Formula milk supplementation on the postnatal ward: A cross-sectional analytical study
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14.05.2018 |
Biggs K.
Hurrell K.
Matthews E.
Khaleva E.
Munblit D.
Boyle R.
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Nutrients |
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3 |
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© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge.
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The rise of professional obstetric and paediatric care in the pre-revolutionary Transbaikal region
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01.01.2018 |
Batoev S.
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History of Medicine |
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0 |
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© Sergey D. Batoev. The government’s incorporation of the vast territory of the Transbaikal region did not initially involve broad socio-economic development of this region. Gradually, it became clearly understood that for the successful development of the economically advantageous territory it was necessary to solve a number of issues related to the organization of public health care, in particular for women and children. Military and economic measures alone would not ensure the social wellbeing of both the indigenous population and Transbaikal’s new arrivals. The indigenous population,s traditional way of life, the confessional differences between those living in the territory and the severe climatic and geographic conditions slowed the spread of public medicine in this region. The constant shortage of qualified medical personnel, the small number of medical institutions and serious financial difficulties exacerbated the difficult situation. The first measures taken in the social policy field concerned the foundation of the Irkutsk Order of Public Charity in March 1784, but they were not successful in any serious way. State medical care remained inaccessible, therefore the population continued to mainly use folk and Tibetan medicine methods. A definite turning point was observed in the middle of the 19th century. It was then that the first children’s shelters, and the first obstetric institutions for female prisoners appeared. However, it was only at the beginning of the 20th century that obstetric and gynecological hospital beds were introduced in the city hospital in the regional center in Chita. The author of the article notes that for two centuries, during which the territory of Transbaikal was part of the Russian Empire, there were some positive changes in the provision of medical care, including medical care for women and children. Significant financial investment and highly qualified personnel were required for the development of medicine in pre-revolutionary Transbaikal. Attempts by society, including medical organizations, to influence the existing system of medical care without a legislative base and corresponding government support were doomed to failure. There was a need for a radical transformation of health care, including in the field of women’s and children’s health.
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