Systemic lupus erythematosus in pregnancy treated with plasmapheresis

A young woman developed severe systemic lupus erythematosus (SLE) at the beginning of her second pregnancy: her disease was extremely difficult to control and the baby died unexpectedly when 8 weeks old. She became very ill at the same time in her third pregnancy; plasmapheresis appeared to make her management easier, and the 7-month-old baby is doing well.     

COMMUNITY INFLUENCES ON BREAST FEEDING

Summary The incidence of breast feeding in Camden and Paddington is reported for two periods, 1974–75 and 1976–77, In 1976 a programme was begun to encourage breast feeding by increasing contact and support by the health visitor and child health clinic antenatally and postnatally. Fifty-eight per cent of mothers in Camden and 56% of mothers in Paddington breast fed at 3 weeks in 1976–77 compared with 24% (Camden) and 20% (Paddington) in 1974–75, The incidence of breast feeding in the experimental areas was compared with that in a similar control area in which no intervention occurred to investigate whether this increase reflected a widespread increase in the popularity of breast feeding or resulted from intervention. In 1976–77 more mothers in the experimental, than in the control area who breast fed on discharge continued to do so during the first 5 months, Of the mothers who were discharged breast feeding 88% in Camden and 73% in Paddington compared with 57% in the control area were still doing so at 6 weeks. The pattern of home visiting by the health visitors and attendance at the child health clinic was also investigated. More antenatal and postnatal home visits, more clinic visits and earlier home visits took place in the experimental areas compared with the control area. We conclude that the health visitor and child health clinic have an important role to play in the management of lactation.