Breastfeeding of premature infants and sick neonates

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Tilgangur þessarar rannsóknar var að lýsa brjóstagjöf barna við heimferð af nýburagjörgæsludeild og við fjögurra mánaða aldur og athuga hvort fæðingarþyngd barns hafi haft áhrif á gang og árangur brjóstagjafar. Rannsóknin var unnin á nýburagjörgæsludeild Landspítala á þriggja mánaða tímabili. Þátttakendur voru foreldrar 62 af 84 börnum sem útskrifuðust á rannsóknartímabilinu. Gögnum um næringu barnanna og lýðfræðilegum upplýsingum fjölskyldunnar var safnað með spurningalistum sem sendir voru til foreldra. Niðurstöður sýndu að 76% barnanna fengu eingöngu brjóstamjólk við útskrift. Sum drukku hana eingöngu af brjósti, önnur drukku hana hvort tveggja af brjósti og úr pela og enn önnur drukku brjóstamjólkina eingöngu úr pela. Nánast öll börnin, eða 92%, fengu einhverja brjóstamjólk við heimferð. Börn með fæðingarþyngd 2500 g eða yfir voru frekar líklegri til að drekka alla brjóstamjólkina af brjósti (70%) við heimferð en börn með lægri fæðingarþyngd (31%). Ekki var tölfræðilega marktækur munur eftir þyngd á fjölda barna sem drukku eingöngu brjóstamjólk við heimferð. Við fjögurra mánaða aldur drakk 61% barnanna enn eingöngu af brjósti, ekkert barn fékk brjóstamjólk úr pela og 5% fengu blöndu af brjóstaog pelagjöfum. Fleiri börn með fæðingarþyngd undir 2500 g voru hætt að drekka af brjósti við fjögurra mánaða aldur (50%) en þyngri börnin (27%). Niðurstöður sýna að ef barn drakk ekki brjóstamjólkina af brjósti við heimferð var líklegra að það væri hætt að fá brjóstamjólk við fjögurra mánaða aldur. Þessar niðurstöður benda til mikilvægis þess að börn séu farin að drekka af brjósti við heimferð og að huga þurfi að auknum stuðningi við brjóstagjöf eftir heimferð til foreldra barna með lága fæðingarþyngd (undir 2500 g). Einnig benda niðurstöðurnar til þess að skoða þurfi sérstaklega þann möguleika að brjóstagjöf með ábót úr pela sé vel ásættanleg í sumum tilvikum.The aim of this study was to describe infants’ breastfeeding at discharge from the neonatal intensive care unit (NICU) and at the age of 4 months to investigate the impact of birth weight on breastfeeding. The study was conducted at the NICU at the University Hospital in Iceland over a three month period. Participants were parents of 62 out of 84 infants who were discharged during this period. Data concerning infants’ feeding habits and demographics concerning the family was collected by questionnaires mailed to parents. Results showed that 76% of infants were fed exclusively breast milk at discharge but the pattern of feeding varied: Some were drinking only from the breast, others were fed on the breast with additional breast milk from a bottle, and finally some received breast milk exclusively from a bottle. Importantly, almost all infants or 92% were getting some breast milk at discharge. Furthermore, infants with birth weight 2500 g or more were more likely to be entirely fed from the breast (70%) at discharge compared to low birth weight (LBW) under 2500 g (31%) infants. However, there was no statistical difference between the number of LBW and full birth weight infants who were exclusively fed with breast milk at discharge. At 4 months of age, 61% of the infants were still fully breastfed, none received breast milk only by the bottle and 5% received breast milk both from breast and bottle. In addition, the results showed that more LBW infants had stopped breastfeeding (50%) compared to infants with higher birth weight (27%) at 4 months of age. These results indicate that infants who are not breastfed at discharge will be more likely to receive no breast milk at 4 months. These findings indicate the importance of breastfeeding at discharge from the NICU for maintenance of breastfeeding during the first few months of life. Additionally, the results indicate that parents of LBW infants may need more support to maintain breastfeeding after discharge. Especially, it must be taken into account that breastfeeding in combination with bottle feeding may be an acceptable option in some cases

Erum við föst í viðjum vanans : getum við veitt betri fjölskylduhjúkrun?

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenUndanfarin ár hefur umræða um fjölskylduhjúkrun aukist og hafa íslenskir hjúkrunarfræðingar tekið þátt í þeirri umræðu. Höfundar þessarar greinar hafa allir starfað í áratugi við barnahjúkrun. Á þeim tíma hafa orðið miklar breytingar á þátttöku foreldra í umönnun veikra barna. Árið 1975 var heimsóknartími foreldra á barnadeildum 2 klukkustundir á dag en nú líta allir á sólarhringsviðveru foreldra sem sjálfsagðan hlut. Við höfum séð og horft upp á hvað þessi breyting tók oft á og hvað það var erfitt að breyta venjum á skipulagi og hefðum í daglegu starfi. Í dag er umræðan um hlutverk og samstarf við foreldra í öllu ferlinu talin bæði nauðsynleg og eðlileg, bæði innan sjúkrahúss og utan. Margar rannsóknir hafa sýnt mikilvægi samstarfs heilbrigðisstarfsmanna, ekki síst við foreldra langveikra barna því í þeirra tilviki eru það vissulega foreldrarnir sem eru sérfræðingar í líðan og umönnun barna sinna (Ray, 2002). Heilbrigðisstarfsfólk er orðið meðvitaðra en áður var um áhrif hinna ýmsu heilbrigðisvandamála á fjölskylduna. Þekkt eru áhrif svefnvandamála barna á líðan systkina og foreldra og áhrif geðröskunar fullorðinna á líðan maka og barna

Spurningalisti til að meta viðhorf fagfólks til fjölskylduhjúkrunar

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Í þessari grein verður fjallað um spurningalista sem er notaður til að kanna viðhorf hjúkrunarfræðinga til fjölskylduhjúkrunar. Rakin verður þróun spurningalistans í Svíþjóð, kynni íslenskra hjúkrunarfræðinga af listanum og reynsla þeirra við að þýða, staðfæra og nota listann á Landspítala

MAP1B mutations cause intellectual disability and extensive white matter deficit

Publisher's version (útgefin grein). Publisher's note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Discovery of coding variants in genes that confer risk of neurodevelopmental disorders is an important step towards understanding the pathophysiology of these disorders. Wholegenome sequencing of 31,463 Icelanders uncovers a frameshift variant (E712KfsTer10) in microtubule-associated protein 1B (MAP1B) that associates with ID/low IQ in a large pedigree (genome-wide corrected P = 0.022). Additional stop-gain variants in MAP1B (E1032Ter and R1664Ter) validate the association with ID and IQ. Carriers have 24% less white matter (WM) volume (β = −2.1SD, P = 5.1 × 10−8), 47% less corpus callosum (CC) volume (β = −2.4SD, P = 5.5 × 10−10) and lower brain-wide fractional anisotropy (P = 6.7 × 10−4). In summary, we show that loss of MAP1B function affects general cognitive ability through a profound, brain-wide WM deficit with likely disordered or compromised axons.We are grateful to the participants and we thank the psychologists, nurses and staff, in particular Berglind Eiriksdottir, at the Research Recruitment Center and technicians and staff at Röntgen Domus. We also thank the staff at deCODE genetics core facilities and all our colleagues for their important contribution to this work. L.J. received support from the Swedish Society of Medicine, the Swedish Brain Foundation and Swedish Society for Medical Research. The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreements’ no. 115008 (NEWMEDS) and no. 115300 (EUAIMS) of which resources are composed of EFPIA in-kind contribution and financial contribution from the European Union’s Seventh Framework Programme (EU-FP7/2007-2013), EU-FP7 funded grant no. 602450 (IMAGEMEND) and EU funded FP7-People-2011-IAPP grant agreement no. 286213 (PsychDPC).Peer Reviewe

Descriptive Analysis of Intervention for Parents of Young Children Having Sleep Problems

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe aim of this qualitative study was to describe an intervention for parents at a nurse-led clinic for children age 6–24 months with sleeping problems. Data were gathered from 10 families. Intervention sessions were recorded. The nurse also wrote field notes and kept a reflection diary about the interventions. The data were coded in a search for categories of meaning and then grouped and raised to a higher level of abstraction to describe the intervention. Three themes were constructed. Theme 1: Shar- ing Stories, includes establishing a working relationship and learning about the family

Spurningalisti til að meta viðhorf fagfólks til fjölskylduhjúkrunar

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Í þessari grein verður fjallað um spurningalista sem er notaður til að kanna viðhorf hjúkrunarfræðinga til fjölskylduhjúkrunar. Rakin verður þróun spurningalistans í Svíþjóð, kynni íslenskra hjúkrunarfræðinga af listanum og reynsla þeirra við að þýða, staðfæra og nota listann á Landspítala

Breastfeeding progression in late preterm infants from birth to one month.

This study aimed to describe and compare breastfeeding progression, infants' feeding behaviours, maternal feeding difficulties, and mothers' usage of breastfeeding interventions for singleton late preterm (LPT) and term infants. A further aim was to identify associated factors for exclusive breastfeeding at breast at 1 month in LPT infants. This was a cohort study where mothers of LPT infants from a neonatal unit (n = 60), LPT infants from a maternity unit (n = 62), and term infants from a maternity unit (n = 269) answered a questionnaire approximately 1 month after delivery. Findings showed no significant differences in exclusive breastfeeding at breasts between LPT infants admitted to the neonatal unit compared with the maternity unit, during the first week at home (38% vs. 48%), or at 1 month of age (52% vs. 50%). Term infants were more likely to be exclusively breastfed at the breast (86% and 74%, p < 0.05) compared with LPT infants. Multiple regression analysis showed that usage of a nipple shield, not feeding breast milk exclusively during the first week at home, or feeding less than 10 times per day at 1 month were statistically significant for not exclusively breastfeed at the breast. A protective factor was the mothers' experience of having an abundance of milk during the first week at home. In conclusion, LPT infants are less likely to be exclusively breastfed at the breast than term infants, highlighting the need for further research to guide interventions aimed at optimising exclusive breastfeeding rates