OBJECTIVE:Introduction: Birth is associated with the loss of the comfortable intrauterine environment and the beginning of life in the external environment. The newborn undertakes basic life functions in an environment of stimuli to which his nervous system is particularly sensitive. Some fundamental methods that facilitate adaptation to extrauterine life are skin-to-skin contact and the first breastfeeding. Aim: The aim of the study was to assess the provision of the first breastfeeding after natural delivery in Warsaw's medical facilities. PATIENTS AND METHODS:Material and method: The method of direct observation was used in the study. The research material was collected using the authored observation sheet designed for the purposes of the study. The tests were carried out in 11 Warsaw obstetric facilities with varying degrees of referentiality, in which the management agreed to conduct the study. It was ensured that the data collected would be presented anonymously. The research began in January 2016 and was completed in December 2017. RESULTS:Results: During the direct contact of the mother with the child, in 97.37% of the cases the newborn was attached to the mother's breast. In 25.01% of the cases, the duration of the first breastfeeding was over 30 minutes, and in the same number of feedings it ranged from 21-30 minutes. The shortest duration of feeding from 1-5 minutes was observed in 5.58% of the cases. CONCLUSION:Conclusions: In most cases, the first breastfeeding took place within 2 hours of birth. The initiation of breastfeeding after natural delivery took place during the mother's first contact with the child. In more than half of the cases, the first feeding lasted as long as the specialists recommend - over 20 minutes.
INTRODUCTION:Fatty acids are some of the most important components of human milk. Polyunsaturated fatty acids (PUFAs) are essential nutrients required for the optimal growth and development of infants, especially the central nervous system, brain and retina.AIM:To determine the conjugated linolenic acid (CLA) and vaccenic acid (VA) content of human breast milk from mothers consuming different diets, and to compare the results with CLA and VA levels in infant formulas (IF) and follow-up formulas (FF).MATERIAL AND METHODS:Fifty healthy mothers were classified according to their diet status into one of two groups: diet low in dairy products and conventional diet without limiting the intake of dairy products. Dietary intake of dairy fat was determined based on 3-day food diaries. Fatty acid (FA) composition in samples were analyzed by High Resolution Gas Chromatography (HR-GC).RESULTS:In the group of 20 mothers whose diets were deficient in dairy products, the average CLA content of breast milk fat was determined to be 0.27% of total FA, the VA 0.36%. In the group of 30 women consuming dairy products, the average content of CLA and VA in breast milk fat was statistically significantly higher: 0.49% and 0.69% of total FAs, respectively. In the fat of the IF and FF tested (n=11) only trace amounts of both FA were found.CONCLUSION:The results of the study indicate that CLA and VA concentrations of human milk can be influenced by diet. It is recommended that the source of these FAs in the diet of breastfeeding women are natural products and not dietary supplements. The majority of commercially available IF and FF do not contain sufficient amounts of CLA and VA, and that their FA composition is deficient in comparison with breast milk fat.
The issues concerning the transfer of drugs into mothers' milk and their influence on breastfed babies have not been fully studied. Assessment of the situation should include such aspects as drug transfer into fetal blood and into mother's milk, the real risk of inhibiting lactogenesis 2 in women after birth, as welI as the psychological consequences for the mother of suspending breastfeeding. The risk of feeding a newborn with formula based on cow's milk is another fateful issue. The following paper presents the pharmacokinetic characteristics of drugs which determine their transfer level through the placenta and into mother's milk during the perinatal period and lactation.
Cesarean section requires the administration of drugs that should be limited to specific medical indications. It is important to remember that most of the available and currently administered anesthetics can affect the fetus and the newborn. In obstetric anesthesia, only such medication that demonstrates a beneficial pharmacokinetic profile and maximum effectiveness should be administered. In this article, the authors reviewed the pharmacodynamic and pharmacokinetic properties of the drugs used during anesthesia in obstetric procedures. The analysis of the influence of these drugs on the clinical condition of the newborn at birth and during breastfeeding was also presented. Drug safety was determined in the aspect of lactation and natural feeding.
Perinatology is a dynamically developing field of medicine. The progress of technology in recent decades has made it possible to recognize birth defects very early, including those which are lethal or genetically determined. In many clinical situations, it is no longer possible to work alone to reach a definitive diagnosis, plan treatment or predict the clinical course of the affected fetus/newborn. There is a need for teamwork, which ensures the proper, early care starting in the fetal period, not only in the delivery room or NICU. This paper discusses the ethical foundations of creating interdisciplinary teams, taking as an example the Interdisciplinary Team for Fetal Malformation at the Institute of Mother and Child in Warsaw, which has been active for 25 years, and presents how it works in practice. On the basis of the clinical cases that are examined, practical guidelines were formulated for both the work of medical teams and the way parents are informed about the clinical situation of their child and about sharing the care after the birth of the child. A document was also proposed with information on prenatal diagnosis, decisions made by the interdisciplinary team regarding the mother and child, as well as the conclusions resulting from discussions with parents.
