1.  Title: Maternal weight and lean body mass may influence the lactation-related bone changes in young undernourished Indian women. Author: Kulkarni B; Shatrugna V; Nagalla B; Ajeya Kumar P; Usha Rani K; Chandrakala Omkar A Source: British Journal of Nutrition. 2009 May;101(10):1527-33. Abstract: Lactation is known to be associated with a transient loss of bone mineral density (BMD) during 3-6 months post-partum. Bone changes during lactation in women consuming low dietary calcium are not sufficiently studied. The present longitudinal study examined the BMD changes during lactation in undernourished women and the relationship of bone changes to the nutritional status. Whole-body bone mineral content and BMD at hip, lumbar spine and forearm were assessed using dual-energy X-ray absorptiometry in thirty-six lactating women from the low socio-economic group at four time points -- within 1 month after delivery (baseline), and at 6, 12 and 18 months after delivery. Maternal body composition and biochemical parameters of bone metabolism were estimated at the same time. It was observed that femoral neck BMD reduced by 4.6 % at 6 months, but recovery to the baseline was incomplete at 18 months with a deficit of 2 %. Hip BMD reduction at 6 months was transient. Lumbar spine BMD did not show significant loss at 6 months and BMD increased by 3.6 and 6.3 % at 12 and 18 months, respectively. Regression analyses indicated that baseline lean mass was the most important determinant of bone preservation at femoral neck, hip as well as whole body, whereas baseline body weight was the most important determinant of per cent gain in lumbar spine. Maternal nutritional status as indicated by body weight and lean mass appears to influence the lactation-related BMD changes in undernourished women from the low socio-economic group in India. Language: English Keywords: INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | LOW INCOME POPULATION | POSTPARTUM WOMEN | BODY WEIGHT | LACTATION | MALNUTRITION | DIET | SKELETAL EFFECTS | SERUM CALCIUM LEVEL | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Puerperium | Reproduction | Physiology | Biology | Maternal Physiology | Nutrition Disorders | Diseases | Nutrition | Health | Hemic System Document Number: 342007 |
| 2. Title: Pharmacotherapeutic options for the treatment of preeclampsia. Author: McCoy S; Baldwin K Source: American Journal of Health System Pharmacy. 2009 Feb 15;66:337-344. Abstract: Purpose. Pharmacotherapeutic options for the treatment of preeclampsia are reviewed. Summary. Risk factors for the development of preeclampsia include microvascular diseases, such as diabetes mellitus; vascular and connective tissue disorders; hypertension; antiphospholipid antibody syndrome; and nephropathy. Several pathophysiological factors contribute to the development of the preeclamptic state, including vasospasm onset, coagulation system activation, increased inflammatory response, and ischemia. The specific agents used for the treatment of preeclampsia are dependent on a number of factors including symptom severity, maternal or fetal compromise, the progression to eclampsia, gestational period, and cervical status. The diagnosis of preeclampsia beyond the gestation period of 38 weeks requires delivery. The presence of maternal compromise or eclampsia at gestation greater than 20 weeks also necessitates delivery. In cases of chronic or mild hypertension, oral methyldopa may be administered on an outpatient basis. Intravenous hydralazine is a commonly administered arteriolar vasodilator that is effective for hypertensive emergencies associated with pregnancies. The most common adverse effect of hydralazine administration is unpredictable hypotension. Labetalol decreases heart rate and may be preferred because of a lack of reflex tachycardia, hypotension, or increased intracranial pressure. However, the drug of choice for the prevention and control of maternal seizures in patients with severe preeclampsia or eclampsia during the peripartum period is i.v. magnesium sulfate. Therapeutic serum magnesium levels cause cerebral vasodilation, thereby reversing the ischemia produced by cerebral vasospasm during an eclamptic episode. The results of one study indicated that women receiving magnesium sulfate therapy had a 58% lower risk of eclampsia than placebo. Conclusion. Magnesium sulfate remains the drug of choice for the prevention and treatment of preeclampsia. Alternative antihypertensive agents mayprovide additional benefit in the management of hypertension for preeclamptic patients. Language: English Keywords: UNITED STATES OF AMERICA | RECOMMENDATIONS | PREECLAMPSIA | HYPERTENSION | RISK FACTORS | RENAL EFFECTS | SIGNS AND SYMPTOMS | DRUGS | ADMINISTRATION AND DOSAGE | SAFETY | LACTATION | PREVENTION AND CONTROL | Developed Countries | North America | Americas | Pregnancy Complications | Diseases | Vascular Diseases | Health | Urogenital Effects | Urogenital System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Public Health | Maternal Physiology Document Number: 340210 |
| 3. Title: Vitamin D nutritional status of exclusively breast fed infants and their mothers. Author: Seth A; Marwaha RK; Singla B; Aneja S; Mehrotra P; Sastry A; Khurana ML; Mani K; Sharma B; Tandon N Source: Journal of Pediatric Endocrinology and Metabolism. 2009 Mar;22(3):241-6. Abstract: BACKGROUND: Vitamin D nutrition has a profound effect on the development of an infant. Vitamin D status of mothers and their infants are closely correlated. While hypovitaminosis D has emerged as a significant public health problem across all age groups, there is limited information of this condition in lactating mothers and their breast fed infants. AIM: To evaluate the vitamin D status of lactating mothers and their breast fed infants. SUBJECTS AND METHODS: 180 healthy lactating mothers and exclusively breast fed infants, 2-24 weeks old, were recruited for the study. The mother-infant pairs underwent concurrent clinical, biochemical and hormonal evaluation for calcium-vitamin D-PTH axis. RESULTS: The mean serum 25(OH)D values in lactating mothers was 27.2 +/- 14.6 nmol/l (10.9 +/- 5.8 ng/ml), while that of their infants was 28.9 +/- 20.8 nmol/l (11.6 +/- 8.3 ng/ml). Serum 25(OH)D levels <25 nmol/l (10 ng/ml) were found in 47.8% of the mothers and 43.2% of the infants. Among these, elevated PTH levels (>54 pg/ml) were seen in 59.3% of the mothers and 69.6% of the infants. A highly significant negative correlation was found between serum 25(OH)D and PTH in mothers (r = -0.480, p = 0.01) and their infants (r = -0.431, p = 0.01). A strong positive correlation was seen of 25(OH)D levels in mother-infant pairs (r = 0.324, p = 0.001). CONCLUSIONS: A high prevalence of vitamin D deficiency was found in lactating mothers and their exclusively breast fed infants. Infants born to mothers with hypovitaminosis D had 3.8 times higher risk of developing hypovitaminosis D as compared to those born to mothers with normal vitamin D levels. Language: English Keywords: INDIA | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | VITAMIN D | DEFICIENCY DISEASES | LACTATION | Asia, Southern | Asia | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Maternal Physiology Document Number: 341670 |
| 4. Peer Reviewed Title: Breastfeeding duration related to practised contraception in the Netherlands. Author: van Wouwe JP; Lanting CI; van Dommelen P; Treffers PE; van Buuren S Source: Acta Paediatrica. 2009 Jan;98(1):86-90. Abstract: AIM: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. METHODS: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. RESULTS: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3-27.0), the adjusted OR 14.5 (9.3-22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6-19.9) and 11.7 (7.6-17.9). Of all breastfeeding women, 20-27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. CONCLUSION: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | QUESTIONNAIRES | MOTHERS | INFANT | BREASTFEEDING | BOTTLE FEEDING | TIME FACTORS | CONTRACEPTION CONTINUATION | LACTATION | Europe, Western | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Contraceptive Usage | Contraception | Family Planning | Maternal Physiology | Physiology | Biology Document Number: 330861 |
| 5. Title: Iodine status and thyroid function of pregnant, lactating women and infants (0-1 yr) residing in areas with an effective Universal Salt Iodization program. Author: Wang Y; Zhang Z; Ge P; Wang Y; Wang S Source: Asia Pacific Journal of Clinical Nutrition. 2009;18(1):34-40. Abstract: OBJECTIVE: To assess the iodine nutrition and thyroid function of pregnant women, lactating women and infants residing in areas where the Universal Salt Iodization program is in place. METHODS: Pregnant women, lactating women and infants were selected randomly in the regions where iodized salt coverage rate is more than 90% since 2000. Urine iodine levels of pregnant woman, lactating woman and infants, milk iodine of lactating woman, thyroid-stimulating hormone (TSH) and free T4 of women were tested respectively. RESULTS: Median Urinary Iodine (MUI) of infants, three groups of pregnant women (first, second and third trimester) and two groups lactating women (breastfeeding less than or more than six months) were 233, 174, 180, 147, 126 and 145 microg/L, respectively. Median milk iodine of lactating women was 163 microg/L. Percentage of milk iodine < 150 microg/L of early lactating women was 40% less than that of late lactating women (p < 0.01).There was a positive correlation between urine iodine of infants and milk iodine of lactating women (r = 0.526, p = 0.000). T4 of two women were above or below the reference range. Total 15.4% women's TSH were abnormal. Most of these women's urinary iodine were lower than 150 microg/L. CONCLUSION: Iodine status of most of the target population for Universal Salt Iodization program is adequate, but iodine deficiency still existed in some. To assure every new life's brain not be damaged by iodine deficiency, iodine status of targeted populations should be monitored and supplements provided according to the monitoring outcomes. Language: English Keywords: CHINA | RESEARCH REPORT | WOMEN | PREGNANT WOMEN | THYROID EFFECTS | PROTEIN BOUND IODINE ALTERATIONS | NUTRITION | DIET | LACTATION | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Population Characteristics | Endocrine Effects | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System | Health | Maternal Physiology Document Number: 342000 |
6.  Title: Best practices in maternal and newborn care: a learning resource package for essential and basic emergency obstetric and newborn care. Participant's guide. Author: JHPIEGO. Access to Clinical and Community Maternal, Neonatal and Women’s Health Services Program [ACCESS] Source: [Baltimore, Maryland], JHPIEGO, ACCESS Program, 2008. [522] p. Abstract: This selection provides specific learning resources for basic emergency obstetric and newborn care. Learning guides and checklists are provided to test knowledge at the end of modules. Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | STANDARDS | TEACHING MATERIALS | EMERGENCY SERVICES | CHILDBIRTH | ANTENATAL CARE | INFECTION PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | BLEEDING | POSTABORTION CARE | SIGNS AND SYMPTOMS | MATERNAL NUTRITION | LACTATION | BREASTFEEDING | BONDING | TREATMENT | OBSTETRICAL SURGERY | Research Methodology | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Infections | Diseases | Disease Transmission Control | Prevention and Control | Nutrition | Maternal Physiology | Physiology | Biology | Infant Nutrition | Interpersonal Relations | Behavior | Medical Procedures | Medicine | Surgery Document Number: 331781 |
| 7. Title: Subclinical mastitis is common among Ghanaian women lactating 3 to 4 months postpartum. Author: Aryeetey RN; Marquis GS; Timms L; Lartey A; Brakohiapa L Source: Journal of Human Lactation. 2008 Aug;24(3):263-267. Abstract: Subclinical mastitis (SCM) is an asymptomatic inflammation of mammary tissue and has been associated with lactation failure, suboptimal growth in early infancy, and increased risk of mother-to-child transmission of HIV via breast milk. A rapid survey was carried out to determine the prevalence of SCM among lactating Ghanaian women between 3 and 4 months postpartum. Bilateral breast milk samples were obtained from 117 lactating women in Manya Krobo, Ghana and analyzed for sodium (Na) and potassium (K). An elevated sodium/potassium ratio (Na/K) above 1.0 was considered indicative of SCM. Overall, SCM prevalence was observed among 45.3% of the women. About 30% of the women had unilateral SCM. Na/K was associated with maternal age. The high SCM prevalence in Manya Krobo suggests the need for lactation support to reduce SCM and the risk of poor infant outcomes. Language: English Keywords: GHANA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | HUMAN MILK | LACTATION | MAMMARY GLAND EFFECTS | MATERNAL AGE | INFECTIONS | PREVALENCE | BREASTFEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | HIV Infections | Viral Diseases | Diseases | Transmission | Maternal Physiology | Physiology | Biology | Parental Age | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Infant Nutrition | Nutrition | Health Document Number: 308024 |
| 8. Peer Reviewed Title: Cabergoline for suppression of puerperal lactation in a prevention of mother-to-child HIV-transmission programme in rural Malawi. Author: Buhendwa L; Zachariah R; Teck R; Massaquoi M Source: Tropical Doctor. 2008 Jan;38(1):30-32. Abstract: This study shows that cabergoline (single oral-dose) is an acceptable, safe and effective drug for suppressing puerperal lactation. It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | INFANT | RURAL POPULATION | PERSONS LIVING WITH HIV/AIDS | LACTATION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | DRUGS | HIV PREVENTION | WEANING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Maternal Physiology | Physiology | Biology | Disease Transmission Control | Prevention and Control | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Nutrition | Nutrition Document Number: 324831 |
| 9. Title: Risk for postpartum depression, breastfeeding practices, and mammary gland permeability. Author: Flores-Quijano ME; Cordova A; Contreras-Ramirez V; Farias-Hernandez L; Tolentino MC Source: Journal of Human Lactation. 2008;24(1):50-57. Abstract: In a cross-sectional study, 163 breastfeeding women completed the Edinburgh Postnatal Depression Scale (EPDS), a questionnaire on demographics and infant feeding and hand-expressed breast milk for Na and K quantification, between 2 and 12 weeks postpartum. Forty women (24.5%) had an EPDS score compatible with the risk of a depressive episode, and 63 (41%) did not feel confident about breastfeeding. These 2 variables were significantly correlated to each other and individually correlated to breastfeeding exclusiveness. Weeks postpartum was correlated to breastfeeding exclusiveness and Na:K in milk (all P less than .001). A logistic regression model showed that supplementation increased the risk of high Na:K in milk by 209%, whereas a longer time postpartum lowered the risk for mammary gland permeability. This study suggests that postpartum depression and low breastfeeding confidence, which may be present concomitantly, are associated with increased mammary gland permeability, only to the extent in which depression dissuades the mother from exclusive breastfeeding. (author's) Language: English Keywords: SCOTLAND | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | POSTPARTUM WOMEN | BREASTFEEDING, EXCLUSIVE | DEPRESSION | HUMAN MILK | MAMMARY GLAND EFFECTS | LACTATION | Developed Countries | United Kingdom | Europe, Western | Europe | Research Methodology | Puerperium | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Health | Mental Disorders | Diseases | Maternal Physiology | Physiology | Biology Document Number: 324668 |
| 10. Title: Adequacy of vitamin A and fat in the breast milk of lactating women in south Sri Lanka. Author: Liyanage C; Hettiarachchi M; Mangalajeewa P; Malawipathirana S Source: Public Health Nutrition. 2008 Jul;11(7):747-50. Abstract: OBJECTIVE: To determine vitamin A (retinol) and fat concentrations in breast milk during early lactation. METHODS: Healthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method. RESULTS: Subjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0.10 to 2.46 micromol/l, with a mean of 0.50 micromol/l, and correlated positively with parity (Pearson correlation coefficient, r = 0.307; P = 0.01) and negatively with period of lactation (r = -0.209; P = 0.05). The fat content of breast milk ranged between 5.09 and 56.46 g/l with a mean of 26.95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r = 0.274; P = 0.01) and height (r = 0.328; P < 0.001) of the mothers. CONCLUSIONS: In this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92.0%) were not providing the minimum daily requirement (1.05 micromol/l) of retinol to their babies. Language: English Keywords: SRI LANKA | RESEARCH REPORT | ANTHROPOMETRY | WOMEN | HUMAN MILK | LACTATION | VITAMIN A | LIPIDS | TIME FACTORS | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Vitamins and Minerals | Population Dynamics Document Number: 328817 |
| 11. Title: Non-puerperal induced lactation: An infant feeding option in paediatric HIV / AIDS in tropical Africa. Author: Ogunlesi TA; Adekanmbi FA; Fetuga BM; Ogundeyi MM Source: Journal of Child Health Care. 2008 Sep;12(3):241-248. Abstract: A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed. (author's) Language: English Keywords: NIGERIA | AFRICA, SUB SAHARAN | CRITIQUE | HIV | AIDS | BREASTFEEDING | LACTATION | INFANT NUTRITION | INFANT HEALTH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PROGRAM ACCEPTABILITY | Africa, Western | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Nutrition | Health | Maternal Physiology | Physiology | Biology | Child Health | Disease Transmission Control | Prevention and Control | Program Evaluation | Programs | Organization and Administration Document Number: 327934 |
| 12. Title: Prevalence ratio of HTLV-1 in nursing mothers from the state of Paraiba, northeastern Brazil. Author: Pimenta FC; Haddad SK; de Medeiros Filho JG; Costa MJ; Diniz MF Source: Journal of Human Lactation. 2008 Aug;24(3):289-292. Abstract: The human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus known as a direct causal agent of a malignant disease. The vertical route of HTLV transmission is the most frequent pathway of the virus contamination. This study was performed to determine the prevalence ratio of HTLV-1 infection among nursing women. From January 2004 to January 2005, blood samples from 1033 nursing mothers from Paraiba, Brazil were evaluated for HTLV antibodies by ELISA and HTLV-1 viral particles confirmed by polymerase chain reaction (PCR). HTLV antibodies were detected in 7 women. The overall seroprevalence ratio was 0.68% and HTLV-1 viral sequences were confirmed by PCR in 2 women. These preliminary data suggest that HTLV screening should be introduced as a mandatory test before breastfeeding and breast milk donation in Paraiba, Brazil. Additionally, counseling programs would help reduce the prevalence ratio of HTLV-1 infected individuals in this Brazilian region. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MOTHERS | WOMEN IN DEVELOPMENT | PREVALENCE | LACTATION | VIRAL DISEASES | SCREENING | HUMAN MILK | BREASTFEEDING | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Measurement | Maternal Physiology | Physiology | Biology | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Nutrition | Nutrition Document Number: 308025 |
| 13. Peer Reviewed Title: Forty days and forty nights: a biocultural perspective on postpartum practices in the Amazon. Author: Piperata BA Source: Social Science and Medicine. 2008 Oct;67(7):1094-1103. Abstract: The immediate postpartum period is recognized as a special time in many societies and is commonly associated with food and work restrictions. The logic of food restrictions during a period of increased energy and protein needs has been challenged, but few data are available to test the impact of these practices on the diets of lactating women. In the eastern Amazon the immediate postpartum period is referred to as resguardo, lasts for 40-41 days and includes food taboos and work restrictions. Taking a biocultural perspective, this paper combines data on the beliefs and attitudes surrounding the practice of resguardo with quantitative data on the actual dietary intakes and activity patterns of a cohort of 23 lactating women followed from birth through 15 months postpartum. This paper addresses three topics: (1) shared ideals regarding resguardo; (2) adherence to food and work restrictions; and (3) the impact of these practices on women's dietary intakes and energy expenditure. The results show that the majority of women adhered to food taboos and work restrictions. During resguardo energy expenditure in physical activity was lower, reducing women's energy needs and allowing them to devote more time to infant care. However, energy intakes were also lower. The reduction in dietary intake was impacted more by work restrictions and the loss of women in subsistence tasks during resguardo than by adherence to food taboos. In addition to altering maternal energetic strategies, resguardo served an important social function by reinforcing bonds and, for young women, marking the transition to womanhood. Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | MOTHERS | POSTPARTUM | DIET | NUTRITION | CALORIC INTAKE | TABOO | LACTATION | BELIEFS | ATTITUDES | Latin America | Americas | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Health | Culture | Maternal Physiology | Physiology | Biology | Psychological Factors | Behavior Document Number: 308017 |
| 14. Title: Pregnancy and lactation hinder growth and nutritional status of adolescent girls in rural Bangladesh. Author: Rah JH; Christian P; Shamim AA; Arju UT; Labrique AB Source: Journal of Nutrition. 2008 Aug;138(8):1505-1511. Abstract: Adolescent pregnancy is associated with adverse birth outcomes. Less is known about its influence on maternal growth and nutritional status. We determined how pregnancy and lactation during adolescence affects postmenarcheal linear and ponderal growth and body composition of 12-19 y olds in rural Bangladesh. In a prospective cohort study, anthropometric measurements were taken among primigravidae (n = 229) in the early first trimester of pregnancy and at 6 mo postpartum. Randomly selected never-pregnant adolescents (n = 458) of the same age and time since menarche were measured within 1wk of these assessments. Annual changes in anthropometric measurements were compared between the 2 groups adjusting for confounders using mixed effects regression models. The mean + or - SD age and age at menarche of adolescents were 16.3 + or - 1.6 y and 12.7 + or - 1.2 y, respectively. Unlike pregnant girls who did not grow in height (-0.09 + or - 0.08 cm/y), never-pregnant girls increased in stature by 0.35 + or - 0.05 cm/y. The adjusted mean difference between the 2 groups was 0.43 + or - 0.1cm (P < 0.001). Similarly, whereas never-pregnant girls gained BMI, mid-upper arm circumference, and percent body fat, pregnant girls declined in every measurement by 6 mo postpartum, resulting in adjusted mean + or - SD differences in annual changes of 0.62 + or - 0.11 kg/m2, 0.89 + or - 0.12 cm, and 1.54 + or - 0.25%, respectively (all P < 0.001). Differences in changes in all anthropometric measurements except height were greater among adolescents whose first pregnancy occurred <24 mo vs. > or = 24 mo since menarche (BMI, -1.40 + or - 0.18 vs. -0.60 + or - 0.11 kg/m2; all interaction terms, P < 0.05). Pregnancy and lactation during adolescence ceased linear growth and resulted in weight loss and depletion of fat and lean body mass of young girls. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | LACTATION | GROWTH | NUTRITION | NUTRITION INDEXES | BODY WEIGHT | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Maternal Physiology | Physiology | Biology | Child Development | Health Document Number: 327807 |
| 15. Title: Co-factors for abnormal lactate levels among persons with HIV disease at a tertiary HIV care setting in South India. Author: Sundaram M; Srinivas CN; Shankar EM; Deepak M; Murugavel KG Source: Food and Chemical Toxicology. 2008 Aug;46(8):2823-5. Abstract: BACKGROUND: The co-factors underlying abnormal lactate level remains to be determined in resource-limited settings. In a cross-sectional study conducted between January 2004 and July 2006, we determined the proportion of HIV-infected persons with abnormal lactate levels and correlated the association of certain co-factors of abnormal lactate levels at a tertiary HIV care centre in Chennai, Southern India. METHODS: Lactate was estimated by the enzymatic method using an Olympus AU 400 autoanalyzer. Absolute CD4+T lymphocyte count was determined by the Guava personal cell analyser (Guava Technologies Inc., Hayward, CA, USA). Subjects were classified to have normal or abnormal values of lactate based on the reference interval (0.3-2.2 mmol/L). A p value 0.05 was considered statistically significant. RESULTS: A total of 225 HIV-infected individuals (HAART experienced 213 (95%) and HAART naive (5%)) were included in the analysis. Mean age was 34+/-8 and 36+/-9 years for the individuals with normal and abnormal lactate levels respectively. Of these 185 (82%) had normal (0.3-2.2 mmol/L) and 40 (18%) had abnormal (>2.2 mmol/L) lactate levels. Significant difference in relation to female gender was observed between the normal and abnormal groups (p=0.03). Among the abnormal group, 39 (97.5%) subjects were HAART experienced compared to 174 (94.1%) normal group. Among the abnormal group, 24 (60%) individuals had a CD4 count of <200 cells/microL as compared to 76 (41.1%) normal subjects. CONCLUSION: Female gender should be carefully monitored with respect to their clinical, laboratory and biological data to diminish the occurrence of lactic acidosis. Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN | TERTIARY SECTOR | LACTATION | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | TREATMENT | Developing Countries | Asia, Southern | Asia | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Demographic Factors | Population | Macroeconomic Factors | Economic Factors | Maternal Physiology | Physiology | Biology | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328327 |
| 16. Peer Reviewed Title: Miscarriage rate in pregnancy-breastfeeding overlap [letter] Author: Verd S; Moll J; Villalonga B Source: Contraception. 2008 Oct;78(4):348-9; author reply 349. Abstract: Shaaban and Glasier [1] report on the prevalence of pregnancy during breastfeeding. We would like to highlight a point of this study: Table 1 of the paper shows a rate of 22% miscarriages (2.83 previous deliveries and 0.79 previous miscarriages per study participant). Instead, the 1995 Stratification, Social Mobility and Fertility Survey in Egypt (SSMF) reports a 13% pregnancy loss from a nationally representative sample (9669 pregnancies reported by 2596 women) [2]. There is a significant difference between Shaaban and Glasier's sample and SSMF results (chi 258, pb.00001). Shaaban and Glasier have found a rate of miscarriages higher than expected. In fact, most studies demonstrate a spontaneous recognized miscarriage rate of 10-15% [3]. Shaaban and Glasier's finding is unexpected because the research is performed in a rural setting and the mean age of participants is 28 years; these patient characteristics result in a low rate of pregnancy loss [2,3]. A possible explanation for this finding is that the study's patients have a high rate of pregnancy-breastfeeding overlap (25.3%). Data on miscarriage of the subsample of 661 pregnant patients during breastfeeding would confirm or discard this hypothesis. We would welcome this piece of information because it would help to decide about safety of tandem breastfeeding. Tandem breastfeeding (TN) is the term for nursing siblings who are not twins, concurrently. Lactation is more demanding than pregnancy in energy terms. Therefore, a sustained decline in weight gain from birth to 6 months (-0.7 SD) [4] and a decline in height until 1 year of age have been reported in TN infants from undernourished populations. On the other hand, there is a good fit to the 2006 WHO Child Growth standards within a well-nourished population of TN infants: when expressed as SD scores, TN infants' weights were +0.35 at 3 months and +0.38 at 1 year, and lengths were -0.05 at 3 months and +0.28 at 1 year of age [5]. As far as we know, there are no data at all on the effects of TN on pregnancy loss and there is only one position paper on TN. It was written by the American College of Family Physicians, and they cautiously state that if the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman's personal decision. The elegant paper of Shaaban and Glasier could begin to fill this gap. (full-text) Language: English Keywords: EGYPT | CRITIQUE | PREVALENCE | POSTPARTUM WOMEN | PREGNANCY | FETAL DEATH | BREASTFEEDING | LACTATION | Developing Countries | Africa, North | Africa | Measurement | Research Methodology | Puerperium | Reproduction | Mortality | Population Dynamics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology Document Number: 329276 |
| 17. Peer Reviewed Title: Widowhood, family size, and post-reproductive mortality: A comparative analysis of three populations in nineteenth-century Europe. Author: Alter G; Dribe M; van Poppel F Source: Demography. 2007 Nov;44(4):785-806. Abstract: Researchers from a number of disciplines have offered competing theories about the effects of childbearing on parents' postreproductive longevity. The "disposable soma theory" argues that investments in somatic maintenance increase longevity but reduce childbearing. "Maternal depletion" models suggest that the rigors of childrearing increase mortality in later years. Other researchers consider continued childbearing a sign of healthy aging and a predictor of future longevity. Empirical studies have produced inconsistent and contradictory results. Our focus is on the experience of widowhood, which has been ignored in previous studies. We hypothesize that the death of a spouse is a stressful event with long-term consequences for health, especially for women with small children. Data are drawn from historical sources in Sweden, Belgium, and the Netherlands from 1766 to 1980. Postreproductive mortality was highest among young widows with larger families in all three samples. Age at last birth had little or no effect. We conclude that raising children under adverse circumstances can have long-lasting, harmful effects on a mother's health. (author's) Language: English Keywords: EUROPE | RESEARCH REPORT | WOMEN | FAMILY SIZE | PREGNANCY | CHILDBIRTH | LACTATION | LONGTERM EFFECTS | AGE FACTORS | WOMEN'S HEALTH | MORTALITY | LENGTH OF LIFE | Developed Countries | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Reproduction | Pregnancy Outcomes | Maternal Physiology | Physiology | Biology | Time Factors | Population Dynamics | Population Characteristics | Health Document Number: 322849 |
| 18. Peer Reviewed Title: Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Author: Brenna JT; Varamini B; Jensen RG; Diersen-Schade DA; Boettcher JA Source: American Journal of Clinical Nutrition. 2007 Jun;85(6):1457-1464. Abstract: Concentrations of the long-chain polyunsaturated fatty acids (LCPUFAs) docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) in human breast milk are important indicators of infant formula DHA and AA concentrations, and recent evidence suggests that neural maturation of breastfed infants is linked to breast-milk LCPUFA concentrations. We report a descriptive meta-analysis that considered 106 studies of human breast milk culled to include only studies that used modern analysis methods capable of making accurate estimates of fatty acid (FA) profiles and criteria related to the completeness of reporting. The final analysis included 65 studies of 2474 women. The mean (±SD) concentration of DHA in breast milk (by wt) is 0.32 ± 0.22% (range: 0.06-1.4%) and that of AA is 0.47 ± 0.13% (range: 0.24 -1.0%), which indicates that the DHA concentration in breast milk is lower than and more variable than that of AA. The highest DHA concentrations were primarily in coastal populations and were associated with marine food consumption. The correlation between breast-milk DHA and AA concentrations was significant but low (r = 0.25, P = 0.02), which indicates that the mean ratio of DHA to AA in regional breast milk varies widely. This comprehensive analysis of breast-milk DHA and AA indicates a broad range of these nutrients worldwide and serves as a guide for infant feeding. (author's) Language: English Keywords: DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | LITERATURE REVIEW | MOTHERS | INFANT | LACTATION | LIPIDS | DIET | HUMAN MILK | INFANT NUTRITION | ANALYSIS | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Nutrition | Health | Research Methodology Document Number: 317459 |
| 19. Title: Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg. Author: Bystrova K; Widstrom AM; Matthiesen AS; Ransjo-Arvidson AB; Welles-Nystrom B Source: International Breastfeeding Journal. 2007 May 8;2(1):[45] p. Abstract: There are not many studies exploring parity differences in early lactation performance and the results obtained are fairly often contradictory. The present study investigated the effect of different maternity home practices in St. Petersburg, Russia, as well as of physiological breast engorgement and maternal mood, on milk production in primi- and multiparous women on day four. The amount of milk was studied in relation to the duration of "nearly exclusive" breastfeeding. 176 mother-infant pairs were randomised into four groups according to an experimental two-factor design taking into account infant location and apparel. Data were recorded in the delivery ward at 25-120 minutes postpartum and later in the maternity ward. Group I infants (n = 37) were placed skin-to-skin in the delivery ward while Group II infants (n = 40) were dressed and placed in their mother's arms. Both groups later roomed-in in the maternity ward. These infants had the possibility of early suckling during two hours postpartum. Group III infants (n = 38) were kept in a cot in the delivery and maternity ward nurseries with no rooming-in. Group IV infants (n = 38) were kept in a cot in a delivery ward nursery and later roomed-in in the maternity ward. Equal numbers per group were either swaddled or clothed. Episodes of early suckling were noted. Number of breastfeeds, amount of milk ingested (recorded on day 4 postpartum) and duration of "nearly exclusive" breastfeeding were recorded. Intensity of breast engorgement was recorded and a Visual Analogue Scale measured daily maternal feelings of being "low/blue". On day four, multiparas had lower milk production than primiparas when they were separated from their infants and breastfeeding according to the prescriptive schedule (7 times a day; Group III). In contrast, there was no difference in milk production between multi- and primiparous mothers in the groups rooming-in and feeding on demand (Groups I, II and IV), although multiparas had higher numbers of feedings than primiparas. In addition during the first three days postpartum, multiparous mothers had higher perception of physiological breast engorgement and lower intensity of feeling "low/blue" than primiparous mothers. Early suckling was shown to positively affect milk production irrespective of parity. Thus Group I and II infants who suckled within the first two hours after birth ingested significantly more milk on day 4 than those who had not (284 and 184 ml respectively, SE = 14 and 27 ml, p = 0.0006). Regression analyses evaluated factors most important for milk production and found in Groups I and II for primiparous women that early suckling, intensity of breast engorgement and number of breastfeeds on day 3 were most important. Intensity of feeling "low/blue" was negatively related to amount of milk ingested. The significant factor for multiparous women was early suckling. Similar results were obtained in Groups III and IV; however, in primiparous mothers, engorgement was the most important factor and in multiparous women it was rooming-in. Amount of milk produced on day 4 was strongly correlated to a duration of "nearly exclusive" breastfeeding (p < 0.0001). The present data show that ward routines influence milk production. As our data suggest that milk production in primi- and multiparous women may be differently influenced or regulated by complex factors, further research is needed. (author's) Language: English Keywords: RUSSIA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | POSTPARTUM WOMEN | PARITY | POSTPARTUM | LACTATION | EMOTIONS | BREASTFEEDING, EXCLUSIVE | PRIMIPARITY | MULTIPARITY | TIME FACTORS | Developing Countries | Asia, Northern | Asia | Research Methodology | Studies | Puerperium | Reproduction | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Psychological Factors | Behavior | Breastfeeding | Infant Nutrition | Nutrition | Health Document Number: 316249 |
| 20. Peer Reviewed Title: Levonorgestrel pharmacokinetics in plasma and milk of lactating women who take 1.5 mg for emergency contraception. Author: Gainer E; Massai R; Lillo S; Reyes V; Forcelledo ML Source: Human Reproduction. 2007 Jun;22(6):1578-1584. Abstract: Progestin-only methods are among the contraceptive options available for breastfeeding women, however the doses of progestin used in emergency contraception (EC) have not been evaluated in nursing mothers. We therefore investigated the pharmacokinetics of 1.5 mg levonorgestrel (LNG) in lactating women. Twelve healthy exclusively breastfeeding volunteers received 1.5 mg LNG. Women refrained from nursing for 72 h after dosing and fed their infants with milk frozen beforehand. Serial blood and milk samples were collected for 120 h and assayed for LNG and sex hormone binding globulin. LNG concentrations peaked in plasma and in milk 1-4 h and 2-4 h after dosing, respectively. Concentrations in milk (M) paralleled those in plasma (P) but were consistently lower (mean M:P ratio 0.28). Estimated infant exposure to LNG is 1.6 mg on the day of dosing (1 mg in the first 8 h), 0.3 mg on the second day and 0.2 mg on the third day. Nursing mothers may need EC. These results suggest that to limit infant exposure to the period of maximum LNG excretion in milk, mothers should discontinue nursing for at least 8 h, but not more than 24 h, after EC. (author's) Language: English Keywords: CHILE | RESEARCH REPORT | ANALYSIS | MOTHERS | INFANT | BREASTFEEDING | HUMAN MILK | LACTATION | EMERGENCY CONTRACEPTION | LEVONORGESTREL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 317099 |
| 21. Peer Reviewed Title: The contraceptive implant. Author: Hohmann H; Creinin MD Source: Clinical Obstetrics and Gynecology. 2007 Dec;50(4):907-917. Abstract: Contraceptive implants provide long-acting, highly effective reversible contraception. Currently, the only subdermal implant available to women in the United States is the single rod etonogestrel implant, Implanon (N.V. Organon, Oss, the Netherlands) approved by the Food and Drug Administration in July 2006. Implanon is currently approved for 3 years of use, provides excellent efficacy throughout its use, and is easy to insert and remove. Similar to other progestin-only contraceptives, Implanon can cause irregular vaginal bleeding. Implanon has been shown to be safe to use during lactation, may improve dysmenorrhea, and does not significantly affect bone mineral density, lipid profile, or liver enzymes. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE EFFECTIVENESS | USFDA | LOW-DOSE PROGESTINS | MENSTRUATION DISORDERS | DYSMENORRHEA | CONTRACEPTIVE AGENTS, SIDE EFFECTS | LACTATION | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Diseases | Maternal Physiology | Physiology | Biology Document Number: 322250 |
| 22. Title: Contraception and lactation. Author: King J Source: Journal of Midwifery and Women's Health. 2007 Nov-Dec;52(6):614-620. Abstract: The benefits of breastfeeding for both the infant and the mother are undisputed. Longer intervals between births decrease fetal/infant and maternal complications. Lactation is an effective contraceptive for the first 6 months postpartum only if women breastfeed exclusively and at regular intervals, including nighttime. Because a high percentage of women in the United States supplement breastfeeding, it is important for these women to choose a method of contraception to prevent unintended pregnancies. Both the method of contraception and the timing of the initiation of contraceptives are important decisions that a clinician must help the breastfeeding woman make. Ideally, the chosen method of contraception should not interfere with lactation. This article reviews the research on the effect of contraceptives, including hormonal contraceptives, on lactation. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | LACTATIONAL AMENORRHEA METHOD | TIME FACTORS | BREASTFEEDING, EXCLUSIVE | CONTRACEPTIVE USAGE | LACTATION | CONTRACEPTIVE METHODS | IUD | TUBAL LIGATION | NATURAL FAMILY PLANNING | CONTRACEPTIVE AGENTS, FEMALE | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Family Planning, Behavioral Methods | Family Planning | Population Dynamics | Breastfeeding | Infant Nutrition | Nutrition | Health | Contraception | Maternal Physiology | Physiology | Biology | Female Sterilization | Sterilization, Sexual | Contraceptive Agents Document Number: 323918 |
| 23. Peer Reviewed Title: Breast-feeding pattern and onset of menstruation among Yoruba mothers of South-west Nigeria. Author: Kuti O; Adeyemi AB; Owolabi AT Source: European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):335-339. Abstract: The objective was to determine the breast-feeding practices and duration of lactational amenorrhoea among women within the first year of delivery in a Nigerian population. Cross-sectional study carried out between January 2005 and April 2006, among mothers within one year of delivery, who were attending the Infant Welfare Clinic at Wesley Guild Hospital, Ilesa, Nigeria. Using a semi-structured questionnaire, mothers were interviewed to obtain information regarding their socio-demographic characteristics, parity, breast-feeding habits, use of contraception and onset of menstruation after delivery. Information obtained was analysed using the Statistical Package for Social Sciences (SPSS) software version 11. All 268 (100%) mothers interviewed breast-fed their babies, 261 (97.4%) of which for at least 6 months. Most (71.6%) suckled exclusively for 6 months and more; only 10 (3.7%) never carried out exclusive breast-feeding. Age, parity and educational level did not affect the duration of exclusive breast-feeding. Lactational amenorrhoea lasted 3 months or more in 229 (85.5%) of the mothers. Of the 174 who exclusively breast-fed for 6 months, 109 (62.6%) remained amenorrhoeic during that time and, hence, met the criteria for use of LAM contraception. Exclusive breast-feeding among nursing mothers is highly prevalent among Yoruba mothers of South-west Nigeria. Since lactational amenorrhoea lasts 6 months in about two-thirds of the women nursing for that period of time, there is a great potential for the application of LAM for contraception. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | QUESTIONNAIRES | MOTHERS | POSTPARTUM | BREASTFEEDING, EXCLUSIVE | LACTATION | AMENORRHEA | MENSTRUATION | CONTRACEPTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology | Menstruation Disorders | Diseases | Family Planning Document Number: 322476 |
| 24. Title: Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women. Author: Li W; Qiu Y Source: Chinese Medical Journal. 2007 May 20;120(10):868-870. Abstract: Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery. A questionnaire was used to obtain data from 101 breastfeeding mothers. The following elements were analyzed: age, education level, breastfeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature (BBT) measurement. By ultrasonography, 53 of the 101 women (52.5%) had the first ovulation (follicle >1.8 cm in diameter) within 154 days after delivery on average, among whom 11 (10.9%, 11/101) had restoration of ovulation within 4 months and 42 (41.6%, 42/101) had it after 4 months. In women with follicles >1.8 cm in diameter (n=53), the menstruation resumed (138+or-84) days after delivery, and the supplementary feeding was started at (4.0+or-1.1) months, which were significantly earlier than those in the women with follicular diameter <1.7 cm (n=48; (293+or-88) days, (5.1+or-1.3) months; t=9.003, P<0.01 and t=4.566, P<0.01). In the women with follicles >1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter <1.7 cm had menstrual resumption at the same time ( X(2)=16.91, P<0.01). The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation (n=100, r=0.4764, P<0.01) and first ovulation after delivery (n=53, r=0.5554, P<0.01). In this series, no woman had pregnancy within 18 months postpartum. Supplementary feeding can affect the restoration of menstrual cycles and ovulation in lactating postpartum women. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | QUESTIONNAIRES | POSTPARTUM WOMEN | BREASTFEEDING | LACTATION | SUPPLEMENTARY FEEDING | MENSTRUATION | TIME FACTORS | OVULATION | Asia, Eastern | Asia | Developing Countries | Puerperium | Reproduction | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology | Population Dynamics | Demographic Factors | Population Document Number: 319871 |
| 25. Title: Assessment of intake inadequacy and food sources of zinc of people in China. Author: Ma G; Li Y; Jin Y; Du S; Kok FJ Source: Public Health Nutrition. 2007 Aug;10(8):848-854. Abstract: The objectives were to assess the intake inadequacy and food sources of zinc of people in China. Diets of 68 962 subjects aged 2-101 years (urban 21 103, rural 47 859) in the 2002 China National Nutrition and Health Survey were analysed. Dietary intake was assessed using 24-hour recall for three consecutive days. Zinc intake inadequacy was calculated based on values suggested by the World Health Organization. The median zinc intake ranged from 4.9mgday/-1 (urban girls, 2-3 years) to 11.9 mgday/-1 (rural males, 19+ years). The zinc density of urban residents (2-3 to 19+ years) was 5.0-5.3mgday/-1 (1000 kcal)/-1, significantly higher than that of their rural counterparts (4.7-4.8mgday/-1 (1000 kcal)/-1). Differences in food sources of zinc from cereal grains (27.4-45.1 vs. 51.6-63.2%) and animal foods (28.4-54.8 vs. 16.8-30.6%) were found between urban and rural residents. Zinc from vegetables and fruits (8.2-13.8 vs. 9.7-12.4%) and legumes (1.3-3.3 vs. 2.5-3.4%) was comparable between urban and rural residents. The proportion of zinc intake inadequacy ranged between 2.8% (urban females, 19+ years) and 29.4% (rural lactating women). Rural residents had higher proportions of zinc intake inadequacy than their urban counterparts. Significantly higher proportions of zinc inadequacy were found in the category of phytate/zinc molar ratio > 15 for both rural and urban residents. About 20% of rural children are at risk of inadequate zinc intake, with phytate as a potential important inhibitor. Moreover, lactating women are also considered a vulnerable group. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | HEALTH SURVEYS | URBAN POPULATION | RURAL POPULATION | DIET | NUTRITION | MALNUTRITION | NUTRITION SURVEYS | ZINC | SEX FACTORS | AGE FACTORS | LACTATION | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Health | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Maternal Physiology Document Number: 321043 |
| 26. Title: Zinc and copper metabolism in pregnancy and lactation of adolescent women. Author: Maia PA; Figueiredo RC; Anastacio AS; da Silveira CL; Donangelo CM Source: Nutrition. 2007 Mar;23(3):248-253. Abstract: Pregnant and lactating adolescent women are at risk of zinc and copper deficiency but their capacity for metabolic adaptation is poorly known. This study investigated the effect of pregnancy and lactation on zinc and copper metabolism in adolescent women by comparing biochemical indices between groups in different reproductive states. Habitual dietary intake and biochemical indices (zinc, copper, alkaline phosphatase, and ceruloplasmin in plasma; zinc [E-Zn], metallothionein [E-MT], and superoxide dismutase [E-SOD] in erythrocytes) and their relation were compared among non-pregnant non-lactating adolescents (NPNLs; n = 26), third-trimester pregnant adolescents (PAs; n = 26), and lactating adolescents up to 3 mo postpartum (LAs; n = 21). Zinc and copper intakes were not different across groups (on average, 8.7 and 1.0 mg/d, respectively). PAs had lower plasma zinc but higher plasma copper, alkaline phosphatase, and ceruloplasmin levels than did LAs and NPNLs (P < 0.05). E-SOD and E-Zn were similarin all groups but E-MT was higher in the PA and LA groups than in the NPNL group (P < 0.05). Correlations between plasma copper and ceruloplasmin and between E-MT and E-Zn were observed in the LA and NPNL groups (r = 0.64, P < 0.01) but not in the PA group. In contrast, correlations between plasma alkaline phosphatase and plasma zinc, between E-MT and plasma zinc, and between E-SOD and E-Zn were observed only in the PA group (r = 0.46, P < 0.05). Zinc and copper biochemical responses to pregnancy and lactation in the adolescent women studied appeared qualitatively similar to those described in previous studies in adult women. However, the significant correlations observed between the activity of zinc-dependent enzymes and plasma (or erythrocyte) zinc suggest that a poor maternal zinc status may limit the metabolic adaptation capacity of these adolescent women especially during pregnancy. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | PREGNANT WOMEN | POSTPARTUM WOMEN | COPPER | ZINC | METABOLIC EFFECTS | MATERNAL NUTRITION | LACTATION | MATERNAL PHYSIOLOGY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition | Health Document Number: 313057 |
| 27. Title: A study of breast feeding practices among infants in a rural area of West Bengal. Author: Mandal PK; Sardar JC; Chatterjee C; Lahiri SK; Ghosh P Source: Indian Journal of Preventive and Social Medicine. 2007 Jan-Jun;38(1-2):28-31. Abstract: A longitudinal observational study was undertaken in a rural block of a district in West Bengal state to assess the breast feeding practices among infants. Study revealed that exclusive breast feeding was persistently lower compared to national values. It also showed a steady decline with age and dropped to 10% at 6 months of age. 15% were predominantly breast fed and 75% were partially breast fed at that age. All the infants continued breast feeding till the observation period. 93.3% infants received colostrums. 71.7% newborns received pre-lacteal feeds and honey was the commonest prelacteal feed offered. Mothers stated that lactation failure was the reason behind early initiation of complementary feeding. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | RURAL AREAS | MOTHERS | INFANT | BREASTFEEDING | BEHAVIOR | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | LACTATION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Geographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology Document Number: 323900 |
| 28. Title: [Overview of actions to control vitamin A deficiency of in Brazil] [Panorama das acoes de controle da deficiencia de vitamina A no Brasil] Author: Martins MC; de Oliveira YP; Coitinho DC; Santos LM Source: Revista de Nutricao / Brazilian Journal of Nutrition. 2007 Jan-Feb;20(1):5-18. Abstract: This manuscript aims to describe the implementation of actions to control vitamin A deficiency in Brazil. The study was based on secondary data obtained from official reports and technical documents from the former Instituto Nacional de Alimentacao e Nutricao (inactivated in 1997), from the Coordenacao Geral da Política Nacional de Alimentacao e Nutricao, Ministry of Health and information obtained from key informants employing the multidimensional approach based on the triad: structure-process-result. Brazil was pioneer in taking the initiative of linking vitamin A distribution to the National Immunization Days, a strategy that later on was recommended by the World Health Organization and the United Nations Children's Fund. Since 1983, vitamin A megadoses are employed as a strategy to fight this micronutrient deficiency by the Ministerio da Saude. Coverage of the target population (children 6-59 months old) is steadily increasing, reaching 72% and 68% in the years 2002 and 2003 respectively. These coverage rates are similar to those reported in the 40 countries that have also adopted this strategy. Since 2001 the program was extended to lactating women, in the immediate post-partum period. The program achievements until 1992 were very modest, fact that could be explained by the irregularity of vitamin A capsule distribution. From 1994 on the distribution was more constant, but the need to promote more integrated actions in the health services, as well as far reaching social actions, beyond the routine distribution of vitamin A capsules, still remains. (author's) Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | VITAMIN A | DEFICIENCY DISEASES | NUTRITION PROGRAMS | LACTATION | INTEGRATED PROGRAMS | FOOD SUPPLEMENTATION | MATERNAL NUTRITION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Maternal Physiology | Programs | Organization and Administration | Nutrition Document Number: 316395 |
| 29. Peer Reviewed Title: Efficacy of daily and monthly high-dose calciferol in vitamin D -- deficient nulliparous and lactating women. Author: Saadi HF; Dawodu A; Afandi BO; Zayed R; Benedict S Source: American Journal of Clinical Nutrition. 2007 Jun;85(6):1565-1571. Abstract: We previously found a high prevalence of vitamin D deficiency and low medication regimen compliance in Arab and East Indian women residing in the United Arab Emirates (UAE). The appropriate dosing regimen for improving vitamin D status in this population is not known. We aimed to determine the efficacy of daily and monthly supplementation with vitamin D2, the only high-dose calciferol available in the UAE, in lactating and nulliparous women. Healthy lactating (n = 90) and nulliparous (n = 88) women were randomly assigned to consume 2000 I vitaminD2/d or 60 000 I vitamin D2/mo for 3 mo. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured by radioimmunoassay at baseline and every month. Most women had vitamin D deficiency [ie, 25(OH)D < 50 nmol/L] at study entry. Mean ± SD25(OH)D concentrations at 3mo were significantly higher than baseline in both lactating (39.8 ± 12.4 and 25.2 ± 10.7 nmol/L, respectively) and nulliparous (40.4 ± 23.4 and 19.3 ± 12.2 nmol/L, respectively) women (P < 0.001 for both). In total, vitamin D supplementation was effective in achieving serum 25(OH)D concentrations of >/=50 nmol/L in 21 (30%) of 71 women at endpoint. Oral vitamin D2 supplementation with 2000 I/d or 60 000 I/mo for 3 mo was safe, and it increased serum 25(OH)D concentrations significantly; however, only a small proportion of the women studied achieved concentrations of >/=50 nmol/L. This suggests that, when sunlight exposure is limited, doses of vitamin D2 higher than those currently studied may be needed. Monthly dosing appears to be a safe and effective alternative to daily dosing. (author's) Language: English Keywords: MIDDLE EAST | INDIA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | LACTATION | NULLIPARITY | VITAMIN D | DEFICIENCY DISEASES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | SAFETY | Asia, Southern | Asia | Developing Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Parity | Fertility Measurements | Fertility | Population Dynamics | Vitamins and Minerals | Nutrition Disorders | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Effectiveness | Contraception | Family Planning | Public Health Document Number: 317460 |
| 30. Peer Reviewed Title: Effects of maternal vitamin supplements on malaria in children born to HIV-infected women. Author: Villamor E; Msamanga G; Saathoff E; Fataki M; Manji K Source: American Journal of Tropical Medicine and Hygiene. 2007 Jun;76(6):1066-1071. Abstract: Vitamin deficiencies are frequent in children suffering from malaria. The effects of maternal multivitamin supplementation on the risk of malaria in children are unknown. We examined the impact of providing multivitamins or vitamin A/ß-carotene supplements during pregnancy and lactation to HIV-infected women on their children's risk of malaria up to 2 years of age, in a randomized, placebo-controlled trial. Tanzanian women (N = 829) received one of four daily oral regimens during pregnancy and after delivery: 1) vitamins B, C, and E (multivitamins); 2) vitamin A and ß-carotene (VA/BC); 3) multivitamins including VA/BC; or 4) placebo. After 6 months of age, all children received 6-monthly oral vitamin A supplements irrespective of treatment arm. The incidence of childhood malaria was assessed through three-monthly blood smears and at monthly and interim clinic visits from birth to 24 months of age. Compared with placebo, multivitamins excluding VA/BC reduced the incidence of clinical malaria by 71%(95% CI = 11-91%; P = 0.02), whereas VA/BC alone resulted in a nonsignificant 63% reduction (95% CI = -4% to 87%; P = 0.06). Multivitamins including VA/BC significantly reduced the incidence of high parasitemia by 43% (95% CI = 2-67%; P = 0.04). The effects did not vary according to the children's HIV status. Supplementation of pregnant and lactating HIV-infected women with vitamins B, C, and E might be a useful, inexpensive intervention to decrease the burden of malaria in children born to HIV-infected women in sub-Saharan Africa. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | CLINICAL TRIALS | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | VITAMINS AND MINERALS | PREGNANCY | PREGNANCY OUTCOMES | LACTATION | RISK FACTORS | INFANT HEALTH | MALARIA PREVENTION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Physiology | Biology | Reproduction | Maternal Physiology | Child Health | Health | Malaria | Parasitic Diseases Document Number: 317465 |
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