Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and crucial for cognitive development in early life. Newborn DHA intake completely depends on preformed DHA in mother’s breast milk. In advancing years, globalization has been declining the fish intake of Asian countries. This study aims to determine DHA intake among lactating mothers in Jakarta and its association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centers, Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum were taken using consecutive sampling method. Characteristics data were taken by interviews and DHA intake was assessed with the semiquantitative food frequency questionnaire. Breast milk specimens were collected in the morning and its DHA content was analyzed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test were used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e., 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation. The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant. A moderate positive correlation was found between maternal DHA intake with breast milk DHA (r = 0.478, p < 0.001). Conclusion:  Maternal DHA intake has moderate positive correlation with breast milk DHA, more than half of the subject had DHA intake below FAO recommendation

Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and crucial for cognitive development in early life. Newborn DHA intake completely depends on preformed DHA in mother’s breast milk. In advancing years, globalization has been declining the fish intake of Asian countries. This study aims to determine DHA intake among lactating mothers in Jakarta and its association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centers, Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum were taken using consecutive sampling method. Characteristics data were taken by interviews and DHA intake was assessed with the semiquantitative food frequency questionnaire. Breast milk specimens were collected in the morning and its DHA content was analyzed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test were used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e., 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation. The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant. A moderate positive correlation was found between maternal DHA intake with breast milk DHA (r = 0.478, p < 0.001). Conclusion:  Maternal DHA intake has moderate positive correlation with breast milk DHA, more than half of the subject had DHA intake below FAO recommendation

Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and one of the most important nutrient for cognitive development in early life. During early life, there is very limited metabolic capability to convert omega-3 fatty acids to DHA. Therefore, newborn intake of DHA completely depends on preformed DHA in mother’s breast milk. This study aims to determine DHA intake among lactating mothers and their association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centre in Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum was taken using consecutive sampling method. Mother’s DHA intake was assessed with a semiquantitative food frequency questionnaire. Post-feed breast milk specimens were collected in the morning, transported with cool boxes, and stored in the laboratory at -70° C before the analyses. Breast milk DHA content was analysed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test was used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e. 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation (200 mg/day). The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant based on FAO recommendation (0.1% of total energy requirement). There was a moderate correlation between subject DHA intake with breast milk’s DHA content (r = 0.478, p < 0.001).  Conclusion:  More than half of the subjects had DHA intake below FAO recommendation. Our finding showed a positive moderate correlation between DHA intake and breast milk DHA among lactating mothers

EFFECT OF MATERNAL VITAMIN D SUPPLEMENTATION DURING LACTATION EFFECT ON INFANTS' PROPENSITY TO INFECTION : AN EVIDENCE-BASED CASE REPORT

Abstract Introduction: Vitamin D deficiency has become more prevalent around the world along with a sedentary lifestyle and limited exposure to sunlight. Deficiencies of vitamin D in lactating mothers could cause deficiencies in their infants and vitamin D deficient infants are at higher risk of having infectious diseases. Supplementation of Vitamin D to lactating mothers may benefit both mothers and infants to reduce infection morbidity. Methods: Relevant literature research was conducted in PubMed, Cochrane, and SciELO using relevant keywords and advanced search methods. Relevant literature was then screened for duplication, relevance, and eligibility. Results: A randomized-controlled trial was selected. The study showed that supplementation of 3000µg oral vitamin D3 to lactating mothers significantly raise their infants' serum vitamin D (p<0.01) and reduce infection morbidity (p<0.01) Conclusions: Oral supplementation of vitamin D3 could be given to lactating mothers to improve their infants' serum vitamin D and reduce infection morbidity. Keywords: vitamin D, lactation, infants' infectio

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

Background Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. Methods This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. Results Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. Conclusions After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies

Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study

Background Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. Methods Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals. Results From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560). Conclusions Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P &lt; 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P &lt; 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease

Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.

AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. RESULTS: This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients. CONCLUSIONS: In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease