Aguiar Hélder, Silva Ana Isabel
Unidade de Saúde Familiar Vale do Vouga, ACES Entre Douro e Vouga II - Aveiro Norte, Aveiro, Portugal.
Acta Med Port. 2011 Dec;24 Suppl 4:889-96. Epub 2011 Dec 31.
Breast milk is considered by the WHO the ideal food for the first months of life. Although health professionals are aware of recommendations, high rates of drop-outs have been identified in Portugal. A false notion of hypogalactia is the major factor for early termination, which is allied to the technical difficulties of the feeding. Health professionals, often lacking training in the area, may have difficulty in reassuring mothers in these situations. In Portugal, at the 3rd month, most mothers stop breastfeeding by indication of their medical assistant.
Gather evidence about the advantages of breast-feeding compared to artificial milk, and establish useful strategies in clinical practice to avoid early withdrawal.
A survey was conducted for articles from the last six years in the major sites of evidence-based medicine and reference sites (Pubmed, Cochrane, National Guideline Clearinghouse, Tripdatabase, WHO).
Breast-feeding is clearly associated with benefits to the infant, including significant protective effects for gastrointestinal infections (64%), middle ear (23- 50%), severe respiratory infections (73%) and for acute lymphocytic leukemia (19%) and sudden death syndrome in infants (36%). We also found long-term benefits, such as for obesity (7-24%) and other cardiovascular risk factors in adulthood. The mother also benefits from its protective effect for cancers of the breast and ovary, and diabetes mellitus type 2 as also, proportionate to the duration of breastfeeding. Health professionals have an important role in the initiation and continuation of breastfeeding. The notion of its advantages, the communication prior to delivery, accessibility support and training in technical aspects of correct picks are the proven strategies for evidence explored in the article.
Breast milk contains several unique and exclusive elements, orchestrators of its health benefits. Postnatal period is critical to the development of neuro--hypothalamic circuits involved in appetite control--nutritional programming--in which leptin, present in breast milk, appears to have a decisive role.
Despite scientific advances, breast milk continues to demonstrate clear advantages for human health in the short and long term. Proper feeding technique is not often achieved by the dyad mother-infant alone, warning for a greater involvement of health professionals. It is urgent to continue to insist on training for the improvement of the indices relating to this area in Portugal.
世界卫生组织认为母乳是婴儿出生后最初几个月的理想食物。尽管健康专业人员知晓相关建议，但葡萄牙的母乳喂养中断率依然很高。对乳汁分泌不足的错误认知是早期断奶的主要因素，这与喂养过程中的技术困难相关。健康专业人员往往缺乏该领域的培训，在这种情况下可能难以安抚母亲。在葡萄牙，到第3个月时，大多数母亲会根据其医疗助理的建议停止母乳喂养。
收集母乳喂养相较于人工喂养优势的证据，并在临床实践中确立避免过早断奶的有效策略。
对过去六年在主要循证医学网站和参考网站（PubMed、Cochrane、国家指南库、Trip数据库、世界卫生组织）上的文章进行了一项调查。
母乳喂养显然对婴儿有益，包括对胃肠道感染（64%）、中耳感染（23%-50%）、严重呼吸道感染（73%）、急性淋巴细胞白血病（19%）和婴儿猝死综合征（36%）有显著的保护作用。我们还发现了长期益处，比如对肥胖（7%-24%）以及成年期其他心血管危险因素的影响。母亲也能从母乳喂养对乳腺癌、卵巢癌和2型糖尿病的保护作用中受益，且受益程度与母乳喂养的持续时间成正比。健康专业人员在母乳喂养的开始和持续过程中起着重要作用。母乳喂养的优势理念、分娩前的沟通、可获得的支持以及正确哺乳技术方面的培训，都是本文所探讨的经证实的有效策略。
母乳含有多种独特且独有的成分，这些成分是其健康益处的促成因素。产后时期对于参与食欲控制——营养编程的神经下丘脑回路的发育至关重要，而母乳中含有的瘦素似乎在其中起着决定性作用。
尽管有科学进展，但母乳在短期和长期内对人类健康仍显示出明显优势。母婴二元组合往往难以掌握正确的喂养技巧，这警示需要健康专业人员更多地参与。迫切需要继续坚持培训，以改善葡萄牙在这一领域的相关指标。
