Separate care for a new mother and infant may affect the duration of breastfeeding, breastfeeding behaviour and may have an adverse effect on neonatal and maternal outcomes.
Matched MeSH terms: Breast Feeding/statistics & numerical data*
To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear.
BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus Aureus. Incidence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.
OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Central Register of Clinical Trials (The Cochrane Library 2007, Issue 4), MEDLINE (1996 to 2007) and EMBASE (January 1985 to 2007). We contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles
SELECTION CRITERIA: Randomized and quasi-randomized clinical trials comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis were selected.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author.
MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as "supportive therapy" versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.
AUTHORS' CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded randomized clinical trials to determine whether antibiotics should be used in this common postpartum condition.
Matched MeSH terms: Breast Feeding/adverse effects*
In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries.
To compare weight gain and head growth in very-low-birthweight (VLBW, <1501 g) infants with or without exposure to short duration of skin-to-skin contact (STSC) during their stay in a neonatal intensive care unit.
The aim of this study is to highlight the baseline characteristics of the results of a screening test for anaemia among infants in a village in Okinawa, Japan. The groups were classified into two; infants with and without anaemia. A total of 201 infants were screened at 3-4 months, 9-10 months and 18 months. The study showed that gestational age and BMI were predictive of anaemia at 3-4 months of age. At 9-10 months, types of feeding and weight ratio were the only factors that were found to be significantly predictive of anaemia. However, no factor was found to be predictive of anaemia at 18 months. Anaemia cases were found to occur at 3-4 months and 9-10 months. Most of the anaemia cases have successfully undergone treatment.
Matched MeSH terms: Breast Feeding/statistics & numerical data
In a case-control study carried out in the Kuala Lumpur Maternity Hospital between 1st July 1995 and 31st January 1996 the objectives were (1) to determine the rate of breastfeeding in surviving very low birthweight (VLBW, < or = 1500 g) Malaysian infants following the introduction of the Baby Friendly Hospital Concept, and (2) to identify significant predictors associated with successful breastfeeding in these infants. During the study period, 201 (1.24 per cent) of live-born infants were VLBW infants, 192 (95.5 per cent) were Malaysians, and 141 (73.4 per cent) of them survived to go home. The breastfeeding rate among all surviving VLBW Malaysian infants at the time of discharge was 40.2 per cent (57/141). The mothers of 126 (89.4 per cent) VLBW Malaysian infants were interviewed before discharge. Logistic regression analysis showed that, after controlling for various confounders, the significant predictors associated with successful breastfeeding were: (a) Malay mothers (odds ratio: 6.0; 95 per cent CI: 1.9, 19.4), (b) mothers with educational levels of between 7 and 9 years (odds ratio: 3.6; 95 per cent CI: 1.0, 12.2), and (c) earlier age of commencement of enteral feeds in the VLBW infants (for each additional day delay in commencement of feeding, odds ratio of breastfeeding was 0.5; 95 per cent CI: 0.4, 0.8).
Matched MeSH terms: Breast Feeding/statistics & numerical data*
A prospective observational study of feeding in low birth weight (LBW) infants with birth weight (BW) of at least 1.8 kg admitted to the Neonatal Intensive Care Unit (NICU) showed that nearly 80% of mothers provided expressed breastmilk (EBM) and a further 14% breastfed their infants before discharge. Weight gain was overall poor at a mean of 9.48 +/- 7.82 grams per kg per day with those on predominant EBM feeding (EBM > 70%) doing worse than those on predominant preterm formula (PTF) feeding (EBM < 31%), weight gain being 5.40 +/- 6.88 and 11.10 +/- 8.15 grams per kg per day respectively (p < 0.01). Weight gain was also poorer (7.72 +/- 5.55 grams per kg per day) in patients with respiratory distress syndrome (RDS) compared to those who did not have RDS (12.02 +/- 9.58 grams per kg per day). p < 0.05. Incidence of infants < 10th centile body weight at birth was 16.8% and at discharge was 69.1%.
This report examines Malaysian women's perceptions of the contraceptive effect of breastfeeding, the determinants of their perceptions, and any effect these perceptions might have on nursing duration and contraceptive use. The report also considers whether women are consciously replacing breastfeeding with modern contraceptive methods. Data from the 1976 Malaysian Family Life Survey are analyzed, and the author concludes that Malaysian women do perceive that breastfeeding has a contraceptive effect, but that this perception is not universal. Ethnicity and desire for a particular family size are the most significant determinants of this perception. Finally, Malaysian women's recognition of the contraceptive effect of nursing does not influence either the duration of their breastfeeding or their adoption of contraception. Malaysian women may not be abandoning breastfeeding to adopt contraception. More probably, breastfeeding declines and contraceptive prevalence increases with modernization.
Prolonged lactation and early supplementation have been traditional practices among low-income mothers in Malaysia, the Caribbean, Nigeria and Zaire. Early supplementation is still the norm but there have been some substantial changes in the types of supplement offered. Thus, except in Zaire, there is now widespread use of processed milks as supplements for very young infants. The use of processed milks began in the 1920s in Malaysia and the Caribbean, but not until the 1960s in Nigeria. Processed milks are, as yet, rarely used in Zaire. The use of processed milks has not, however, led to the abandonment of traditional paps. The latter are still given as supplements to young infants in Nigeria and to older infants in Malaysia and the Caribbean. Breast-feeding duration has declined in Malaysia and the Caribbean although initiation is almost universal. In Nigeria and Zaire most low-income mothers continue to breast-feed for at least 12 months. The changes in the types of supplements used and in breast-feeding duration are analogous to the changes observed in industrialised countries from the mid-19th century, and many of the associated factors are similar: urbanisation; female participation in the labour force; increased availability of processed milks and their promotion both by companies and the health sector; and the regimentation of breast-feeding. This review highlights the negative role played by the health sector in the past, and discusses its future role in promoting and supporting breast-feeding.
This analysis has identified several factors contributing to the dramatic decline in infant mortality since World War II in Malaysia, as well as one factor that prevented the infant mortality rate from declining even more rapidly. Our main findings are the following: On average, mothers' education more than doubled over the study period, contributing to the decline in their infants' mortality. In addition, the beneficial effect of mothers' education on infant survival appears to have become stronger over the study period. Hence, further advances in education should lead to further improvements in infants' survival prospects. Another analysis of these data (Peterson et al. 1985) found that education is somewhat more influential in affecting child mortality in low-mortality, high-income areas than in the opposite type of areas. Therefore, socioeconomic development may have complemented, instead of substituted for, the the beneficial effect of mothers' education in promoting infant and child survival in Malaysia. Improvements in water and sanitation also contributed to the infant mortality decline, especially for babies who did not breastfeed. However, unlike education, these influences have become less important over time, especially for babies who are not breastfed. Hence, further improvements in water and sanitation, a goal of Malaysia's Rural Environmental Sanitation Programme, may have smaller relative effects on infant mortality than did previous improvements. Targeting such improvements on areas where women breastfeed little or not at all, however, will increase their effectiveness in promoting infant survival. The substantial reductions in breastfeeding that have taken place since World War II have kept the infant mortality rate in Malaysia from declining as rapidly as it would have otherwise. We estimate that, in our sample, the detrimental effects on infant survival of the decline in breastfeeding have more than offset the beneficial effects of improvements in water and sanitation. Unlike some other researchers (e.g., Palloni 1981), we find that changes in fertility levels and in the timing and spacing of births have had negligible effect in explaining the decline in infant mortality within the samples we have considered. We have excluded births to older women from our analysis, however; this exclusion may have led to an understatement of the influence of changes in the age pattern of childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)
Mothers' recall data collected in Malaysia in 1976-1977 are analyzed to study correlates of mortality of 5471 infants. Respondent population is 1262 women living in 52 primary sampling units of Peninsular Malaysia. Lengths of unsupplemented and supplemented breastfeeding and presence of piped household water and toilet sanitation are related to infant mortality in regressions that also control other correlates. The analysis is disaggregated into three periods of infancy. Through six months of feeding, unsupplemented breastfeeding is more strongly associated with fewer infant deaths than is supplemented breastfeeding. Type of sanitation is generally more strongly associated with mortality than is type of water supply. The effects of breastfeeding and the environmental variables are shown to be strongly interactive and to change systematically during the course of infancy. Breastfeeding is more strongly associated with infant survival in homes without piped water or toilet sanitation. In homes with both modern facilities, supplemented breastfeeding has no significant effect, and unsupplemented breastfeeding is statistically significant only for mortality in days 8-28. Presence of modern water and sanitation systems appears unimportant for mortality of infants who are breastfed without supplementation for six months.
This article examines retest reliability and digit preference in retrospective survey data on breastfeeding duration and type of supplementary food, covering three decades and reported by more than 1200 Malaysian women. Women with little or no education, rural residents, and those of Malay ethnicity are found to give less reliable data. In a logistic regression analysis, these respondent characteristics are more important determinants of data quality than the length of the recall period.
Traditionally, Malaysian women (Malay, Indian and Chinese) breastfed their infants as a matter of course and for an extended period of time; only elite Chinese women might have resorted to a wet-nurse. But the introduction of condensed and dehydrated milk in colonial Malaya from the late nineteenth century, and the later marketing also of commercially manufactured baby foods, led to some variation in traditional practice. Structural changes, industrialiZation and urbanisation affected social as well as economic life, and again these broad changes had an impact on infant feeding. Today, few women remain unfamiliar with the wide range of infant food products sold in the most isolated provision shops. This paper focuses on key sociological factors that might predict the frequency and duration of breastfeeding and weaning patterns. The data analysed below, collected during semi-structured interviews with 278 women presenting at Maternal and Child Health Clinics in Peninsular Malaysia, are in part confusing. They suggest that the women most likely to bottle feed only or to breast feed for a short period, and to use commercial baby foods, are young, with one child only, who reside in urban or peri-urban areas and have a reasonable household income. Higher educated women, and women whose husbands are in non-traditional occupations, are also less likely to breast feed or to do so for an extended period. But the profile of infant feeding practices is by no means clear. One of the shortcomings of the study relates to the method of collection of data, and highlights the need for detailed ethnographic studies to better explore the variability and complexity of the patterns of infant feeding.
Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.
Recent research has shown that children born before and after short birth intervals run a considerably greater risk of dying in infancy or childhood than do others. This report investigates which women have short interbirth intervals, under what circumstances, and for what reasons. The analysis uses data from the Malaysian Family Life Survey to examine influences on the two main behaviors--breastfeeding and contraceptive use--that affect birth interval length, and assesses the the impact of these same variables on the probability of having a birth interval of less than 15 months. The analysis shows that many of the independent variables affect breastfeeding and contraceptive use in opposite directions, with no significant net effect on the likelihood of a short interval. For example, a woman's education is negatively related to the probability that she breastfeeds, positively related to the probability that she uses contraceptives, and has no significant effect on the likelihood that the interpregnancy interval is less than 15 months. Having a family planning clinic nearby is associated with less breastfeeding, offsetting whatever positive effects family planning clinics have on contraceptive use in terms of the percentage of birth intervals that are so short as to be detrimental to infant and child health. Hence, factors that increase contraceptive use do not necessarily reduce the incidence of short interbirth intervals, because they are also associated with reduced breastfeeding. We simulate the proportion of intervals that would be short for alternative combinations of breastfeeding and contraceptive use in the population and show that over the period covered by the data (1961-75), breastfeeding had a considerably greater effect on preventing short interbirth intervals than did contraceptive use.