Frequency of “Nursing Strike” among 6-Month-Old Infants, at East Tehran Health Center and Contributing Factors

Objective:An abrupt refusal by the infant to breastfeed is often called “nursing strike”. In fact a common reason for cessation of nursing is infant’s refusal to breast feed. This problem can often be overcome. This paper has aimed to identify the causes of “breast feeding refusal” or “nursing strike” in 6 month old infants visiting the East Tehran health center for their scheduled vaccination of 6 months old. Materials and methods:Totally 175 six month old infants were enrolled in this study. A questionnaire was filled by mother for each child and later the infants with “nursing strike” were compared with all others. Results:In this study prevalence of breast feeding refusal in infants was 24%.There was significant relation between the “breastfeeding refusal” and maternal academic education or working status. In this study mothers reported various reasons associated with “refusal breast feeding. According to the mothers playful infant and nasal obstructions were the probable causes for refusal. Conclusion:There is a diverse variety of factors influencing nursing strike. Most of these factors can be prevented by identifying the background reasons and proper training

A Single Center Study of the Effects of Trained Fathers' Participation in Constant Breastfeeding

Constant breastfeeding that depends on the family support. Fathers' involvement is as an important factor of successful breastfeeding. The aim of this study was to evaluate the influence of fathers' participation in constant breastfeeding in Vali-E-Asr Hospital, Tehran, Iran. This interventional study was piloted on spouses of pregnant women participating in pregnancy courses. The case group consisted of fathers attending training courses of breastfeeding during pregnancy (Group A), and the control group was made up of fathers who did not take part in training courses (Group B). The courses were held three times from the 30th week of gestation to the end of pregnancy in a family health research center. Fathers attended three training sessions where they were trained by brochures. After delivery newborns were weighted and examined for jaundice (3-5 days, 30 days, three and six months after birth). According to mothers' views, spouses' participation, encouragement and support in group A, was 11 times more than group B. It means that 47 (94%) of spouses in the group A participated in mothers' constant breastfeeding, but fathers' participation in group B was 60% (30 spouses). This study showed that breastfeeding was more constant in the group that fathers participated in breastfeeding training course. One of the reasons for such a significant difference was spouses' participation, encouragement and support in the trained group. This study showed that fathers' involvement in training programs may influence constancy of breastfeeding

Profile of neonatal mortality in the Islamic Republic of Iran in 1391

Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the Core Strategy and Policies. This study was aimed to determine the classification of causes of neonatal death in Iran. Methods: Neonatal mortality refers to deaths of young children, typically those less than 28 days of age. It is measured by the neonatal mortality rate (NMR), which is the number of deaths of neonates per 1000 live births.This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days), in IRAN's hospitals in 2012 that registered in the Perinatal Mortality Surveillance System (hospital-based system). Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analyses, burden of disease analyses, and comparative risk assessment we classified the causes of death according to International statistical classification of diseases version 10 (ICD 10), divided into three cause mortality strata. Results: The most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92%) with the highest incidence of  "disorders related to length of gestation and fetal growth" (37.7%) in this group. Also 2419 (20/82%) of deaths caused by "Congenital malformations, deformations and chromosomal abnormalities" and 147 (1/26%) cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71/29%), with the highest percentage in the disorders related to "length of gestation and fetal growth" (29/65%). Conclusion: Policies and interventions should be in line with the priority given to the most common causes of death in prenatal care, prevention and treatment of complications of pregnancy and delivery

Profile of neonatal mortality in Iran in 1391

Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the core strategy and policies. This study was aimed to determine the classification of causes of neonatal death in Iran. Methods: Neonatal mortality refers to deaths of young children. It is measured by the neonatal mortality rate (NMR), which is the number of deaths of neonates per 1000 live births. This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days), in Iran's hospitals in 2012 that registered in the perinatal mortality surveillance system (hospital-based system). Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analysis, burden of disease analysis, and comparative risk assessment we classified the causes of death according to international statistical classification of diseases version 10 (ICD 10), divided into three cause mortality strata. Results: Results showed the most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92%) with the highest incidence of "disorders related to length of gestation and fetal growth" (37.7%) in this group. Also it shows that 20.82% of deaths caused by "congenital malformations, deformations and chromosomal abnormalities" and 1.26% cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71.29%), with the highest percentage in the disorders related to "length of gestation and fetal growth" (29.65%). Conclusion: According to this study the "certain conditions originating in the perinatal period" special "disorders related to length of gestation and fetal growth" was the main cause of neonatal mortality. Also "congenital malformations, deformations and chromosomal abnormalities" was the second cause of neonatal mortality

Correlation between Lead in Maternal Blood, Umbilical Cord Blood, and Breast Milk with Newborn Anthro-pometric Characteristics

Background: Breast milk can be a source of toxic material, along with the transfer of nutrients needed for infant growth. This study was conducted to measure the level of lead in maternal and neonatal blood and breast milk in Tehran, Iran.Methods: In this cross-sectional study, 150 mothers and their infants were studied. Samples of maternal blood, fetal umbilical cord blood, breast milk, and amount of lead measured by atomic absorption method were collected. Correlations between lead levels and demographic characteristics of mother and infants were assessed.Results: The mean levels of lead in maternal and neonatal blood and breast milk were 9.79±4.31, 8.29±4.83, and 8.65±3.67 μg/dl, respectively. The different levels of lead were associated with cord blood, maternal blood, and breast milk. No significant relationship was found between lead levels and neonatal parameters (i.e., weight, height, and head circumference). The Spearman's correlation also showed the association between different levels of lead with cord blood, maternal blood, and breast milk. Linear regression also did not show any relationship between lead levels in cord blood, milk, and mother blood with newborn growth parameters.Conclusion: The present study failed to find a significant correlation between lead and newborn birth parameters. In our study, lead levels in maternal blood, breast milk, and cord blood were lower, compared those of the previous years in Iran; however, it needs to decrease, because lead even at very low concentrations may also have adverse effects

Neonatal mortality rate in Iran: the Iranian Perinatal Mortality Surveillance System

Background: Neonatal mortality is the major proportion of children mortality under five years and it is considered as the main health indicator in the first year of life. This paper has aimed to review the neonatal mortality in the numbers recorded at the Iranian Perinatal Mortality Surveillance System (IPMSS) by Iran Ministry of Health and Medical Education. Methods: A descriptive study was done in 2014. For assessment of sampling quality and quantity, 24 hospitals randomly were selected. Recorded information, related to perinatal mortality (deaths from 22 completed weeks of gestation until 30 completed days after birth inclusive of stillbirths and neonatal mortality) from selected hospitals, was compared with recorded data in IPMSS. Results: Results showed that, out of 1,725 perinatal deaths occurred in hospitals, 1,480 (85.80%) deaths were recorded in IPMSS. Of 1,041 neonatal deaths that occurred in hospitals (in hospital wards and delivery rooms), 875 (84.05%) were in IPMSS. It shows that a correction coefficient for hospital neonatal mortality was 1.1904. Based on analyzing process, correction coefficients for stillbirth reported by hospitals, stillbirth for all over the country and perinatal death were 1.130, 1.1775 and 1.2443, respectively. Considering these correction coefficients – that enabled to calculate 15,130 neonatal deaths – and 1,421,689 live births (according to Statistics Center) in 2012, neonatal mortality rate was 10.64 in 1,000 live births. Conclusion: Our data showed some problems in the registration system. Although implementation and supervision of such Surveillance System are not easy, they are essential and provide valuable data in perinatal audit and neonatal health care practices

Frequency of Exclusive Breastfeeding and Its Affecting Factors in Tehran, 2011

This study was designed to assess the frequency of exclusive breastfeeding in two health centers of Shahid Beheshti University of Medical sciences in Khak Sefid, Tehran, Iran. A total of 175 mothers, referred for the third dose of their infants' DPT vaccination program participated in the study by completing a questionnaire regarding characteristics of their pregnancy, delivery and exclusive breastfeeding within the first six months of birth. Two-variable analysis and logistic regression test were applied to evaluate factors influencing exclusive breastfeeding. Results indicated that the frequency of exclusive breastfeeding, i.e., breastfeeding within the first six months of birth without the use of any other food with or without vitamin supplementation, was 31.17% (95% CI=23.77%-38.57%), which means 48 infants of 154<179 days old Among 154 infants (<179 days old) 48 did not have a history of being separated from their mothers. In logistic regression analysis, the variables which were directly associated with exclusive breastfeeding, with 0.05 significance level of alpha, included breastfeeding within the first hour of birth, eight times or more breastfeeding per day and receiving breastfeeding education during pregnancy. Variables with a negative association with breastfeeding included lack of breast milk, presence of a breast problem that could hinder breastfeeding, bottle feeding, physician or family's advice not to breastfeed and infant's refusal to breastfeed. Frequency of breastfeeding within the six months of birth is less than similar frequencies which are obtained by asking about breastfeeding on the day of the interview. It is recommended to apply real frequency for assessment, evaluation and programming of exclusive breastfeeding during the first six months of birth