Exclusive breastfeeding protects against postpartum migraine recurrence attacks?

Abstract

Migraine, mainly without aura, is influenced by cyclical hormones changes that occur during the women's reproductive life [1][2][3][4] . It is predominantly during the menstrual period that attacks occur and, in some cases, exclusively 5 . The most accepted hypothesis for the physiopathology of attacks during menstruation lies in the sharp decrease of estrogens durestrogens dur-during the premenstrual period 1,5,6 . However, the majority of the pregnant women that are migraine sufferers before pregnancy show migraine improvement or even disappearance during pregnancy 7,8 . Absence of cyclical hormonal fluctuations during pregnancy, mainly estrogens that rise during this period, is pointed as one of the most important causes of such behavior 4,8 . AbsTRACT Objectives: To observe postpartum migraine recurrence among migraine sufferers before pregnancy, its classifications and associated factors and to compare women, who were exclusively breastfeeding, with those that used other forms of infant feeding. Methods: Out of 686 consecutively assisted women, at the first postnatal week, 266 were identified as migraine sufferers before pregnancy. Among those, one in five that were exclusively breastfeeding (53) and all the ones consecutively using others forms of infant feeding (40) were interviewed at the first and forth postpartum weeks. Results: After multivariable analysis, exclusive breastfeeding, no breastfeeding problems, and low income were associated with decrease in migraine recurrence at the first postpartum week. At the fourth week, exclusive breastfeeding continued to be a protective factor. Conclusions: A decrease in postpartum migraine recurrence seems to be another advantage of exclusive breastfeeding.Key words: migraine without aura, migraine with aura, breast feeding, postpartum period. REsumoObjetivos: Observar a recorrência de enxaqueca no período pós-parto em mulheres com enxaqueca antes da gestação, suas classificações e fatores associados e comparar mulheres que apenas amamentavam com aquelas que alimentavam seus filhos de outro modo. Métodos: De 686 mulheres consecutivamente assistidas na primeira semana pós-parto, 266 foram identificadas como portadoras de enxaqueca antes da gestação. Destas, uma em cada cinco que se encontravam amamentando exclusivamente (53) e aquelas que usavam outras modalidades de alimentação (40) foram entrevistadas na primeira e quarta semanas pós-parto. Resultados: Após análise multivariada, observou-se que praticar aleitamento materno exclusivo, não ter problemas relacionados à amamentação e ter baixa renda estavam associados à diminuição da recorrência da enxaqueca na primeira semana pós-parto. Na quarta semana, a prática do aleitamento materno exclusivo continuou sendo fator protetor em relação à enxaqueca. Conclusões: A diminuição da recorrência da enxaqueca pós-parto parece ser uma vantagem adicional do aleitamento materno exclusivo.Palavras-Chave: enxaqueca sem aura, enxaqueca com aura, aleitamento materno, período pós-parto.

Passing the baton: Mentoring for adoption of active‐learning pedagogies by research‐active junior faculty

“…The maximum group size was five students.Group outingIn the first two weeks of the semester, each group and its peer facilitator were expected to have a meeting in an enjoyable place where they could get to know each other, compose a written set of guidelines for their group, and set consequences for violations of their guidelines. All members needed to sign off on a copy of the guidelines and consequences, which was given to the instructor .Learning issue reportsRequired until the student received an excellent grade. Then these became optional.Required for every articleWriting assignmentEach student selected a different hemoglobinopathy and wrote a 5–10 page paper about its biochemistry and phenotypic effects.NoneTo familiarize students with the field, each selected and described the work of a research‐active biochemist that s/he thought was interesting.Jig‐sawAn exercise that was used to introduce additional classic articles, expand community among biochemistry majors, and increase individual accountability .Not usedConcept mappingUsed to connect articles studied during the Jig‐Saw activity to the course theme and prepare for the midterm examination.Used to connect Pasteur and Harden and Young articles.Used to connect Pasteur, Harden and Young, and/or Fleming articles.Tutors (peer facilitators)Junior biochemistry majors.…”

Headache Research and Medical Practice in Brazil: An Historical Overview

“…In this context, the women, because of their role in domestic tasks, such as nursing their offspring, appear to be the gender selected by the evolutionary process to harbor such physiological and/or morbid conditions in order to encourage a nonmigratory pattern of behavior. Lactation and pregnancy, conditions that make it difficult for a group to change territory, are associated with a low frequency of migraine. On the other hand, menses and migraine, common in nonpregnant women, are impairing factors for itinerant behavior.…”

“…Comparing with the normal weight group (32%), the prevalence was higher in overweight children (39%; odds ratio [OR] 1.35, 95% confidence interval [CI] 0.51‐3.61) and even higher in the obese group (52%; OR 2.25, 95% CI 0.99‐5.12). Metabolic syndrome was found in 25%, and patients with the syndrome did not have higher prevalence of headache (52% vs 45%); (3) In adults, the metabolic syndrome does not appear to influence headache prevalence in obese patients; (4) A score to differentiate migraine from tension‐type headache was established, using 536 headache attacks reported by 121 nurses during a 2‐month follow‐up; (5) 14 new cases of corpalgia in migraine patients were described; (6) The continuous prophylactic use of propranolol, amitryptiline, or simvastatin in migraineurs decreases both the frequency of headache attacks and the production of nitric oxide in the blood; (7) Vitamin B6 has a preventive effect on menstrual migraine when used at a dose of 600 mg/day from the 14th day until menstruation; (8) Clinical symptomatology of the postdural puncture headache and risk factors were evaluated in 640 raquianesthesias; (9) Melatonin‐induced analgesia in addition to inhibiting neoplasic growth using a mouse or rat as the animal model; (10) The history of primary headache is a risk factor of headache related to hemodialysis (52% vs 12%); (11) A descriptive, comparative, cross‐sectional study with 110 postmenopausal women (recent [<5 years] vs late [≥5 years]) showed that the recent postmenopausal group presented highest average scores in the memory/concentration, vasomotor symptoms, and attractiveness domains in the Women's Health Questionnaire for assessment of their quality of life; (12) Prior history of headache is a risk factor of postmastectomy pain (OR 1.92; 95% CI: 1.10‐3.34); (13) Sentinel headache, as warning sign of subarachnoid hemorrhage due to ruptured intracranial aneurysm, was present in 18% of the patients; (14) The characteristics of head pain in response to an experimental cold stimulus to the palate in 414 volunteers were described; (15) Chronic posttraumatic headache after mild traumatic brain injury is similar to migraine in women; (16) There was migraine remission in 35%, 77%, 79%, respectively, in the first, second, and third trimesters among migraine without aura sufferers during pregnancy, and exclusive breastfeeding was associated with a lower chance of migraine recurrence at the first postpartum month; (17) Perfumes, paints, gasoline, and bleach are the most frequent odorants that trigger migraine attacks; Osmophobia predominated in patients with migraine and may be a specific maker to differentiate migraine from tension‐type headache; (18) In a population of 726 children and adolescents, headache was significantly associated with myopia (OR 2.67), hyperopia (OR 3.10), astigmatism (1.86), and strabismus (5.21); (19) Water deprivation is associated with increase of pain in the head in rats; (20) In a study involving 417 university students, 53% of them mentioned they ha...…”

An Overview of Importance of Breastfeeding

“…On the other hand mothers who had breastfed their babies are less likely to suffer from hypertension (25) and with increased breastfeeding duration decreased the risk of developing cardiovascular disease in 50 year old mothers (26). Also were less prone to develop breast cancer (27)(28)(29) and recurrence rate of postpartum migraine (30,31).…”