新生儿母乳性黄疸转归时间观察

母乳性黄疸在新生儿高胆红素血症中所占比重可高达80％以上。目前母乳性黄疸可分为早发型和迟发型二类。迟发型指母乳喂养儿黄疸出现时为生后6～8天，持续数周至数月消失。本所指及所观察为迟发型母乳性黄疸，查阅有关献对母乳性黄疸的发展及消失转归时间均无明确记载。观察母乳性黄疸转归时间，对指导母乳喂养，做好乳母思想工作有重要意义。     

54例新生儿母乳性黄疸临床分析

目的：提高对新生儿母乳性黄疸的认识,探讨母乳性黄疸的发病机制及治疗新途径,方法：将1999年12月收治的54例已确诊为新生儿母乳性黄疸患儿,在不中断母乳喂养的情况下,给予口服思密达1．5g,q8h,用10％葡萄糖15ml,调匀口服。结果：黄疸消失时间最短的3天,最长的9天,平均5天;54例黄疸全消退,无一例发生核黄疸,结论：对母乳性黄疸,不一定采用传统的停哺母乳方法,可不中断母乳喂养,口服思密达,也能取得满意疗效。     

母乳性黄疸70例临床分析

母乳性黄疸1960年由Arias及Gartner首先报告,指母乳喂养的新生儿无其他原因以血未结合胆红素增高为主的高胆红素血症.欧美发病为O.5%～2.6%,日本10%～15%,近年来国内由于对母乳性黄疸(breast milk jaundice,BMJ)认识提高,加以大力提倡母乳喂养,开展母婴同室,母乳喂养率明显上升,随之母乳喂养性黄疸的发病率也明显增加.     

妈咪爱合鲁米那早期干预治疗新生儿母乳性黄疸

近年来由于大力提倡母乳喂养,母乳性黄疸发生率有逐年增加趋势.母乳性黄疸早期干预治疗非常重要,我院产科新生儿随访门诊对78例母乳性黄疸进行了早期干预治疗,报道如下.     

母乳性黄疸32例治疗报告

母乳性黄疸仅有未结合胆红素增高,分为早发型和晚发型。随着母乳喂养的增加,我们收治的母乳性黄疸新生儿也有明显增加。新生儿血清胆红素水平对个体的危害性受机体状态和环境多种因素影响。根据日令、体重及黄疸程度对母乳性黄疸进行干预治疗,避免发生不可逆损害。     

母乳性黄疸44例治疗分析

为探讨母乳性黄疸的治疗。分析４４ 例乳儿在综合性治疗的同时,①人工喂养组停用母乳改用配方奶喂养３ 天;②混合喂养组采用配方奶加母乳喂养３ ～５ 天,后继续母乳喂养;③纯母乳喂养组仍用纯母乳喂养,结果：３ 组血总胆红素值无显著差异,而黄疸消退时间,前２ 组非常显著缩短。结论：加用配方乳对母乳性黄疸的治疗有效,简易方便,又不影响母乳喂养。     

26例晚发性母乳性黄疸临床分析

报告26例晚发性母乳性黄疸,对其发生机理、诊断标准、处理及预后进行了讨论,强调尽管母乳喂养可使一定比例的新生儿出现黄疸,但因预后良好,应积极提倡和推广母乳喂养。     

母乳性黄疸44例治疗分析

为探讨母乳性黄疸的治疗。分析４４例乳儿在综合性治疗的同时,①人工喂养组停用母乳改用配方奶喂养３天;②混合喂养组采用配方奶加母乳喂养３～５天,后继续母乳喂养;③纯母乳喂养组仍用纯母乳喂养,结果：３组血总胆红素值无显著差异,而黄疸消退时间,前２组非常显著缩短。结论：加用配方乳对母乳性黄疸的治疗有效,简易方便,又不影响母乳喂养。     

迟发性母乳性黄疸治疗的探讨

近年来随着母乳喂养率的增加及对母乳性黄疸认识的不断提高,母乳性黄疸诊断率有所上升。现将我院1997年2月至1999年7月,产后6周门诊复诊时仍持续存在肉眼黄疸的185例患儿报告如下。     

母乳性黄疸临床分析

母乳性黄疸由美国Arias及Gartner等于1960年首先报道.其主要特点为新生儿母乳喂养后未结合胆红素升高,临床出现黄疸.由于母乳喂养推广及对母乳性黄疸认识的提高,该病的发生率有上升趋势.2009年3月～2010年12月收治的黄疸中母乳性占46%,现就母乳性黄疸进行探讨.     

病理性黄疸新生儿巨细胞病毒感染的临床研究

目的 分析病理性黄疸患儿巨细胞病毒(CMV)感染情况,探讨母乳CMV-DNA检测的临床意义。方法 选取庆阳市人民医院住院的病理性黄疸新生儿300例,用FQ-PCR方法检测患儿血浆、外周血单个核细胞(PBMC)、尿液和母乳的CMV-DNA,ELISA法检测患儿血清CMV-IgM和IgG,分析CMV感染患儿的临床数据。结果 300例病理性黄疸新生儿中,CMV感染的阳性率为13.33%(40例),其中患儿血清CMV-IgM阳性率为4.33%(13例),CMV-IgG阳性率为80.85%(228例)。母乳CMV-DNA阳性率为46.00%(138例),患儿血浆CMV-DNA阳性率为4.00%(12例),PBMC CMV-DNA阳性率为6.67%(20例),患儿尿液CMV-DNA阳性率为10.00%(30例)。患儿尿液CMV-DNA的阳性率与乳汁CMV-DNA的阳性率有显著相关性(P<0.01)。40例CMV感染患儿中,婴儿肝炎综合症为13例(32.50%),新生儿肺炎12例(30.00%),缺血缺氧性脑病6例(15.00%),听力损伤5例(12.50%),腹股沟斜疝2例(5.00%)。结论 CMV感染是新生儿病理性黄疸主要原因之一;检测产妇母乳中CMV-DNA对母乳喂养具有临床指导意义,有助于预防CMV感染。     

新生儿黄疸的发病情况及社区管理

目的:了解社区新生儿黄疸发生及处置情况,为进一步加强社区新生儿黄疸的管理提供依据。方法:对2008年1月～2010年12月什刹海社区预防保健科访视的新生儿就其黄疸发生情况及黄疸原因等内容进行分析。结果①母乳喂养新生儿黄疸发生率为31.33%,混合喂养为20.70%,人工喂养为1 5.94%:母乳喂养与混合喂养、母乳喂养与人工喂养黄疸发生率之间差别有显著性(P<0.01);②轻度黄疸占87.32%,中重度黄疸占12,68%,无核黄疸发生;③生理性黄疸占54.23%,母乳性黄疸占28.29%;④黄疸发生率为26.45%,其中男33.09%,女19,19%男女新生儿黄疸发生率之间差别有显著性(P<0.01)。结论:母乳喂养黄疸儿发生率高于混合喂养及人工喂养。新生儿黄疸发生率男高于女有待进一步探讨。205例黄疸儿无一例核黄疸发生,社区访视指导非常重要,社区目前黄疸儿的处置方法行之有效。     

剖宫产术后母乳喂养的几点体会

目的为了提高剖宫产术后母乳喂养率。方法由专职护士有针对性地对产妇进行合理指导和心理疏导,采用产前健康教育,指导产妇正确的哺乳技巧。结果增进母乳喂养,及时疏通乳腺管等,提高纯母乳喂养率。结论产妇术后乳汁充足达到80％以上．纯母乳喂养率85％以上,比过去产妇乳汁充足和纯母乳喂养有了提高。     

Survey on parenting practices among Chinese in Singapore

INTRODUCTION: Cultural, religious and personal factors impact greatly on parenting. This survey aims to identify gaps in knowledge and perception about common parenting issues, with respect to mandarin-speaking Chinese in Singapore. There is an emphasis on first-time parents, who the authors feel may be the group which will require additional education and support on these issues. METHODS: A 37-item written survey was conducted before a public mandarin-language forum. Our response rate was 67 percent. RESULTS: Only 44 percent felt that paediatricians allocated sufficient time to discuss parenting issues. 99 percent of parents believed that breast milk was better than formula milk and that 93 percent intended to breastfeed. However, the vast majority of respondents thought that breastfeeding should be stopped if jaundice developed, and that sunning was effective in preventing jaundice. Moreover, the majority did not recognise the seriousness of jaundice, prolonged or otherwise. Widespread misconceptions existed about milk formulas, with half of the respondents thinking that it was necessary to change to lactose-free formula once a child developed diarrhoea. The majority also thought that certain milk formulas could help improve IQ. CONCLUSION: We hope that more comprehensive and accessible parental education will be available to aid in raising awareness of parental practices, and to dispel misconceptions regarding neonatal care.     

母乳中部分胃肠激素对新生儿早发型母乳性黄疸的影响

目的:探讨母乳中胃动素、胃泌素、生长抑素对新生儿早发型母乳性黄疸的影响。方法:应用放射免疫分析法对63例生后6d内的早发型母乳性黄疸患儿血中及其母亲乳汁中的胃动素(MTL)、胃泌素(GAS)和生长抑素(SS)浓度进行测定,并与39例生后6d内的正常新生儿进行对照。结果:母乳性黄疸患儿血中及其母亲乳汁中MTL、GAS水平均低于正常对照组且有显著性差异(P<0.001);患儿血中SS水平(47.5±18.6)ng/L虽低于正常对照组(51.4±22.8)ng/L,但无显著性差异(P>0.05);而患儿母亲乳汁中SS水平(31.9±11.7)ng/L则高于正常对照组(28.9±9.7)ng/L,但也无显著性差异(P>0.05)。结论:母乳中MTL、GAS偏低,外源性胃肠激素的摄入减少可能是早发型母乳性黄疸患儿血中MTL、GAS水平偏低及发生早发型母乳性黄疸的原因之一。     

World Health Assembly recommends exclusive breastfeeding for first six months

Exclusive breastfeeding means that the infant receives only breast milk (from his or her mother or a wet nurse or expressed breast milk) and no other liquids or complementary foods with the exception of undiluted drops or syrups consisting of vitamin and mineral supplements or medicines. During this period water is not permitted. The resolution (WHA 54.2) urges Member States to support exclusive breastfeeding for first six months as a global public health recommendation and to provide safe and appropriate complementary foods, with continued breastfeeding for up to two years or beyond. Breastfeeding Promotion Network of India (BPNI) has issued guidelines for breastfeeding and complementary feeding.     

A new look on neonatal jaundice

Out of 6586 live born babies, 736 babies with jaundice were studied from 1st July 1996 to 30th June, 1997, in a city based medical college nursery. Physiological jaundice was present in 8.92% of all live born babies and accounted for 79.89% of babies with jaundice. Breast milk jaundice and prematurity were next common causes responsible for 5.29% each of all cases with neonatal jaundice. Septicaemia caused jaundice in 4.75% cases. Among the babies with jaundice appearing between day 4 and day 7 of life, breast milk jaundice was the commonest cause occurring in 49.25% cases. The last entity surfaced probably due to exclusive breastfeeding recently initiated in the baby friendly hospital nursery.     

灌肠联合苯巴比妥对母乳性黄疸患儿体液和细胞免疫功能的影响研究

目的研究灌肠联合苯巴比妥对母乳性黄疸患儿体液和细胞免疫功能的影响。方法选取2009年2月～2012年1月我院进行治疗的64例母乳性黄疸患儿为研究对象,根据随机数字表法将其分为灌肠组（对照组）和灌肠联合苯巴比妥组（观察组）,每组各32例。将两组患儿治疗后3、7、10d及10d以上的黄疸消退率、治疗前后的体液和细胞免疫功能指标进行比较。结果观察组治疗后3、7、10d的黄疸消退率明显高于对照组,而其治疗后3、7、10d的体液和细胞免疫指标改善幅度也大于对照组,差异有统计学意义（P〈0．05）。结论灌肠联合苯巴比妥对母乳性黄疸患儿体液和细胞免疫功能的影响明显,可显著改善患儿的机体免疫力。     

影响母乳喂养的相关因素调查

目的 调查影响母乳喂养的相关因素.方法 选择在我院分娩的产妇338例为调查对象,产后进行随访,调查分析影响产妇母乳喂养的相关因素.结果 纯母乳喂养171例,占50.6%,混合喂养146例,占43.2%,人工喂养21例,占6.2%.自觉母乳量、母乳喂养是否改变体型的看法、母乳喂养信心是影响母乳喂养的相关因素（P＜0.01）.结论 母乳喂养信心、自觉母乳量、母乳喂养是否改变体型的看法是影响母乳喂养的相关因素.     

四连康及蒙托石散治疗母乳性黄疸的疗效研究

目的:探讨四连康(双歧杆菌四联活菌)、蒙脱石散治疗婴儿黄疸的疗效分析。方法:将85例母乳性黄疸病例随机分为4组,A组对照组(20例),B组四连康组(25例),C组蒙脱石组(20例),D组四连康联合蒙脱石组(20例),四组均停母乳。观察其黄疸消退情况,治疗前后胆红素水平变化。结果:5 d后监测血胆红素水平,B组、C组、D组均较对照组血胆红素下降明显,差异有统计学意义(P<0.01),黄疸消退平均时间较对照组明显提前,差异有统计学意义(P<0.01)。不同治疗组间黄疸消退时间及胆红素下降值亦不相同。结论:四连康和蒙脱石散治疗婴儿母乳性黄疸均有显著效果,可促进胆红素排泄,缩短患儿住院治疗时间,且两者疗效相当,联合用药效果更明显。