morbidity, weight and size at birth after 3 and 6 months. Microstat statistical package allowed processing the whole information. Statistic X2 was used. In case of significant differences, then Duncan's multiple comparison statistic was applied. RESULTS: the mothers in the trained group exclusively breastfed their infants mostly for 4 to 6 months whereas the untrained ones did it for 1 to 3 months. In the control group, morbid processes, hospitalizations and use of antibiotics were more common. The study group reached the best percentiles of weight-to-age and weight-to-height. CONCLUSIONS: the educational intervention proved to be effective since longer length of exclusive breastfeeding, less morbidity and higher percentiles of weight and height for age were reached in the study group.

Introducción del gluten y riesgo de enfermedad celíaca / Gluten introduction and coeliac disease risk

No disponible

The use of Computerized Instrument to Follow Practices at the Baby / Friendly Hospital Initiative

The results allowed concluding that the computerized tool for

monitoring and evaluation of BFHI is a useful and liable instrument