Szoptatás Portál ... naprakész információk a szoptatásról

R. Shapiro, M. Hughes, A. Ogwu, D. Kitch, S. Lockman, C. Moffat, J. Makhema, S. Moyo, I. Thior, K. McIntosh, E. van Widenfelt, J. Leidner, K. Powis, A. Asmelash, E. Tumbare, S. Zwerski, U. Sharma, E. Handelsman, O. Jayeoba, E. Moko, S. Souda, E. Lubega, M. Akhtar, C. Wester, W. Snowden, M. Martinez-Tristani, L. Mazhani, M. Essex, The Mma Bana Study Team

5th IAS Conference on HIV Treatment, Pathogenesis and Prevention, Cape Town

Background: No randomized trial has previously compared highly active antiretroviral therapy (HAART) regimens in pregnancy or during breastfeeding.

Methods: HIV-infected pregnant women with CD4 ≥200 cells/mm3 randomized to co-formulated abacavir/zidovudine/lamivudine (Arm A) vs. lopinavir/ritonavir/combivir (Arm B) from 26-34 weeks gestation through planned weaning by 6 months postpartum. Women with CD4 < 200 cells/mm3 received nevirapine/combivir (observational group) from 18-34 weeks gestation. Primary outcomes were: 1) maternal HIV-1 RNA suppression < 400 copies/mL at delivery and throughout breastfeeding at 1, 3, 6 months (or weaning), and 2) MTCT rates by infant HIV DNA PCR at birth and 1, 3, 6 months.

Rangmar Goelz, Eva Hihn, Klaus Hamprecht, Klaus Dietz, Gerhard Jahn, Christian Poets,
and Martin Elmlinger
Pediatr Res 65: 458–461, 2009

Preterm infants can inoculate virulent cytomegalovirus (CMV) through their mothers’ raw breast milk. Complete virus inactivation is achieved only by heat treatment, but the effect on growth factors has never been assessed systematically.

Hamprecht K, Maschmann J, Jahn G, Poets CF, Goelz R.

J Clin Virol. 2008 Mar;41(3):198-205.

Abstract

Breastfeeding has a major impact on HCMV epidemiology. The incidence of postnatal HCMV reactivation during lactation equals the maternal seroprevalence. Infectious virus, viral DNA and RNA can be isolated easily from cell and fat-free milk whey. Early onset of viral DNAlactia and virolactia as well as high viral load in milk whey are maternal risk factors for virus transmission.

Paul A. Byrne, Carol Miller, Kathy Justus
Breastfeeding Medicine. 2006, 1(4): 263-270.

Abstract

Group B streptococcus is currently the most common cause of sepsis and meningitis in newborns. How should mothers whose breast milk cultures show growth of this microorganism be managed regarding breastfeeding? This case study discusses the possible transfer of group B streptococcus to a preterm infant from mother's milk. It also describes the process that was taken to preserve the breastfeeding experience while the infant was treated. The questions provoked during this investigation prompted the authors to revise procedures in their special care nursery for dealing with infants and mothers presenting with signs of infection. In this case, providing treatment for the mother and infant and withholding breast milk from the infant until cultures were negative, while supporting the mother's milk supply, made it possible for this mother to continue to breastfeed.

Forrás

The value of human milk

• Exclusive breastfeeding for six months followed by continued breastfeeding with complementary foods and fluids for up to age two years and beyond (the World Health Organization standard) is the normal, optimal way of feeding infants and the foundation of health and development, except in rare circumstances.

Robert M. Lawrence
Breastfeeding Medicine. 2006, 1(2): 99-107.

Abstract

Human cytomegalovirus (HCMV) can be transmitted through breast milk to neonates. Although healthy full-term infants rarely develop symptoms of CMV infection; premature or low-birth-weight infants can experience symptomatic infection that is occasionally severe. There is limited information on the long-term effects of postnatal CMV infection in premature infants, suggesting that these infants do not develop cognitive function delays or hearing loss, although those with intrapartum infection do. Readily available methods of treating breast milk to inactivate the CMV either diminish the immunologic and nutritive benefits of breast milk or incompletely inactivate the virus.

Dan Miron, Sharon Brosilow, Klari Felszer, Dan Reich, David Halle, Daniel Wachtel, Arthur I Eidelman and Yechiel Schlesinger

Journal of Perinatology (2005) 25, 299−303

Abstract

OBJECTIVES:
To determine the incidence and clinical manifestations of human breast milk (HMB)-associated acquired cytomegalovirus (CMV) infection in small premature infants.

Exclusive breastfeeding – breastfeeding with no other food or drink, not even water – is the ideal mode of infant feeding for the first six months of life. For optimal growth, development and health, infants should be exclusively breastfed for their first six months, and should then receive nutritionally adequate and safe complementary foods, while breastfeeding continues up to 24 months or beyond.
With the onset of the HIV/AIDS epidemic, however, and the recognition that HIV-infected mothers can transmit HIV to their infants through breastfeeding, specific recommendations apply to infants born to HIV-infected mothers. The overall aim of these recommendations is to achieve the ultimate goal of increasing child survival, while reducing HIV infection in infants and young children.

A teljes cikk a WHO oldalán olvasható.

Physicians caring for infants born to women infected with human immunodeficiency virus (HIV) or at risk for HIV infection are likely to be involved in making recommendations concerning the appropriateness of breastfeeding or the use of expressed human milk.
PEDIATRICS Vol. 96 No. 5 November 1995 pp.977-979

A teljes cikk itt található.

Az egészségügyi dolgozók gyakran kerülnek olyan helyzetbe, hogy tanácsot kell adniuk, vajon biztonságos-e egy tuberculosisban szenvedő édesanya esetében a szoptatás. Korábban ilyen esetben a csecsemőt elkülönítették az anyától, legalábbis arra az időre, amíg az anya fertőzőképes volt. Az elkülönítés a szoptatást és a baba gondozását lehetetlenné tette az édesanya számára, a csecsemőt pedig - a mesterséges táplálás következtében - a fertőzések és az alultápláltság kockázatának tette ki. Ezek az intézkedések ma már nem javasoltak.

A teljes cikk a WHO oldalán olvasható.