lunedì 25 agosto 2008

Poesie, fotografie e racconti sulla maternità
























Vorrei, col vostro contributo, creare una galleria di poesie, immagini e racconti sulla maternità: dal concepimento all'allattamento al seno, da rendere disponibili a tutti.
INVIATE PURE LE IMMAGINI, LE POESIE ED I RACCONTI CHE VI SONO PIU' PIACIUTI

Thanks to your contribution I wish to publish on this blog a nice gallery of pictures, poems and stories about childbirth. FEEL FREE TO POST.

martedì 19 agosto 2008

Piccole veneri al British Museum


Ho fotografato queste statuine, alte pochi centimetri e risalenti ad epoche lontane. Mi hanno sempre affascinata queste figure femminili tanto che, quando sono in vena, provo anch'io a fare qualche tentativo con la creta o col DAS e costruisco una mia venere magari incinta o allattante.
Spesso mi chiedo che significato abbiano avuto veramente per le nostre lontane "ave".


Vacanze a Vienna

Agosto 2008
Una toccata e fuga a Vienna per ricaricare le batterie. Un giorno e mezzo a Vienna per avere un'idea di com'è...ed è proprio bella, rococò gotico, liberty e barocco ti circondano. L'albergo prenotato via internet, era pulito, conveniente ed abbastanza centrale. Ho fatto bella gita organizzata su di un pulman per vedere le zone più caratteristiche di Vienna ed il castello di Maria Teresia sovrana illuminata, amatissima dal popolo che ebbe (deformazione professionale) 16 FIGLI!!!!!!! La guida viennese ha spiegato in modo chiaro e originale ed io ...ho capito tutto, pur non parlando tedesco da molto tempo.
Difficile trovare un ristorante tipico viennese, l'ho trovato dopo due ore di intensa ricerca, quando le gambe cominciavano a cedere e la fame mi faceva avere allucinazioni....non avrei mai e poi mai mangiato italiano in Austria! Difficile orientarsi col trasporto pubblico: nessuno sa niente, le indicazioni sono pessime e.... Roma è molto, molto meglio. Per un pelo non ho perso il volo di ritorno.
Merita comunque di essere vista e credo che prima o poi ci tornerò con marito e figlie.
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sabato 16 agosto 2008

Nigeria lagging behind in achieving MDGs

UNICEF says Nigeria lagging behind in achieving MDGs
LAGOS (Xinhua)-- The UN Children's Fund UNICEF has rated Nigeria low in its effort in attaining its Millennium Development Goals (MDGs), according to a report by the UNICEF office in Nigeria received here on Wednesday.
The report said Nigeria had not made sufficient progress in the attainment of most of the targets of the MDGs set by the UN to eradicate poverty, reduce child and maternal mortality, fight disease and achieve environmental sustainability by 2015. The UNICEF report indicated that Nigeria had a 29 percent prevalence of underweight children in 2006 and an annual reduction rate of only 2.2 percent. UNICEF said though Nigeria recorded 68 percent net school enrolment, there was still no progress towards the MDG target, on the achievement of the Universal Basic Education. It said Nigeria had a 0.89 percent gender parity index, with 72 percent male net enrolment to 64 percent in female, on the elimination of gender disparity in primary education, according to
Allattamento al seno http://www.epicentro.iss.it/argomenti/allattamento/allattamento.asp
Il latte materno rappresenta il miglior alimento per i neonati, perché fornisce tutti i nutrienti di cui hanno bisogno nella prima fase della loro vita, come per esempio certi acidi grassi polinsaturi, proteine, ferro assimilabile. Inoltre, contiene sostanze bioattive e immunologiche che non si trovano nei sostituti artificiali e che invece sono fondamentali sia per proteggere il bambino da eventuali infezioni batteriche e virali, sia per favorire lo sviluppo intestinale.

È per questo che tutti i bambini dovrebbero essere esclusivamente allattati al seno per i primi sei mesi di vita (26 settimane). Secondo le indicazioni dell’Organizzazione mondiale della sanità, dell’Unicef e dell’Unione Europea, recepite anche dal nostro ministero della Salute, l’allattamento al seno dovrebbe poi continuare per due anni e oltre, secondo il desiderio della mamma e del bambino.

Secondo la definizione dell’Oms, l’allattamento può essere:
allattamento al seno esclusivo: solo latte materno
allattamento al seno predominante: latte materno + liquidi non nutritivi
allattamento complementare: latte materno + latte di formula.
Come favorire l’allattamento al seno
Innanzitutto è importante che fin dai primi minuti madre e figlio rimangano insieme, facendo in modo che si instauri il cosiddetto contatto “pelle-a-pelle”: il corpo della madre aiuta il bambino a mantenere una temperatura adeguata (molto importante per bambini molto piccoli o nati pretermine ma anche per i bimbi sani nati a termine) e il bambino è meno stressato, più calmo e ha respiro e battito cardiaco più regolari. Il primo contatto con il seno dovrebbe avvenire entro un’ora dalla nascita, lasciando la mamma e il bambino, insieme al papà se presente, liberi di interagire spontaneamente, senza interferenze esterne.

Altre raccomandazioni importanti sono:
allattare il bambino “a richiesta”, senza seguire orari rigidi
controllare la posizione e l’attacco al seno del bambino, evitando di staccarlo prima che abbia finito
non dare al bambino altri liquidi diversi dal latte materno prima della prima poppata, così come evitare il latte o altri cibi artificiali, acqua, zucchero o acqua zuccherata tra una poppata e l’altra (nei primi sei mesi, infatti, quando il bambino ha sete prende quello che viene definito il “primo latte”, meno grasso e più ricco di acqua e zuccheri, mentre quando ha fame rimane attaccato più a lungo, fino a prendere anche “l’ultimo latte”, molto più ricco di grassi. Per questa ragione, spesso nei mesi caldi i bambini fanno poppate più brevi e frequenti)
evitare l’uso di tettarelle artificiali, biberon e ciucci, soprattutto nei primi mesi di vita
non lavare il seno dopo ogni poppata ed evitare l’uso di creme o unguenti durante l’allattamento; la normale igiene della mamma è sufficiente e il seno è provvisto di ghiandole che provvedono ad una naturale disinfezione dell’areola.
I vantaggi per il bambino
È ormai condiviso a livello internazionale che l’allattamento al seno:
riduce l’incidenza e la durata delle gastroenteriti
protegge dalle infezioni respiratorie
riduce il rischio di sviluppare allergie
migliora la vista e lo sviluppo psicomotorio
migliora lo sviluppo intestinale e riduce il rischio di occlusioni
Alcuni studi, inoltre, hanno ipotizzato che il latte materno possa contribuire anche a ridurre il rischio di numerose patologie:
numerose infezioni (enterocolite necrotizzante, meningite, botulismo e infezioni del tratto urinario)
malattie autoimmunitarie, come per esempio il diabete di tipo 1 e di tipo 2
sindrome da morte improvvisa del lattante (Sids)
obesità nella vita adulta.
I vantaggi per la madre
Anche per la madre l’allattamento al seno ha delle ricadute positive:
quanto più comincia precocemente, accelera la ripresa dal parto e l’involuzione dell’utero e riduce il rischio di emorragia e di mortalità
riduce la perdita di sangue, contribuendo così a mantenere il bilancio del ferro
prolunga il periodo di infertilità post parto
favorisce la perdita di peso e il recupero del peso forma
riduce il rischio di cancro della mammella prima della menopausa.
Alcuni studi, inoltre, hanno ipotizzato che il latte materno possa contribuire anche a ridurre il rischio di cancro dell’ovaio e di osteoporosi.
ControindicazioniAlla luce delle conoscenze attuali, le condizioni in cui l’allattamento al seno è sconsigliato sono piuttosto limitate. Oltre al caso in cui venga diagnosticata al bambino la galattosemia, una rara malattia metabolica, l’allattamento non dovrebbe avvenire quando nella madre è presente almeno una delle seguenti condizioni:
sieropositività e trattamento con farmaci antiretrovirali per la terapia dell’Aids
tubercolosi attiva e non curata
uso di droghe
terapia antitumorale (chemioterapia o radioterapia) in corso.
In generale, la maggior parte dei farmaci che vengono prescritti dopo una gravidanza non interferiscono con l’allattamento. In ogni caso, è bene chiarire con il proprio medico di famiglia l’eventualità di sospendere o meno l’allattamento in caso di una determinata terapia. Per informazioni sulla compatibilità dei farmaci con l’allattamento è possibile contattare l’Istituto Mario Negri di Milano.
EpiCentro
Ultimo aggiornamento martedi 24 giugno 2008
Cnesps - Istituto superiore di sanità - 2001-2008


giovedì 14 agosto 2008

Kangaroomothercare- Dr Bergman


Overview - Physiology and Research of KMC Click the links below to jump to the relevant section: • Research on SSC (Skin to Skin Contact)BreastfeedingBreast Milk and ImmaturityNeuroscience and Stress Kangaroo Mother Care (KMC) has been variously defined, but two essential components are skin-to-skin contact (SSC), and breastfeeding (BF). From the biological perspective, in the immediate newborn period of Homo sapiens, skin-to-skin contact represents the correct "habitat", and breastfeeding represents the "niche" or pre-programmed behaviour designed for that habitat. RESEARCH ON SSCIn the uterine habitat, oxygenation is provided through the placenta and the cord, as well as warmth, nutrition and protection. These are the four basic biological needs. Parturition (birth) represents a "habitat transition". In the new habitat, the basic needs remain the same. Research over the last ten years provides strong support for the contention that newborn itself in the skin-to-skin habitat, not the mother or the health services, provides these basic needs. Oxygenation has been shown to be improved on SSC, to the extent that KMC is used successfully to treat respiratory distress. The breathing becomes regular and stable, and is coordinated with heart rate. When removed from incubator and placed SSC, oxygen saturation may rise slightly, or the percentage of oxygen provided to maintain good saturation can be lowered. Heart Rate is increased when placed SSC. Though we can regard this increase as being with the clinically normal range, what is seen is actually a return to the physiologically normal heart rate, the lower rate being due to "protest despair behaviour". Infants removed from incubators and placed SSC show a rise in temperature and a dramatic drop in glucocorticoids, as predicted by the "protest-despair response". Mothers are able to control the infants temperature within a very narrow range, far better than an incubator. To accomplish this, her core temperature can rise to two degrees Centigrade if baby is cold, and fall one degree if baby is hot. Skin-to-skin contact is better than incubator for rewarming hypothermic infants. Self-attachment refers to the phenomenon that fullterm undrugged infants, left on their mother's chest and undisturbed, will all breastfeed spontaneously within one hour, with no help at all. But this behaviour is dependent on SSC. Mother and infant should NOT be separated. The stimulations the newborn gives the mother during SSC elicit caregiving and protective behaviours from the mother. The baby’s legs kicking on the mother’s abdomen cause the mother’s uterus to contract strongly, preventing post-partum bleeding. Nutrition is improved, both with respect to the mother’s ability to breastfeed, and with respect to the newborn’s utilisation of the feed. The volume of mother’s milk is greatly increased, and the frequency of feeds provided likewise. Even without the increased milk, with the vagal stimulation the infant receives, the gut is better able to use the milk provided, and grows faster. Immunity is improved, demonstrable even 6 months later. Prematures seem to have poor immune systems, and are susceptible to allergies, infections and feeding problems in the first year of life. Early SSC dramatically reduces these problems. Infections are reduced when SSC and exclusive breastfeeding are firmly introduced. Necrotizing enterocolitis (a potentially lethal and very costly disease to treat) has been dramatically reduced in many units following a KMC programme. In no published paper is a single adverse outcome reported for KMC. Positive effects on the mother are better bonding, healing of emotional problems associated with premature birth, among others.BREASTFEEDINGBreastfeeding is a behaviour based on hindbrain functions that regulate hormones, autonomic functions and the somatic system. Key to understanding breastfeeding behaviours in the transitional and newborn periods is "state organisation". State Organisation refers to the ability to control the level of arousal, or of being awake. A scale of state organisation can be described varying from deep sleep to hard crying, each being associated with particular behaviours and conditions. For breastfeeding an infant should be in an awake state, and should thereafter be in quiet sleep for optimal development. KMC has profoundly beneficial effects on the state organisation of newborns. "Suckling" is the "chewing movement" an infant makes on the nipple. Quite apart from suckling as a means to ingest food, this behaviour has essential effects. Suckling stimulates the back of the palate, and results in intense vagal stimulation, which is vital for the general wellbeing of the baby. Suckling releases hormones similar to morphine in the brain, and gives powerful pain relief to infants. While it was observed that ability to suck on a bottle only started at 34 weeks post-conceptional age, recent research has shown that suckling from the breast is possible at 28 weeks. Suckling is a myographically distinct behaviour from sucking, and research on sucking on bottles of premature infants shows it clearly to be stressful. Premature infants are unable to coordinate their breathing and their swallowing. Back to Top BREAST MILK AND IMMATURITYCompared to that other mammals, human milk is extremely thin in terms of protein, fat and carbohydrate contents. Protein in particular. In olden days, protein was measured in terms of “nitrogen”, the assumption being that the majority of the nitrogen was a constituent of proteins. For a cow, protein nitrogen is 98%. For a human however, it is only 75%, and the non-protein nitrogen (NPN) is full quarter of the content. What human milk lacks in terms of concentration, it makes up for in terms of variety, well over two hundred NPN compounds have been found. These are related to the evolutionary immaturity of the newborn. NEUROSCIENCE AND STRESS The primary violation, the worst case scenario, to any newborn is separation from its habitat/mother. This applies to Homo sapiens as fully as to other mammals studied. “Protest-despair” behaviour is a stress reaction, and the hormones related to this have been extensively studied. At high levels, these hormones are intrinsically neurotoxic to the brain, particularly areas of the hindbrain, and any area which may be already a little hypoxic. SSC has been shown to markedly reduce these levels.

lunedì 11 agosto 2008

Breastfeeding


Breasfeeding in bottle culture


For some mothers, bottle feeding their babies is something they have always wanted to do as it gives them flexibility and helps them maintain a good level of independence. Artificial infant feeding has been culturally marked as more advanced and is socially more accepted than natural infant feeding.
Fortunately, breast feeding is on the rise as more and more new mothers acknowledge the endless benefits for themselves and, more importantly, for their offspring. Yet, in order for the use of breast milk to become normal again rather than the “alternative”, we still have to overcome cultural taboos.
The History of Bottle Feeding
Archaeological findings have shown that breast feeding substitutes were used thousands of years ago. Historically, substitute milk was given to infants whose mothers died or were too sick to feed their babies, usually with limited possibility of wet nursing at hand. Cow’s milk or goat’s milk were commonly used to replace mother’s milk. In addition, babies were sometimes given supplementary solid food, such as a paste made of bread or flour mixed with milk or water. Needless to say that infant mortality rate was extremely high – from 50 to 99% . History and cross-cultural studies have revealed that the increase in bottle feeding resulted in an increase in infant deaths, especially where standards of hygiene were not met. It is a fact, that artificial infant feeding can hold more risks for baby.
During the industrial revolution artificial feeding became popular in Britain as women had to leave their children behind to work in the factories. The first scientific breast milk substitute was invented in 1867 by a German chemist. It was a combination of cow’s milk, flour, potassium bicarbonate and malt. However, the popularity of bottle feeding increased when condensed milk was developed in the late 19th century. The social consensus about how best to feed baby in a modern world which was filled with new scientific achievements, changed towards artificial infant feeding. Bottle feeding was sold as nutritious, safe and easy to prepare with no need for refrigeration. More importantly, pasteurization of milk and sterilization of feeding equipment made artificial infant feeding a safer alternative; thus, making bottle feeding more popular. In addition, medical representatives and scientists celebrated this new supposedly convenient way of feeding baby. As a result, breast feeding became comparatively unpopular as figures show that only 20 to 30% of babies were actually breastfed during WWII in the USA. However, the 1980s proved difficult for companies such as Nestlé when their involvement with medical establishments in order to sell formula feeding in the third world was revealed.
Bottle feeding is still the number one choice for many new mothers. This can have different personal or even medical reasons, although modern living standards are mainly to blame for the change in maternal attitude over the past century.
Why is Breast Feeding a Challenge?
Organisations such as the La Lèche League or the Breastfeeding Network help to promote breastfeeding with all its benefits which, as a result, is becoming increasingly popular.
Fortunately, more and more women decide to at least try to feed their newborn themselves. National statistics show that there is a steady increase in initial infant breastfeeding (66% in 1995 to 69% in 2000). However, statistics also reveal that many new mothers give up breastfeeding after only a few weeks: after only one week, 55% of women breastfeed, after six weeks 43% and after 4 months 28% still feed their babies. In our modern culture, natural feeding is a challenge because bottle feeding still tends to be regarded as “easier”. Generations of parents who bottle fed their babies pass on what they have been sold decades ago. In addition, new breastfeeding problems arise that find appropriate discussion grounds in our civilisation, such as the “insufficient milk” syndrome. Yet, only about 5% of mothers show real physical difficulty to breastfeed, thus confirming that the idea of not making enough milk is a modern invention. Women may actually feel that they do not have enough milk to feed their baby but the reasons are not physical. It is more likely that the early difficulties mother and baby experience together result from stressful birthing environment, such as the hospital, where unknown staff and routine as well as doubtable reputation feed initial anxiety and thus, can add to the overall picture of the insufficient milk syndrome. Breast feeding can be highly influenced by psychosomatic elements, such as stress, anxiety, worries, depression and much more. Feeding is a natural self-regulating and extremely efficient process which is susceptible to how mothers feel, as much as anything. If a new mother does not receive the support she needs, the let-down reflex (milk flows from the ducts towards the nipple) is more difficult to be stimulated.
Besides the modern argument of “lack of sufficient milk”, many more interruptions help reduce the chance of breastfeeding, such as aesthetically motivated breast operations or if a separation of mother and baby after birth is unnecessarily prolonged. In addition, our natural desire for information societies has caused multiple parenting theories to shoot out of the grounds. Instead of helping reduce new parent’s fears they tend to increase and even confuse them. One of the often cited parent strategies is “feeding on schedule”. However, feeding in intervals causes unnecessary stress because the composition of the milk changes in a way that causes baby to feel hungry all the time. As a result, the mother will think that she does not produce enough milk whereas the truth is that she has waited too long.
Modern ways of living can make it extremely difficult for new mothers to embrace breast feeding. Their cultural background, lack of support within their own family or friends and misleading parenting information facilitate the return to bottle feeding. Moreover, cultural expectations of women who often have to return to work early in order to earn a living or pursue a career do not improve early parenting conditions.
While breast feeding is part of our natural survival strategy, bottle feeding is part of our modern culture. It gives new mothers the chance to cope easier with expectations and to help handle natural infant needs in an over-regulated world. We are aware of the fact that human milk is best for baby. Thus, it is the mother’s individual choice of how to feed her infant and to build a strong bond.
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