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Biomedical subjects

E Helsing

Publications and source records attributed to E Helsing.

At least 19 recordsLinked to original sources
PubMed2002

Breastfeeding, baby friendliness and birth in transition in North Western Russia: a study of women's perceptions of the care they receive when giving birth in six maternity homes in the cities of Archangelsk and Murmansk, 1999.

UNLABELLED: Women's own views on the quality of the birthing care they received were recorded in a small study in the cities of Archangelsk and Murmansk in February 1999. Six maternity wards took part; one hospital had already been designated as a Baby Friendly Hospital (BFH) according to the strict global criteria of the WHO/UNICEF-recommended Baby Friendly Hospital Initiative (BFHI). Two of the hospitals had made profound changes in feeding routines and were by their own reckoning close to achieving this distinction, and were included in the BFH group. Three maternity wards were far from being in compliance with the BFHI approach and were grouped as the Non-Baby-Friendly Hospitals (NBFH). A total of 180 newly delivered mothers answered a 60-item questionnaire about their birthing and breastfeeding experiences. The questions were chosen from an existing protocol, the WEB (Women's Experiences of Birth) developed by one of the authors (BC). The study was part of an informal evaluation of five years of BFHI activities in the Barents Region, supported by Norway, and also aimed at recording any positive carry-over effect of the BFHI into obstetric routines as a whole. CONCLUSION: It was found that the project definitely had had an impact; feeding practices at the BFH were markedly closer to the international BFHI recommendations than at the NBFH. BFH mothers, however, reported suffering from breastfeeding problems just as often or more so than NBFH mothers. Possible explanations are discussed; it is concluded that this cross-sectional study may depict a transitory situation in the BFH. At the two hospitals not yet assessed, although staff felt that they had made profound changes, they may not yet have grasped the full extent and stringency of the changes required. The study shows that, despite good will, some practical details had not yet been worked out, resulting in a mixed outcome for the mothers. There was no noticeable carry-over of the attitudes and basic ideas of the project into obstetric care, either in the BFH or in the NBFH, so changes in this area may require separate strategies.

Adult↗
PubMed2001

Exclusive breastfeeding in the era of AIDS.

The aim of this study was to describe breastfeeding practices, as well as what pregnant women know about breastfeeding and mother-to-child transmission (MTCT) of HIV, and explore factors associated with exclusive breastfeeding, especially in the presence of HIV/AIDS. A cross-sectional interview survey of 500 pregnant women was conducted in the Kilimanjaro region, supplemented by focus group discussions with pregnant women. Among the 309 mothers having previously breastfed, 85% had initiated breastfeeding within the first few hours postpartum, and 18% of newborns received some prelacteal food. Mean duration of breast-feeding was 23.7 months, but 46% of mothers had introduced other fluids early. Knowledge of HIV-transmission through breastfeeding was not associated with breastfeeding practices. Married women (odds ratio [OR] = .09, 95% confidence interval [CI] = .04-.24) and those having knowledge of exclusive breastfeeding (OR = .08, 95% CI = .02-.31) were the least likely to end exclusive breastfeeding early. Exclusive breastfeeding is a rare practice, and MTCT of HIV may further complicate recommendations with regard to this practice.

Adolescent↗
PubMed2000

Promotion of breastfeeding intervention trial (PROBIT): a cluster-randomized trial in the Republic of Belarus. Design, follow-up, and data validation.

This paper summarizes the objectives, design, follow-up, and data validation of a cluster-randomized trial of a breastfeeding promotion intervention modeled on the WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI). Thirty-four hospitals and their affiliated polyclinics in the Republic of Belarus were randomized to receive BFHI training of medical, midwifery, and nursing staffs (experimental group) or to continue their routine practices (control group). All breastfeeding mother-infant dyads were considered eligible for inclusion in the study if the infant was singleton, born at > or = 37 weeks gestation, weighed > or = 2500 grams at birth, and had a 5-minute Apgar score > or = 5, and neither mother nor infant had a medical condition for which breastfeeding was contraindicated. One experimental and one control site refused to accept their randomized allocation and dropped out of the trial. A total of 17,795 mothers were recruited at the 32 remaining sites, and their infants were followed up at 1, 2, 3, 6, 9, and 12 months of age. To our knowledge, this is the largest randomized trial ever undertaken in area of human milk and lactation. Monitoring visits of all experimental and control maternity hospitals and polyclinics were undertaken prior to recruitment and twice more during recruitment and follow-up to ensure compliance with the randomized allocation. Major study outcomes include the occurrence of > or = 1 episode of gastrointestinal infection, > or = 2 respiratory infections, and the duration of breastfeeding, and are analyzed according to randomized allocation ("intention to treat"). One of the 32 remaining study sites was dropped from the trial because of apparently falsified follow-up data, as suggested by an unrealistically low incidence of infection and unrealistically long duration of breastfeeding, and as confirmed by subsequent data audit of polyclinic charts and interviews with mothers of 64 randomly-selected study infants at the site. Smaller random audits at each of the remaining sites showed extremely high concordance between the PROBIT data forms and both the polyclinic charts and maternal interviews, with no evident difference in under- or over-reporting in experimental vs control sites. Of the 17,046 infants recruited from the 31 participating study sites, 16,491 (96.7%) completed the study and only 555 (3.3%) were lost to follow-up. PROBIT's results should help inform decision-making for clinicians, hospitals, industry, and governments concerning the support, protection, and promotion of breastfeeding.

Adult↗
PubMed1997

On the clear need to meet and learn to speak clearly: statement from the World Health Organization.

Dietary assessment, a young subspecialty of nutrition science, includes most of the elements that are unique to the science. The lack of common definitions of terms, and hence, of an unequivocal terminology, often frustrates communication efforts in the field. Furthermore, scientists from the easternmost parts of Europe, whose career advancement depended for a long time on avoiding mistakes, may find it enigmatic that dietary assessment methods demand a focus on finding and describing errors. The opportunity to meet and exchange views in the classic way--by direct dialogue--that is offered by conferences such as this one should help to bring about the common understanding required for good communication.

Diet↗
PubMed1997

Nutrition monitoring of Russian schoolchildren in a period of economic change: a World Health Organization multicenter survey, 1992-1995.

Annual surveys of the food intakes and nutritional status of schoolchildren (aged 10 and 15 y) in a Moscow district were conducted in 1992-1995, a period of rapid economic transformation in Russia. Food intake was assessed through use of two 24-h recalls. A few socioeconomic variables-parental educational level, family size, participation in organized sports, and use of school breakfast and lunch options-were included in the dietary interview. Nutritional status was assessed by measurement of height and weight and comparison with international standards. There was a slight difference in the food pattern in the two age groups and some differences between boys and girls. Milk and other dairy products, fruit, juices, and vegetables were consumed in small quantities and relatively infrequently. Bread and bread products, porridge, confectionery, and meat and meat products were consumed more frequently and in larger quantities. Protein contributed approximately 12% and fat 29-32% of dietary energy. About 70% of the subjects had low intakes of riboflavin and calcium compared with reference values. Mean nutrient intakes did not change significantly during the study period. During the first 3 y of the study period, there was a nonsignificant overall decrease in height and weight but this was within the limits of normal variation.

Adolescent↗
PubMed1995

Traditional diets and disease patterns of the Mediterranean, circa 1960.

The 16 countries that border the Mediterranean sea differ markedly in geography, as well as in the health, political institutions, and economic status of their populations. Although many studies have examined the effects of lifestyle factors on the health of Mediterranean populations, few have investigated nutritional aspects, and even fewer have examined dietary patterns across countries. Few sources of data permit comparison of food and nutrient intakes among the various Mediterranean populations. I explore the concept of a Mediterranean diet through analysis of World Health Organization standardized mortality data and the only available data on food patterns throughout the region, the Food and Agriculture Organization food balance sheets, from the early 1960s to the present. Caveats about the use of food balance data are well known; they reflect disappearance of food groups from the marketplace, and only indirectly indicate information about dietary intake. Even with these limitations, the data indicate some similarities in the food availability patterns of Mediterranean countries: a relatively high proportion of energy from cereals, vegetables, and fruits, relatively less meat consumption than in northern Europe, and greater reliance on vegetable than on animal fats. This pattern is associated with distinctly lower rates of chronic diseases than those found in many developed countries in Europe and elsewhere. Changes in health patterns during the past 30 y reflect changes in food availability patterns during that period toward those more typical of northern Europe and the United States.

Cerebrovascular Disorders↗
PubMed1995

Mediterranean diet pyramid: a cultural model for healthy eating.

We present a food pyramid that reflects Mediterranean dietary traditions, which historically have been associated with good health. This Mediterranean diet pyramid is based on food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s, where adult life expectancy was among the highest in the world and rates of coronary heart disease, certain cancers, and other diet-related chronic diseases were among the lowest. Work in the field or kitchen resulted in a lifestyle that included regular physical activity and was associated with low rates of obesity. The diet is characterized by abundant plant foods (fruit, vegetables, breads, other forms of cereals, potatoes, beans, nuts, and seeds), fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts, normally with meals. This diet is low in saturated fat (< or = 7-8% of energy), with total fat ranging from < 25% to > 35% of energy throughout the region. The pyramid describes a dietary pattern that is attractive for its famous palatability as well as for its health benefits.

Animals↗
PubMed1995

Changes in breastfeeding practices in Norwegian maternity wards: national surveys 1973, 1982 and 1991.

Total breastfeeding rates in Norway increased from < 30% at 12 weeks in 1968 to > 80% in 1991. Concomitant changes in routines related to breastfeeding in all Norwegian maternity wards were examined in 1973, 1982 and 1991. Head midwives responding to identical survey questionnaires described "usual practices" in their wards. The considerable changes over these 18 years reflected international recommendations such as those summarized in WHO/UNICEF's 1989 Joint Statement and "Ten steps to successful breastfeeding". Undisturbed and prolonged contact between mother and baby became more common, as did more respect for the needs of the nursing couple, and more individualized care. In responses to open-ended questions, many respondents expressed a positive attitude towards these changes, while "clusters" of negative attitudes were also seen. As research on inborn infant behaviour and mother-infant interaction proceeds, the present survey suggests areas where further information may benefit both mothers and health workers.

Breast Feeding↗
PubMed1994

Dietary assessment issues of concern to policymakers: statement from the World Health Organization.

The uses of dietary assessment are many and are increasing as are the demands for better quality of the dietary data collected. International meetings on dietary-assessment methodology provide opportunities for sharing experiences and for in-depth discussion among those from different countries who are working to solve similar problems. Although the state of assessment methodology has improved, continued efforts are needed worldwide to further enhance expertise in dietary assessment at local levels. Strategies to improve dietary assessment include increasing awareness among policymakers and academics of the existence of high-quality information about what people eat and how this information may or may not be used, improving communication and dissemination of available nutrition information, and continuing to improve the quality of the information collected and the speed with which it is put to use.

Epidemiologic Methods↗
PubMed1992

Food and drugs: the perils of plenty.

The abundance of both food and pharmaceuticals in much of Europe has brought serious health problems as well as benefits. It is no longer possible to assess the quality of most products on the basis of physical examination, and labels often carry information that is incomprehensible to lay persons. Governments should ensure that consumers can understand both the broad principles of healthy living and the nature of the foodstuffs and medicines on offer. It is also important that prescribers be kept abreast of developments in the pharmaceutical field.

Drug Labeling↗
PubMed1991

Unsupplemented breastfeeding in the maternity ward. Positive long-term effects.

Feeding routines in the maternity ward were investigated in 204 mother-infant pairs before and in 203 after a change towards earlier, more frequent breastfeeding and elimination of routine substitute feeds. In the intervention group, the volume of breast-milk increased, while the use of formula and sugar solution decreased correspondingly. The infants in the intervention group lost more weight during the first 2-3 days (6.4% versus 4.6%), but regained their birth weight faster than the supplemented control group. The incidence of hyperbilirubinemia was not significantly different in the two groups. No cases of hypoglycemia were diagnosed. At 6 months, 87% of the infants in the intervention group were still fed at the breast, compared with 66% in the control group. The weight curves were comparable up to 9 months, when intervention group infants were found to weigh slightly less. These follow-up results must be interpreted with some caution due to the low but comparable response rate of the two groups. Thus the intervention study demonstrated that healthy, full-term infants usually have no need for supplements to their mothers' milk provided they have had a satisfactory start in life with early and frequent feeds at the breast. The follow-up study indicated that a more "physiological" start of breastfeeding may have had a positive long term effect on the overall duration of the lactational period.

Breast Feeding↗