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Breastfeeding and Childhood Obesity
C O N V E R S A T I O N S
W I T H
C O L L E A G U E S
,It’s no wonder that health
Breastfeeding and Childhood Obesity Exploring the Links adgenefits I heard a lactation consultant describe a link between breastfeeding and preventing childhood obesity. Is there any evidence for this claim? Interestingly, a study published at the end of 1999 in the British Medical Journal would substantiate that claim. Researchers examined approximately 10,000 school children in Germany who were breastfed or were bottle fed. The children were examined at either age 5 or age 6 and measurements, such as height, weight, and BMI were recorded. Researchers discovered that the prevalence for obesity in children who were never breastfed was 4.5 percent, compared with 2.8 percent in those who were breastfed at birth. Researchers also noted a 30 percent risk reduction for excessive weight and a 40 percent reduction in obesity risk for those who were breastfed exclusively for at least six months. The researchers concluded that promoting breastfeeding for newborns for at least the first six months may aid in helping children maintain a healthy weight (BMJ, 319: 147-150).
. A. I)
Examining Certification I’ve been reading with interest the different viewpoints a expressed by nurses in AWHONN Lifelines regarding certification. I was wondering if there’s any evidence in support of certification? What a timely question. In fact, findings from a large, unpublished study of U.S. and Canadian nurses who hold professional certification, indicate that such certification is one aspect in reducing total health care errors, according to statements from the American Nurses Credentialing Center (ANCC). In the wake of an Institute of Medicine study that found that health care errors kill as many as 98,000 people a year, this study sought to determine the link between certification and error reduction. The study, conducted by the Nursing Credentialing Research Coalition, evaluated responses provided by more than 19,500 certified nurses regarding demographics, and personal and professional outcomes enabled by certification. Study participants were selected randomly from 20 of the 23 current nurse cer~
A
AWWONN L i f e l i n e s
tifying bodies. Specifically, nurses in the study stated that certification enabled them to experience fewer adverse events and fewer errors in patient care; it also helped them feel more confident in their ability to detect early sign/symptoms of complications in patients and to initiate early and prompt interventions for such complications. Clearly, controlled, randomized research is needed to support the claims made by this survey, but the results are intriguing. Currently, more than 350,000 of the more than 2 million nurses nationwide and in Canada hold professional certification in their field of specialty.
Gauging Herbal Interactions I read recently that some herbs, such as S t . John’s Wort, may pose increased risks for dangerous interactions with prescription drugs. With more and more women telling health care practitioners about the herbs and supplements they use, I‘d like to know if there are any good resources practitioners can use to counsel patients regarding possible interactions?
care practitioners seek practical resources for counseling patients who consume herbals and other over-the-counter supplements. Recent studies published in The Lancet (Feb. 12, 2000) found that St. John’s Wort (Hypericum perforaturn) may interact with several prescription drugs. Also, a recent FDA advisory concerning the use of the antiHIV protease inhibitor Indinavir concurrently with products containing St. John’s Wort, have prompted these questions. The limited research about herbs and supplements has contributed to a severe shortage of authoritative information, as does a lack of reporting mechanisms for adverse events associated with herbs and nutriceutical consumption. Surveys have also shown that, although a significant shift is underway, a majority of patients who consume herbs and supplements do not inform their health care providers about using these products. Information about interactions and adequate reporting procedures are therefore crucial in developing a framework of information about interactions, which can serve to further research, product safety, consumer and health professional education, and regulatory initiatives, such as accurate product labeling. In answer to your inquiry, there are a number of places where practitioners can start, in addition to the published literature. Check out these: Integrative Medical Arts has established an Internet-based resource for reporting interactions and adverse reactions involving herbs and nutritional supplements: http://www.lnteractionReport. org, Interactions” is a comprehensive database resource on drug-herb and drug-nutrient interactions. This publication is available on CD-ROM and will soon be accessible on the Web at http://www.lBISpro.com and select websites HealthWWWeb is IBIS’S consumer division and is host of a consumer-based website that details the interactions of herbs and perscription drugs. Visit http://www.choicesforhealth.com to learn more
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Volume 4, issue 2
W I T H
C O L L E A G U E S
,It’s no wonder that health
Breastfeeding and Childhood Obesity Exploring the Links adgenefits I heard a lactation consultant describe a link between breastfeeding and preventing childhood obesity. Is there any evidence for this claim? Interestingly, a study published at the end of 1999 in the British Medical Journal would substantiate that claim. Researchers examined approximately 10,000 school children in Germany who were breastfed or were bottle fed. The children were examined at either age 5 or age 6 and measurements, such as height, weight, and BMI were recorded. Researchers discovered that the prevalence for obesity in children who were never breastfed was 4.5 percent, compared with 2.8 percent in those who were breastfed at birth. Researchers also noted a 30 percent risk reduction for excessive weight and a 40 percent reduction in obesity risk for those who were breastfed exclusively for at least six months. The researchers concluded that promoting breastfeeding for newborns for at least the first six months may aid in helping children maintain a healthy weight (BMJ, 319: 147-150).
. A. I)
Examining Certification I’ve been reading with interest the different viewpoints a expressed by nurses in AWHONN Lifelines regarding certification. I was wondering if there’s any evidence in support of certification? What a timely question. In fact, findings from a large, unpublished study of U.S. and Canadian nurses who hold professional certification, indicate that such certification is one aspect in reducing total health care errors, according to statements from the American Nurses Credentialing Center (ANCC). In the wake of an Institute of Medicine study that found that health care errors kill as many as 98,000 people a year, this study sought to determine the link between certification and error reduction. The study, conducted by the Nursing Credentialing Research Coalition, evaluated responses provided by more than 19,500 certified nurses regarding demographics, and personal and professional outcomes enabled by certification. Study participants were selected randomly from 20 of the 23 current nurse cer~
A
AWWONN L i f e l i n e s
tifying bodies. Specifically, nurses in the study stated that certification enabled them to experience fewer adverse events and fewer errors in patient care; it also helped them feel more confident in their ability to detect early sign/symptoms of complications in patients and to initiate early and prompt interventions for such complications. Clearly, controlled, randomized research is needed to support the claims made by this survey, but the results are intriguing. Currently, more than 350,000 of the more than 2 million nurses nationwide and in Canada hold professional certification in their field of specialty.
Gauging Herbal Interactions I read recently that some herbs, such as S t . John’s Wort, may pose increased risks for dangerous interactions with prescription drugs. With more and more women telling health care practitioners about the herbs and supplements they use, I‘d like to know if there are any good resources practitioners can use to counsel patients regarding possible interactions?
care practitioners seek practical resources for counseling patients who consume herbals and other over-the-counter supplements. Recent studies published in The Lancet (Feb. 12, 2000) found that St. John’s Wort (Hypericum perforaturn) may interact with several prescription drugs. Also, a recent FDA advisory concerning the use of the antiHIV protease inhibitor Indinavir concurrently with products containing St. John’s Wort, have prompted these questions. The limited research about herbs and supplements has contributed to a severe shortage of authoritative information, as does a lack of reporting mechanisms for adverse events associated with herbs and nutriceutical consumption. Surveys have also shown that, although a significant shift is underway, a majority of patients who consume herbs and supplements do not inform their health care providers about using these products. Information about interactions and adequate reporting procedures are therefore crucial in developing a framework of information about interactions, which can serve to further research, product safety, consumer and health professional education, and regulatory initiatives, such as accurate product labeling. In answer to your inquiry, there are a number of places where practitioners can start, in addition to the published literature. Check out these: Integrative Medical Arts has established an Internet-based resource for reporting interactions and adverse reactions involving herbs and nutritional supplements: http://www.lnteractionReport. org, Interactions” is a comprehensive database resource on drug-herb and drug-nutrient interactions. This publication is available on CD-ROM and will soon be accessible on the Web at http://www.lBISpro.com and select websites HealthWWWeb is IBIS’S consumer division and is host of a consumer-based website that details the interactions of herbs and perscription drugs. Visit http://www.choicesforhealth.com to learn more
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Volume 4, issue 2