The relationship between pacifier use, bottle feeding and breast feeding

OBJECTIVE

To investigate the influence of pacifier use and the introduction of formula milk on breast feeding.

METHODS

The mothers of 356 healthy newborn infants who initiated breast feeding while in-patients were interviewed within 3 days of birth and later at 2 and 6 months postpartum. Information regarding previous birth, breast-feeding frequency, pacifier use and the adoption of formula milk were obtained. The data were analyzed using chi2 and Kruskal-Wallis tests.

RESULTS

At the end of the second month, 264 (74%) of the mothers were still breast feeding; by the end of the sixth month this had fallen to 236 (66%). Among the 356 mothers, 152 had at least one previous infant, and 132 (86.8%) of them had breast fed a previous infant. Of the women who breast fed their previous infant for more than 2 months, 112 (84.8%) breast fed the current child until the end of the second month and 104 (78.7%) until the end of the sixth month after delivery. Of all investigated patients, 204 were primiparous (57.3%). Of these, 152 (74.5%) breast fed until the end of the second month, and 132 (64.7%) until the end of the sixth month after delivery. Amongthe 204 primiparae, 92 (45%) gave formula to their newborn infants. Forty-four of these 92 mothers (47.8%) had discontinued breast feeding by the end of the second month. Among the 356 newborn infants, 220 used pacifiers at the end of the second month. Within this group, 72 (33%) of the infants did not breast feed, while 148 (67%) did breast feed. Of all investigated mothers, 136 did not give pacifiers to their infants and only eight of these mothers (6%) had stopped breast feeding at the end of the second month.

CONCLUSIONS

We found an inverse correlation between pacifier usage and breast feeding. Breast feeding was most common among multiparous mothers.

[Effectiveness of high-frequency oscillatory ventilation in the treatment of lung hypoplasia in connection with intrauterine growth retardation and maternal pre-eclampsia]

The authors examine in a retrospective study the effectivity of high frequency oscillatory ventilation in group of intrauterine retardated babies with clinical signs of lung hypoplasia. During one year period they treated 12 intrauterine retarded patients with high frequency oscillatory ventilation because of failure of conventional ventilation. The indications were in seven cases the high pCO2 level and in five ones low saturation in spite of surfactant administration. The birth weight of babies were between 770 grams and 2150 grams, and theirs gestational age between 29 and 35 weeks. Four patients died. The causes of death were in two cases severe cardiomyopathy and at two patients intraventricular haemorrhage. Two survivors are suffering of bronchopulmonary dysplasia. They suggest that immediate high frequency ventilation reduces the period of mechanical ventilation and the number of residual picture. They suggest, that lung hypoplasia is an underestimated diagnosis in intrauterine retardated babies. If the cause of respiratory failure in cases complicated with maternal preeclampsia is not only hyaline membrane disease it is necessary to look for signs of lung hypoplasia and to follow the treatment with high frequency oscillatory ventilation.

Follow-up studies of newborn-babies with congenital ventriculomegaly

The authors present the results of their follow-up studies of data from the last four years on patients with congenital ventriculomegaly.

OBJECTIVE

To study the psychomotor and mental developmental outcome of neonates with congenital ventriculomegaly diagnosed prenatally. In addition, patients were also classified into subgroups with subgrouping based on the etiology and complications of congenital ventriculomegaly and on the absence of ventriculoperitoneal shunt placement, and the findings compared between the different subgroups.

METHODS

Level 3 fetal ultrasonography was used for the prenatal diagnosis of congenital ventriculomegaly in 30 infants. Using neurological examination and the modified Brunet-Lézine infant test performed postnatal follow-up of motor and sensory development and intelligence, respectively.

RESULTS

The results show thirteen symptomless, well-developing patients, ten moderately handicapped patients and seven severely handicapped patients. Newborns with isolated, moderate ventriculomegaly have the best outcome.

[The effect of the delivery method on the mortality of very low birth weight infants in case of breech presentation]

The authors have investigated the data of 1009 neonates born from breech presentation in the I. Department of Obstetrics and Gynecology of Semmelweis Medical School between January 1., 1990 and December 31., 1995. The frequency of caesarean section in this group was 75.5%. In the subgroup of very small neonates (those under the birthweight of 1500 grams) caesarean section was performed in 71.4%. In this group 73.8% of the neonates were alive on the 28th postpartum day, as opposed to 37.7% in the group spontaneously delivered. The difference proved to be significant in the group weighing between 750 and 1249 grams. Intraventricular haemorrhage was also more frequent in the group spontaneously delivered. The difference was not significant in the groups under 750 grams and between 1250 and 1500 grams birthweight. Based on their investigation the authors conclude, that in the group of fetuses whose estimated birthweight is predicted to be between 750 and 1250 grams by ultrasound examination, perinatal mortality and morbidity rates in breech presentation can be improved by performing caesarean section.

Very-low-birthweight breech infants: short-term outcome by method of delivery

The purpose of this study was to determine the incidence of mortality and morbidity of the very-low-birthweight infant (< 1,500 g) in breech presentation based on mode of delivery and birthweight. A retrospective chart review of 1,009 infants who were in breech presentation at the time of delivery between January 1, 1990 and December 31, 1995 at the First Department of Obstetrics and Gynecology of Semmelweis Medical School in Budapest, Hungary. Data collected included birthweight, mode of delivery, pregnancy complications and neonatal mortality and morbidity. Comparison of groups was made based on mode of delivery, and data were analyzed using Fisher's exact test and chi-square analysis. For those infants weighing less than 1,500 g at birth, vaginal delivery was associated with higher mortality than for those delivered abdominally (73.8% vs. 37.7%, P < 0.001). There was no significant difference in survival for those infants weighing 1,500 g or more. Regarding morbidity, in those infants weighing less than 1,500 g, vaginal delivery was associated with a higher incidence of 1 min Apgar below 4 (21.7% vs. 5.2%, P < 0.001), a higher incidence of 5-min Apgar scores below 4 (11.6% vs. 1.2%, P < 0.001), a higher incidence of grade III or grade IV IVH (18.8% vs. 3.5%, P < 0.001) and a higher incidence of necrotizing enterocolitis (5.8% vs. 0.6%, P < 0.05). There is an increased incidence of mortality and morbidity for the VLBW breech infant delivered vaginally. Cesarean delivery may improve outcome for these infants.