Showing posts with label Infant. Show all posts

Monday, August 22, 2011

Breastfeeding . Why Human milk is irreplaceable?

World Breastfeeding Week 1–7 August 2011

World Breastfeeding Week is celebrated every year from 1 to 7 August in more than 120 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.

Breastfeeding is the best way to provide newborns with the nutrients they need. WHO recommends exclusive breastfeeding until a baby is six months old, and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond.

Introduction to Breastfeeding

Breast milk is thought to be the best form of nutrition for neonates and infants. The properties of human milk facilitate the transition of life from in utero to ex utero. This dynamic fluid provides a diverse array of bioactive substances to the developing infant during critical periods of brain, immune, and gut development. The clinician must be familiar with how the mammary gland produces human milk and how its properties nourish and protect the breastfeeding infant.

Clinicians play a crucial role in a mother's decision to breastfeed and can facilitate her success in lactation. Although a mother may not be aware of the evidence indicating that breast milk contributes to her baby's short-term and long-term well-being, she has developed certain attitudes and cultural beliefs about breastfeeding. The issue of bonding between mother and newborn may be a strong factor; however, stronger cultural or societal barriers may result in the decision to formula feed. Such issues must be understood for successful counseling. The mother makes her decision regarding breastfeeding prior to delivery in more than 90% of cases; therefore, her choice of infant nutrition should be discussed starting in the second trimester and continue as part of an ongoing dialogue during each obstetric visit.

Breastfeeding or bottle feeding your newborn baby is a personal decision. If you choose to breastfeed, it will be helpful if you are in a supportive environment and have resources to assist you with questions you may have or problems that may develop.

Consider attending a series of La Leche League meetings or reading La Leche League's book on breastfeeding (The Womanly Art of Breastfeeding) before the birth of your baby.
Ask other breastfeeding mothers for advice.
A supportive network including other like-minded mothers helps with the commitments of this style of feeding.
If you are undecided at birth time, consider a one-month trial. It is easy to go from breastfeeding to bottle-feeding.
The first month of breastfeeding is the most difficult, so if you get through that period, the rest will be easier.

Campaign Video : "Breastfeeding: First food for champions!"

Comparison with Formula-Feeding

The ideal food for human infants is human milk. Human milk contains all the right ingredients—protein, carbohydrates, fats, vitamins, minerals, and water—in just the right balance. No formula can make that claim. Infant formula manufacturers attempt to artificially duplicate human milk. Formula feeding is a practice that is relatively recent—about 60 years—compared to the beginning of humankind (not to mention all other mammals) relying on breast milk.
Formula does not contain the disease-fighting factors or the digestive enzymes that breast milk has. The nutrients in formula are more difficult for a baby to digest and absorb than the nutrients in human milk, requiring the baby to handle excess waste. Some formulas may have a less than optimal composition by containing too much salt and/or not enough cholesterol, fats, lactose, zinc, and iron, among other nutrients.

Some infants fed a cow's milk-based formula may develop allergies to the proteins in the cow's milk. Infants who are allergic to cow's milk often are also allergic to "hypoallergenic" (non-allergy-causing) soy formulas.
During the early months, a formula-fed baby may develop signs of allergy to or intolerance of a particular formula. These signs may include the following:
- Bouts of crying after feeding
- Vomiting after most feedings
- Persistent diarrhea or constipation
- Colic with a distended tense painful abdomen after feeding
- Generally irritable behavior
- A red, rough sandpaper-like rash especially around the face or anus or in both places
- Frequent colds and ear infections
- Red itchy rash especially in the folds of the elbow and knee joints
These signs, or the baby's preference, may lead you through a series of different formulas, often each more expensive than the last.
Formula-fed infants may be exposed to a variety of environmental substances used during the preparation of the formula or carried as a minor contaminate from which breastfed infants are protected.

Benefits of Breastfeeding

With rare exceptions, breast milk is the preferred feeding for infants and confers unique benefits.

Breastfed babies (for at least 6 months) may be at reduced risk for many acute and chronic diseases, including gastrointestinal tract infection (like diarrhea), lower respiratory tract infections (like a cold), urinary tract infections, otitis media (ear infections), and allergic reactions (like atopic dermatitis and asthma).
The effect of breastfeeding in protecting against infection is well established. Infants who were fully breastfed for 6 months or more seem to have higher mental development when compared with infants who were never breastfed. Some studies show that the effects of breastfeeding may carry over and also protect young children and adolescents from becoming overweight.
Milk has biologic specificity—meaning that every species of animal who breastfeeds their babies makes a milk that is unique for the young of that species.
The amounts of nutrients change to match your baby's rapidly changing needs.
The fat content increases during a feeding so that the baby gets the right amount of fat. Human milk contains the right kinds of fats along with an enzyme (lipase) that helps digest the fat.
Cholesterol is high in human milk, lower in cow's milk, and very low in formulas. Cholesterol promotes brain growth and provides basic components of hormones, vitamin D, and intestinal bile.
Milk (cow's, formula, and human) contains two main proteins: whey and casein. Whey is easier for humans to digest and is found in higher concentrations in human milk.
Around 6 months of age, the baby's intestines mature and become less open to proteins that may harm the body as allergenic proteins (allergens). Giving only human milk until the intestines mature is the best way to keep potentially allergy-causing proteins out of baby's blood.
Human milk includes helpful proteins not naturally found in milk made by cows or companies.
Human milk is fresh and contains more lactose (sugar) than cow's milk. Formulas add sucrose or glucose (other types of sugars).
Vitamins and minerals have a higher bioavailability in human milk. In other words, the body uses most of what is in the milk. There is very little waste.
The germs in the baby's environment, to which the mother has been exposed, cause the mother to produce antibodies to that germ, which are passed on to the breastfeeding infant.
Breastfeeding relaxes mother and baby.
Women who breastfeed have a lower incidence of breast cancer.
Breastfed babies tend to be healthier.
Breastfeeding is less expensive.

Prepare for Breastfeeding

There is really no physical preparation that is necessary for breastfeeding. Education about the benefits and practice of breastfeeding is the best preparation. Contrary to some popular beliefs, it is not necessary to "toughen up" or prepare the nipples in advance for breastfeeding. Some techniques of stimulating the nipples may actually be harmful.
Sometimes women prepare for breastfeeding by exposing the nipples to air for a certain amount of time each day; while this has not been shown to be medically useful, it is likely not harmful either.
Take a breastfeeding class. Your hospital may offer breastfeeding classes as part of the childbirth class. These classes can put you in touch with a lactation specialist who may later be your personal breastfeeding consultant.
Join your local La Leche League or other breastfeeding support group. Call (800) LA LECHE to find your local leader.
Talk with supportive friends who encourage your feeding choices.
Learn proper positioning and latch-on techniques.

First Feedings

Within a few minutes after birth, most babies can be introduced to breastfeeding. Relax. Most babies take a few licks, sucks, and pause. Sucking in frequent bursts and pauses is the usual pattern for the first few hours and sometimes even the first few days. The first milk the mother produces, colostrum, is the best food.
Breastfeeding also helps the uterus contract, which helps stop uterine bleeding.
Try to room-in with your baby. When you see your baby begin to open its eyes, look around, and put his or her fist into his or her mouth, then it is time to offer your breast.
- Try to make the nurses understand that you wish to breastfeed and that your baby should not be given sugar water or formula without you and your health care provider being aware and consenting.
- You may need to have the nurses actually put a sign on your baby's bed restricting bottle-feeding.
Try latching the baby on at the first signs of hunger. Do not wait until the baby cries, or you will teach the baby to cry to get your attention. The baby will get upset more quickly the longer you take to respond.

Conclusion :

Human milk, in addition to its numerous nutrients that make it an ideal food source for the growing term infant, is a bioactive fluid that evolves from colostrum to mature milk as the infant matures. This bioactive fluid contains numerous factors and live cells that, in concert, promote the growth and well-being of the breastfeeding infant. Oliver Wendell Holmes said it best when he stated, "A pair of substantial mammary glands has the advantage over the two hemispheres of the most learned professor's brain, in the art of compounding a nutritious fluid for infants." With the ever-expanding knowledge resulting from current research, commercial formula clearly cannot replicate all of the valuable properties that are inherent in human milk.

Source:
world_breastfeeding_week
breastfeeding/article
http://emedicine.medscape.com/article/1835675-overview
http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Pages/CommonQuestions.aspx
http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Page /EducationalMaterialsforBreastfeedingFamilies.aspx
http://www.webmd.com/parenting/baby/baby-food-nutrition-9/default.htm
http://www.happybabyfood.com/health-nutrition/47/210-happybaby-nutrition-guide
Age by age guide to feeding your baby http://www.babycenter.com/0_age-by-age-guide-to-feeding-your-baby_1400680.bc

Monday, December 20, 2010

Important aspects about Down Syndrome

What is Down Syndrome?

Down syndrome (also called Trisomy 21 ) is a genetic disorder that occurs in approximately 1 of 800 live births. It is the leading cause of cognitive impairment.

Down syndrome is associated with mild to moderate learning disabilities, developmental delays, characteristic facial features, and low muscle tone in early infancy.

Many individuals with Down syndrome also have heart defects, leukemia, early-onset Alzheimer's disease, gastro-intestinal problems, and other health issues. The symptoms of Down syndrome range from mild to severe.

Life expectancy for individuals with Down syndrome has dramatically increased over the past few decades as medical care and social inclusion have improved. A person with Down syndrome in good health will on average live to age 55 or beyond.

About Down's syndrome

Down's syndrome is caused by an extra chromosome. Chromosomes are structures that contain genes - these contain the instructions for life and are inherited from parents. Normally, our cells contain 46 chromosomes: 23 inherited from each parent. In Down's syndrome a mistake is made during cell division, this is most likely to occur when the sperm or egg is being formed causing 24 chromosomes to be present rather than the usual 23. After the egg is fertilised by the sperm the cells have 47 chromosomes rather than the normal 46 chromosomes.

Types of Down's syndrome

Trisomy 21 - this is when all the cells have an extra chromosome 21. This happens in most people with Down's syndrome.

Translocation - this is when an extra fragment of chromosome 21 attaches to another chromosome. This happens in about one in 25 people with Down's syndrome.

Mosaicism - this is when only some cells have an extra chromosome 21 while others don't. This happens in about one in 50 people with Down's syndrome.

Symptoms of Down's syndrome

The extra chromosome 21 causes characteristic physical features in people with Down's syndrome. These usually include some, but not always all, of the following.

Physical Features

Low-set eyes that slope upwards, with vertical skin folds (epicanthic folds) between the upper eyelids and the inner corner of the eye.
A small mouth, which means the tongue may seem big and may stick out.
A flattening at the back of the head.
A flattened nose bridge.
Broad hands with a single crease.
Floppiness due to loose muscle tone.
Small, low-set ears.
A low birth weight and short stature.

Intellectual Disability

Most people with Down syndrome have some degree of mental retardation, or intellectual disability, usually in the mild to moderate range. This is usually characterized by delay in development, language, and memory. Down syndrome is among the most common causes of mental retardation.

Note: Many of these physical features can be found in the general population; having some of these characteristics doesn't necessarily mean that a person has Down's syndrome.

Complications of Down's syndrome

People with Down's syndrome are more likely to have the following.

Heart problems.
Eye problems, such as short- or long-sightedness or cataracts (cloudy patches in the lens of the eye).
Hearing problems, ranging from mild to complete deafness.
Thyroid problems, including low or more rarely, high levels of the thyroid hormones.
Poor immunity and so are prone to chest infections, coughs and colds.
Problems with the digestive system, such as persistent diarrhoea or constipation; babies may have feeding problems and may not gain weight normally.
Dementia at an earlier age (it occurs 20 to 30 years earlier than in the rest of the population).

It's important for people with Down's syndrome to have regular health checks so that these conditions can be diagnosed and treated at an early stage.

Development

All people with Down's syndrome have some level of learning disability but the severity can differ between individuals. Children usually learn to walk, talk, read and write, but more slowly than other children of their age. People with Down's syndrome learn to do things throughout their lives at different rates.

Causes of Down's syndrome

Down's syndrome is caused by an extra chromosome. This happens as a result of a problem in cell division but it's not known what causes that to happen. However, the chance of having a baby with Down's syndrome increases with the mother's age.
Mother's age at conception Risk of Down syndrome:

25 years 1 in 1,250
30 years 1 in 1,000
35 years 1 in 400
40 years 1 in 100
45 years 1 in 30

However, most babies with Down's syndrome are born to women under 35, since these women account for the majority of the childbearing population.
The chance of you having a baby with Down's syndrome has nothing to do with where you live, your social class or your race. You can't do anything before or during pregnancy to change the chance of your baby having Down's syndrome.

Diagnosis of Down's syndrome

Babies with Down's syndrome are usually diagnosed in the first few days after birth. Doctors and midwives are trained to identify the physical characteristics associated with the condition. Some babies have almost no physical signs while others have all of them. A chromosome test is then used to confirm the diagnosis. The doctor will take a blood sample from the baby. This is sent to a laboratory for tests.
There are also screening tests for Down's syndrome that you can have while you're pregnant. Screening takes place during either the first trimester (three months) or second trimester (six months) by either ultrasound or through a blood test, or a combination of both. Screening tests don't give a definite answer, but can tell you if your baby has an increased risk of having Down's syndrome.

If the screening tests show that your baby has an increased risk of having Down's syndrome; you will be offered further diagnostic tests, such as chorionic villus sampling (following a first-trimester screening test) or amniocentesis (following a second-trimester screening test). These tests involve some risk to mother and baby so are usually only offered to women if earlier screening tests suggest the baby is likely to have Down's syndrome. For more information about these tests, see related topics.
When Down syndrome is diagnosed after birth, it is usually suspected based on the physical characteristics of the infant. The definitive diagnosis, though, is made by chromosomal karyotype ("mapping") analysis.

There are several screening tests done in pregnancy that may help diagnose Down syndrome:

Alpha fetoprotein (AFP) screening is a simple blood test done between 15 and 20 weeks' gestation in all pregnancies.

It is not a specific test (meaning that it will not give an exact diagnosis), but, if abnormal, will generally lead to further testing. The blood test is used along with gestational age and maternal age to indicate if a higher risk of Down syndrome, neural tube defect, or other genetic abnormalities are present.

High-resolution ultrasound of the fetal neck during the second trimester of pregnancy may also help to diagnose Down syndrome. Generally, more testing is done if the ultrasound is suspicious.

Amniocentesis or chorionic villus sampling are more invasive tests that carry some risk but can give a definitive diagnosis of Down syndrome by chromosomal analysis.

Depending on a woman's risk of Down syndrome, she may see a geneticist or discuss having a diagnostic procedure done during her pregnancy (prenatal diagnosis).

Living with Down's syndrome

People with Down's syndrome have special medical and social needs, but they can live full lives, take part in further education, have jobs and relationships, and live independently.

Medical and social support

            A team of professionals will help support people with Down's syndrome, and their families. This team may include your GP, a pediatrician, midwife, health visitor, occupational and speech therapists and a physiotherapist for example.
           Specialist doctors monitor all babies with Down's syndrome for health problems, and children with the condition have regular growth, hearing and sight, and thyroid checks. It's also important for adults with          Down's syndrome to have regular sight, hearing and thyroid function tests.
           Occupational therapists and dietitians can help with issues such as nutrition and educational support. Most children with Down's syndrome go to mainstream schools, but there are schools for children with special needs.

Down's syndrome Q&A

See our answers to common questions about Down's syndrome, including:

Sources:

Antenatal care: Routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), March 2008.www.nice.org.uk
Why is Down's syndrome referred to as a genetic condition? Down's Syndrome Association. www.downs-syndrome.org.uk, accessed 15 December 2009
Learning about intellectual disabilities and health: Down's syndrome. St Georges University of London. www.intellectualdisability.info, accessed 15 December 2009
Basic medical surveillance essentials for people with Down's syndrome. Cardiac disease: Congenital and acquired. UK Down's Syndrome Medical Interest Group, 2007. www.dsmig.org.uk
Down's syndrome: Coeliac disease/gluten sensitivity. UK Down's Syndrome Medical Interest Group. www.dsmig.org.uk, accessed 15 December 2009
Health FAQs. Down's Syndrome Association. www.downs-syndrome.org.uk, accessed 15 December 2009
Testing for Down's syndrome in pregnancy. NHS Antenatal and Newborn Screening Programmes. www.fetalanomaly.screening.nhs.uk, accessed 15 December 2009
Pre-conception - advice and management. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 15 December 2009
Information for parents: Down syndrome. Department for Children SAF. http://publications.everychildmatters.gov.uk, accessed 15 December 2009
Choosing the right school for your child: A guide for parents and carers. Mencap. www.mencap.org.uk, accessed 15 December 2009
Down's syndrome: A guide for new parents. Down's Syndrome Association. www.downs-syndrome.org.uk, accessed 15 December 2009
Pradhan M, Dalal A, Khan F, et al. Fertility in men with down syndrome: A case report. Fertil Steril 2006; 86(6):1765
Van Cleve SN, Cannon S, Cohen W. Part 2: Clinical practice guidelines for adolescents and young adults with down syndrome: 12 to 21 years. J Pediatr Health Care 2006; 20(3):198-205
National strategy for speech, language and communication: 2005-2010. Down's Syndrome Association. www.downs-syndrome.org.uk, accessed 15 December 2009
Behind Closed Doors: Down Syndrome http://www.npr.org/templates/story/story.php?storyId=10167662
Health Supervision for Children With Down Syndrome http://aappolicy.aappublications.org/cgi/reprint/pediatrics;107/2/442.pdf

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