Literature review for - Flourish Paediatrics

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Impact of Maternal Obesity on Breastfeeding Outcomes Search results Data were extracted from 1 systematic literature review (utilising data from 22 multinational), and 1 Australian prospective cohort study and 1 Australian cross-sectional study. Sufficient evidence was found to make statements on the relationship between maternal obesity and breastfeeding outcomes. Breastfeeding outcomes investigated included breastfeeding initiation/ at discharge and breastfeeding duration (any or exclusive). What is the evidence that maternal obesity is negatively associated with breastfeeding outcomes? Draft Evidence statement There is evidence that maternal obesity is negatively associated with the initiation of breastfeeding and probably breastfeeding duration? Draft Grade B Component Rating Notes Evidence Base Good 1 SLR (22 studies), 1 prospective cohort studies and 1 crosssectional study Consistency Good The majority of studies (9/10 studies in SLR) reported a negative association between maternal obesity and the initiation of breastfeeding. The evidence was less consistent (7/15 studies in SLR) with regard to breastfeeding duration. Clinical impact Good Majority of studies found a negative association with breastfeeding initiation Generalisability Excellent Most studies in the SLR involved Western populations and other studies were Australian Applicability Excellent Directly applicable In total 9/10 studies considered in the SLR found that overweight and obese women were less likely to commence breastfeeding. This association was significantly different in all but 3 studies including 2 West Australian studies. 7/15 studies in the SLR reported a shorter duration among obese women than normal weight women after adjusting for confounders. 2 studies in countries with high breastfeeding initiation rates found no association with breastfeeding duration. 1 study from Kuwait found a positive association between higher maternal weight and breastfeeding duration. The recent cohort and the cross-sectional studies reported a negative association with breastfeeding duration. 79
Whether the mechanism for this association is biological or psychological, behavioural and/or cultural is unclear (Amir & Donath, 2007). Obese women have been reported to experience greater mechanical difficulties of latching on and proper positioning of the infant (Rasmussen and Kjolhede 2004). Despite initial difficulties, with lactation guidance the vast majority of overweight women are able to successfully establish exclusive breastfeeding (Dewey, Nommsen-Rivers et al. 2003). 80
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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
Page 35 and 36: Birth weight and breastfeeding If t
Page 37 and 38: 3500-3999 vs 3000-3499 1.00 (95% CI
Page 39 and 40: Population/study information Perth,
Page 41 and 42: Any breastfeeding duration No adjOR
Page 43 and 44: cohort study reported no associatio
Page 45 and 46: Results [8] Intro of formula at 4 w
Page 47 and 48: Clinical 1 1 1 importance Clinical
Page 49 and 50: 6. If mother-baby separation is una
Page 51 and 52: Studies reviewed to make evidence s
Page 53 and 54: Reference Scott JA, Binns CW, Oddy
Page 55 and 56: Effect on risk There was no associa
Page 57 and 58: Studies used to make evidence state
Page 59 and 60: infant Clinical 1 1 1 4 importance
Page 61 and 62: Reference Qiu et al Asia Pac J Clin
Page 63 and 64: Social support (other than fathers)
Page 65 and 66: pregnancy interventions on breastfe
Page 67 and 68: Reference Scott JA, Landers MCG, Hu
Page 69 and 70: weeks, 3 months & 6 months postpart
Page 73 and 74: Quality P O P Results Breastfeeding
Page 75 and 76: analysis analysis Effect on risk No
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: Quality P P O P Results Adj OR any
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 and 128: 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
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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
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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
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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
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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
Page 595 and 596:
If an infant is not breastfed, or i
Page 597 and 598:
Interventions to Promote Breastfeed
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ethnicity or maternal age cannot be
Page 601 and 602:
three months, interventions involvi
Page 603 and 604:
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
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
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Griffiths, D. M. (2004). "Do tongue
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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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