Tehran University Medical Journal

Background: dehydration fever is a common problem during the first week of life. This study aimed to compare the characteristics of neonates with fever due to dehydration and healthy infants.
Methods: This cross-sectional study was performed on 324 neonates including 120 neonates with normal body temperature and 204 neonates with fever due to dehydration (hyperthermia) referred to Ghaem Hospital in Mashhad, Iran from 2017 to 2019, using a convenience sampling method and a researcher-made questionnaire. Infants presenting with elevated body temperature and having an axillary temperature above or equal to the rectal temperature and with no clinical or laboratory evidence of infection were considered as fever due to dehydration (case group). Infants who were referred for a routine examination or had jaundice but did not require treatment were considered as controls. Infant characteristic (neonatal age, sex, Apgar score, defecation frequency, the first defecation, breastfeeding frequency, urinary frequency, duration of feeding, birth weight, daily weight loss, daily weight loss percentage, lethargy, irritability, mucosal dryness, status fontanelles, hyperthermia, convulsion, apnea, decreased consciousness and  infant hospitalization) and maternal information (age, weight, parity, hospital stay, breast problems, mode of delivery, breastfeeding position, delayed breastfeeding, and pregnancy problems. The data were analyzed using Student’s t-test, Chi-square and SPSS software, version 20 (IBM SPSS, Armonk, NY, USA).
Results: In dehydration fever of newborn, admission weight, frequency and duration of feeding, defecation frequency, maternal age were low, but time to first feeding were high (P<0.05). In fever of dehydration: restlessness, mucosal dryness, fontanel status, seizure, apnea, decreased consciousness, breastfeeding with traditional remedies, inappropriate breastfeeding position, lack of let-down reflex, delayed onset of lactation, breast problems and jaundice were more frequent.
Conclusion: Infants with fever of dehydration were more likely to weight loss, delayed in first feeding, shorter feeding times and lower duration of feeding, higher sodium, urea, creatinine, and blood glucose levels. According to the results of this study, breast problems, inappropriate breastfeeding position, absence of reflux, delayed lactation, less frequent breastfeeding, consumption of breast milk with dextrose, manna, and clay tap were risk factors for dehydration fever.
 

Background: Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection. It been associated causally with a diverse spectrum of gastrointestinal disorders including chronic gastritis, peptic ulcer disease, gastric adenocarcinoma. We conducted a study to Evaluation of the role of breastfeeding and breast milk on the colonization of H. pylori in the gastrointestinal tract of 2-24 month old.
Methods: This cross-sectional study was performed on 92 children referred to Ali Asghar Hospital of Iran University of Medical Sciences for two years (from July 2015 to June 2017). At first, a questionnaire was recorded by the neonatal specialist including demographic and clinical characteristics of the infants. Stool samples were taken from infants at 2, 6, 12, and 24 months of age. We used the H. pylori stool antigen test to detection infection in the selected group of children. H. pylori status was evaluated by an enzyme-linked immunosorbent assay (ELISA).
Results: In the study of breastfeeding at 12 months of age, 51.1% were fed only dry milk and 28.3% were breastfed only. At 24 months, 22 infants (24%) were breastfed with supplemental feeding and 54 children (58.7%) were  formula-fed only and 8 children (8.7%) were breastfed only. In our study, the prevalence of H. pylori in infants of Tehran, at 2, 6, 12, and 24 months, were 0%, 6.5%, 15.21%, and 34.4%, respectively. Of the 92 children studied, during the first month, 25 children (27.2%) only formula-fed and 49 children (53.3%) were breastfed only and (19.6%) 18 infants were breastfed with dry milk. The prevalence of H. pylori infection was 28.3%. The prevalence of H. pylori infection was 20% in the breastfeeding group and 44% in the infant dry milk feeding group. The prevalence of H. pylori antigen was greater than 12 IU/ml in infants 2, 6, 12, and 24 months of age, including 19.92 (20.6%), 19.92 (20.6%), 24.92 (26.1%) and 21.92 (22.8%), respectively.
Conclusion: According to the findings of the article, breastfed children compared to formula-fed children were less infected by Helicobacter pylori.

Background: The rate of exclusive breastfeeding in Iran at the ages of 3 and 6 months is estimated to be 44% and 27%, respectively, which is still far from the optimal index of the World Health Organization until 2030 (70% in the first six months). In order to monitor breastfeeding counseling centers, which have been set up with the aim of promoting breastfeeding and supporting mothers who have problems with breastfeeding.
Methods: This is a descriptive-retrospective study and all the mothers who were referred to the Health and Treatment Center No. 2 in Mashhad between April 2019 and March 2019 were examined. This health center has two active counseling clinics and the collection of information is based on documents registered in offices and computers. The inclusion criteria for study were not having breast diseases, having an infant child, being able to read and write and living in Mashhad city. The exclusion criteria were also the unwillingness to participate in the study and the newborn suffering from diseases that are incompatible with breastfeeding. Therefore, census sampling was done. The data were analyzed using SPSS 16 software and the significance level was less than 0.05.

Results: In 42.8% of cases, mothers had started feeding combined formula with breast milk before visiting, and in 28.1% of cases, when referring to counseling milk clinics, it was reported that the baby was fed only with formula. After breastfeeding consultations and follow-ups at the end of six months, the rate of exclusive breastfeeding is 34.1% (12% increase compared to the initial reference) and combined formula feeding with breastmilk is 27.8% (a 22% decrease compared to the first visit). And feeding with powdered milk alone was calculated to be 36.5% (an increase of 8.4% compared to the first visit). Conclusion: The positive role of breastfeeding counseling center in reducing the cases of artificial feeding is clear, and it is recommended to prepare written instructions based on the challenges in breastfeeding for breastfeeding counseling in the first month after delivery.