Prevalence and duration of breast-feeding in Manitoba.

The rate of breast-feeding in the first 3 months post partum was studied in a group of 456 mothers. At 3 months 58% had been or still were breast-feeding their infants. The mothers who breast-fed were older, had a higher level of education, had a higher socioeconomic status, and were more likely to live on farms or in small towns, to have attended prenatal education classes and to have previously breast-feds. There were no significant differences between the method of feeding and the sex or birthweight of the infant, the maternal weight/height ratio or the participation of the father in the prenatal education classes. At 1 month 45% of the infants, at 2 months 35% and at 3 months 28% were being breast-fed. Public programs to promote breast-feeding as normal, beneficial and satisfying to both mother and infant are necessary so that more mothers will attempt to breast-feed their infants. Support for continuance of breast-feeding is needed in the hospital as well as in the home and the community.     

Infant feeding practices: 1984-85 versus 1977-78.

In 1979 and 1980 the Canadian Paediatric Society''s Nutrition Committee published guidelines for professionals counselling mothers of infants on feeding practices. The practices in 1984-85 of mothers in Toronto were determined for comparison with the practices identified in a similar study conducted in Toronto and Montreal in 1977-78 to ascertain if practices had changed in favour of the recommendations. Between July 1984 and February 1985, 404 metropolitan Toronto mothers of infants were interviewed. Compared with the 1977-78 group of mothers, more of the 1984-85 mothers had chosen to breast-feed and fewer had stopped breast-feeding in the first month. As well, fewer of the 1984-85 infants had been fed unmodified cow''s milk in the first 6 months of life and introduced to solid foods before 4 months of age. We conclude that major changes in infant feeding practices had occurred since 1977-78 and that the 1984-85 practices corresponded closely to the infant feeding guidelines.     

Breast-feeding after inferior pedicle reduction mammaplasty

The breast-feeding practices of a series of postpartum women, who had undergone prior reduction mammaplasty by means of an inferior pedicle approach, are reported in this retrospective study. Also identified are the factors that influenced the decision to breast-feed postoperatively. From a patient pool of 544 individuals who elected to have reduction mammaplasty between 1984 and 1994 (age range, 15 to 35 years), 334 could be contacted and interviewed by means of telephone by using a standardized questionnaire. Successful breast-feeding was defined as the ability to feed for a duration equal to or greater than 2 weeks. Seventy-eight patients had children after their breast reduction surgery. Fifteen of the 78 patients (19.2 percent) breast-fed exclusively, 8 (10.3 percent) breast-fed with formula supplementation, 14 (17.9 percent) had an unsuccessful breast-feeding attempt, and 41 (52.6 percent) did not attempt breast-feeding. Of the 41 patients not attempting to breast-feed, 9 patients did so as a direct consequence of discouragement by a health care professional. Further reasons for feeding with supplementation, having an unsuccessful attempt, and not attempting to breast-feed are presented. Of the 78 women who had children postoperatively, a total of 27 were discouraged from breast-feeding by medical professionals with only 8 of the 27 (29.6 percent) subsequently attempting, despite this recommendation. In comparison, 26 patients were encouraged to breast-feed; nineteen (73.1 percent) of them did subsequently attempt breast-feeding. This rate is statistically significant by using a chi2 test with 1 df(p = 0.0016). Postpartum breast engorgement and lactation was experienced by 31 of the 41 patients not attempting to breast-feed. Of these 31 patients, 19 believed that they would have been able to breast-feed due to the extent of breast engorgement and lactation experienced. Given the use of an inferior flap mammaplasty technique and patient encouragement, the possibility for breast-feeding after reduction mammaplasty exists. This prevalence falls near the breast-feeding rate found in the population not having undergone breast surgery, according to an article in the Canadian Journal of Public Health.     

Mothers' attitudes in infant feeding at Newcastle General Hospital in summer 1975.

Two-hundred successively delivered mothers were asked about their attitudes towards feeding their babies, the influences on them, and their personal and social backgrounds. Initially 39% intended to breast-feed, though in the first few weeks many gave up. Choosing to breast-feed, and success in doing so, were strongly associated with higher social class. The commonest reason given by those who chose the bottle was the embarrassment of breast-feeding. Efforts to increase the numbers of mothers choosing to breast-feed should concentrate on those mothers who remain undecided on their method of feeding. If they are to breast-feed their babies successfully they will need careful advice and support both before and after delivery.     

Breast-feeding after vertical mammaplasty with medial pedicle

A retrospective study was performed in which the breast-feeding success of women of childbearing age (15 to 40 years) with macromastia but no prior breast surgery was compared with that of women of similar age who had undergone medial pedicle/vertical pattern reduction mammaplasty. All women completed a self-administered questionnaire that provided information on their breast-feeding success. The control group consisted of 149 women with macromastia (mean age, 27 years) who had been evaluated for possible breast reduction surgery and who had children before their consultation. The study group consisted of 58 women (mean age, 29 years) who had children after their vertical mammaplasty. The mean weight of breast tissue removed was 610 g per breast. None of the patients had absent nipple sensation. A period of 2 weeks or more was chosen as the defining duration of a successful breast-feeding attempt. Those individuals judged able to breast-feed were further classified on the basis of having breast-fed exclusively or with supplementation. The results demonstrated that, of the women who attempted to breast-feed, 61 percent in the control group and 65 percent in the study group were successful, with no significant difference between the groups (p > 0.05). The breakdown of the successful groups indicated that 36 percent in the control group and 38 percent in the study group supplemented their breast-feeding with formula. The groups were not significantly different (p > 0.05). In conclusion, this study found no significant difference in the rate of breast-feeding success between women who had medial pedicle/vertical pattern reduction mammaplasty and women who had no prior breast surgery.     

Promotion of breast-feeding in a Chinese community in Montreal.

Following a prospective survey that showed a very low rate of breast-feeding (10%) in 1977-79 among Chinese women in Montreal, a culturally targeted program, which included individual prenatal counselling and a community-wide promotion and education campaign, was developed to improve the rates. The study group consisted of all Chinese women delivering in 1980 and 1981 who had taken their infants to one pediatrician for continuing care. The rates of breast-feeding in the 88 women who had received prenatal counselling and the 93 women who had not were compared. Although the rates were substantially increased for both groups over the 1977-79 rate (54% and 34% in 1980 and 65% and 55% in 1981 respectively), the 2-year rate was significantly higher for the counselled group compared with the uncounselled group in the later study (59% v. 43%). The greatest effect of counselling was seen in young, primiparous women of higher socioeconomic status who spoke French or English in addition to Chinese. However, 33% of the counselled women who had started breast-feeding had stopped by 1 month, compared with only 15% of the uncounselled women. Thus, although the rates of breast-feeding in ethnic groups can be increased with the use of a language- and culture-specific approach, more support and encouragement must be given to women who start breast-feeding so that they will continue longer.     

Breast-feeding and respiratory syncytial virus infection.

The pattern of breast-feeding in 127 infants admitted to hospital with respiratory syncytial virus infection was compared with that in 503 age-matched controls. Thirty per cent of children with infection had been breast-fed compared with 49% of controls. The approximate relative risk of being admitted to hospital with respiratory syncytial virus infection if not breast-fed was 2.2. Several other factors were also considered, including an assessment of maternal care and home environment; the mother''s age, marital state, and smoking habits; the number of siblings; and gestation. Adverse factors were all associated with an increased risk of admission with infection, but breast-feeding still appeared to provide protection after controlling for these other factors in turn. These findings provide further support for encouraging mothers to breast-feed their infants and should prompt further studies into the immune status of mothers and into the nature of the protective factors in their breast milk.     

Daily changes in population structure and production of Eudiapomus gracilis (G.O. Sars) (Copepoda, Calanoida) during summer in a shallow lake (Balaton, Hungary)

Population structure and production of Eudiaptomus gracilis(G.O. Sars) have been calculated from daily measurements inLake Balaton for one month during each summer in 1975 and 1977.Fecundity was different in the two years 6.98 ? 1.16 and 10.68? 1.42 in 1975 and 1977, respectively. A total of 80% and 64%of the population were made up of larvae in 1975 and 1977, respectively.The ratio of males to females was 1:1.63 and 1:1.1, respectively.In 1975 it was possible to follow the development of cohorts,19 –20 days in the former year, 17 –20 days in thelatter. In both years of examination 80 – 83% of naupliiand 12–15% of copepodites were eliminated. Daily net biomassproduction was 6.88 mg (dry wt.)/m³ in 1975 and 1.94 mg (drywt.)/m³ in 1977. Ratios of eggs, nauplii and copepodites indaily production was 1:2.4:1.4 in 1975 and 1:1.0:1.0 in 1977.The daily potential biomass production were 34.40 mg (dry wt.)/m³ and 10.28 mg (dry wt.)/m³ and the elimination were 80 and81 wt.%, respectively. P/B ratio — allowing for net productionvalues — was nearly the same in both periods of investigation(0.12 and 0.099 respectively).     

Career choices,work patterns and perceptions of undergraduate education of McMaster medical graduates: comparison between men and women.

A survey of the first six classes to graduate from McMaster University''s medical school was carried out 5 years after graduation for the classes of 1972 to 1974 and 2 years after graduation for the classes of 1975 to 1977. Although the men and women entered similar fields of medicine the women were more likely to have taken time away from work and to be working fewer hours, and more women than men were influenced by their spouses in their career choices. More women than men expressed some dissatisfaction with the 3-year undergraduate program, and more women identified the "anxiety level created" as a weakness of the program. The women compared their preparation for the first year of postgraduate training with that of other trainees somewhat less favourably than did the men.     

The recovery of fertility during breast-feeding in Assiut, Egypt

A longitudinal study of twenty-six breast-feeding and twelve non-breast-feeding postpartum women was conducted in Assiut, Egypt in order to determine the time that ovulation resumed after childbirth, and the effect of breast-feeding frequency on the period of lactational anovulation. Breast-feeding women experienced the onset of follicular development, vaginal bleeding, ovulation and pregnancy significantly later than women who did not breast-feed. Ovulatory and non-ovulatory breast-feeders reported similar frequencies of breast-feeding episodes. The introduction of dietary supplements commonly preceded ovulation. An algorithm using three simple variables observable to the breast-feeding mother was found to predict up to 100% of the first ovulations. All breast-feeding women who did not give supplements and did not have a vaginal bleeding episode by 6 months postpartum were anovular by strict criteria for ovulation. Ovulation did not precede bleeding or supplementation in the women who experienced these events before 6 months, yielding a highly effective formula for preventing unplanned pregnancy by the informed use of breast-feeding.     

Fertility change in Costa Rica 1960-84: analysis of retrospective lifetime reproductive histories

Lifetime reproductive histories of a 1984-85 nationally representative sample of 870 women aged 25-59 years provided data to describe the evolution of fertility, contraception, breast-feeding, and natural fecundability in Costa Rica between 1960 and 1984. The contraceptive prevalence rate increased from 23% in 1965 to 58% in 1975 and 66% in 1984. Duration of breast-feeding was stable during the 1960s, decreased in the early 1970s, and increased after about 1976. Fecundability among women who did not practise contraception was lower than expected and declined between 1960 and 1975, probably because of selection effects. Despite a high consistency between estimations from the reproductive histories and other sources of data, some suggestion of omissions of short periods of contraceptive use in the distant past was detected. The survey may have reduced recall errors by using a calendar that summarizes major life events together. The analysis demonstrated the feasibility and usefulness of asking for lifetime reproductive histories in fertility surveys in developing countries.     

Effect of breast-feeding on pituitary-ovarian function after childbirth

Pituitary and ovarian function at the end of pregnancy and during the first six weeks after delivery was investigated serially in women who fully breast-fed their infants and in women who did not. In the women who did not breast-feed the plasma prolactin level decreased rapidly and from the third day after delivery was significantly lower than in the breast-feeding mothers, reaching the normal range of the menstrual cycle by the third week of the puerperium. In the breast-feeding mothers the plasma prolactin was still raised six weeks after delivery. The levels of FSH in both groups were identical and increased over the third week of the puerperium. Plasma oestrogen fell steeply in both groups during the first two weeks after delivery. In the breast-feeding mothers plasma oestrogen remained depressed but increased in the non-lactating women, reflecting follicular development in the ovary in response to FSH; the plasma oestrogen levels were significantly higher in the non-lactating women from the 17th day of the puerperium onwards. These findings support the concept that in breast-feeding women prolactin delays the return of ovulation by inhibiting the ovarian response to FSH stimulation.     

The influence of acculturation on breast-feeding initiation and duration in low-income women in the US

While the 'immigrant health paradox' posits better health behaviours and outcomes for immigrants upon arrival to the US, research suggests that this advantage may deteriorate over time. This study analysed the relationship of acculturation and breast-feeding initiation and duration among a sample of predominantly Latina, low-income women in the US. The four measures of acculturation included: mother's nativity (foreign born vs US born), mother's parents' nativity (foreign born vs US born), years of US residence (<8 years vs > or =8 years) and a dichotomous measure of language acculturation adapted from three items on Marin's acculturation scale (preferred language spoken at home, reading language and writing language) as exclusive use of native language versus non-exclusive use (mixed or English only) (Marin et al., 1987; Marin & Gamba, 1996). Final multivariable models showed that mothers who exclusively used their native language were more likely to initiate breast-feeding as well as breast-feed for longer duration compared with mothers with non-exclusive use, whereas years of US residence and mother's nativity were not significantly associated with breast-feeding initiation or duration. Mother's parents' nativity also emerged as a significant predictor of breast-feeding duration, both within final models for immigrants and across study participants. Programmes providing nutrition education to low-income women may wish to consider the role of language as an important determinant of breast-feeding. The role of mother's parents' nativity on breast-feeding practices deserves exploration in future studies, as the cultural practices taught by family members born outside the US may exert strong pressure within immigrant families now living in the US.     

The influence of the frequency of nursing and of previous lactation experience on serum prolactin in lactating mothers

Serum prolactin levels were measured for 97 women from Zaire for 22 months postpartum. These 97 women were divided into 3 groups according to how frequently they breast-fed their children. These results were compared with the prolactin levels of 25 nonlactating, nonpregnant women. The prolactin levels increased with the frequency of breast-feeding. The postpartum decrease in serum prolactin is quicker among women who breast-feed less frequently; the serum prolactin levels returned to normal ranges within 6 months postpartum among women who breast-fed their children 1-3 times/day. No correlation could be found between previous breast-feeding or the parity of women and prolactin levels during subsequent pregnancies.     

Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey

BACKGROUND: Hypernatremic dehydration in neonates is a potentially devastating condition. Recent reports have identified breast-feeding malnutrition as a key factor in its pathophysiology. METHODS: Using a theoretical framework for breast-feeding kinetics, a retrospective chart review of all neonates less than 28 days of age who were seen at either British Columbia''s Children''s Hospital or the Vancouver Breastfeeding Centre between 1991-1994 was conducted to identify and classify possible causes of breast-feeding malnutrition among neonates who developed hypernatremic dehydration. RESULTS: Twenty-one cases hypernatremic dehydration were identified. Infant weight loss ranged from 8% to 30% of birth weight, and serum sodium levels ranged from 146 mmol/L to 207 mmol/L. In each case, maternal or infant factors (e.g., poor breast-feeding technique, lactation failure following postpartum hemorrhage and infant suckling disorders associated with cleft palate or ankyloglossia) that could interfere with either lactation or breast-feeding dynamics and account for insufficient breast milk intake were identified. INTERPRETATION: Prenatal and in-hospital screening for maternal and infant risk factors for breast-feeding malnutrition combined with early postpartum follow-up to detect excessive infant weight loss are important for the prevention of neonatal hypernatremic dehydration.     

Fascioloides magna in white-tailed deer (Odocoileus virginianus): observations on the pairing tendency

Fascioloides magna (Bassi 1875) was recovered from 227 of 312 (73%) white-tailed deer (Odocoileus virginianus) in southern Texas between 1971 and 1975. Deer from age classes more than 1 year old had infection rates of from 64 to 84%. Few dead flukes were found. Flukes occurred exclusively in the livers of infected animals and were paired in 256 of 301 (85%) fibrous hepatic capsules. The prevalence of immature flukes with an average of one immature per infected liver was similar in all age classes, suggesting a relationship between fluke pairing and maturation.     

Budgerigar-fancier's lung: the commonest variety of allergic alveolitis in Britain.

A questionnaire survey of 1005 consecutive attenders at four outpatient clinics yielded 117 (12%) budgerigar fanciers (exposed to budgerigars- known in North America as parakeets-for at least three months) and 296 (29%) former fanciers. Twnety had precipitins to budgerigar serum or droppings or both, and 10 of these together with 39 precipitin-negative patients reported undue breathlessness on exertion during exposure to buderigars. These 59 patients were investigated further, seven completing a series of inhalation provocation tests with budgerigar antigens designed to confirm or exclude budgerigar-fancier''s lung (BrFL). Typical positive responses were obtained from four current and one former fancier. The prevalence of confirmed BrFL among the 11n current budgerigar fanciers was 3.4% (four cases). This was biased, however, by the inclusion of one patient whose attendance at the surveyed clinic was attributable to the disease. With the exclusion of this patient, confidence limits suggested that the true prevalence of BrFL among current budgerigar fanciers in the general population lies between 0.5% and 7.5%, which is similar to the prevalence of farmer''s lung in farm workers. In view of the enormous population at risk, however, this implies that BrFL rather than farmer''s lung is by far the commonest type of allergic alveolitis in Britain.     

The macrobenthos of the river IJssel

Summary This survey of the macrobenthos of the River IJssel, a branch of the River Rhine, was conducted in 1973, 1975, 1976 and 1977. The water quality was poor in 1973 and 1976 and relatively good in 1975 and 1977.The numbers of macroinvertebrate species and numbers of individuals in the stone samples taken from the jetties were lowest in 1976 and highest in 1977.The species composition of the Tubificidae showed a marked difference in various types of substratum at one locality.Decrease of water quality since a study of LAUTERBORN (1918) is reflected by impoverishment of the fauna; for instance, insects have disappeared to a large extent.     

May mothers given warfarin breast-feed their infants?

Warfarin was measured with a sensitive and specific method in the plasma and breast milk of 13 mothers. Less than 0-08 micronmol warfarin per litre (25 ng/ml) of breast milk was found in each instance. Seven of the mothers were breast-feeding their infants, in none of whom was warfarin detected in the plasma; furthermore, in three the British corrected ratio of the plasma was appreciably less than that of the mother and was within the expected range. We conclude that nursing mothers given warfarin may safely breast-feed their infants.