This diploma thesis explores the ways in which physiotherapeutic procedures and concepts can be used to positively affect puerperium after a physiological childbirth. The beginning of the theoretical part describes the physiology of puerperium, lactation, women's psychological well- being during the postpartum period and postpartum complications. The main part of the thesis focuses on the application of physiotherapeutic methods and concepts during puerperium. The output of this part forms an information handout with exercises appropriate throughout puerperium. In the practical part of the thesis, a questionnaire survey of two groups of women at the end of puerperium took place to objectively evaluate the effect of the information handout. The aim was to find out whether women who are prepared for the puerperium and know how to use targeted exercises to support the regeneration of the body after childbirth experience a milder course of the puerperium, feel psychologically better and evaluate their breastfeeding effectiveness more positively. The experimental group (n = 32) received the information handout during pregnancy and used it in puerperium. The control group (n = 37) did not receive the handout. The standardized Edinburgh Postnatal Depression Scale questionnaire was used to assess the...

OBJECTIVE: This study was conducted to compare the relative influence of the socioeconomic status of both mothers and fathers on feeding method and cosleeping. METHODS: The time and method of feeding and sleeping were recorded in a log during the 4th-week postpartum and analyzed according to the parental Hollingshead Index of Social Position in 33 families with their first newborn. RESULTS: The effect of socioeconomic status on feeding and sleep was parent specific. Low socioeconomic status of the mother, but not the father, was associated with cosleeping (t ≤ 2.39, P < .01); whereas, a low socioeconomic status of the father, but not the mother, was associated with bottle-feeding rather than breast-feeding (t ≤ 1.94, P < .05). CONCLUSIONS: Socioeconomic status of the parents differentially affects neonatal care. Programs to increase breast-feeding rates would be most effective if designed for and aimed at the fathers. Copyright © 2007 Wolters Kluwer Health | Lippincott Williams and Wilkins.

Bakgrund: WHO och UNICEF förespråkar amningsstart direkt efter förlossning och rekommenderar att helamning fortgår under barnets första sex månader. Tidigare forskning visar att mammor upphör med amningen tidigare och i många fall är det associerat med brist på stöd från omgivning och familj.  Syfte: Syftet med denna studie var att identifiera och syntetisera mammors upplevelser av hur specialistsjuksköterskor på BVC skapar amningsstöd.  Metod: En metasyntes av kvalitativa artiklar har genomförts. Sökning av artiklar gjordes via databaserna Cinahl och PubMed. De 15 kvalitativa artiklarna har analyserats utifrån Noblit och Hares (1988) sju steg. Resultat: I resultatet framkom två huvudteman Emotionellt, informativt och praktiskt stöd samt Socialt stöd. Under det första huvudtemat framkom det fyra underteman; Konsekventa råd skapar en känsla av säkerhet belyser vikten av att specialistsjuksköterskan ger emotionellt stöd, tydlig och korrekt information om amning till mammor. Adekvat kunskap om amning ger ett ökat självförtroende som visar att när mammorna fick grundläggande amningskunskaper av specialistsjuksköterskan kunde amningen upprätthållas i större utsträckning. Känslan av att vara kompetent minskar skuldkänslor hos mammor och infinner sig när grundläggande kunskap ges. Känslomässigt stöd ökar mammors tilltro till kroppens egen förmåga handlar om mammor behov att få realistiskt och emotionellt amningsstöd. Det andra huvudtemat består av tre underteman. Närvaro från partner och familj har betydelse för amningsförmågan och Delaktighet i andra forum har betydelse för att känna sig motiverad till fortsatt amning belyser vikten av socialt, men även digitalt nätverk. Kontinuitet från specialistsjuksköterskan ger en känsla av lugn och harmoni och visar på vikten av ett fysiskt amningsstöd från specialistsjuksköterskan. Slutsats: Mammor som ammar sina barn är i behov av stöd tidigt i amningsprocessen. Det har framkommit att olika stöd är av vikt för mammor för att kunna upprätthålla amningen. Om stödet från specialistsjuksköterskan uteblir är det svårare för mammor att uppehålla amningen. En viktig del i stödet är att som specialistsjuksköterska kunna erbjuda kontinuitet för att ge en känsla av lugn och harmoni. Mammor behöver även de sociala stödet från partner, familj och andra forum för att gynna amningen. / Background: WHO and UNICEF advocate breastfeeding immediately after childbirth and recommend that babies continue to be breastfed exclusively for the first 6 months after childbirth. Previous research shows that mothers cease breastfeeding sooner, and in many cases it is associated with a lack of support from family and the surrounding environment. Purpose: The purpose of this study was to identify and synthesize how mothers experience the breastfeeding support provided by specialist nurses at pediatric clinics. Method: A qualitative metasynthesis has been completed. Searching of articles was performedby the databases Cinahl and PubMed. The final literature search yielded 15 qualitative articles and were analyzed according to Noblit and Hare’s seven steps. Result: From the result, two main themes emerged: Emotional, informative and practical support and Social support. Within the first main theme, four sub themes emerged; Consistent advice creates a sense of safety which highlights the importance of the specialist nurse providing emotional support and clear and correct information about breastfeeding to the mothers. Adequate knowledge about breastfeeding increases self-confidence shows that when the mothers received essential breastfeeding knowledge by the specialist nurse the breastfeeding could be maintained to a greater extent. The feeling of being competent decreases feelings of guilt in mothers when essential knowledge is provided. Emotional support increases mothers’ trust to their bodies’ capabilities comprised mothers' need for realistic and emotional breastfeeding support. The second main theme consists of three sub-themes. The presence of a partner and family is significant for the ability to breastfeed and Participating in other forums is of significance t to feeling motivated to continue breastfeeding highlights the importance of social but also digital networks. Continuity from the specialist nurse gives a sense of calm and ease, and shows the significance of physical breastfeeding support from the specialist nurse. Conclusion: Mothers that breastfeed their babies are in great need of support early on in the breastfeeding process. Without the support it is harder for mothers to maintain breastfeeding. It is evident that different types of support are significant for mothers to be able to maintain breastfeeding. The health benefits of breastfeeding are great. Previous research shows that breastfeeding can decrease risk of infections and Sudden Infant Death Syndrome, as well as mothers who breastfeed have a lower risk of breast cancer.

No / The aim of this research was to evaluate the effectiveness of a school-based intervention designed to enhance young people's motivations to breastfeed. A cluster randomized controlled trial was conducted involving 50 post-primary schools from across Northern Ireland. However, dropout and exclusion criteria utilized for the current study resulted in an effective sample size of 42 schools. The intervention was delivered in two 35-min classroom sessions targeting those beliefs identified by the theory of planned behaviour (TPB) as significant in predicting motivation to breastfeed. Questionnaires incorporating the key components of the TPB were administered to all intervention and control schools at baseline, 1 and 6 months post-intervention. Multi-level modelling was used to analyse the data. Findings suggest that the intervention was effective in that it increased females' intentions to breastfeed, expanded their knowledge and led to more favourable attitudes and perceptions of subjective norms. Notably, females' knowledge increased more in secondary schools than in grammar schools irrespective of whether they were control or intervention schools. The research has provided evidence to support the use of the TPB in the design and evaluation of an intervention to increase females' intentions to breastfeed.

Background: The international recommendation regarding breastfeeding is that children should be completely breastfed for the first six months and then partly up to two years. Despite recommendations on breastfeeding, together with proven health effects for the child and the mother, this is not a reality today. The question is what it could be due to, for some it is about medical reasons and for others it is about a lack of knowledge or a desire to share the feeding with their partner. Regardless of the reason, it is important as a specialised nurse to be able to support in an adequate way.  Purpose: The aim was to describe how specialised nurses within child health care support mothers to breastfeed. Method: Semi-structured interviews were conducted with specialised nurses working within child health care in south-west Sweden. Seven specialised nurses participated in the study. The data was analyzed inductively with qualitative content analysis according to Graneheim &amp; Lundman (2004). Result: The data analysis resulted in three categories: "The importance of having a good attitude" which implied specialised nurses attitude towards the family and "The importance of using different strategies" was about being able to adapt the nursing based on the unique situation. The third category "The importance of obtaining information" described the need of obtaining knowledge to be able to support in an adequate way. All categories had associated subcategories. Conclusion: The specialised nurses described that their treatment was an important part of their work and strove for an open approach. They needed to include the whole family and adapt the care to their wishes. Previous research confirms that an optimal support can contribute to a well-functioning breastfeeding.

No description available.

This study investigated stable-isotope ratio evidence of weaning for the late Anglo-Saxon population of Raunds Furnells, Northamptonshire, UK. delta(15)N and delta(13)C values in rib collagen were obtained for individuals of different ages to assess the weaning age of infants within the population. A peak in delta(15) N values at about 2-year-old, followed by a decline in delta(15) N values until age three, indicates a change in diet at that age. This change in nitrogen isotope ratios corresponds with the mortality profile from the site, as well as with archaeological and documentary evidence on attitudes towards juveniles in the Anglo-Saxon period. The pattern of delta(13) C values was less clear. Comparison of the predicted age of weaning to published data from sites dating from the Iron Age to the 19th century in Britain reveals a pattern of changing weaning practices over time, with increasingly earlier commencement and shorter periods of complementary feeding in more recent periods. Such a change has implications for the interpretation of socioeconomic changes during this period of British history, since earlier weaning is associated with decreased birth spacing, and could thus have contributed to population growth.

Problématique. Basée sur les constats effectués lors d’un essai clinique randomisé qui visait à évaluer les effets du lait maternel de fin d’expression sur la croissance et le développement de nouveau-nés prématurés et qui s’est soldé par un recrutement infructueux, une intervention de soutien à la lactation chez les mères de nouveau-nés prématurés a été développée. La mère d’un nouveau-né prématuré est en effet trois fois plus à risque qu’une autre de présenter une production lactée insuffisante. Il est donc crucial de soutenir ces mères dans l’établissement et le maintien d’une production lactée adéquate. Le but de cette étude pilote est d’estimer les effets d’une intervention de soutien à la lactation sur l’expression de lait maternel et la production lactée de mères ayant donné naissance prématurément ainsi que d’évaluer les aspects d’acceptabilité et de faisabilité de l’intervention, de l’étude et de ses procédures. Hypothèse de recherche. Les mères de nouveau-nés prématurés qui reçoivent une intervention de soutien à la lactation expriment leur lait significativement plus longtemps et plus fréquemment et produisent significativement un plus grand volume de lait à plus grande concentration lipidique sur une base quotidienne que celles qui reçoivent les soins usuels. Méthode. Devis : Projet-pilote de type essai clinique randomisé. Échantillon: Quarante mères de nouveau-nés prématurés de <30 semaines de gestation admis à une unité de soins intensifs néonatals. Procédures: Les mères du groupe témoin reçoivent les soins usuels alors que celles du groupe expérimental reçoivent une intervention de soutien à la lactation. Cette dernière comporte quatre volets: une séance d’enseignement portant sur l’établissement et le maintien d’une production lactée suffisante, un suivi téléphonique, une ligne d’aide téléphonique et le prêt d’un tire-lait électrique double pompage. Dans les deux groupes, les mères sont amenées à tenir un journal de bord de leurs séances d’expression et du volume de lait maternel exprimé. Résultats. L’étude et ses procédures de même que l’intervention de soutien sont acceptables et faisables. Les résultats observés en lien avec l’hypothèse de recherche sont orientés dans la même direction que cette dernière à l’exception de la concentration lipidique du lait maternel. Recommandations. Une étude à plus grande échelle doit être réalisée afin d’évaluer les effets de l’intervention de soutien à la lactation sur la production lactée de mères de nouveau-nés prématurés. Quant à la clinique, des actions concertées doivent être menées afin de créer un contexte propice et des conditions favorables à l’expression de lait maternel chez les mères de nouveau-nés prématurés. / Problem statement. Based on observations from an unsuccessful randomized clinical trial that aimed to evaluate the effects of hindmilk on the short-term growth and development of preterm infants, a lactation support intervention for mothers of preterm infants has been developed. Mothers who give birth prematurely are three times more likely to have an insufficient milk output compared to those who give birth at term. It is therefore crucial to support these mothers in order to facilitate the establishment and maintenance of their milk supply. The aim of this pilot study is to estimate the effects of a lactation support intervention on the expression of breast milk and milk output of mothers who gave birth prematurely and assess the acceptability and feasibility of the intervention, study and its procedures. Research hypothesis. A lactation support intervention in mothers who deliver prematurely enables them to express their milk significantly longer and more frequently, and produce a greater milk output with a higher lipid concentration compared to mothers who deliver prematurely and receive usual care. Method. Design: A pilot study of a randomized clinical trial. Sample: Forty mothers of preterm infants born at <30 weeks of gestation and admitted to a neonatal intensive care unit. Procedures: The mothers in the control group receive usual care while those in the experimental group receive a lactation support intervention. The intervention has four components: an education session on the establishment and maintenance of an adequate milk supply, a telephone follow-up, a telephone helpline and the loan of a double electric breast pump. In both the intervention and control groups, mothers kept a logbook of the frequency, duration and volume of their breast milk expressions. Results. Both the study design and the intervention are feasible and acceptable to mothers of preterm infants. With the exception of milk lipid concentration, the results are oriented in the same direction as the research hypothesis. Recommendations. A larger scale study should be conducted to evaluate the effects of the lactation support intervention on the frequency, duration, and volume of breast milk expression among mothers of premature infants. As for the clinical practice, concerted interprofessional actions must be undertaken to create the environment and conditions conducive to breast milk expression in these mothers.

Thesis "Myofunctional disorder of children" is about myofunctional disorder with a focus on logopedics and issues of human speech. The whole work has, however, significantly multidisciplinary character. The theoretical part of the thesis is focused on orofacial complex, swallowing and speech complex in all its breadth. It is also focused on nutrition problems at an early age and on related activities. Readers can also find information about orthodontic anomalies that are directly related to myofunctional disorder. A large area is dedicated to myofunctional disorder itself - terminology, etiology, symptomatology, diagnosis, prevention and therapy. As an important section of practical part of the work serves a research on a sample of 15 children diagnosed with myofunctional disorder. The sample was subjected to qualitative analysis, where an outcome demonstrates 3 case studies demonstrating the degree of seriousness of 3 myofunctional disorders. Additionally, there is also simple quantitative analysis and its outcome is an overview chart. KEYWORDS Myofunctional disorder, orofacial, tongue, ortodontic anomalies, breast- feeding, suckling, mastification, swallowing, speech - articulation.

INTRODUÇÃO: Alimentação adequada e saudável é essencial para o pleno desenvolvimento infantil. A alimentação complementar (AC) deve ser iniciada de maneira oportuna e segura, suprindo as necessidades nutricionais da criança. Mães com depressão pós-parto (DPP) apresentam dificuldades nos cuidados gerais e nas práticas relacionadas à alimentação da criança. O objetivo do presente estudo é verificar a associação entre DPP e introdução precoce de alimentos complementares (IPAC), aos 4 meses de idade da criança, e descrever a frequência de alimentos introduzidos precocemente. METODOLOGIA: Estudo transversal, realizado entre agosto de 2013 a agosto de 2014, a partir de dados coletados entre 6 e 9 meses após o parto de 326 puérperas que já haviam participado de ensaio de comunidade (PROGRAVIDA). Dados referentes a IPAC e outras informações foram coletados por meio de questionário estruturado. A DPP foi avaliada por meio do \"Patient Health Questionnaire-9\". Modelos de regressão de Poisson com variância robusta, seguindo modelo hierárquico, foram usados para avaliar a associação entre DPP e IPAC. No modelo bruto foi estimada a razão de prevalência (RP) e o intervalo de confiança de 95% (IC95%) entre DPP e IPAC, levando-se em conta a randomização das participantes no estudo original. No modelo multivariado foram estimadas as RP e IC95% entre DPP e IPAC, ajustadas por variáveis sócio demográficas e socioeconômicas (etnia, escolaridade, renda familiar mensal, situação de trabalho materno e situação conjugal), dados maternos (idade, número de filhos e tipo de parto), dados perinatais (idade da criança e peso ao nascer) e dados da criança (uso de chupeta e aleitamento materno). A análise estatística foi realizada com uso do programa STATA 12 e o nível de significância estatística foi considerado igual ou inferior a 5%. RESULTADOS: A prevalência geral de IPAC foi de 75,8% (IC95% 0,71-0,80). No modelo bruto, não foi encontrada associação entre depressão e IPAC (RP:0,97; IC 95% 0,83 - 1,14). Na análise multivariada, constatou-se menor prevalência de IPAC entre mulheres que ainda amamentavam aos 6 meses, naquelas que trabalhavam fora e entre aquelas com menor renda familiar. A estimativa da associação bruta entre DPP e IPAC não se modificou significativamente após ajustes para possíveis variáveis confundidoras. Portanto, puérperas com depressão grave à moderada não apresentaram diferenças na IPAC, comparadas às mulheres sem depressão ou com depressão leve (RP:0,96; IC 95% 0,81 - 1,12). Os alimentos com maior proporção de introdução precoce foram água, chá e outros leites, e os com menor proporção foram carnes, arroz e feijão e massas, não havendo diferenças entre os grupos¸ segundo depressão materna. CONCLUSÃO: Verificou-se elevada prevalência de IPAC, independentemente dos níveis de depressão. Intervenções para restringir a IPAC não devem priorizar o estado de humor da mulher no puerpério, mas sim a prática do aleitamento e aspectos sociais, tais como renda familiar e trabalho externo da mãe / INTRODUCTION: Adequate and healthy feeding is essential for infant and child development. Complementary feeding must occur in timing and appropriately, supplying child´s nutritional needs. Postpartum depressed (PPD) mothers show difficulties in general care and practices related to child´s feeding. The aim of this study is to verify the association between PPD and early complementary foods introduction (IPAC), at 4 months old, and to describe the frequency of early food\'s introduction. METHODOLOGY: Cross-sectional study, performed from August 2013 to August 2014, through data collected between 6 to 9 months after labor, from 326 puerperal women who had participated in a community trial (PROGRAVIDA). IPAC data and other information were collected via structured questionnaire. PPD was evaluated through the \"Patient Health Questionnaire-9\". Poisson regression models with robust variance, following a hierarchical model, were used to evaluate the association between PPD and IPAC. In the simplified model, the prevalence ratio (PR) and 95% confidence level (95%CI) between PPD and IPAC was estimated, taking into consideration the randomization of participants in the community trial. Multivariate models estimated the PR and 95%CI between PPD e IPAC, adjusted for socio-demographic and socioeconomic variables (ethnicity, education, monthly family income, employment and marital status), maternal data (age, number of children and type of delivery), perinatal data (age and birth weight) and child data (pacifier use and breastfeeding). The statistical analysis was performed with STATA 12 software and the significance level was considered equal or lower than 5%. RESULTS: The IPAC general prevalence was 75.8% (95%IC 0.71 - 0.80). In the simplified model no association was found between depression and IPAC (PR: 0.97; 95%CI 0.83 - 1.14). In the multivariate analysis, it was encountered a lower prevalence of IPAC among women who were still breastfeeding at 6 months, in those who worked out and among women with lower family income. The estimate of the simplified association between PPD and IPAC did not change significantly after adjustment for possible confounding variables. Therefore, postpartum women with severe to moderate depression did not present differences in IPAC, compared to women without depression or mild depression (PR: 0.96; 95%CI 0.81 - 1.12). Foods with a higher proportion of early introduction were water, tea and other milks, and the ones with the lowest proportion were meats, rice and beans and pasta, and there were no differences between the groups¸ according to maternal depression. CONCLUSION: There was a high prevalence of IPAC, independently of depression levels. Interventions to restrict IPAC should not prioritize woman\'s mood in the puerperium, but rather the practice of breastfeeding and social aspects, such as family income and mother\'s external work