Editorial

4 pages, 189 KiB

Open AccessEditorial

by Juan Brines, Virginie Rigourd and Claude Billeaud

Healthcare 2022, 10(1), 106; https://doi.org/10.3390/healthcare10010106 - 06 Jan 2022

Cited by 7 | Viewed by 2236

The third edition of the Nursing and Pediatrics Congress was held in Paris from 16–19 June 2021, with the aim of contributing the experiences and reflections of relevant health professionals (pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians, and lactation consultants) to the knowledge [...] Read more.

The third edition of the Nursing and Pediatrics Congress was held in Paris from 16–19 June 2021, with the aim of contributing the experiences and reflections of relevant health professionals (pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians, and lactation consultants) to the knowledge of the most critical period of human life: its first 1000 days [...] Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

Research

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11 pages, 877 KiB

Open AccessArticle

Microbiological Quality of Milk Donated to the Regional Human Milk Bank in Warsaw in the First Four Years of Activity

by Kamila Strom, Sylwia Jarzynka, Anna Minkiewicz-Zochniak, Olga Barbarska, Gabriela Olędzka and Aleksandra Wesolowska

Healthcare 2022, 10(3), 444; https://doi.org/10.3390/healthcare10030444 - 26 Feb 2022

Cited by 3 | Viewed by 2883

Abstract

As the survival rate for preterm infants increases, more emphasis is placed on improving health-related quality of life through optimal nutritional management. Human Milk Banks (HMBs) provide bioactive nutrients and probiotic microorganisms to premature newborns, especially in the first year of life. Donated [...] Read more.

As the survival rate for preterm infants increases, more emphasis is placed on improving health-related quality of life through optimal nutritional management. Human Milk Banks (HMBs) provide bioactive nutrients and probiotic microorganisms to premature newborns, especially in the first year of life. Donated milk screening and selection of potential donors ensures the quality and microbiological safety of the donated milk. Therefore we reviewed the basic characteristics of donors and the amounts and contamination of breast milk donated to the Regional Human Milk Bank (RHMB) in Warsaw. In four years, the RHMB collected 1445.59 L of milk, of which 96.60% was distributed among hospitalised infants. Additionally, breastmilk from donor candidates (139 samples from 96 women) was tested at least once in the first year of lactation. First analyses showed that 18 women’s milk samples were microbiologically pure, and 78 samples had one or more species of commensal and/or potentially pathogenic bacteria. In human milk samples from 10 women, the bacteria level was above the standard required by the RHMB; therefore, donors were re-educated, and further samples were tested. Most women followed the recommendations on hygienic expression and storage of milk before transfer to the RHMB. Our analysis will help to increase the accessibility and quality of raw donor milk and to meet the needs of more newborns. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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11 pages, 429 KiB

Open AccessArticle

Nutrition of Pregnant and Lactating Women in the First 1000 Days of Infant

by Claude Billeaud, Juan Brines, Wafae Belcadi, Bérénice Castel and Virginie Rigourd

Healthcare 2022, 10(1), 65; https://doi.org/10.3390/healthcare10010065 - 30 Dec 2021

Cited by 4 | Viewed by 3475

Abstract

Nutrition for pregnant and breastfeeding women is fundamental to the development of the child in its first 1000 days and beyond. To evaluate the adequacy of this nutrition, we have relied on historical dietary surveys and on personal French studies (4 studies from [...] Read more.

Nutrition for pregnant and breastfeeding women is fundamental to the development of the child in its first 1000 days and beyond. To evaluate the adequacy of this nutrition, we have relied on historical dietary surveys and on personal French studies (4 studies from 1997 to 2014) involving dietary surveys over 3 days (3D-Diet). Furthermore, our team specialized in lipids has measured the fatty acids of breast milk, which reflect the dietary intake of lipids, from breast milk (1997–2014) and from the lipids of cord blood and maternal fat tissue, in 1997. According to our results, pregnancy needs require an additional 300 Kcal, but surveys show a bad equilibrium of macronutrients: an excess of proteins of fetus [17% of total energy intake (TEI) vs. 15%], excess of fats (45% vs. 35%), excess of saturated fatty acids (SFA), not enough polyunsaturated fatty acids (PUFA), particularly omega 3, and a deficit in carbohydrates (45% vs. 55%). There is also a deficiency in calcium, iron, magnesium, zinc, and vitamins D, B6, B5, and folates. Breast milk adequately provides all the macronutrients necessary for the growth of the child. Proteins and carbohydrates vary little according to the mother’s diet; on the other hand, its composition in lipids, trace elements, and vitamins is highly variable with the mother’s diet of breast milk. In our study in 2014, in 80 participants, the diet was low in calories (1996 Kcal vs. 2200 Kcal RDA), normoprotidic, normolipidic, but low in carbohydrate, especially polysaccharides. We note a very insufficient intake of fish and dairy products, and therefore calcium, but also magnesium, zinc, iron, and vitamins D, E, B6, and folate. Consequently, if the mother does not achieve a diet adequate to her needs during pregnancy and breastfeeding, it will be necessary to resort to medicinal supplements in minerals, trace elements, vitamins, and omega 3. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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13 pages, 411 KiB

Open AccessArticle

Surveillance of Parenting Outcomes, Mental Health and Social Support for Primiparous Women among the Rural-to-Urban Floating Population

by Jiemin Zhu, Ziwen Ye, Qiyu Fang, Lingling Huang and Xujuan Zheng

Healthcare 2021, 9(11), 1516; https://doi.org/10.3390/healthcare9111516 - 06 Nov 2021

Cited by 10 | Viewed by 2005

Abstract

China has the largest population of floating rural-to-urban women worldwide, most of whom are of childbearing age. However, few studies have been conducted to monitor the changing trends in parenting outcomes, mental health and social support for these women in the early postpartum [...] Read more.

China has the largest population of floating rural-to-urban women worldwide, most of whom are of childbearing age. However, few studies have been conducted to monitor the changing trends in parenting outcomes, mental health and social support for these women in the early postpartum period. In this quantitative longitudinal study, 680 primiparous women among the floating population were recruited in Shenzhen, China. Face-to-face collection of socio-demographic questionnaires was completed by researchers in maternity wards on the third postnatal day. Follow-up electronic questionnaires were dispatched to women via email or WeChat at 6 weeks and 12 weeks following childbirth, including the Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS) and Postnatal Social Support Scale (PSSS), to measure maternal self-efficacy (MSE), postpartum depression (PPD) and social support, respectively. The mean scores of MSE for these floating women were 67.16 (14.35) at 6 weeks postpartum and slightly increased to 68.71 (15.00) at 12 weeks postpartum. The mean scores of EPDS remained almost stable, from 11.19 (4.89) to 11.18 (5.34) at the two time points. The prevalence of mild and severe PPD among floating women at 6 and 12 weeks after childbirth decreased from 54.4% to 40.1% and from 50.6% to 35.4%, respectively. The mean score of social support was 37.04 (10.15) at 6 weeks postpartum and slightly improved to 38.68 (10.46) at 12 weeks postpartum. Primiparous women among the rural-to-urban migrant population had an obviously negative status of parenting outcomes and mental health; and there was a lack of social support after childbirth. In future, tailored evidence-based interventions are highly needed to promote floating women’s parenting outcomes, mental wellbeing and social support in the early stages of motherhood. As a higher-risk group of PPD, primiparous women among the floating population require effective and accessible mental health care after childbirth, such as early PPD screening and timely therapeutic methods. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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12 pages, 451 KiB

Open AccessEditor’s ChoiceArticle

The First 1000 Days: Impact of Prenatal Tobacco Smoke Exposure on Hospitalization Due to Preschool Wheezing

by Cyrielle Collet, Michael Fayon, Florence Francis, François Galode, Stephanie Bui and Stephane Debelleix

Healthcare 2021, 9(8), 1089; https://doi.org/10.3390/healthcare9081089 - 23 Aug 2021

Cited by 5 | Viewed by 1754

Abstract

Preschool wheezing and related hospitalization rates are increasing. Prenatal tobacco smoke exposure (PTSE) increases the risk of wheezing, yet >20% of French women smoke during pregnancy. In this observational retrospective monocentric study, we assessed the link between PTSE and hospital admissions. We included [...] Read more.

Preschool wheezing and related hospitalization rates are increasing. Prenatal tobacco smoke exposure (PTSE) increases the risk of wheezing, yet >20% of French women smoke during pregnancy. In this observational retrospective monocentric study, we assessed the link between PTSE and hospital admissions. We included infants <2 years of age admitted for acute wheezing. A phone interview with mothers was completed by electronic records. The primary endpoint was the ratio of cumulative duration of the hospitalization stays (days)/age (months). 129 children were included (36.4% exposed to PTSE vs. 63.6% unexposed). There was a significant difference in the duration of hospitalization/age: 0.9 days/month (exposed) vs. 0.58 days/month (unexposed) (p = 0.008). Smoking one cigarette/day during pregnancy was associated with an increase in hospitalization duration of 0.055 days/month (r = 0.238, p = 0.006). In the multi-variable analysis, this positive association persisted (β = 0.04, p = 0.04; standardized β = 0.27, p = 0.03). There was a trend towards a dose-effect relationship between PTSE and other important parameters associated with hospital admissions. We have demonstrated a dose-effect relationship, without a threshold effect, between PTSE and duration of hospitalization for wheezing in non-premature infants during the first 2 years of life. Prevention campaigns for future mothers should be enforced. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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10 pages, 648 KiB

Open AccessArticle

Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

by Hanne Lademann, Karl Abshagen, Anna Janning, Jan Däbritz and Dirk Olbertz

Healthcare 2021, 9(8), 994; https://doi.org/10.3390/healthcare9080994 - 04 Aug 2021

Cited by 4 | Viewed by 2262

Abstract

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with [...] Read more.

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 ± 16 vs. 105 ± 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 ± 13 vs. 93 ± 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 ± 13 vs. 96 ± 20, p = 0.527; Psychomotor Developmental Index 105 ± 11 vs. 105 ± 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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13 pages, 1245 KiB

Open AccessArticle

The Effects of Conflicts and Self-Reported Insecurity on Maternal Healthcare Utilisation and Children Health Outcomes in the Democratic Republic of Congo (DRC)

by Tingkai Zhang, Xinran Qi, Qiwei He, Jiayi Hee, Rie Takesue, Yan Yan and Kun Tang

Healthcare 2021, 9(7), 842; https://doi.org/10.3390/healthcare9070842 - 03 Jul 2021

Cited by 4 | Viewed by 4127

Abstract

Background The Democratic Republic of Congo (DRC) has experienced political unrest, civil insecurity, and military disputes, resulting in extreme poverty and a severely impaired health care system. To reduce the morbidity and mortality in women and children by strengthening healthcare, this study aimed [...] Read more.

Background The Democratic Republic of Congo (DRC) has experienced political unrest, civil insecurity, and military disputes, resulting in extreme poverty and a severely impaired health care system. To reduce the morbidity and mortality in women and children by strengthening healthcare, this study aimed at exploring the relationship between self-reported insecurity of mothers and maternal health-seeking behaviours and diseases in children in the DRC. Method Data collected from 8144 mothers and 14,403 children from the Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics in 2017–2018, in collaboration with the United Nations Children’s Fund (UNICEF), was used. The severity of the conflict in different provinces was measured using the Uppsala Conflict Data Program (UCDP) reports. Multivariate logistic regression and stratified analysis were utilized to explore the association between conflicts with maternal health-seeking behaviours and diseases among children. Results High self-reported insecurity was positively associated with skilled antenatal care (OR1.93, 95%CI 1.50–2.49), skilled attendants at delivery (OR1.42, 95%CI 1.08–1.87), and early initiation of breastfeeding (OR1.32, 95%CI 1.04–1.68). These associations were more significant in regions with more armed conflict. It was also found that children of mothers with high self-reported insecurity were more likely to suffer from diarrhoea (OR1.47, 95%CI: 1.14–1.88), fever (OR1.23, 95%CI 1.01–1.50), cough (OR1.45, 95%CI 1.19–1.77), and dyspnea (OR2.04, 95%CI 1.52–2.73), than children of mothers with low self-reported insecurity. Conclusions Conflicts increases mothers’ insecurities and negatively affects children’s development. However, high conflict regions have to increase governmental and international assistance to promote the availability and access to maternal and child health services. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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Review

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8 pages, 1186 KiB

Open AccessReview

Keypoints to Successful Newborn Hearing Screening. Thirty Years of Experience and Innovations

by Jose Miguel Sequi-Canet and Juan Brines-Solanes

Healthcare 2021, 9(11), 1436; https://doi.org/10.3390/healthcare9111436 - 25 Oct 2021

Cited by 4 | Viewed by 1765

Abstract

Congenital deafness is a major pediatric problem, affecting about 1.5–3 per 1000 newborns. The early treatment through cochlear implantation and auditory rehabilitation has been a historic milestone. Early diagnosis of congenital deafness is an essential requirement to obtain the best results, which is [...] Read more.

Congenital deafness is a major pediatric problem, affecting about 1.5–3 per 1000 newborns. The early treatment through cochlear implantation and auditory rehabilitation has been a historic milestone. Early diagnosis of congenital deafness is an essential requirement to obtain the best results, which is achieved through neonatal screening, a diagnostic practice that we began systematically at the Hospital Clínico in Valencia (Spain) 30 years ago. Neonatal hearing screening is successful in most developed countries. Its implementation has been slow due to the multiple difficulties that its universal application entails since it involves several health professionals and must be carried out, in a short time interval after birth. In addition, it must have a good performance that prevents the overload of other services and that requires experience and continuous adjustments in search of proper protocols. The aim of this review is to shed some light on some key points of neonatal hearing screening, highlighting our experience in the solutions to common problems. We will discuss about techniques, protocols and neonatal or nutritional factors that can influence the screening results. To a summary of our work, an update on the subject is provided with the intention of sharing experiences and facilitating the start-up of the new units. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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17 pages, 1698 KiB

Open AccessEditor’s ChoiceReview

The First Thousand Days: Kidney Health and Beyond

by Chien-Ning Hsu and You-Lin Tain

Healthcare 2021, 9(10), 1332; https://doi.org/10.3390/healthcare9101332 - 06 Oct 2021

Cited by 9 | Viewed by 4886

Abstract

The global burden of chronic kidney disease (CKD) is rising. A superior strategy to advance global kidney health is required to prevent and treat CKD early. Kidney development can be impacted during the first 1000 days of life by numerous factors, including malnutrition, [...] Read more.

The global burden of chronic kidney disease (CKD) is rising. A superior strategy to advance global kidney health is required to prevent and treat CKD early. Kidney development can be impacted during the first 1000 days of life by numerous factors, including malnutrition, maternal illness, exposure to chemicals, substance abuse, medication use, infection, and exogenous stress. In the current review, we summarize environmental risk factors reported thus far in clinical and experimental studies relating to the programming of kidney disease, and systematize the knowledge on common mechanisms underlying renal programming. The aim of this review is to discuss the primary and secondary prevention actions for enhancing kidney health from pregnancy to age 2. The final task is to address the potential interventions to target renal programming through updating animal studies. Together, we can enhance the future of global kidney health in the first 1000 days of life. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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Other

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11 pages, 389 KiB

Open AccessPerspective

Breast-Feeding from an Evolutionary Perspective

by Juan Brines and Claude Billeaud

Healthcare 2021, 9(11), 1458; https://doi.org/10.3390/healthcare9111458 - 28 Oct 2021

Cited by 2 | Viewed by 1928

Abstract

Lactation is the most critical period of mammal feeding given the compulsory dependence on milk of the offspring during a more or less extensive period following birth. This has also been the case for the human species until relatively recent times when heterologous [...] Read more.

Lactation is the most critical period of mammal feeding given the compulsory dependence on milk of the offspring during a more or less extensive period following birth. This has also been the case for the human species until relatively recent times when heterologous milk processing has allowed the alternative of artificial lactation. The advantages and disadvantages of natural and artificial lactation (formula) have been widely discussed from the biological, psychological and cultural perspectives, without reaching a general agreement among the breastfeeding women themselves or among the health professionals concerned. On the subject of breastfeeding, the information available is enormous but as in other instances, the excess of it has often made it difficult to acquire objective knowledge on the matter that has hindered decision-making in specific circumstances. This situation is understandable given the diversity and the innumerable contingencies that the mother and health professionals must face in their natural and social (cultural) environments. To reduce these difficulties and taking into consideration the biological and cultural aspects involved in infant feeding, this article analyzes some aspects of the subject from the point of view of biological evolution as the mother-child dyad, mother-infant conflicts, in particular the conflict of weaning, late-onset primary lactase deficiency and the prevention from childhood of adult diseases. All of which allows to offer a testimony of gratitude and respect to women who have assumed the responsibility of breastfeeding their infants because without them the human species would not have existed. Full article

(This article belongs to the Special Issue The First 1000 Days of Infant)

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