Literature review for - Flourish Paediatrics

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BREASTFEEDING AND MATERNAL AND INFANT OUTCOMES What are the benefits of breastfeeding (partial and exclusive) and the risks of not breastfeeding (any and exclusive), to infants and mothers, both in the short term and long term? Evidence statement Grade Evidence statement Grade Evidence statement Grade Evidence statement Grade Component Rating Notes Infants who are exclusively breastfed for six months experience less morbidity from gastrointestinal infection than those who are mixed breastfed as of three or four months. B Infants, from either developing or developed countries, who are exclusively breastfed for six months or longer do not have deficits in growth compared to those who are not exclusively breastfed. B There are no apparent risks in a general recommendation for exclusive breastfeeding for the first six months of life, in both developing and developed-countries. However, infants should still be managed individually in order to achieve sufficient growth and minimise adverse outcomes. B Mothers of infants exclusively breastfed for 6 months or more have more prolonged lactational amenorrhea. B Evidence Base Excellent 8 Systematic reviews [3 are Cochrane; 3 with meta-analysis (5P, 1O, 2N)]; 5 protective effect on breastfeeding success, 1 had no results and 1 found maternal perceived insufficient milk supply increased risk of lactation failure. Consistency Good Definitions of breastfeeding (exclusive, partial, any) vary across studies. Consistent for support prolonging breastfeeding. Some of the same studies covered by the reviews Clinical impact Good For provision of support, the RR for ceasing breastfeeding was approx.0.65 to 0.9. When expressed as odds ratios for continued breastfeeding the ORs for support ranged from 1.9 to 5.2. Generalisability Excellent Breastfeeding definitions and rates are applicable to Australian women Applicability Good While some reviews include studies conducted in developing countries, only those applicable to developed countries have been applied in developing the BOEs The studies included in the body of evidence statement are shown in Table 24.2. 499
Table 24.2 Summary used to make evidence statement for breastfeeding and maternal and infant outcome STUDY DETAILS (Review) Affiliation/sourc e of funds Szajewska et al. 2006 Kramer et al. 2002 Bhutta et al. 2008 Medical University of Warsaw, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich McGill University, WHO Expert Committee on the optimal duration of exclusive breastfeeding Study design Systematic Review Meta-Analysis Systematic Review Level of evidence III-1 Evidence obtained from welldesigned pseudorandomised controlled trials (alternate allocation or some other method). III-2 Evidence obtained from comparative studies (including systematic reviews of such studies) with concurrent controls and allocation not randomised, cohort studies, case-control studies, or interrupted time series with a control group. Date of search 1966-2004 Prior to 1966 - 2000 NS Number of 1 22 (11 from developing and 11 from 34 Aga Khan University Bangladesh, Centre for Health and Population Research, Johns Hopkins Bloomberg School of Public Health USA, London School of Hygiene and Tropical Medicine, University of California, Federal University of Rio Grande de Sul Brazil, Sitaram Bhartia Institute of Science and Research India, World Bank Washington, Save the Children UK, Emergency Nutrition Network, International Food Policy Research Institute, Food for Education Programmes, Global Alliance against malnutrition, Bill and Melinda Gates Foundation, UNICEF Innocenti Research Centre III-2 Evidence obtained from comparative studies (including systematic reviews of such studies) with concurrent controls and allocation not randomised, cohort studies, case-control studies, or interrupted time series with a control group. 500
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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
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Location (rural vs urban) and breas
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Effect on risk New Territories not
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Socioeconomic status Sufficient evi
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Quality P P O P Results Adj OR any
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Whether the mechanism for this asso
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obesity and infant feeding intentio
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Parity and Breastfeeding Parity has
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Quality P P P P Results No signific
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discharge. Quality P P P P Results
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Effect on risk There was not associ
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Effect on risk No effect of parity
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For Australian mothers 5 studies fo
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25-29 1.710 (1.085, 2.698) ≤24 1.
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30-34: 0.87 (95%CI 0.64-1.18) Adjus
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Clinical 1 2 1 relevance Generalisa
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Reference Binns CW, Gilchrist D, Gr
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Population/study information Infant
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Intervention/ comparator 40 years v
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Maternal education and breastfeedin
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Effect on risk Mothers who complete
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significant independent association
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Demand feeding, Rooming in and brea
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Effect on risk There was no signifi
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1991. Quality P P P P Results No sp
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Cultural differences on Exercise an
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During pregnancy, women should avoi
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findings of this study support the
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N 14 countries 3032 17 359 singleto
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8. Encourage breastfeeding on deman
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Breastfeeding and SIDS BREASTFEEDIN
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descriptive) RESULTS Outcome EXTERN
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Additional Notes 1. Clinical Eviden
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Use of Pacifiers for the Prevention
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American Academy of Pediatrics Poli
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Parslow et al. 2004). In addition,
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N Population/study information 570
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Both the Baby Friendly Hospital Ini
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lanolin, aerosol spray, ointment, f
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Incidence of nipple pain/trauma No
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Effect on risk Sore nipples, althou
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Systemic antibiotics are recommende
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Results Routine Care Versus Heat Ve
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anticipatory guidance with regard t
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In a cohort of 280 mother-infant pa
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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
Page 455 and 456: Table 1 Death rates from coronary a
Page 457 and 458: Figure 1 Hazard ratios for coronary
Page 459 and 460: These adaptations permanently ‘re
Page 461 and 462: postnatal growth—programs to avoi
Page 463 and 464: “Health care professional’ - a
Page 465 and 466: 7.3. No financial or material induc
Page 467 and 468: Appendix 460
Page 469 and 470: 9 FISH (S1.1) Data was extracted fr
Page 471 and 472: allergies. Assigned to n-3 egg, no
Page 473 and 474: Table 13.1 Studies used to make evi
Page 475 and 476: 14 SUGARS (S1.1) SUGARS and DENTAL
Page 477 and 478: Effect on risk (Increase/None /Prot
Page 481 and 482: Clinical importance Clinical releva
Page 483 and 484: Population/study information [6] Ch
Page 489 and 490: obesity (P=0.008) and 6.2-fold risk
Page 491 and 492: quality and were both conducted in
Page 493 and 494: associated with a decreased risk of
Page 495 and 496: The systematic review was of very p
Page 497 and 498: Effect on risk (0.45-76.85). (OR ra
Page 499 and 500: excluded. from the Denver metropoli
Page 501 and 502: 21 DIETARY PATTERNS (U1.1) What die
Page 503 and 504: Applicability Excellent Studies con
Page 505: or Neutral) plus descriptive) RESUL
Page 509 and 510: Statistical analysis methods Overal
Page 511 and 512: from 8 - 12 months (outcome three);
Page 513 and 514: infants with low z-scores provided
Page 515 and 516: Kajosaari 1983 and Oddy 1999 report
Page 517 and 518: of upper respiratory infectionRR 0.
Page 519 and 520: still be managed individually so th
Page 521 and 522: Length of follow-up Outcome(s) meas
Page 523 and 524: 0.94 (95% CI 0.87 -1.01). Professio
Page 525 and 526: Conclusion Additional professional
Page 527 and 528: Outcome(s) measured INTERNAL VALIDI
Page 529 and 530: Conclusion PIM is one of the most c
Page 531 and 532: Table 24.3 Summary used to make evi
Page 533 and 534: BREASTFEEDING AND SUDDEN INFANT DEA
Page 535 and 536: RESULTS Outcome EXTERNAL VALIDITY G
Page 537 and 538: ALCOHOL, CAFFEINE AND BREASTFEEDING
Page 539 and 540: Table 26.1 Summary of studies to ma
Page 541 and 542: SELENIUM AND BREASTFEEDING OUTCOMES
Page 543 and 544: Table 26.2 Summary of studies used
Page 545 and 546: FACTORS ASSOCIATED WITH ENHANCED BR
Page 547 and 548: Total number of participants Popula
Page 549 and 550: weight loss).Comparison one: contro
Page 551 and 552: month) (outcome five). For the 8-12
Page 553 and 554: study also provided data on head ci
Page 555 and 556: 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
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that breastfeeding, with exclusive
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they noted that “during the first
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lower percentiles (0.4 and 2 percen
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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
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If an infant is not breastfed, or i
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Interventions to Promote Breastfeed
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ethnicity or maternal age cannot be
Page 601 and 602:
three months, interventions involvi
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Data Collection and Analysis: We us
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Major Reviews of Infant Feeding 200
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Proportion of adult smokers who hav
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figures indicate that we have littl
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Funding has also been allocated to
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National Longitudinal Survey of Chi
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608
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infectious diseases. There is a lar
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In Queensland, according to the 200
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eastfeeding at 6 months were among
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gestational age or who have experie
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Ten Steps to Successful Breastfeedi
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620
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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
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Population/ study information A tot
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Population/ study information The s
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Type of study Breastfee ding defini
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References Abou-Dakn, M., A. Richar
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Barclay, A. R., R. K. Russell, et a
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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
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Rasmussen, K. and C. Kjolhede (2004
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Stettler, N. (2007). "Nature and st
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Whitaker-Worth, D. L., V. Carlone,
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INDEX A Abscess ...................
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Literature review for - Flourish Paediatrics

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