scholarly journals What Evidence Do We Have for Pharmaceutical Galactagogues in the Treatment of Lactation Insufficiency?—A Narrative Review

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 974 ◽  
Author(s):  
Luke E. Grzeskowiak ◽  
Mary E. Wlodek ◽  
Donna T. Geddes
Keyword(s):  
Clinical Practice ◽  
Breast Milk ◽  
Milk Composition ◽  
Narrative Review ◽  
Pharmacological Intervention ◽  
Future Research ◽  
Individual Treatment ◽  
Efficacy And Safety ◽  
Milk Supply ◽  
Insufficient Milk

Inadequate breast milk supply is a frequently reported reason for early discontinuation of breastfeeding and represents a critical opportunity for intervening to improve breastfeeding outcomes. For women who continue to experience insufficient milk supply despite the utilisation of non-pharmacological lactation support strategies, pharmacological intervention with medications used to augment lactation, commonly referred to as galactagogues, is common. Galactagogues exert their pharmacological effects through altering the complex hormonal milieu regulating lactation, particularly prolactin and oxytocin. This narrative review provides an appraisal of the existing evidence regarding the efficacy and safety of pharmaceutical treatments for lactation insufficiency to guide their use in clinical practice. The greatest body of evidence surrounds the use of domperidone, with studies demonstrating moderate short-term improvements in breast milk supply. Evidence regarding the efficacy and safety of metoclopramide is less robust, but given that it shares the same mechanism of action as domperidone it may represent a potential treatment alternative where domperidone is unsuitable. Data on remaining interventions such as oxytocin, prolactin and metformin is too limited to support their use in clinical practice. The review provides an overview of key evidence gaps and areas of future research, including the impacts of pharmaceutical galactagogues on breast milk composition and understanding factors contributing to individual treatment response to pharmaceutical galactagogues.

scholarly journals The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 486 ◽  
Author(s):  
Elvira Verduci ◽  
Maria Lorella Giannì ◽  
Giulia Vizzari ◽  
Sara Vizzuso ◽  
Jacopo Cerasani ◽  
...  
Keyword(s):  
Health Outcome ◽  
Breast Milk ◽  
Human Milk ◽  
Maternal Diet ◽  
Milk Composition ◽  
Narrative Review ◽  
Future Health ◽  
Interconnected System ◽  
Offspring Health ◽  
Diet And Lifestyle

The benefits of human milk for both mother and infant are widely acknowledged. Human milk could represent a link between maternal and offspring health. The triad mother-breast milk-infant is an interconnected system in which maternal diet and lifestyle might have effects on infant’s health outcome. This link could be in part explained by epigenetics, even if the underlining mechanisms have not been fully clarified yet. The aim of this paper is to update the association between maternal diet and human milk, pointing out how maternal diet and lifestyle could be associated with breast-milk composition, hence with offspring’s health outcome.

Breastfeeding

2017 ◽  
Author(s):  
Janet Medforth ◽  
Linda Ball ◽  
Angela Walker ◽  
Sue Battersby ◽  
Sarah Stables
Keyword(s):  
Breast Milk ◽  
Infant Nutrition ◽  
Milk Supply ◽  
Breastfeeding Practices ◽  
Returning To Work ◽  
Common Problems ◽  
Insufficient Milk

This chapter considers all aspects of breastfeeding. The latest Baby Friendly Initiative standards are detailed, along with the advantages of, and contraindications to, breastfeeding. The constituents of breast milk and their role in infant nutrition are identified. Recently recognized changes in the structure of the lactating breasts are presented. There are detailed sections on the management and support of breastfeeding. Practices shown to be detrimental to successful breastfeeding are highlighted. Expression of breast milk and breastfeeding and returning to work are fully explained, as well as discontinuation of breastfeeding. Common problems encountered whilst breastfeeding are considered, including sore/cracked nipples, engorgement, blocked ducts, mastitis, breast refusal, insufficient milk supply, and Candida infection (thrush). Breastfeeding in special situations is also explored. The importance of correct nutrition and breastfeeding is reviewed.

scholarly journals Whole Medical Systems versus the System of Conventional Biomedicine: A Critical, Narrative Review of Similarities, Differences, and Factors That Promote the Integration Process

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Erik W. Baars ◽  
Harald J. Hamre
Keyword(s):  
Clinical Practice ◽  
Conventional Medicine ◽  
Narrative Review ◽  
Future Research ◽  
Integration Process ◽  
Medical Systems ◽  
Methodological Issues ◽  
High Quality Research ◽  
Safety And Efficacy ◽  
Legal Frameworks

Background. There is an increasing need for a worldwide professional integration of conventional medicine and traditional/complementary whole medical systems (WMSs). However, the integration is perceived by conventional medicine as problematic or unacceptable, because of a supposed lack of evidence for specific effects of WMSs therapies and supposed prescientific or unscientific paradigms of WMSs. Objectives. To review the literature on the features of WMSs, similarities and differences between conventional medicine and WMSs, and scientific and clinical practice issues that should be dealt with in order to promote the integration process. Methods. A critical, narrative review of the literature on six WMSs. Results and Conclusions. Key factors for the integration of WMSs and conventional medicine are as follows: legal frameworks, quality standards, high-quality research on safety and efficacy of WMS interventions, infrastructure, and financial resources. For scientific assessment of WMSs, there are unresolved ontological, epistemological, and methodological issues and issues of diagnostics, therapy delivery, and outcome assessment in clinical practice. Future research not only should be directed at quality assurance and generating the necessary data on safety and efficacy/effectiveness but also should address more fundamental (ontological, epistemological, and methodological) issues, in order to overcome the differences between WMSs and conventional medicine.

scholarly journals Reverse tapered versus non-tapered peripherally inserted central catheters: A narrative review

2021 ◽  
pp. 112972982110099
Author(s):  
Sergio Bertoglio
Keyword(s):  
Clinical Practice ◽  
Clinical Studies ◽  
Postoperative Bleeding ◽  
Narrative Review ◽  
Efficacy And Safety ◽  
Exit Site ◽  
Peripherally Inserted Central Catheters ◽  
Safety And Efficacy ◽  
Central Catheters

Introduced over 20 years ago, the reverse tapering design for PICC catheters is supposed to have some benefits in terms of both efficacy and safety. In particular, it would ensure less postoperative bleeding at the exit site and greater effectiveness in preventing kinking or twisting of the same. Since its introduction, these hypothesized advantages have never been demonstrated in clinical studies, however very scarce, which have highlighted neither advantages nor disadvantages of reverse tapered catheters when compared to non-reverse tapered ones. This narrative review analyzes some aspects of the use of reverse tapered PICCs, also paying attention to some possible undesirable effects that have arisen from the introduction into clinical practice of new subcutaneous systems of securement of PICCs to the skin. Clinicians should be aware of the fact that reverse tapering design does not represents a sure improvement in terms of safety and efficacy of PICCs and its adoption should be weighed against possible clinical disadvantages.

scholarly journals Parent–Child Reminiscing about Past Pain as a Preparatory Technique in the Context of Children’s Pain: A Narrative Review and Call for Future Research

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 130
Author(s):  
Maria Pavlova ◽  
Serena L. Orr ◽  
Melanie Noel
Keyword(s):  
Clinical Practice ◽  
Narrative Review ◽  
Future Research ◽  
Pediatric Pain ◽  
Autobiographical Memories ◽  
Factors Influencing ◽  
Agents Of Change ◽  
Immediate Experience ◽  
Children's Pain ◽  
Parent Child

Pain permeates childhood and remains inadequately and/or inconsistently managed. Existing research and clinical practice guidelines have largely focused on factors influencing the immediate experience of pain. The need for and benefits of preparing children for future pain (e.g., painful procedures) has been well established. Despite being a robust predictor of future pain and distress, memories of past painful experiences remain overlooked in pediatric pain management. Just as autobiographical memories prepare us for the future, children’s memories for past pain can be harnessed to prepare children for future painful experiences. Children’s pain memories are malleable and can be reframed to be less distressing, thus reducing anticipatory distress and promoting self-efficacy. Parents are powerful agents of change in the context of pediatric pain and valuable historians of children’s past painful experiences. They can alter children’s pain memories to be less distressing simply by talking, or reminiscing, about past pain. This narrative review summarizes existing research on parent–child reminiscing in the context of acute and chronic pediatric pain and argues for incorporation of parent–child reminiscing elements into preparatory interventions for painful procedures.

scholarly journals Using domperidone to increase breast milk supply: a clinical practice survey of Australian neonatal units

2017 ◽  
Vol 47 (6) ◽  
pp. 426-430 ◽  
Author(s):  
Christine E. Gilmartin ◽  
Lisa H. Amir ◽  
Marene Ter ◽  
Luke E. Grzeskowiak
Keyword(s):  
Clinical Practice ◽  
Breast Milk ◽  
Milk Supply ◽  
Practice Survey

scholarly journals Counseling of exclusive breastfeeding during antenatal care (ANC) and perceptions of insufficient milk supply

2020 ◽  
Vol 7 (2) ◽  
pp. 65
Author(s):  
Eka Nurhayati ◽  
Sandra Fikawati
Keyword(s):  
Breast Milk ◽  
Antenatal Care ◽  
Milk Production ◽  
Exclusive Breastfeeding ◽  
Health Personnel ◽  
Milk Supply ◽  
Cross Sectional ◽  
Extra Food ◽  
Breastfeeding Counseling ◽  
Insufficient Milk

<p align="center"><strong>ABSTRAK</strong></p><p> </p><p><strong><em>Latar Belakang:</em></strong><em> Persepsi Ketidakcukupan ASI (PKA) adalah pikiran atau perasaan ibu terhadap kondisi ketiadaan atau berkurangnya produksi ASI sehingga ibu merasa bahwa ASI-nya tidak cukup untuk memenuhi kebutuhan bayinya. PKA menjadi alasan utama ibu berhenti menyusui secara dini dan alasan untuk memberikan makanan tambahan lebih awal pada bayinya. Prevalensi PKA belum diketahui secara pasti, diperkirakan antara 30-80% dari ibu yang menyusui mempunyai PKA. </em></p><p><strong><em>Tujuan :</em></strong><em> untuk mengetahui faktor paling dominan dalam PKA.<strong></strong></em></p><p><strong><em>Metode:</em></strong><em> Desain penelitian ini menggunakan Cross Sectional. Jumlah sampel dalam penelitian ini sebanyak 71 sampel ibu yang memiliki bayi 0-6 bulan yang gagal menyusui secara eksklusif dikarenakan mengalami PKA. </em></p><p><strong><em>Hasil:</em></strong><em> Hasil analisis didapatkan sebanyak 59 (83,1%) ibu memiliki PKA dengan ASI yang cukup. Ada hubungan yang bermakna konseling ASI saat Antenatal Care (ANC) dengan PKA yang mempunyai ASI cukup, ibu yang tidak mendapatkan konseling saat ANC berpeluang 19,7 kali mempunyai PKA, p=0,012; OR=19,746 (CI 95% 1,926-202,456). </em></p><p><strong><em>Kesimpulan:</em></strong><em>  Konseling ASI pada saat ANC yang berkualitas merupakan hal yang sangat penting dilaksanakan oleh petugas kesehatan untuk persiapan menyusui. Pemanfaatan “Temu wicara” dalam konsep 10 T dalam ANC perlu diefektifkan untuk membahas persiapan laktasi. </em></p><p><em> </em></p><p><strong><em>KATA KUNCI: </em></strong><em>persepsi ketidakcukupan ASI, konseling ASI <strong></strong></em></p><p align="center"><strong><em> </em></strong></p><p><strong><em> </em></strong></p><p align="center"><strong><em>ABSTRACT</em></strong></p><p><strong><em>Background:</em></strong><em> Perceptions of Insufficient Milk Supply (PIM) is the mother's thoughts or feelings about the condition of the absence or reduction in milk production. She felt that her breast milk is not enough to satisfy the needs of the baby. PIM was the main reason mothers stop breastfeeding early and a reason to give extra food early on the baby. Prevalence of PIM is not certain, it is estimated between 30-80% of breastfeeding mothers has PIM.       </em></p><p><strong><em>Objectives:</em></strong><em> This study aimed to find out the most dominant factors related to PIM.</em></p><p><strong><em>Methods:</em></strong><em> Design of this study using cross-sectional. The numbers of samples in this study were 71 samples of mothers with babies’ 0-6 months exclusive breastfeeding failure due to experiencing PIM. </em></p><p><strong><em>Results:</em></strong><em> Found as many as 59 (83.1%) mothers had PIM with enough milk. There is a significant correlation counseling exclusive breastfeeding during Antenatal Care (ANC) by PIM that has enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PIM, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456). </em></p><p><strong><em>Conclusion:</em></strong><em> Exclusive Breastfeeding counseling during ANC quality does health personnel in preparation for breastfeeding implement a very important thing. Utilization of “Gathering of speech” in the concept of 10 T in the ANC should be effected to discuss preparation for lactation.</em></p><p><em> </em></p><p><strong><em>KEYWORDS</em></strong><em>: exclusive breastfeeding, perceptions of insufficient milk supply</em></p>

Women And Depression: Future Research, Clinical Practice, And Public Policy

2002 ◽  
Author(s):  
Carolyn M. Mazure ◽  
Laura J. Bierut ◽  
Steven D. Hollon ◽  
Susan G. Kornstein ◽  
Charlotte Brown
Keyword(s):  
Public Policy ◽  
Clinical Practice ◽  
Future Research

The application of virtual reality in health professions� digital education: a narrative review (Preprint)

2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car
Keyword(s):  
Virtual Reality ◽  
Professional Education ◽  
Health Professions ◽  
Health Professions Education ◽  
Narrative Review ◽  
Current Evidence ◽  
Future Research ◽  
Educational Content ◽  
Potential Applications

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.

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