Objective: To know recommendations on breastfeeding by Mexican pedia-tricians. Methods: Cross-sectional, descriptive study conducted through a survey of Mexican pediatricians. Results: Two hundred and fifty-four pedi-atricians (range 27 to 72 years) were surveyed. Most of them worked in public hospital or private practice or both. Among them 94.5% recom-mended newborn early contact with mother and 54.3% rooming. Exclusive breastfeeding was suggested by 89.8%, out of them 51.9% for 6 months. Breastfeeding on demand was counseled by 88.2% and 84.6% without fixed schedules. Pacifier use was rejected by 86.6%. 51.2% used iron supplements and 59.5% used other vitamins. Stopping breastfeeding in special situations was suggested by 87.4%; of them, 86.6% in case of infection with AIDS; 74.4% if the mother used drugs; 74.4% by infection with hepatitis B virus; 49.6% in case of mastitis; 17.3% in newborns with jaundice; and 18.5% in other situations. Finally, 93.3% of pediatricians surveyed reported interest in breastfeeding; 54.7% obtained information in medical journals; 54.7% through medical courses, and 31.9% in books. 58.3% of respondents oriented on breastfeeding according to WHO recommendations; 31.5% did so regularly and 10.2% did not. Conclusions: Pediatricians play a major role in breastfeeding promotion, but their formation is scarce and they are not prepared to counsel patients. Governments of developing countries should promote breastfeeding to ensure the health and proper development of infants.
Cite this paper
Reyes-Vázquez, H. , Lopez-Enriquez, C. , Bribiesca-Godoy, F. , Espinosa-Aguilera, A. , Morfin-Maciel, B. M. and Martínez-Aguilar, N. E. (2019). Breastfeeding Recommendations. Pediatricians Mexicans Survey. Open Access Library Journal, 6, e2816. doi: http://dx.doi.org/10.4236/oalib.1102816.
Colchero, M.A., Contreras-Loya, D., López Gatell, H. and González de Cosio, T. (2015) The Costs of Inadequate Breastfeeding of Infants in Mexico. The American Journal of Clinical Nutrition, 101, 579-586. https://doi.org/10.3945/ajcn.114.092775
Pacheco, A.R., Barile, D., Underwood, M.A. and Mills, D.A. (2015) The Impact of the Milk Glycobiome on the Neonate Gut Microbiota. Annual Review of Animal Biosciences, 16, 419-445. https://doi.org/10.1146/annurev-animal-022114-111112
Valentino Coppa, G., Gabrielli, O., Bertino, E., Zampini, L., Galeazzi, T., Padella, L., et al. (2013) Human Milk Glycosaminoglycans: The State of the Art and Future Perspective. Italian Journal of Pediatrics, 39, 2-8. https://doi.org/10.1186/1824-7288-39-2
Howie, P.W., Forsgth, J.S., Ogston, S.A., Clark, A. and duFlorey, C. (1990) Protective Effect of Breast Feeding against Infection. British Medical Journal, 300, 11-16. https://doi.org/10.1136/bmj.300.6716.11
Chen, A. and Rogan, W.J. (2004) Breastfeeding and the Risk of Postneonatal Death in the United States. Pediatrics, 113, e435-e439. https://doi.org/10.1542/peds.113.5.e435
Victora, C.G., Barros, F.C., Vaughan, J.P. and Tlixeira, A.R.M. (1987) Evidence for Protection by Breast-Feeding against Infant Deaths from Infectious Diseases in Brazil. The Lancet, 8, 319-322. https://doi.org/10.1016/S0140-6736(87)90902-0
Andres, A., Cleves, M.A., Bellando, J.B., Pivik, R.T., Casey, P.H. and Badger, T.M. (2012) Developmental Status of 1 Year Old Infants Fed Breast Milk, Cow’s Milk Formula, or Soy Formula. Pediatrics, 129, 1134-1140. https://doi.org/10.1542/peds.2011-3121
Romieu, I., Her-nández-Avila, M., López, L. and Romero-Jaime, R. (1996) Breast Cancer and Lactation History in Mexican Women. American Journal of Epidemiology, 143, 543-552. https://doi.org/10.1093/oxfordjournals.aje.a008784
Thapa, S., Short, V.R. and Potts, M. (1988) Breast-Feeding, Birth Spacing and Their Effects on Child Survival. Nature, 335, 679-682. https://doi.org/10.1038/335679a0
Mihrshahi, S., Ampon, R., Webb, K., Almqvist, C., Kemp, A.S., Hector, D., et al. (2007) The Association between Infant Feeding Practices and Subsequent Atopy among Children with a Family History of Asthma. Clinical & Experimental Allergy, 37, 671-679. https://doi.org/10.1111/j.1365-2222.2007.02696.x
Wegienka, G., Zoratti, E. and Cole, J.C. (2015) The Role of the Early-Life Environment in the Development of Allergic Disease. Immunology and Allergy Clinics of North America, 35, 1-17. https://doi.org/10.1016/j.iac.2014.09.002
Rive-ra-Pasquel, M., Escobar-Zaragoza, L. and González de Cosío, T. (2015) Breastfeeding and Maternal Employment: Results from Three National Nutritional Surveys in Mexi-co. Maternal and Child Health Journal, 19, 1162-1172. https://doi.org/10.1007/s10995-014-1622-9
Winikoff, B. and Laukaran, V.H. (1989) Breast-Feeding and Bottle-Feeding Controversies in the Developing World: Evidence from a Study in Four Countries. Social Science & Medicine, 29, 859-868. https://doi.org/10.1016/0277-9536(89)90085-3
González de Cosío, T., Escobar-Zaragoza, L., González-Castell, D., Reyes-Vázquez, H. and Rivera-Dommarco, J.A. (2013) Breastfeeding in Mexico Was Stable, on Average, But Deteriorated among the Poor, Whereas Complementary Feeding Improved: Results from the 1999 to 2006 National Health and Nutrition Survey. The Journal of Nutrition, 143, 664-671. https://doi.org/10.3945/jn.112.163097
Margen, S., Melnick, V., Neuhauser, L. and Ríos, E. (1991) Infant-Feeding in Mexico: A Study of Health Facilities and Mothers Practices in Three Regions. Nestlé Infant Formula Audit Commission, Emoryville.
González de Cosío, T., Es-cobar-Zaragoza, L., González Castell, L.D. and Rivera-Dommarco, J.A. (2013) Infant Feeding Practices and Deterioration of Breastfeeding in Mexico. Salud Pública de México, 55, s170-s179.
Flores-Huerta, S. and Cisneros-Silva, I.E. (1997) Mother-Infant Rooming-In and Exclusive Breastfeeding. Salud Pública de México, 39, 110-116. https://doi.org/10.1590/S0036-36341997000200004
Cisneros-Silva, I.E., Flores-Huerta, S. and Rosas-Gallegos, M.C. (1995) Mother-Infant Rooming-In and Beginning of Breast Feeding in a Tertiary Care Hospital. Salud Pública de México, 37, 424-429.
Alves, A.L., Oliveira, M.I. and Moraes, J.R. (2013) Breastfeed-ing-Friendly Primary Care Unit Initiative and the Relationship with Exclusive Breast-feeding. Revista de Saúde Pública, 47, 1130-1140.
Forrester-Knauss, C., Merten, S., Weiss, C., Ackermann-Liebrich, U. and Zemp Stutz, E. (2013) The Baby-Friendly Hospital Initiative in Switzerland: Trends over 9-Year Period. Journal of Human Lactation, 29, 510-516. https://doi.org/10.1177/0890334413483923
Ziegler, E.E., Nelson, S.E. and Jeter, G.M. (2009) Iron Supplementation of Breastfed Infants from an Early Age. The American Journal of Clinical Nutrition, 89, 525-532. https://doi.org/10.3945/ajcn.2008.26591
Nagpal, J., Sachdev, H.P., Singh, T. and Mallika, V. (2004) A Randomized Placebo-Controlled Trial of Iron Supplementation in Breastfed Young Infants Initiated on Complementary Feeding: Effect on Hematological Status. Journal of Health, Population and Nutrition, 22, 203-211.
Taylor, J.A., Geyer, L.J. and Feldman, K.W. (2010) Use of Supplemental Vitamin d among Infants Breastfed for Porlonged Periods. Pediatrics, 125, 105-111. https://doi.org/10.1542/peds.2009-1195
ESPGHAN Committee on Nutrition (2009) Breastfeeding: A Commentary by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition, 49, 112-115. https://doi.org/10.1097/MPG.0b013e31819f1e05
Ward, R.M., Bates, B.A., Benitz, W.E., Burchfield, D.J., Ring, J.C., Walls, R.P., et al. (2001) The Transfer of Drugs: An Other Chemicals into Human Milk. Pediatrics, 108, 776-789. https://doi.org/10.1542/peds.108.3.776
Ahn, J., Salem, S.B. and Cohem, S.M. (2010) Evaluation and Management of Hepatitis B in Pregnancy: A Survey of Current Practices. Gastroenterology & Hepatology, 6, 570-578.
Zheng, Y., Lu, Y., Ye, Q., Xia, Y., Zhou, Y., Yao, Q., et al. (2011) Should Chronic Hepatitis B Mothers Brestfeed? A Meta Analysis. BMC Public Health, 11, 502. https://doi.org/10.1186/1471-2458-11-502
Giles, M.L., Garland, S.M., Grover, S.R., Lewin, S.M. and Hellard, M.E. (2006) Impact of an Education Campaign on Management in Pregnancy of Women Infected with a Blood-Borne Virus. The Medical Journal of Australia, 184, 389-392.
Delgado, S., Arrollo, E., Jiménez, E., Fernández, L. and Rodriguez, J.M. (2009) Mastitis infecciosa durante la lactancia. Un problema infravalorado. Acta Pediátrica Espa?ola, 67, 77-84.
National Institute for Health and Clinical Excellence (2006) NICE Clinical Guide 37. Routine Postnatal Care of Women and Their Babies. http://guidance.nice.org.uk/cg37
Nielsen, O.H., Maxwell, C. and Hendel, J. (2014) IBD Medications during Pregnancy and Lactation. Nature Reviews Gastroenterology & Hepatology, 11, 116-127. https://doi.org/10.1038/nrgastro.2013.135
Davanzo Dal Bo, S., Bua, J., Copertino, M., Zanelli, E. and Matarazzo, L. (2013) Antiepileptic Drugs and Brastfeeding. Italian Journal of Pediatrics, 39, 50-61. https://doi.org/10.1186/1824-7288-39-50
Ref Ghanem, F.A. and Movahed, A. (2008) Use of Antihypertensive Drugs during Pregnancy and Lactation. Cardiovascular Therapeutics, 26, 38-49. https://doi.org/10.1111/j.1527-3466.2007.00036.x
Sachs, H.C. (2013) The Transfer of Drugs and Therapeutics into Human Breast Milk: An Update of Selec-tive Topics. Pediatrics, 132, e795-e809. https://doi.org/10.1542/peds.2013-1985
Serrano Aguayo, P., García de Quiros Mu?oz, J.N., Breton, L.I. and Cozar León, M.V. (2015) Tratamiento de enfermedades endocrinológicas durante la lactancia. Medicina Clínica, 144, 73-79. https://doi.org/10.1016/j.medcli.2014.04.021
Rowe, H., Baker, T. and Hale, T.W. (2013) Maternal Medication, Drug Use and Breastfeeding. Pediatric Clinics of North America, 60, 275-294. https://doi.org/10.1016/j.pcl.2012.10.009
Freed, G.L., Clark, S.J., Sorenson, J., Lohr, J.A., Cefalo, R. and Curtis, P. (1995) National Assessment of Physicians’ Breast-Feeding Knowledge, Attitudes, Training, and Experience. JAMA, 273, 472-476. https://doi.org/10.1001/jama.1995.03520300046035
Pound, C.M., Williams, K., Grenon, R., Aglipay, M. and Plint, A.C. (2014) Breastfeeding Knowledge, Confidence, Beliefs, and Attitudes of Canadian Physicians. Journal of Human Lactation, 30, 298-309. https://doi.org/10.1177/0890334414535507
Freed, G.L., Clark, S.J., Lohr, J.A. and Sorenson, J.R. (1995) Pediatrician Involvement in Breast-Feeding Promotion: A National Study of Residents and Practitioners. Pediatrics, 96, 490-494.