Microbiology

Submitted by Sherwin N. Genova

Submitted to Ms. Reah Fojas

 Maternal and
Child
Nursing Journal

Submitted by Shiela Santos

Submitted to Mrs. Reah Fojas

MCN, The American Journal of Maternal/Child Nursing:

March/April 2006 - Volume 31 - Issue 2 - pp 106-113
Feature articles
Breastfeeding Behaviours’ and Experiences of Adolescent
Mothers
SPEAR, HILA J. PhD, RN, IBCLC

Purpose: To examine the breastfeeding experiences and related behaviours of adolescent mothers
after discharge from the hospital.

Study Design and Methods: Descriptive telephone survey with both open-and closed-ended
questions. Outcome variables included breastfeeding experiences and infant feeding practices. A
convenience sample of mothers (N = 53), ranging in age from 14 to 19 years, were interviewed
by telephone 5 months to 2 years post delivery.

Results: Over one half (60.3%) of the adolescent mothers breastfed for 2 months or longer
(average 3.15 months), only 22.6% breastfed for 6 months or more, and 39.6% breastfed for 1
month or less. Friends, families, and healthcare professionals were supportive of breastfeeding,
but participants found prenatal and postpartum education about breastfeeding to be limited.
Many indicated that they were not plainly informed about the superiority of breast milk and the
health advantages of breastfeeding. One mother stated, they just asked if I wanted to bottle or
breastfeed and didn't tell me about the benefits of breastfeeding.

Clinical Implications: Nurses and physicians who provide care for childbearing women need to
promote breastfeeding among adolescents in a better way. Prenatal anticipatory guidance related
to the physical aspects of breastfeeding, support after adolescent mothers are discharged from the
hospital, and advocacy for breastfeeding in the school and workplace setting are warranted.
Nurses should consider establishing postpartum education programs for breastfeeding
adolescents, for almost all of the participants in this study expressed the need for more postnatal
breastfeeding support as indicated by this representative statement: I think that it would help you
to be able to breastfeed if nurses could phone call you more than just once; my baby latched on
good in the hospital; I had trouble later after we went home.
Reaction As a student nurse we are promote exclusively breastfeeding for a new born
baby up to 6 months or more. Breast milk is a complex and complete food for the babies, it is
convenient, free, and even alternative formula or the commercial milk powder cannot match the
mother’s milk. Below are some of the advantages of breastfeeding.

ADVANTAGES OF BREASTFEEDING
:

FOR BABY

1. Due to the anti-infective properties of breast milk, breastfed babies tend to have less
incidence of or less pronounced symptoms of ear infections, respiratory illness, allergies,
diarrheal, and vomiting.

2. Due to the digestibility of breast milk, breastfed babies are rarely constipated.

3. The stools of breastfed babies are mild-smelling.

4. SIDS (Sudden Infant Death Syndrome) is less common in breastfed babies.

5. Breast milk is constantly changing in its composition to meet the changing needs of the
baby. It has the exact combination of protein, fats, vitamins, minerals, enzymes, and
sugars needed for the human infant at various stages of his growth.
6. Breastfed babies are constantly exposed to a variety of tastes through their mother's milk.

7. Breastfed children are at less risk for chrohn's disease and juvenile diabetes.

8. Children who were breastfed are less likely to need orthodontic work such as braces due to the
unique sucking action required with breastfeeding. They also seem to have better overall dental
health than formula-fed children. Children who were breastfed need speech therapy less often
than those who were bottle-fed.

9. IQ levels are an average of 8 points higher in children who were breastfed.

10. Adult daughters who were breastfed are at less risk for breast cancer.

11. Adults who were breastfed have a lower risk for high cholesterol and asthma.

12. The bond between mother and child seems to be enhanced with breastfeeding.

FOR MOTHER
 1. Nursing immediately following delivery causes the uterus to contract lessening the risk
of postpartum hemorrhage.

2. The uterus of a breastfeeding mother shrinks to its pre-pregnancy size more quickly.

3. Calories are burned while breastfeeding. It takes approximately 20 calories to produce

an ounce of milk.

4. Women who nurse their babies for at least 6 months lessen their chances of pre-
menopausal breast cancer.

5. Osteoporosis and cervical cancer are less common in women who breastfed.

6. The return of fertility is delayed with breastfeeding.

7. Breastfeeding is more economical than formula feeding. The cost of formula for 12
months is approximately $1000 - $1200.

8. Breast milk is always available, clean, and the right temperature.

9. Many mothers feel a special satisfaction in nutritional needs of their babies.

MCN, The American Journal of Maternal/Child Nursing:
May/June 2010 - Volume 35 - Issue 3 - p 150–155
doi: 10.1097/NMC.0b013e3181d765a8
Feature Article

One Consequence of Infertility Treatment: Multifetal

Pregnancy
Little, Cindy M. PhD, WHNP-BC, CNS

This article discusses the issue of multifetal pregnancy as a result of fertility treatments.
Pregnancies with multiple gestations are associated with serious infant and maternal health risks
as well as psychological distress and significant financial consequences, and are a far too
common consequence of infertility treatments such as assisted reproductive technology (ART)
and ovulation induction drugs. Women with multifetal pregnancies are at a higher risk for
multiple pregnancy complications and maternal morbidity/mortality as well as stress, depression,
and anxiety disorders, especially when there is the threat of a loss of one or more fetuses. The
rise in rates of multifetal gestation and the accompanying increased risk to both mother and
fetuses have led the American Society for Reproductive Medicine and the Society for Assisted
Reproductive Technology to develop guidelines to limit the number of transferred embryos
during in vitro fertilization. Nurses who work with infertile women are in a position to educate
them about the risks, benefits, and alternatives associated with ARTs and multifetal pregnancies,
and should endeavor to learn as much as possible about this topic.
Reaction
People are very fascinated with twins and other multiples. It seems
mysterious how one pregnancy can result in more than one baby. In the
Philippines having more than one baby in a single labor is consider a good
luck or a blessing. Some people believe eating a twin banana or any twin
fruits can lead better chances that a mother to have multifital pregnancy.
Below are some facts about how multiple pregnancy made.

How Twins Are Made

There are a couple of ways that multiples are conceived:

• Multiple eggs are released or there is more than one ovulation. Both
(or more) eggs are fertilized and you have fraternal twins. This can happen
with or without fertility drugs.
• One egg is release but splits in two. Identical twins are made. This can
happen with or without fertility drugs.
• In cases of IVF, there are usually 3 or more fertilized eggs put back into
the uterus. The rationale is that not all of these will implant, though
sometimes they do.

Once conceived you have a lot of possibilities on placentas, implantation

locations, number of amniotic sacs. For example, you can have two babies,
two placentas, and two sacs. You can have two babies one placenta, two
sacs. It will be important to know exactly what you are dealing with,
particularly when it comes to amniotic sacs.

How Multiples Are Discovered

Many people learn about their multiples at an early ultrasound. Although

some critics say that before twelve weeks gestation there is still a high risk
of Vanishing Twin Syndrome (VTS), where one baby stops growing and is
either absorbed back into the mother's body or is still born when the other
twin is born.

Some people find a rapid rate of grow in their uterus which leads some to
suspect twins. I will say, for all of you second timers out there, that your
bellies will grow faster than with your first pregnancy, so don't automatically
assume twins.

Sometimes multiple heart beats are heard, leading your practitioner to

believe that there is more than one bundle of joy in your uterus.

Some women find out when they have abnormally high levels on the AFP test
that multiples are on the way, since multiple babies would increase the
levels of these hormones. It's also sometimes possible to detect multiples
with serial hCG levels in early pregnancy. The more babies the faster the
rate of rise in the hCG which should nearly double every 48 hours with a
singleton.

About 3% of all twin pregnancies are undetected until birth. It is possible to

have an ultrasound and not see the other baby, though rare.

Multiple Pregnancy

Being pregnant with multiples is not necessarily a high risk situation, except
when dealing with higher order multiples or specific problems. Someone on
the bulletin board phrased it as being "high need." I really think that this is a
positive shift away from the technical side. Find a practitioner who is
experienced with multiples births, but one who will not panic at every corner.

In general you need to increase the amount of protein that you eat. Protein is
the building block of every cell in your body and your babies' bodies. It will
help you build a good placenta and a strong amniotic sac. A healthful diet
will also help fight against infection.

You will probably see your practitioner more frequently towards the end of
pregnancy. You may have more testing than most women during pregnancy,
but not always. Some of these might include: non-stress testing, more
ultrasounds, etc.
Complications

There can be a higher risk for complications. You will be monitored for the
normal complications of pregnancy like high blood pressure, and fetal
growth. However, twins and other multiples can have higher incidences of
things such as Intrauterine Growth Restriction (IUGR), Twin to Twin
Transfusion (TTTS), and others. Remember to keep your appointments,
watch your diet and do your Fetal Kick Counts.

Multiple Birth

In years past cesarean became popular for multiple births. Now that rate is
about 50% for twins, and declining. We've found that vaginal birth is usually
very safe for multiples, who frequently need the stimulation and rise in
hormones levels associated with labor.

Whether or not you will have a vaginal birth will depend on many factors,
including the position of the babies, and how the babies tolerate labor.

If your babies are in a position where neither can move, they are said to be
locked. These babies will have to be born via cesarean.

Breech babies really depend on the size of the baby and the skill of the
practitioner. Usually if baby A (The first baby in the pelvis.) is head down a
vaginal birth will be attempted. If Baby B is breech or transverse an internal
or external version may be attempted to help facilitate the birth, or that
baby may be allowed to be born breech.

Monoamniotic twins will also be born via cesarean, due to the added risk of
cord entanglement.

No matter how your twins were conceived, or how they were born, babies
are delightful. Parenting multiples has its special challenges, but it also
yields special rewards.
LifeART (and/or) MediClip image copyright 2008

Wolters Kluwer Health, Inc.- Lippincott Williams & Wilkins. All rights reserved.