Previously we have shared the guidelines pertaining to the early initiation and continuation of breast feeding and complementary feeding for newborns and infants. However there are concerns regarding breast feeding for women living with HIV. In particular, evidence has been reported that antiretroviral (ARV) interventions to either the HIV-infected mother or HIV-exposed infant can significantly reduce the risk of postnatal transmission of HIV through breastfeeding. This evidence has major implications for how women living with HIV might feed their infants, and how health workers should counsel these mothers. In light of this, the World Health Organization (WHO) commenced a guideline development process, culminating in a Guideline Development Group meeting in Geneva on 22–23 October 2009. We share here the revised guidelines by WHO for principles and recommendations for infant feeding inthe context of HIV.
Kangaroo mother care to reduce morbidity and mortality and improve growth in low birth weight infants-The Guidelines
by Jai K DasFor many small preterm infants, receiving prolonged medical care is important. However, kangaroo mother care (KMC) is an effective way to meet baby’s needs for warmth, breastfeeding, protection from infection, stimulation, safety and love. Kangaroo mother care is care of preterm infants carried skin-to-skin with the mother. It is a powerful, easy-to-use method to promote the health and well-being of infants born preterm as well as full-term. We share the WHO guidleines regarding KMC.
Low birth weight (LBW) has been defined by the World Health Organization (WHO) as weight at birthless than 2500 g. LBW infants are at higher risk of early growth retardation, infectious disease, developmental delay and death during infancy and childhood. Experience from developed and low- and middle-income countries has clearly shown that appropriate care of LBW infants, including feeding, temperature maintenance, hygienic cord and skin care, and early detection and treatment of complications, can substantially reduce mortality in this highly vulnerable group. Interventions to improve feeding are likely to improve the immediate and longerterm health and well-being of the individual infant and have a significant impact on neonatal and infant mortality levels in the population. We share the WHO guidelines for feeeding in LBW infants.
About one third of deaths in children under 5 years of age are due to underlying undernutrition, which includes stunting, severe wasting, deficiencies of vitamin A and zinc, and suboptimum breastfeeding. Childhood malnutrition is prevalent in low and middle income countries (LMICs). According to an estimate, 19.4% of children <5 years of age in these countries are underweight (weight-for-age Z score <-2) and about 29.9% are stunted in the year 2011 (height-for-age Z score <-2). The prevalence of both underweight and stunting was highest in Africa and South-Central Asia and stunting and wasting along with intrauterine growth restriction (IUGR) are responsible for about 2.1 million deaths worldwide in children <5 years of age. It is well recognized that the period of 6-24 months of age is one of the most critical time periods in the growth of the infant. The incidence of stunting is the highest in this period as children have high demand for nutrients and there are limitations in the quality and quantity of available foods, especially after exclusive breastfeeding.
Special Community Case Management Supplement in the American Journal of Tropical Medicine and Hygiene
by Jai K DasWhether breast cancer screening does more harm than good has been debated extensively. The main questions are how large the benefit of screening is in terms of reduced breast cancer mortality and how substantial the harm is in terms of overdiagnosis, which is defined as cancers detected at screening that would not have otherwise become clinically apparent in the woman's lifetime.
Essential Interventions, Commodities and Guidelines for Reproductive, Maternal, Newborn and Child Health
by Jai K DasResearch reporting guidelines are standard statements that provide guidance on how to report research methodology and findings. These are in the form of checklists, flow diagrams or texts. Most of the biomedical journals require authors to comply with these guidelines. Guidelines are available for reporting various study designs:
- CONSORT Statement (reporting of randomized controlled trials)
- STARD (reporting of diagnostic accuracy studies)
- STROBE (reporting of observational studies in epidemiology)
- PRISMA (reporting of systematic reviews)
- MOOSE (reporting of meta-analyses of observational studies)
The Effect of Adding Ready-to-Use Supplementary Food to a General Food Distribution on Child Nutritional Status and Morbidity: A Cluster-Randomized Controlled Trial
by Jai K DasSerious and Life-Threatening Pregnancy-Related Infections: Opportunities to Reduce the Global Burden
by Courtney A. GravettThis Policy Forum article aims to highlight opportunities for screening and appropriate treatment of life-threatening pregnancy-related interventions.
This report by the WHO shows the current burden of childhood mortality, with some progress towards meeting MDG 4. However, this rate of progress is not sufficient to meet the MDG 4.
This article is an introduction to cluster randomised trials.