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Human milk banking.
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Lactose Intolerance and Health U.S.
- Clinical Report Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (03 Years of Age)
- Recommendations for the Prevention of Streptococcus pneumoniae Infections in Infants and Children: Use of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and Pneumococcal Polysaccharide Vaccine (PPSV23)
- Cystic Fibrosis Pulmonary Guidelines
Human milk banking.
It is universally accepted that breast milk is the optimum exclusive source of nutrition for the first six months of life, and may remain part of the healthy infant diet for the first two years of life and beyond. Despite advances in infant formulas, human breast milk provides a bioactive matrix of benefits that cannot be replicated by any other source of nutrition. When the mother's own milk is unavailable for the
sick, hospitalized newborn, pasteurized human donor breast milk should be made available as an alternative feeding choice followed by commercial formula. There is a limited supply of donor breast milk in Canada and it should be prioritized to sick, hospitalized neonates who are the most vulnerable and most likely to benefit from exclusive human milk feeding.
Key Words: Breast milk; Human donor breast milk; Human milk banking;
Preterm infant
http://consensus.nih.gov/2010/lactose.htm
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Lactose Intolerance and Health U.S. Department of Health and Human Services
Lactose Intolerance and Health U.S. Department of Health and Human Services
National Institutes of Health Volume 27, Number 2 February 22–24, 2010
NATIONAL INSTITUTES OF HEALTH
NIH State-of-the-Science Conference Statement on Lactose Intolerance and Health
Objective
To provide healthcare providers, patients, and the general public with a responsible assessment of currently available data on lactose intolerance and health.
Participants A non-Department of Health and Human Services, nonadvocate 14-member panel representing the fields of internal medicine, pediatrics, pediatric endocrinology, gastroenterology, hepatology, neonatology and perinatology, geriatrics, radiology, maternal and fetal nutrition, vitamin and mineral metabolism,
nutritional sciences, bone health, preventive medicine, biopsychology, biostatistics, statistical genetics, and epidemiology and a public representative. In addition,
22 experts from pertinent fields presented data to the panel and conference audience.
Evidence Presentations by experts and a systematic review of the literature prepared by the University of Minnesota Evidencebased Practice Center, through the Agency for Healthcare Research and Quality (AHRQ). Scientific evidence was given precedence over anecdotal experience.
Conference Process The panel drafted its statement based on scientific
evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the
audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. 2 This statement is an independent report of the panel
and is not a policy statement of the National Institutes of Health (NIH) or the Federal Government. Conclusions • Lactose intolerance is a real and important clinical syndrome, but its true prevalence is not known.• The majority of people with lactose malabsorptiondo not have clinical lactose intolerance. Many individuals who think they are lactose intolerant are not lactose malabsorbers. • Many individuals with real or perceived lactose intolerance avoid dairy and ingest inadequate amounts of calcium and vitamin D, which may predispose them
to decreased bone accrual, osteoporosis, and other adverse health outcomes. In most cases, individuals do not need to eliminate dairy consumption completely.
• Evidence-based dietary approaches with and without dairy foods and supplementation strategies are needed to ensure appropriate consumption of calcium and other nutrients in lactose-intolerant individuals.
• Educational programs and behavioral approaches for individuals and their healthcare providers should be developed and validated to improve the nutrition and symptoms of individuals with lactose intolerance and
dairy avoidance.
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Clinical Report Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (03 Years of Age).
Baker RD, Greer FR .Clinical Report Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (03 Years of Age). Pediatrics Volume 126, Number 5, November 2010
FROM THE AMERICAN ACADEMY OF PEDIATRICS
This clinical report covers diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants (both breastfed and formula fed) and toddlers from birth through 3 years of age. Results of recent basic research support the concerns that iron-deficiency anemia and iron deficiency without anemia during infancy and childhood can have longlasting detrimental effects on neurodevelopment. Therefore, pediatricians and other health care providers should strive to eliminate iron deficiency and iron-deficiency anemia. Appropriate iron intakes for
infants and toddlers as well as methods for screening for iron deficiency
and iron-deficiency anemia are presented. Pediatrics 2010;126: 000
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Recommendations for the Prevention of Streptococcus pneumoniae Infections in Infants and Children: Use of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and Pneumococcal Polysaccharide Vaccine (PPSV23)
Routine use of the 7-valent pneumococcal conjugate vaccine (PCV7), available since 2000, has resulted in a dramatic reduction in the incidence of invasive pneumococcal disease (IPD) attributable to serotypes of Streptococcus pneumoniae contained in the vaccine. However, IPD caused by nonvaccine pneumococcal serotypes has increased, and nonvaccine serotypes are now responsible for the majority of the remaining cases of IPD occurring in children. A 13-valent pneumococcal conjugate vaccine has been licensed by the US Food and
Drug Administration, which, in addition to the 7 serotypes included in the original PCV7, contains the 6 pneumococcal serotypes responsible for 63% of IPD cases now occurring in children younger than 5 years. Because of the expanded coverage provided by PCV13, it will replace PCV7. This statement provides recommendations for (1) the transition from PCV7 to PCV13; (2) the routine use of PCV13 for healthy children and children with an underlying medical condition that increases the risk of IPD; (3) a supplemental dose of PCV13 for (a) healthy children 14 through 59 months of age who have completed the PCV7 series and (b) children 14 through 71 months of age with an underlying medical condition that increases the risk of IPD who have completed the PCV7 series; (4) "catch-up" immunization for children behind schedule; and (5) PCV13 for certain children at high risk from 6 through 18 years of age. In addition, recommendations for the use of pneumococcal polysaccharide vaccine for children at high risk of IPD are also updated. Pediatrics 2010;126:186–190
COMMITTEE ON INFECTIOUS DISEASES
KEY WORDS
pneumococcal vaccine, invasive pneumococcal disease, immunization, PCV7, PCV13, PPSV23
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Cystic Fibrosis Pulmonary Guidelines
Pulmonary Complications: Hemoptysis and Pneumothorax-Patrick A. Flume, Peter Mogayzel, J Jr., Robinson KA, Rosenblatt RL, Quittell L, Marshall BC, and the Clinical Practice Guidelines for Pulmonary Therapies Committee* Am. J. Respir. Crit. Care Med Vol 182, 2010,:298-306
Rationale: Cystic fibrosis (CF) is a recessive genetic disease characterized by dehydration of the airway surface liquid and impaired mucociliary clearance. As a result, individuals with the disease have difficulty clearing pathogens from the lung and experience chronic pulmonary infections and inflammation. There may be intermittent pulmonary exacerbations or acute worsening of infection and obstruction, which require more intensive therapies. Hemoptysis and pneumothorax are complications commonly reported in patients with cystic fibrosis.
Objectives: This document presents the CF Foundation's Pulmonary Therapies Committee recommendations for the treatment of hemoptysis and pneumothorax.
Methods: The committee recognized that insufficient data exist to develop evidence-based recommendations and so used the Delphi technique to formalize an expert panel's consensus process and develop explicit care recommendations.
Measurements and Main Results: The expert panel completed the survey twice, allowing refinement of recommendations. Numeric responses to the questions were summarized and applied to a priori definitions to determine levels of consensus. Recommendations were then developed to practical treatment questions based upon the median scores and the degree of consensus.
Conclusions: These recommendations for the management of the patient with CF with hemoptysis and pneumothorax are designed for general use in most individuals but should be adapted to meet specific needs as determined by the individuals, their families, and their health care providers. It ishopedthat the guidelines providedin this manuscript will facilitate the appropriate application of these treatments to improve and extend the lives of all individuals with
cystic fibrosis.
Keywords: cystic fibrosis; hemoptysis; pneumothorax; complications;
guidelines
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