This study reports the temporal pattern of milk output in 2 groups of lactating mothers during the first 6 weeks postpartum. A study aim was to examine if the average milk output for postpartum days 6 and 7 (baseline) predicts milk adequacy at week 6 postpartum. Mothers of preterm (< or = 31 weeks) infants (n = 95) used mechanical expression to initiate and maintain their milk supply; mothers of a singleton healthy term infant (n = 98) fed their infant at the breast. Baseline milk output was predictive of milk adequacy, defined as > or = 500 mL/d at week 6 (P = .000). Preterm mothers were 2.81 times more at risk of not producing adequately than term mothers were. Study findings suggest that interventions that promote the initiation and maintenance of an adequate milk supply during the first week postbirth are critical.

Milk production was examined in 39 lactating mothers of non-nursing preterm infants from 2 tertiary care centers. The purposes of this study were (1) to compare milk production of those using sequential single (SEQ) or simultaneous double (SIM) breast-pumping regimen, and (2) to examine the relationship of selected variables to inadequate (< 3500 g/week) and adequate (> or = 3500 g/week) milk production. In multivariate analysis, mothers using SIM produced a similar amount of milk by weight during weeks 2 to 5 postpartum compared to those using SEQ. A logistic regression model including frequency of kangaroo care, frequency of pumping, high versus low income, and previous breastfeeding experience was predictive of mothers producing adequate versus inadequate milk volume 79% of the time. All of the mothers producing > 3500 g at week 2 produced adequate amounts of milk at weeks 4 and 5. None of the mothers producing < 1700 g at week 2 reached adequate production by weeks 4 and 5. Of the remaining mothers who produced 1700 g to 3500 g at week 2, 54% achieved adequate production during weeks 4 and 5 postpartum.

The HAQ score is significantly associated with BMI in FMS with a trend towards significance for fatigue and TP. Weight loss may improve physical functioning in this disorder.

Sprains and overuse were common climbing injuries, with the upper extremity being the most frequently injured body part. Rock climbers who participated in traditional or solo climbing, or who have climbed while under the influence or drugs or alcohol, reported more injuries.

WHAT'S KNOWN ON THIS SUBJECT: Bacteremia occurs in 2.2% of febrile infants who have a blood culture drawn. Regional data suggest that Escherichia coli, group B Streptococcus, and Staphylococcus aureus are leading causes; however, the geographic boundaries of these data limit universal applicability. WHAT THIS STUDY ADDS:This is the first national study examining epidemiology of bacteremia in febrile infants admitted to a general inpatient unit. The most common pathogens were Escherichia coli (42%), group B Streptococcus (23%), and Streptococcus pneumoniae (6%). No Listeria monocytogenes was identified.abstract BACKGROUND: Fever in infants is a common clinical dilemma. The objective of this study was to present data from hospital systems across the northeast, southeast, mid-west, and western United States to identify the pathogens causing bacteremia in febrile infants admitted to general care units. METHODS:This was a retrospective review of positive blood culture results in febrile infants aged #90 days admitted to a general care unit across 6 hospital systems. Data were collected from January 1, 2006 through December 31, 2012 from emergency departments and general inpatient units. Cultures from ICUs, central lines, or infants who had complex comorbidities were excluded, as were repeat cultures positive for the same bacteria. Common contaminants were considered pathogens if they were treated as such. RESULTS:We identified 181 cases of bacteremia in 177 infants. The most common pathogen was Escherichia coli (42%), followed by group B Streptococcus (23%). Streptococcus pneumoniae was more likely in older infants (P = .01). Non-low-risk bacteremic infants were more likely to have E coli or group B Streptococcus than low-risk bacteremic infants. We identified no cases of Listeria monocytogenes. Variation between sites was minimal.CONCLUSIONS: This is the largest and most geographically diverse study to date examining the epidemiology of bacteremia in infants.We suggest E coli is the most common cause of bacteremia in previously healthy febrile infants admitted to a general inpatient unit. We identified no cases of L monocytogenes and question whether empirical therapy remains necessary for this pathogen. Pediatrics 2013;132:990-996

This article summarizes the development and psychometric properties of the first self-administered, paper-and-pencil instrument that measures maternal quality of life during the early postpartum period. The definition, domains, and conceptual model by Ferrans and Powers (QLI) were used to develop the Maternal Postpartum Quality of Life (MAPP-QOL) tool. A convenience sample of 184 mothers completed the MAPP-QOL at week 1 and 3 postpartum. Component analysis revealed five domains: psychological/baby; socioeconomic; relational/spouse-partner; relational/family-friends; and health & functioning. Internal consistency reliability for the five subscales resulted in Cronbach's alpha coefficients ranging from .82 to .96. Stability reliability ranged from .66 to .76. The MAPP-QOL and a single-item measure of life satisfaction correlated (r = .69), suggesting convergent validity; discriminant validity was supported by negative correlations with the three negative mood states of the Multiple Affect Adjective Check List-Revised (MAACL-R) as well as poor sleep and fatigue scores. Acceptable reliability and construct validity suggest that the MAPP-QOL may be used in research. Further testing with larger and more diverse samples is recommended.

This study examined potential primary mediators, such as intended length to breastfeed, maternal education, income, and infant gestation, and secondary mediators, such as early frequency of breast stimulation, early milk output, and supplementation with artificial milks that may influence milk output in mothers of preterm and term infants the first 6 weeks postpartum. Analysis suggested that for mothers of a preterm infant (n = 95), the primary mediators, income and infant gestation, and the secondary mediators, early milk output/d and early frequency/d, accounted for 53.5% of the variance in milk output/d at week 6. For mothers of a term infant (n = 98), the primary mediator, income, and secondary mediators, early milk output/d and supplementation, accounted for 48.4% of the variance in milk output/d at week 6. Further research is needed to determine what early interventions may improve milk output in mothers at risk for lactation failure.

Smokers reported significantly more pain, numbness, patient global severity, and functional difficulties than non-smokers. There was no significant difference between smokers and non-smokers for fatigue and TP.