MATERNAL & CHILD HEALTH
Technical Information Bulletin
A Review of the
Medical Benefits
and Contraindications
to Breastfeeding in
the United States
Ruth A. Lawrence, M.D.
October 1997
Cite as
Lawrence RA. 1997.
A Review of the Medical Benefits and Contraindications to Breastfeeding in the
United States (Maternal and Child Health Technical Information Bulletin). Arlington, VA:
National Center for Education in Maternal and Child Health.
A Review of the Medical Benefits and Contraindications to Breastfeeding intheUnitedStates (Maternal
and Child Health Technical Information Bulletin) is not copyrighted with the exception of tables
1–6. Readers are free to duplicate and use all or part of the information contained in this publi-
cation except for tables 1–6 as noted above. Please contact the publishers listed inthe tables’
source lines for permission to reprint. In accordance with accepted publishing standards, the
National Center for Education in Maternal and Child Health (NCEMCH) requests acknowledg-
ment, in print, of any information reproduced in another publication.
The mission of the National Center for Education in Maternal and Child Health is to promote
and improve the health, education, and well-being of children and families by leading a nation-
al effort to collect, develop, and disseminate information and educational materials on maternal
and child health, and by collaborating with public agencies, voluntary and professional organi-
zations, research and training programs, policy centers, and others to advance knowledge in
programs, service delivery, and policy development. Established in 1982 at Georgetown
University, NCEMCH is part of the Georgetown Public Policy Institute. NCEMCH is funded
primarily by the U.S. Department of Health and Human Services through the Health Resources
and Services Administration’s Maternal and Child Health Bureau.
Published by
National Center for Education in Maternal and Child Health
2000 15th Street, North, Suite 701, Arlington, VA 22201-2617
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This publication has been produced by the National Center for Education in Maternal and Child Health
under its cooperative agreement (MCU-119301) with the Maternal and Child Health Bureau, Health
Resources and Services Administration, Public Health Service, U.S. Department of Health and Human
Services.
A Review of the Medical Benefits and Contraindications to Breastfeeding intheUnitedStates 3
Preface
In its report Breastfeeding: WIC’s Efforts to
Promote Breastfeeding Have Increased (1993), the
U.S. General Accounting Office (GAO) recom-
mended that the U.S. Department of
Agriculture (USDA) and the U.S. Department
of Health and Human Services (DHHS)
develop written policies defining the condi-
tions that would contraindicate breastfeeding
and determining how and when to communi-
cate this information to all pregnant and
breastfeeding participants of the Special
Supplemental IntroductiontoSocialStratificationintheUnitedStatesIntroductiontoSocialStratificationintheUnitedStates Bởi: OpenStaxCollege 1/3 IntroductiontoSocialStratificationintheUnitedStatesThe car a person drives can be seen as a symbol of money and power This Rolls Royce sits outside the Bellagio Hotel in Las Vegas, Nevada (Photo courtesy of dave_7/flickr) Robert and Joan have spent their entire lives in Cudahy, Wisconsin, a small town of about 18,000 The high school sweethearts got married after graduation and later bought a house After Robert served two years inthe Army, he came home and accepted a job 2/3 IntroductiontoSocialStratificationintheUnitedStatesin a foundry, working on machinery and equipment Joan worked as a hotel receptionist until she quit her job to raise their two children, Michael and Lisa Robert and Joan worked hard to make sure their kids had good lives The kids went to Cudahy High School, like their parents, and took part in many extracurricular activities Michael played football and Lisa participated inthe debate team and Spanish Club, and served as class vice president After high school, Michael’s and Lisa’s lives took two divergent paths Michael stayed close to home, earning a degree in hotel management at a community college He began working the front desk of a downtown Milwaukee hotel, a job similar tothe one his mother held so long ago He married Donna, a high school classmate who now worked in a day-care center The couple bought a house two miles from his parents and eventually had three children of their own Lisa’s experiences, meanwhile, took her from place to place She double-majored in psychology and social work at the University of Wisconsin-Madison, then was accepted tothe University of California-Berkeley, where she earned her master’s and doctoral degrees inSocial Welfare She worked as a teaching assistant and helped organize a summit on institutional racism Lisa received a grant to start a Hispanic youth program in Denver, Colorado There, she met Mario, a cook, and helped him learn English The couple soon got married and moved into an apartment in a poor section of the city They had a daughter, Alaina Soon after, Lisa accepted an assistant professorship at the University of Colorado That summer, while visiting her hometown of Cudahy, Lisa revealed some surprising news to her parents She explained that she, Mario, and Alaina, were moving to Torreón, Mexico, to be close to Mario’s family Lisa would research for a book proposal she’d written and guest lectured at the nearby university They planned to return in two or three years, in time for Alaina to start school intheUnitedStates Robert and Joan were proud of their children Michael and Lisa both had happy marriages, healthy children, and secure jobs However, Robert and Joan puzzled over the different life paths their children took Michael married a local woman, worked inthe area, and stayed close with family and friends Lisa moved far from home, married a foreigner, was fluent in two languages, and wanted to live in a foreign country Joan and Robert had trouble understanding their daughter’s choices Michael was a chip off the old block, while Lisa seemed like a stranger 3/3 Downloaded from http://aidsinfo.nih.gov/guidelines on 12/14/2012 EST.
Recommendations for Use of Antiretroviral Drugs in Pregnant
HIV-1-Infected Women for Maternal Health and Interventions to
Reduce Perinatal HIV Transmission intheUnited States
Downloaded from http://aidsinfo.nih.gov/guidelines on 12/14/2012 EST.
Visit the AIDSinfo website to access the most up-to-date guideline.
Register for e-mail notification of guideline updates at http://aidsinfo.nih.gov/e-news.
Downloaded from http://aidsinfo.nih.gov/guidelines on 12/14/2012 EST.
Recommendations for Use of Antiretroviral Drugs
in Pregnant HIV-1-Infected Women for Maternal
Health and Interventions to Reduce Perinatal HIV
Transmission intheUnited States
Developed by the HHS Panel on Treatment of HIV-Infected
Pregnant Women and Prevention of Perinatal Transmission —
A Working Group of the Office of AIDS Research Advisory Council (OARAC)
How to Cite the Perinatal Guidelines:
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal
Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-
Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV
Transmission intheUnited States. Available at
http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf.
Accessed (insert date) [include page numbers, table number, etc. if applicable]
It is emphasized that concepts relevant to HIV management evolve rapidly. The Panel has a
mechanism to update recommendations on a regular basis, and the most recent informa-
tion is available on the AIDSinfo website (http://aidsinfo.nih.gov).
access AIDSinfo
mobile site
Downloaded from http://aidsinfo.nih.gov/guidelines on 12/14/2012 EST.
Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to
Reduce Perinatal HIV Transmission intheUnitedStates i
What’s New inthe Guidelines? (Last updated July 31, 2012; last reviewed
July 31, 2012)
Key changes made to update the September 14, 2011, version of the guidelines are summarized below.
Throughout the revised guidelines, significant updates are highlighted and discussed. The addendum to the
guidelines—Supplement: Safety and Toxicity of Individual Antiretroviral Agents in Pregnancy—
includes updated information from the Antiretroviral Pregnancy Registry and updates on recent studies of
various antiretroviral agents in human pregnancy.
Lessons from Clinical Trials of Antiretroviral Interventions to Reduce Perinatal
Transmission of HIV and Table 3, Results of Major Studies on Antiretroviral Prophylaxis
to Prevent Mother-to-Child Transmission of HIV:
• Table 3 updated to include data on 48-week results of the Breastfeeding and Nutrition (BAN) study
in Malawi.
Preconception Counseling and Care for HIV-Infected Women of Childbearing Age and
Table 4, Drug Interactions Between Hormonal Contraceptives and Antiretroviral Agents:
• Table 4 updated NATIONAL ACTION PLAN for
CHILD INJURY PREVENTION
An Agenda to Prevent Injuries and Promote the Safety
of Children and Adolescents intheUnited States
The National Action Plan for Child Injury Prevention is a publication of the National Center
for Injury Prevention and Control of the Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention
Thomas R. Frieden, MD, MPH, Director
National Center for Injury Prevention and Control
Linda C. Degutis, DrPH, MSN, Director
Division of Unintentional Injury Prevention
Grant T. Baldwin, PhD, MPH, Director
Suggested citation:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
National Action Plan for Child Injury Prevention. Atlanta (GA): CDC, NCIPC; 2012
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
An Agenda to Prevent Injuries and Promote
the Safety of Children and Adolescents inthe
United States
NATIONAL ACTION PLAN
for CHILD INJURY PREVENTION
2012
[...]... list of actions by type of injury • Develop and mobilize a plan: Outline a plan of action as a platform for organizing and implementing child injury prevention actions for theUnitedStates • Evaluate and monitor progress: Evaluate and monitor the progress made intheUnitedStatesinthe coming years after attending to recommendations laid out inthe plan 32 National Action Plan for Child Injury Prevention... Framework for Action? The plan is structured across six domains relevant to child injury prevention, each containing goals and actions based on what we know, where we need to go, and how to get there The following six domains comprise the blueprint for action: 1 Data and surveillance: includes the ongoing and systematic collection, analysis, and interpretation of child health data for planning, implementing,... understanding of child injuries to inform program and policy decisions 35 DATA AND SURVEILLANCE Goal: Upgrade and enhance systems to address gaps in data Data collected in existing systems can be enhanced by improving the methods used to obtain, aggregate, and expand the information collected New tools to measure the economic costs and comparative effectiveness of child injury prevention, treatment, and. .. Protect the Ones You Love website at www.cdc.gov/safechild 16 National Action Plan for Child Injury BioMed Central Page 1 of 10 (page number not for citation purposes) Human Resources for Health Open Access Research National trends intheUnitedStates of America physician assistant workforce from 1980 to 2007 Xiaoxing Z He* 1 , Ellen Cyran 2 and Mark Salling 2 Address: 1 Department of Health Sciences, Cleveland State University, 2121 Euclid Avenue HS 122, Cleveland, OH 44115, USA and 2 Northern Ohio Data & Information Service, Cleveland State University, 1717 Euclid Avenue, Cleveland, OH 44115, USA Email: Xiaoxing Z He* - xiaoxing.he@jhsph.edu; Ellen Cyran - e.cyran@csuohio.edu; Mark Salling - m.salling@csuohio.edu * Corresponding author Abstract Background: The physician assistant (PA) profession is a nationally recognized medical profession intheUnitedStates of America (USA). However, relatively little is known regarding national trends of the PA workforce. Methods: We examined the 1980-2007 USA Census data to determine the demographic distribution of the PA workforce and PA-to-population relationships. Maps were developed to provide graphical display of the data. All analyses were adjusted for the complex census design and analytical weights provided by the Census Bureau. Results: In 1980 there were about 29 120 PAs, 64% of which were males. By contrast, in 2007 there were approximately 97 721 PAs with more than 66% of females. In 1980, Nevada had the highest estimated rate of 40 PAs per 100 000 persons, and North Dakota had the lowest rate (three). The corresponding rates in 2007 were about 85 in New Hampshire and ten in Mississippi. The levels of PA education have increased from less than 21% of PAs with four or more years of college in 1980, to more than 65% in 2007. While less than 17% of PAs were of minority groups in 1980, this figure rose to 23% in 2007. Although nearly 70% of PAs were younger than 35 years old in 1980, this percentage fell to 38% in 2007. Conclusion: The trends of sustained increase and geographic variation inthe PA workforce were identified. Educational level, percentage of minority, and age of the PA workforce have increased over time. Major causes of the changes inthe PA workforce include educational factors and federal legislation or state regulation. Background The physician assistant (PA) profession of theUnitedStates of America (USA) emerged inthe late 1960s, and has continued to thrive, becoming internationally recog- nized [1-3]. As health care professionals, PAs are licensed to practice medicine with physician supervision [4]. PAs' practices are not only inthe areas of primary care, internal medicine, family medicine, pediatrics, obstetrics, and gynecology, but also in surgery and the surgical subspe- cialties. Physicians may delegate to PAs those medical duties that are within the physician's scope of practice and the PA's training and experience. Therefore, a broad range of diagnostic and therapeutic services are delivered by PAs to diverse RESEARCH Open Access A national survey of ‘inactive’ physicians intheUnitedStates of America: enticements to reentry Ethan A Jewett 1 , Sarah E Brotherton 2* , Holly Ruch-Ross 3 Abstract Background: Physicians leaving and reentering clinical practice can have significant medical workforce implications. We surveyed inactive physicians younger than typical retirement age to determine their reasons for clinical inactivity and what barriers, real or perceived, there were to reentry into the medical workforce. Methods: A random sample of 4975 inactive physicians aged under 65 years was drawn from the Physi cian Masterfile of the American Medical Association in 2008. Physicians were mailed a survey about activity in medicine and perceived barriers to reentry. Chi-square statistics were used for significance tests of the association between categorical variables and t-tests were used to test differences between means. Results: Our adjusted response rate was 36.1%. Respondents were fully retired (37.5%), not currently active in medicine (43.0%) or now active (reentered, 19.4%). Nearly half (49.5%) were in or had practiced primary care. Personal health was the top reason for leaving for fully retired physicians (37.8%) or those not currently active in medicine (37.8%) and the second highest reason for physicians who had reentered (28.8%). For reentered (47.8%) and inactive (51.5%) physicians, the primary reason for returning or considering returning to practice was the availability of part-time work or flexible scheduling. Retired and currently inactive physicians used similar strategies to explore reentry, and 83% of both gro ups thought it would be difficult; among those who had reentered practice, 35.9% reported it was difficult to reenter. Retraining was uncommon for this group (37.5%). Conclusion: Availability of part-time work and flexible scheduling have a strong influence on decisions to leave or reenter clinical practice. Lack of retraining before reentry raises questions about patient safety and the clinical competence of reentered physicians. Background Physician reentry first achieved recognition as an impor- tant workforce policy issue i n 2002, with an artic le by Mark et al. in which physician reentry was defined as “returning, after an extended absence, tothe profes- sional activity/clinical practice f or which on e has bee n trained, certified or licensed” [1]. Discussions within theUnitedStates of America began among federal policy makers, medical and specialty societies, and educators, leading tothe American Academy of Pediatrics (AAP) establishing a multi-organizational Physician Reentry into the Workforce Project (Reentry Project) in 2006. In 2008, the AAP and the American Medical Association (AMA) co-sponsored the Physician Reentry tothe Workforce Conference to identify steps for the imple- mentation of a formal physician reentry system. Both ... After Robert served two years in the Army, he came home and accepted a job 2/3 Introduction to Social Stratification in the United States in a foundry, working on machinery and equipment Joan worked.. .Introduction to Social Stratification in the United States The car a person drives can be seen as a symbol of money and power This Rolls Royce sits outside the Bellagio Hotel in Las Vegas,... children of their own Lisa’s experiences, meanwhile, took her from place to place She double-majored in psychology and social work at the University of Wisconsin-Madison, then was accepted to the University