INFANTS FEEDING PRACTICE IN FIRST SIX MONTHS ACCORDING TO DELIVERY PRACTICES

Cilj rada je bio utvrditi zastupljenost načina prehrane prema načinu poroda, u dojenčadi do šest mjeseci života na području Tuzlanske županije. Ispitanici i metode. Ispitivanjem su obuhvaćena dojenčad uzrasta od 6 mjeseci, rođena u rodilištu Ginekološko-akušerske klinike u Tuzli u razdoblju svibanj–rujan 2004. godine, težine veće od 2500 grama i gestacijske dobi iznad 37 tjedana. Podaci o načinu prehrane dojenčeta u svakom mjesecu života kao i o načinu poroda prikupljeni su anketiranjem 493 majke. Rezultati. Analizirajući način poroda istraživanje je pokazalo da je od 493 majke 95 porođeno carskim rezom. Porod carskim rezom u našem istraživanju kod majki dojilja je bio zastupljen u 18,4%, a kod majki koje su umjetno hranile dojenčad u 22,4% slučajeva (2=0,79, df=1, P=0,37). Zaključak. Ovo istraživanje je potvrdilo da je umjetna prehrana češća kod dojenčadi čije su majke porođene carskim rezom, što pokazuje da je ovim majkama potrebno pružiti posebnu pomoć kako bi u dojenju uspjele.Aim. To investigate the infants’ feeding practice in the first six months of life in Tuzla canton according to delivery practices. Methods. The infants were born in Gynaecology-Obstetrics Department in Tuzla in the period May – September 2004, with infant’s birth weight >2500 g and >37 weeks of gestational age. Infants’ feeding practices and type of delivery were collected by questionnaires sent to mothers in 13 communities of Tuzla canton. Overall 493 questionnaires were analyzed. Results. One fifth of pregnancies were terminated by caesarean section. Delivery by caesarean section was found in 18.4% mothers of breastfed infants and in 22.4% mothers of infants fed by formula (2=0.79, df=1, P=0.37). Conclusion. Type of delivery had an impact on breastfeeding success. The study confirms that mothers with caesarean section are at greater risk for breastfeeding failure and thus should be targeted for additional attention and support

Neonatal bacterial meningitis: Results from a cross-sectional hospital based study

Objective. The aim of the study was to determine the epidemiological characteristics of bacterial meningitis observed in neonates born in the Department of Gynaecology and Obstetrics, University Clinical Centre Tuzla, Bosnia and Herzegovina, admitted to Intensive care unit (NICU) or readmitted, because of suspected infection, after discharge from the nursery. Subjects and methods. This study was carried out from July 1, 2012 to June 30, 2013. During this period 4136 neonates were born. All neonates admitted to the Intensive care unit with signs and symptoms of systemic infections, and neonates readmitted to the Intensive care unit, after discharge from the nursery for sepsis work up were included in the study. Results. Eighteen of 200 neonates (9%) admitted or readmitted to the NICU developed meningitis. 61% cases were late onset meningitis. The overall incidence was 4.4/1000 live births. The mortality rate was 11.1%. The mean age of symptom presentation was 8.7 days. The most common clinical features were: fever, respiratory distress and jaundice. Significant risk factors for acquiring meningitis were: male gender, Caesarean delivery, stained amniotic fluid. Positive CSF finding were detected in 6/18 (33.3%) of cases. Gram-positive bacteria were more frequently responsible for confirmed meningitis. In all neonates with meningitis blood culture was examined and 5 (50%) yielded Gram-negative bacteria. Conclusion. The high rates of neonatal meningitis with predominant late onset may suggest nosocomial origin. Measures to improve antenatal, intrapartum and delivery care and measures during NICU hospitalisation are necessary to lower the risk of nosocomial infections