Literature review for - Flourish Paediatrics

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Exercise and Breastfeeding Search results The initial search of the databases included 63 references on exercise and breastfeeding. Data were extracted from 4 references, and these publications were used to form the final body of evidence statement. Sufficient evidence was found to make a statement that breastfeeding is not affected by moderate exercise. No evidence is available to make a statement on exercise at the elite sporting level. The Cochrane review stated that the evidence suggests that both diet and exercise together and diet alone help women to lose weight after childbirth. The sample sizes in the RCTs are generally small and further research is required. Breastfeeding and Exercise Does exercise by mothers in the postpartum period affect breastfeeding performance? Draft Evidence statement Draft Grade Component Rating Notes Exercise by mothers does not affect breastfeeding performance B Evidence Base Good 1 systematic reviews (1 systematic review, Cochrane, had a primary endpoint of weight loss and effect of exercise on breastfeeding was an incidental finding) 1 narrative review and 2 cohort studies. Consistency Satisfactory The systematic review and one cohort study found no effect. The other cohort study found a positive effect. Clinical impact Good There was no association between exercise and breastfeeding or on infant growth. Generalisability Excellent Australian USA and UK populations Applicability Excellent Directly applicable. The question of interest is whether exercise by mothers affects breastfeeding performance in any way. Possible mechanisms might include the production of lactic acid during anaerobic exercise that could affect the taste of breastmilk. No evidence was found that moderate levels of exercise had any impact on breastfeeding duration or quality. There were no studies found on elite level professional sports and breastfeeding. 121
Studies used to make evidence statement for Breastfeeding and Exercise Reference Amorim Adegboye 2008 Cochrane review Su 2007Public Health Nutrition McCrory 2001 Nutrition reviews Evenson 2009 J Womens Health Type of study SLR Cohort Narrative review Cohort Level of evidence I (aetiology) II (aetiology) Definition of breastfeeding EBF –defined as a child being fed only on mother’s Full Breastfeeding (WHO ) Any Breastfeeding Not stated Not stated Intervention Comparator milk Exercise Exercise levels measured as MET-hours per week Diet and exercise N 245 587 N=667 Population/study information 6 trials, RCT and quasirandomised A series of small RCTs Population recruited from two hospitals in Perth Review of studies of overweight women in post partum period Quality P P N O Results Exercise had no effect on breastfeeding Exercise and diet together assisted in maternal weight Exercise had no effect on breastfeeding or infant weight gain Moderate weight loss in overweight lactating women does not impair infant growth Survey of barriers to exercise and breastfeeding Pregnancy, Infection, and Nutrition (PIN3) Study recruited pregnant women at
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Infant Feeding Guidelines for Healt
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One of the responses of the Austral
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Table of Contents Introduction ....
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Goat’s milk .....................
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period of this review will generall
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Infant formula - Preparation, use a
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Protein levels of infant formula. F
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a. Will the use of a heavier refere
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Time to first feed and breastfeedin
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controlled for in multivariate logi
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the baby, or for suturing the mothe
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Impact of delivery method on breast
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Studies used to make evidence state
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For those who were fully breastfeed
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Effect on risk 0.56-0.88) Assisted
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significant Breastfeeding initiatio
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Results Adj OR never breastfed Assi
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Birth weight and breastfeeding If t
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3500-3999 vs 3000-3499 1.00 (95% CI
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Population/study information Perth,
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Any breastfeeding duration No adjOR
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cohort study reported no associatio
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Results [8] Intro of formula at 4 w
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Clinical 1 1 1 importance Clinical
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6. If mother-baby separation is una
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Studies reviewed to make evidence s
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Reference Scott JA, Binns CW, Oddy
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Effect on risk There was no associa
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infant Clinical 1 1 1 4 importance
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Reference Qiu et al Asia Pac J Clin
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Social support (other than fathers)
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pregnancy interventions on breastfe
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Reference Scott JA, Landers MCG, Hu
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weeks, 3 months & 6 months postpart
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Quality P O P Results Breastfeeding
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analysis analysis Effect on risk No
Page 77 and 78: Studies used to make evidence state
Page 79 and 80: Location (rural vs urban) and breas
Page 81 and 82: Effect on risk New Territories not
Page 83 and 84: Socioeconomic status Sufficient evi
Page 85 and 86: Quality P P O P Results Adj OR any
Page 87 and 88: Whether the mechanism for this asso
Page 89 and 90: obesity and infant feeding intentio
Page 91 and 92: Parity and Breastfeeding Parity has
Page 93 and 94: Quality P P P P Results No signific
Page 95 and 96: discharge. Quality P P P P Results
Page 97 and 98: Effect on risk There was not associ
Page 99 and 100: Effect on risk No effect of parity
Page 101 and 102: For Australian mothers 5 studies fo
Page 103 and 104: 25-29 1.710 (1.085, 2.698) ≤24 1.
Page 105 and 106: 30-34: 0.87 (95%CI 0.64-1.18) Adjus
Page 107 and 108: Clinical 1 2 1 relevance Generalisa
Page 109 and 110: Reference Binns CW, Gilchrist D, Gr
Page 111 and 112: Population/study information Infant
Page 113 and 114: Intervention/ comparator 40 years v
Page 115 and 116: Maternal education and breastfeedin
Page 119 and 120: Effect on risk Mothers who complete
Page 121 and 122: significant independent association
Page 123 and 124: Demand feeding, Rooming in and brea
Page 125 and 126: Effect on risk There was no signifi
Page 127: 1991. Quality P P P P Results No sp
Page 131 and 132: Cultural differences on Exercise an
Page 133 and 134: During pregnancy, women should avoi
Page 135 and 136: findings of this study support the
Page 139 and 140: N 14 countries 3032 17 359 singleto
Page 141 and 142: 8. Encourage breastfeeding on deman
Page 143 and 144: Breastfeeding and SIDS BREASTFEEDIN
Page 145 and 146: descriptive) RESULTS Outcome EXTERN
Page 147 and 148: Additional Notes 1. Clinical Eviden
Page 149 and 150: Use of Pacifiers for the Prevention
Page 151 and 152: American Academy of Pediatrics Poli
Page 153 and 154: Parslow et al. 2004). In addition,
Page 157 and 158: N Population/study information 570
Page 159 and 160: Both the Baby Friendly Hospital Ini
Page 161 and 162: lanolin, aerosol spray, ointment, f
Page 163 and 164: Incidence of nipple pain/trauma No
Page 167 and 168: Effect on risk Sore nipples, althou
Page 169 and 170: Systemic antibiotics are recommende
Page 171 and 172: Results Routine Care Versus Heat Ve
Page 173 and 174: anticipatory guidance with regard t
Page 175 and 176: In a cohort of 280 mother-infant pa
Page 177 and 178: months in 1987-9. Completed two wri
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Population/study information Sample
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Nipple Shield Use Search results Th
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Other Nipple Problems Eczema and De
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Raynaud’s Phenomenon of the Nippl
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Table. Management of breastmilk ins
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Effect on risk Factor analysis sugg
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Definition of breastfeeding Interve
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Reference Hurley et al. 2008 Gatti
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y test-weighing) Clinical 1 1 1 imp
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Engorgement of the Breast Search re
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more frequently prior to the recurr
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Reference Mangesi & Dowswell 2010 C
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Inflammatory conditions of the brea
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Three studies reported on the occur
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In the management of mastitis, the
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Quality 0 0 P Results The cumulativ
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was an intention to breastfeed. Par
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Level of evidence I (a) I (aetiolog
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Further adequately powered research
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Applicability Satisfactory Results
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Reference Kvist et al. 2007 Kvist e
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egarding aspiration technique Effec
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Many epidemiological studies have d
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normal functioning (Horowitz and Go
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• Ask mothers if they are losing
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the first 3 months postpartum, with
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Effect on risk This variability is
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In a US study of 802 women they fou
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Studies used to determine the risk
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A predictive relationship was consi
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The effect size of social support i
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weeks of delivery Four validated se
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growth faltering N > 22,000 929 chi
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Breast Refusal Search results The i
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Prevalence Rates of Excessive Cryin
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Regurgitation, gastroesophageal ref
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(Dwyer and Ponsonby 2009). Medicati
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ultrasonically. Real time ultrasoni
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Reference Heine et al. (2006) Cheri
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There was no significant associatio
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positioning strategies. The treatme
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Reference van Wijk et al. (2007) Co
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Generalisability Y Y- Italy Y Appli
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myenteric plexus Quality P P N Resu
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comparator N Population/study infor
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Effect on risk There were fewer adv
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Component Rating Notes Evidence Bas
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and/or difficulty of the baby latch
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Reference Dollberg et al. 2006 Srin
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Effect on risk Frenotomy alleviates
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Studies used to make the statement
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Notes on postpartum weight loss Ip
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Main results: Twelve studies met th
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Storage of Expressed Breastmilk Wha
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4. Storage of Expressed Breastmilk
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Expression and Breastfeeding durati
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duration) Clinical 1 1 1 importance
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VI Breastfeeding in specific situat
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Mothers currently using illicit dru
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Summary of the evidence The effect
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showing a negative association with
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Population/study information breast
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Effect on risk response relationshi
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pregnancy Quality P P P P Results A
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Reference Forster DA, McLachlan HL
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who did not stop smoking. duration
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-1, 5) Not breastfeeding: 1% (95% C
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≥6 vs non-smoker Adj OR (95%CI) n
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Larger hospitals - mothers recruite
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The Merck Manual online version als
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Sufficient evidence was found to ma
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Does return to work negatively affe
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Returned to work (
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N [5] 2079 of 3670 questionnaires r
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Reference [1] Forster DA, McLachlan
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technical 0.32 (95%CI 0.25-0.42) Se
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Reference Scott JA, Aitkin I, Binns
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Contraception and Breastfeeding The
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Authors’ conclusions: Postpartum
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ich countries where there it is aff
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eview by (Bulteel and Henderson 200
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Galactosaemia in Infants Search res
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of birth. Every effort should be ma
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Hepatitis C and HIV co-infected mot
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significantly affect HCV transmissi
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The PKU handbook includes the follo
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Tuberculosis and Breastfeeding Sear
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Syphillis in Breastfeeding Mothers
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paediatricians (Australian College
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the Cochrane Central Register of Co
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Objectives: To determine the effect
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Objectives: In newborn infants with
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information on bottle-feeding and d
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Cow’s Milk Search results The ini
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The SLR by Wijndaele and colleagues
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infants were fed formula for 1 mont
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Quality 0 (No to 6.2 and 7.4 P P 0
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Reference Conn et al. 2009 Couper e
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eastfed Fe intake was inadequate fo
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England. After the birth, a short q
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food weighing (BM: n =21; BCM: n =
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Population/study information Sample
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positive stools upon cow milk feedi
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data were collected from the parent
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Applicability Y- Denmark Y - Vietna
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milk during infancy can result in s
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X Infant feeding and later Outcomes
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Overall quality assessment (Positiv
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finally recruited. Outcome measure
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Intervention Comparator N Populatio
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elevance Generalisability Y N Y App
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Current advice from the Australasia
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elevant food allergens altogether.
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71. However, it should be recognise
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Obesity and infant feeding The dura
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) Around six months c) Around six m
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The Paediatrics & Child Health Divi
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Belarus found that during the perio
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The American Academy of Pediatrics
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efore age 4 months was associated w
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isk of obesity at age 7 yrs. while
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Effect on risk Positive Positive Ne
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Results Any breastfeeding reduced t
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eastfeeding promotion intervention
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Effect on risk Negative Negative Ne
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Additional Notes Horta: Meta-analys
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socioeconomic status strongly influ
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Breastfeeding and Obesity Notes Whi
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Breastfeeding and Bowel Disease: Co
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Notes on Coeliac Disease and IBD -
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This paper is not directly related
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Table 1 Death rates from coronary a
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Figure 1 Hazard ratios for coronary
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These adaptations permanently ‘re
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postnatal growth—programs to avoi
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“Health care professional’ - a
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7.3. No financial or material induc
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Appendix 460
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9 FISH (S1.1) Data was extracted fr
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allergies. Assigned to n-3 egg, no
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Table 13.1 Studies used to make evi
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14 SUGARS (S1.1) SUGARS and DENTAL
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Effect on risk (Increase/None /Prot
Page 479 and 480:
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Clinical importance Clinical releva
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Population/study information [6] Ch
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obesity (P=0.008) and 6.2-fold risk
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quality and were both conducted in
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associated with a decreased risk of
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The systematic review was of very p
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Effect on risk (0.45-76.85). (OR ra
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excluded. from the Denver metropoli
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21 DIETARY PATTERNS (U1.1) What die
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Applicability Excellent Studies con
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or Neutral) plus descriptive) RESUL
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Table 24.2 Summary used to make evi
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Statistical analysis methods Overal
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from 8 - 12 months (outcome three);
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infants with low z-scores provided
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Kajosaari 1983 and Oddy 1999 report
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of upper respiratory infectionRR 0.
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still be managed individually so th
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Length of follow-up Outcome(s) meas
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0.94 (95% CI 0.87 -1.01). Professio
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Conclusion Additional professional
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Outcome(s) measured INTERNAL VALIDI
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Conclusion PIM is one of the most c
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Table 24.3 Summary used to make evi
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BREASTFEEDING AND SUDDEN INFANT DEA
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RESULTS Outcome EXTERNAL VALIDITY G
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ALCOHOL, CAFFEINE AND BREASTFEEDING
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Table 26.1 Summary of studies to ma
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SELENIUM AND BREASTFEEDING OUTCOMES
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Table 26.2 Summary of studies used
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FACTORS ASSOCIATED WITH ENHANCED BR
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Total number of participants Popula
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weight loss).Comparison one: contro
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month) (outcome five). For the 8-12
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study also provided data on head ci
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found no reduction in risk of a pos
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espiratory tract infection RR 1.07
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Affiliation/so urce of funds Univer
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Perceived Insufficient Milk (PIM) T
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Overall quality assessment (Positiv
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professional support to be effectiv
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EXTERNAL VALIDITY Generalisabil ity
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people together was specific to bre
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References Abdulwadud Omar, A., & S
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Gatti, L. 2008, "Maternal perceptio
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Poole, J. A., Barriga, K., Leung, D
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Monitoring Breastfeeding in Austral
Page 579 and 580:
Labiner-Wolfe, Judith, Sara B. Fein
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Issues in selecting a growth refere
Page 583 and 584:
that breastfeeding, with exclusive
Page 585 and 586:
they noted that “during the first
Page 587 and 588:
lower percentiles (0.4 and 2 percen
Page 589 and 590:
Breastfeeding is an integral part o
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Royal Australian College of General
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feeding, the AAP firmly adheres to
Page 595 and 596:
If an infant is not breastfed, or i
Page 597 and 598:
Interventions to Promote Breastfeed
Page 599 and 600:
ethnicity or maternal age cannot be
Page 601 and 602:
three months, interventions involvi
Page 603 and 604:
Data Collection and Analysis: We us
Page 605 and 606:
Major Reviews of Infant Feeding 200
Page 607 and 608:
Proportion of adult smokers who hav
Page 609 and 610:
figures indicate that we have littl
Page 611 and 612:
Funding has also been allocated to
Page 613 and 614:
National Longitudinal Survey of Chi
Page 615 and 616:
608
Page 617 and 618:
infectious diseases. There is a lar
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In Queensland, according to the 200
Page 621 and 622:
eastfeeding at 6 months were among
Page 623 and 624:
gestational age or who have experie
Page 625 and 626:
Ten Steps to Successful Breastfeedi
Page 627 and 628:
620
Page 629 and 630:
622
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deficiency has also been associated
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PAHO Guiding Principles for Complem
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Breastfeeding Rates in Australia A
Page 637 and 638:
Population/ study information A tot
Page 639 and 640:
Population/ study information The s
Page 641 and 642:
Type of study Breastfee ding defini
Page 643 and 644:
References Abou-Dakn, M., A. Richar
Page 645 and 646:
Barclay, A. R., R. K. Russell, et a
Page 647 and 648:
Clark, P. M. (1998). "Programming o
Page 649 and 650:
Eglash, A. (2005). "ABM Protocol #8
Page 651 and 652:
Griffiths, D. M. (2004). "Do tongue
Page 653 and 654:
Howard, C. R., N. Lanphear, et al.
Page 655 and 656:
Labiner-Wolfe, J., S. B. Fein, et a
Page 657 and 658:
National Institute of Clinical Stud
Page 659 and 660:
Rasmussen, K. and C. Kjolhede (2004
Page 661 and 662:
Stettler, N. (2007). "Nature and st
Page 663 and 664:
Whitaker-Worth, D. L., V. Carlone,
Page 665 and 666:
INDEX A Abscess ...................
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