Social customs and beliefs regarding breast feeding

This study, undertaken to investigate the social customs and beliefs surrounding breast feeding in Western Rajasthan, India, was conducted at the Umaid Hospital for Women and Children in Jodhpur. 300 women attending the pediatric outpatient and impatient departments and underfive clinics at the hospital constituted the study subjects. The women ranged in age from 15-42 years. They were interviewed to collect information on social and family variables and on breast feeding. Of the 300 women, 65.3% were residents of urban areas. 92.7% of the respondents believed in inaugural feeding with 32.3% preferring honey, followed by, among others, animal milk (17.6%), and janam ghutti (11.7%). Honey and janam ghutti were preferred by rural respondents; jaggery (13.8%), water (9.7%), and tea (7.7%) were preferred by urban women. Ceremonial ritual prior to beginning breast feeding was observed by 47.9% of the urban women (despite better education in urban areas) and 57.7% of the rural women. Colostrum feeding was denied by 32.6% women, but it was favored by 65.8% urban and 46.1% rural women. Nearly 33% urban and 40.9% rural mothers favored the restriction of breast feeding during maternal illness. During illness of the child, 48.4% urban and 51.9% rural women favored breast feeding restriction. The breast-feeding practices reflect a strong interlocking influence with social customs and beliefs as do the preference of women for inaugural feeds. The use of these feeds depends upon local customs and beliefs and the socioeducational level of the population. This is strongly supported by the observation that 79.7% of the women gave inaugural feed because of advice of an elderly family member or family tradition.     

Safety of term birth and cesarean birth rates

This was a parallel of the rate of caesarean section and neurological morbidity of the term newborn. This study was performed on all infants born at a gestational age of 37 weeks or greater in 1981 and 1982 at the Baudelocque Maternity Hospital. The results show a stable caesarean section rate during these two years: 21% in 1981, 20% in 1982; as for the safety of term birth there was only one case of perinatal insult during a vaginal birth responsible for cerebral dysfunction of moderate degree. There was a 18% operative maternal morbidity and there were no deaths. We concluded that a caesarean section rate of 20% in a University Hospital is justified by the virtual absence of neonatal morbidity with an acceptable maternal risk. This rate should not increase. The possible ways of decreasing this rate, while maintaining neonatal safety, must be studied. The original aspect of this work concerns the monitoring of the caesarean section rate by the incidence of neurological complications of all term births during a fixed period of time.     

Resuscitation at birth

It is only in recent years that the techniques used for resuscitation at birth have come under critical review and there have been very few controlled trials to assess their efficacy. Recent studies have indicated that the large majority of asphyxiated term babies can be resuscitated using air rather than 100% oxygen, possibly reducing damage from oxygen free radicals during re-perfusion. Physiological studies have shown that inflation pressures of 25–30 cmH₂O maintained for up to 1 s, only result in approximately 40% of the mean inspiratory volume achieved by babies who breathed spontaneously at birth. These spontaneous inflation volumes can be matched either by maintaining the first inflation for 3 s, or by using pressures of up to 50 cmH₂O for 300 ms, a pattern adopted by spontaneously breathing babies. Bag and mask systems are even less effective, often depending on the Head paradoxical reflex to stimulate respiration rather than producing adequate tidal exchange. Face mask T-piece devices provide more effective ventilatory exchange and are easier to use. Conclusion Although the pattern of ventilatory support in current use often leads to successful resuscitation of asphyxiated babies at birth, more physiological and randomised controlled studies are needed to refine techniques in order to limit babies' exposure to potentially damaging hypoxia to the minimum. Received: 19 January 1998 / Accepted: 19 January 1998     

Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies

Objective

To analyze economic inequality (absolute and relative) due to family income in relation to the occurrence of preterm births in Southern Brazil.

The effect of maternal height on birth weight and birth length

This retrospective study examined the gestational age at which differences were observed between birth weights and birth lengths of infants whose mothers differed by height. Infants whose gestational ages were between 24 and 42 weeks born to women 59-62 inches (150-157 cm) tall were compared to similar infants born to women 66-69 inches (168-175 cm) tall. Significant differences occurred in birth weight and birth length from 35 weeks onward. The infants of the shorter women were symmetrically smaller than the infants of the taller women as the infant ponderal indexes did not differ.     

Morbidity pattern in relation to birth interval and birth order in children

Two hundred fifty six children in the age group of 0–5 year belonging to families registered under the Urban Health Centre were studied. An inverse relationship was observed between birth interval and prevalence of malnutrition, gastroenteritis, anemia and worm infestation. Further a positive correlation was observed between morbidity and increasing birth order more so after 3rd birth order.     

Morbidity pattern in relation to birth interval and birth order in children

Two hundred fifty six children in the age group of 0–5 year belonging to families registered under the Urban Health Centre were studied. An inverse relationship was observed between birth interval and prevalence of malnutrition, gastroenteritis, anemia and worm infestation. Further a positive correlation was observed between morbidity and increasing birth order more so after 3rd birth order.