Abstracts

Swedish parents were asked to respond to a questionnaire when their infants were three months old on sleeping position, feeding habits, parental smoking, and parity. Infant feeding was classified as exclusive breastfeeding, partial breastfeeding or bottle feeding. At age three months over 70 per cent of the 1028 infants studies were exclusively breastfed, 12.5 per cent were partially breastfed and 17.1 per cent were bottle fed. The study found that those who were resistant to recommendations on childcare practices were more likely to smoke and did not breastfeed. This study supports other findings influencing the risk for SIDS, smoking, formula feeding and prone sleeping position.

Infants that died suddenly were studied as part of a European Concerted Action on SIDS. Three pediatric patholo-gists classified 63 cases into three groups: SIDS (19 cases), borderline SIDS (30 cases) and non-SIDS (14 cases). The distribution of the epidemiological risk factors was determined for the three groups. This Dutch study found that non-SIDS cases had received more breastfeeding, parents hardly smoked during pregnancy and after birth and a firm mattress had been used. Borderline SIDS was associated with previous hospital admission, low birth weight and/or short gestation. The SIDS cases were associated with lower socioeconomic status, maternal smoking after birth, bottle feeding and thumb sucking. The authors propose that all categories of sudden death be analyzed with the objective of developing recommendations for prevention.

Breastfeeding promotion programmes were implemented in Polish hospitals in 1993 with the aim of bringing hospital routines in accordance with the Ten Steps of the Baby-Friendly Hospital Initiative criteria. Since levels of implementation of breastfeeding support measures varied greatly from hospital to hospital the authors studied the impact of hospital maternity policies and routines to support breastfeeding on body weight changes in newborns. To do this they used the results of a previous survey of hospital practices carried out in 1995. Data was collected on 11,973 healthy normal birth newborns and percentages of birth weight loss or gain on the day of discharge (flexible discharge schedules of up to seven days) was determined. The results were compared between the hospitals with the highest exclusive breastfeeding rates and supportive practices and those with the lowest rates. Using body weight as an indicator, the study showed the highest average weight loss for all infants to be about four per cent at day two. In hospitals with the best supportive practices and rates of 98.8 per cent exclusive breastfeeding, the average weight loss was slightly higher by the second and third day, but this was regained by day five. This observation supports studies that show small breastmilk intakes for the first 48 hours after birth and increased intakes on the third day with intakes reaching recommended levels by the fifth day. In hospitals with less supportive breastfeeding practices where only 53.6 per cent of infants were exclusively breastfed, the loss continued to the seventh day. The results also support data reported from the University of Rochester which determined that breastfed newborns given added water or formula in the first few days after birth lost more weight and were less likely to start gaining weight by the fourth day compared with exclusively breastfed infants.