Early childhood (birth to 8 years of age) is key to achieving a human being’s maximum developmental potential. This stage comprises the most sensitive period for brain development. This is the time of life when children's developmental potential is most susceptible to environmental stimuli and early experiences, which influence learning, health, behavior and, in the long term, adult social relationships and well-being.
In gestations with high risk of prematurity or potentially needing admission to the Neonatal Care Unit, prenatal admission is an opportunity for communication with the pregnant women.
Evidence-based counseling about the benefits of human milk feeding is a public health intervention that improves breastfeeding rates. Repeated prenatal informational interviews are more effective than isolated interventions and should be documented in the medical record.
Banked human milk (BHM) is the alternative of choice for feeding preterm infants (PTNB) as it provides the opportunity for them to receive a diet consisting of exclusive human milk when the milk of the baby’s own mother is unavailable, scarce or contraindicated.
In terms of its benefits, BHM is somewhat inferior to the mother's own, but superior to artificial formula.
Nutritional interventions are important in the development of young children. However, they are not enough on their own. They must be accompanied by responsive care in the context of early learning opportunities.
A paradigmatic example of adequate nutrition and responsive care is the feeding of human milk on demand to newborns and infants.
The definition of the word “substitute” implies something that has properties similar to those of another thing and may replace it with a lesser degree of quality, or an imitation of lesser quality than the original.
A human milk substitute is any food marketed as a partial or total substitute for breast milk, and the elements for its administration, whether or not they are suitable for that purpose.
The International Code of Marketing of Human Milk Substitutes applies to marketing strategies for the following milk substitute products:
The International Code of Substitutes consists of a set of recommendations aimed at regulating the aggressive and improper marketing of human milk substitutes, bottles and teats, which compete with breastfeeding.
In 1981, the 34th World Health Assembly adopted the International Code of Marketing of Human Milk Substitutes as a minimum requirement to protect and promote adequate feeding of infants and young children.
According to the evidence available, vaccination against Covid 19 disease during pregnancy is safe for both mother and baby.
It is important to discuss this with the health care professional that cares for that pregnancy to promote an informed decision about immunization.
Unvaccinated pregnant women are at increased risk of becoming seriously ill, needing intensive care, and even dying. When they get Covid, birth may be triggered prematurely.
It is very important to discuss vaccinations with the professional who is monitoring pregnancy.
Here are the key issues concerning the vaccination of pregnant women, to be considered from the first antenatal visits:
Education. Conveying quality information can change one of the main barriers against vaccination, i.e., lack of knowledge about susceptibility to vaccine-preventable diseases, the morbidity caused by those diseases, and the risks and benefits of vaccines.
There is evidence about aspects that influence the population's acceptance of vaccines. These should be strategically considered by members of the health team and by those who manage resources for vaccination campaigns.
These aspects include:
Trust: In the efficacy and safety of vaccines and in the delivery system.
Indifference: Some people have a low perception of the risk of vaccine-preventable diseases, leading them to believe immunization is unnecessary. Indifference may be determined by underestimation of their benefit (efficacy or safety) or by knowledge gaps.
Sometimes, several vaccines must be administered simultaneously during pregnancy; such is the case of Tdap (tetanus and diphtheria toxoids with acellular pertussis vaccine) and influenza vaccine, for instance.
In studies that enrolled non-pregnant individuals to assess the safety of concurrent administration of Tdap and influenza vaccines, compared to their separate use, there was no evidence of increased risk of adverse events.