Widström Am

Skin‐to‐skin contact may reduce negative consequences of “the stress of being born”: a study on temperature in newborn infants, subjected to different ward routines in St. Petersburg

Aim: To evaluate how different delivery‐ward routines influence temperature in newborn infants. Methods: A total of 176 newborn mother‐infant pairs were included in a randomized study. The babies were kept skin‐to‐skin on the mothers chest (Skin‐to‐skin group), held in their mothers arms, being either swaddled or clothed (Mothers arms group), or kept in a cot in the nursery, being either swaddled or clothed (Nursery group). Temperature was measured in the axilla, on the thigh, back and foot at 15‐min intervals at from 30 to 120 min after birth. Results: During this time period the axilla, back and thigh temperatures rose significantly in all the treatment groups. The foot temperature displayed a significant fall in the babies in the Nursery group and this decrease was greatest in the swaddled babies. In contrast, foot temperature rose in the babies in the Mothers arms group and in particular in babies in the Skin‐to‐skin group. Foot temperature remained high in the Skin‐to‐skin group, whereas the low temperature observed in the Nursery group gradually increased and two days after birth the difference was no longer significant.

State of the art and recommendations. Kangaroo mother care: application in a high-tech environment.

Since Kangaroo Mother Care (KMC) was developed in Colombia in the 1970s, two trends in clinical application emerged. In low income settings, the original KMC model is implemented. This consists of continuous (24 h/day, 7 days/week) and prolonged mother/parent–infant skin‐to‐skin contact; early discharge with the infant in the kangaroo position; (ideally) exclusive breastfeeding; and, adequate follow‐up. In affluent settings, intermittent KMC with sessions of one or a few hours skin‐to‐skin contact for a limited period is common. As a result of the increasing evidence of the benefits of KMC for both infants and families in all intensive care settings, KMC in a high‐tech environment was chosen as the topic for the first European Conference on KMC, and the clinical implementation of the KMC model in all types of settings was discussed at the 7th International Workshop on KMC. Kangaroo Mother Care protocols in high‐tech Neonatal Intensive Care Units (NICU) should specify criteria for initiation, kangaroo position, transfer to/from KMC, transport in kangaroo position, kangaroo nutrition, parents’ role, modification of the NICU environment, performance of care in KMC, and KMC in case of infant instability.

The position of the tongue during rooting reflexes elicited in newborn infants before the first suckle

A common breast‐feeding problem is when the infant “places its tongue in its palate” and has difficulties in attaching to its mothers nipple. The aim of this study was to document the position of the tongue in the mouth cavity during rooting reflexes elicited in newborn infants before the first suckle. Eleven healthy, full‐term infants were videotaped 101 ± 31 min after birth during an evoked distinct rooting reflex before the first suckle. The videotaped rooting reflex was analyzed in detail concerning the degree of turning of the head, mouth opening and position of the tongue, in pictures that were “frozen” at specific intervals. “Licking movements” preceded and followed the rooting reflex in the alert infants. In 10 of the 11 infants the tongue was placed in the bottom of the mouth cavity during a distinct rooting reflex (p= < 0.05). It is suggested that forcing the infant to the breast might abolish the rooting reflex and disturb placement of the tongue. A healthy infant should have the opportunity of showing hunger and optimal reflexes, and attach to its mothers nipple by itself.

Early lactation performance in primiparous and multiparous women in relation to different maternity home practices. A randomised trial in St. Petersburg.

This article explores the affection and the couple election production logics among teenagers from heterogeneous popular sectors of Cali city (Colombia) according to class gender and race factors. Without seeking to look directly into the conjugality anyway the text enters in the matter of couples election under the restrictions of adolescent and post adolescent life cycle of our research program through the courtship eventually with the option to cohabit and to have an offspring; in accordance with the information picked up to level of the interviews and the focal groups. In second place when having the opportunity of a statistical data through household survey series between 1998 and the 2003 in Cali and the Valle del Cauca urban region where Cali is placed on Afrocolombian and non Afrocolombian population we have been able to attempt a first approach to the racial homogamy phenomenon for the complete households (it means with spouses presence) establishing the necessary links with the qualitative data to look from a macro social perspective the behavior of these logics among the teenagers. For that reason the class gender and race factors are seen through the racial homogamy category in the sense of coming closer to the social constraints of the sexuality as a social practice the affection and the intent of conjugal couple conformation in the Cali society. (authors)

Breast feeding-induced effects on plasma gastrin and somatostatin levels and their correlation with milk yield in lactating females

Maternal gastrin and somatostatin levels have been shown to be influenced during suckling in dogs and pigs. The present study was performed to investigate whether the levels of gastrin and somatostatin are influenced by breast feeding in lactating women. Repeated blood samples were drawn in connection with nursing in 15 females and plasma levels of gastrin and somatostatin were measured by radioimmunoassay. Gastrin levels rose significantly (P = 0.01) within two minutes after onset of suckling. Somatostatin levels either decreased or increased as an effect of breast feeding. The direction of the change was correlated to the pre-suckling somatostatin levels (P less than 0.01). The somatostatin level recorded 60 min after start of breast feeding was significantly lower than basal levels (P less than 0.01) indicating a long-term inhibitory effect on somatostatin secretion. The suckling-induced effect on somatostatin levels was correlated with the amount of milk ejected (Rs - 0.52, P less than 0.05). The mechanism by which suckling influences circulating gastrin and somatostatin levels is unknown, but we suggest that suckling leads to a reflex activation of the vagal nerves, which influence the release of these hormones from the stomach. The size of the gastrointestinal tract is increased during pregnancy and lactation, illustrating that the maternal digestive capacity is adapted to the high demand for energy intake occurring during lactation. We speculate that the suckling stimulus enhances gastric functions by influencing the release of gastrin and somatostatin, which stimulate and inhibit gastric functions and growth, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Suckling in lactating women stimulates the secretion of insulin and prolactin without concomitant effects on gastrin, growth hormone, calcitonin, vasopressin or catecholamines

The levels of growth hormone, vasopressin, prolactin, calcitonin, gastrin, insulin, epinephrine, norepinephrine and dopamine were measured in six lactating women during breast feeding. Prolactin levels increased in response to suckling as expected. In addition, insulin levels rose two-fold. No consistent changes were observed in the levels of the other hormones. It is suggested that the suckling related insulin release is either secondary to a reflexly induced activation of the vagal nerves or to the increased circulating levels of prolactin. Furthermore, it is suggested that the insulin release in response to suckling participates in the stimulation of milk production.

Somatostatin Levels in Plasma in Nonsmoking and Smoking Breast-Feeding Women

ABSTRACT. The objective of the study was to record how somatostatin levels in plasma are altered in response to breast‐feeding during the lactation period and to relate somatostatin levels to the success of the lactational performance and to smoking habits. Fifty‐two women were investigated 4 days post partum and 3‐4 months later. Blood samples were collected and the levels of somatostatin‐like immunoreactivity (below referred to as SLI) were measured with radioimmunoassay. The periods of exclusive breast‐feeding and of mixed feeding were assessed as well as the milk yield. Smoking habits were noted. SLI levels were found to be significantly lower on day 4 after delivery, compared to 3‐4 months later. Also the type of response to breast‐feeding was different. Thus, a significant fall of SLI was seen during breast‐feeding at the maternity unit, but not 3–4 months later. Smoking women breast‐fed fully for a significantly shorter time than nonsmokers and had significantly higher SLI levels at onset of breast‐feeding day 4 post partum. Whether the high somatostatin levels recorded in connection with breast‐feeding in smokers are related to the shorter period of breast‐feeding seen in this group remains to be established. In addition, the highest levels of somatostatin were seen the day after the very last breast‐feeding and a possible role for somatostatin in the weaning process should be explored.

Immunoreactive calcitonin in maternal milk and serum in relation to prolactin and neurotensin

Maternal milk four days post partum contained immunoreactive calcitonin in concentrations which were 22-89 times higher than those noted in concomitantly sampled maternal sera. Neurotensin-like immunoreactivity was barely detectable in milk. It is suggested that calcitonin may be a prerequisite for the concentration of calcium ions in milk but there is also possibility that it acts locally on the intestinal mucosa.

Induction of anti-secretory factor in human milk may prevent mastitis

Aim: The aim of the study was to try to induce anti‐secretory factor (AF) in human milk and possibly prevent mastitis. Methods: Forty mothers who had normal deliveries and healthy full‐term infants were randomly divided into two groups, 3–7 days postpartum. The experimental group received a food inducing AF. The control group received the same type of food, without AF‐inducing properties. Milk was tested for AF after the mothers had eaten the cereals for 4–5 wk. AF was determined by intravenous injection of milk samples into rats measuring their capacity to prevent secretion into a gut loop of the rat injected with cholera toxin. Results: The median levels of AF differed between the experimental (n= 12) and control groups (n= 16): 1.1 (0.7–1.25) units vs 0.1 (0.0–0.25) units, Z =–4.492, p > 0.0001 (11 mothers dropped out and one milk sample is missing from one of the control mothers). The frequency of mastitis in the experimental compared with the control group was reduced (p= 0.0086, permutation test). The median AF levels in mothers with or without mastitis differed; 0.0 (0.0–0.1) vs 0.5 (0.2–1.1), Z =–2.399, p= 0.017.

Maternal somatostatin levels and their correlation with infant birth weight.

Samples of blood were obtained from 52 primiparous breast-feeding women 4 days post partum. Thirty-six of the mothers were still breast-feeding 3–4 months later and had further blood samples taken. Somatostatin levels were analyzed by radioimmunoassay. A highly significant rank correlation (P = 0.0001) between average somatostatin levels on the two occasions was established, although somatostatin levels recorded 3–4 months post partum were significantly higher than those found 4 days post partum (P < 0.01). Furthermore, somatostatin levels obtained 4 days and 3–4 months post partum were inversely related to the birth weight of their children (P = 0.006 and P = 0.03). The significant negative correlation between somatostatin levels recorded 4 days post partum and birth weight of the infants persisted only when non-smokers were investigated. A strong positive correlation between infant birth weight and weight of placenta was found (P = 0.0001) and a negative correlation (P = 0.04) between somatostatin levels and placental weight. A stepwise regression was performed to explain the importance of somatostatin levels in birth weight. Somatostatin levels and smoking had an almost equal influence on the variation in birth weight (∼0%). It is suggested that low maternal somatostatin levels are related to an efficient storage of nutrients in the fetoplacental unit, thereby leading to a high birth weight.