婴儿贫血问题

From: http://www.economist.com/node/21540226 Infantile anaemia Blood simple A small change in how babies are delivered might abolish infantile anaemia 想防止婴儿贫血？很简单 CHILDHOOD anaemia is a problem. Around the world, almost a quarter of under-fives suffer from it. And anaemia is not a trivial thing. A child’s development, both physical and mental, is stifled by a lack of iron. The reason is that, besides its well-known role in haemoglobin, the oxygen-transporting molecule in the blood, iron is also involved in many aspects of brain development. 儿童贫血是个问题。全世界四分之一五岁以下的儿童都患有这种病。贫血可不是件小事。缺铁会阻碍儿童的身体和智力上的发育。原因在于，除了铁在血红蛋白（血液中运输氧气的颗粒）中的重要性，大脑发育的很多方面都需要铁。 A study just published in the British Medical Journal by Ola Andersson, an obstetrician at the Hospital of Halland in Halmstad, Sweden, suggests that a simple change of medical procedure when a child is born may bring a big reduction in anaemia. That change is not to cut the umbilical cord linking the child with the placenta straight after birth—as is standard practice—but, rather, to give it time to transfer more of the placenta’s contents (particularly its blood) to the child it has been nurturing. 《英国医疗期刊》发了一份瑞典哈尔姆斯塔德哈兰省医院的一位产科医师 Ola Andersson的研究。该研究显示，当婴儿出生时，只要做一个小小的医疗程序的改变就能够大幅减少贫血的发生。这个小改变就是在，在胎儿分娩后，不要按照标准的医疗程序立刻剪断脐带，而给点时间让脐带能够继续将一直滋养着婴儿的胎盘内容物（特别是血液）传输到婴儿体内。 The argument in favour of rapid clamping is that too much blood may flow from the detached placenta to the newly born child, and that this can cause problems of its own. But that is unproven, and would be a strike against evolution because, in nature, the umbilicus of a mammal usually does remain attached to the infant for some time after birth. Only the modern technology of clamps and sharp scissors permits the slithery tube to be dealt with at speed. 快速剪断脐带的论据是如果不这么做的话，会有过多血液从母亲体内流到新生儿体内，而这会引发母亲的问题。但是，这个论据是未经证实的，而且也有违进化论。因为，自然中，普通动物在分娩后，脐带还会与婴儿连接一段时间。只是产钳和剪刀的现代技术使得脐带能够被迅速剪断而已。 To test her idea that extended post partum connection to the placenta is good for a child’s health, Dr Andersson and her colleagues recruited 334 pregnant, non-smoking women whose fetuses appeared to be healthy. When these women came to term, their midwives followed one of two sets of instructions, chosen at random and given to them just before each birth. In 166 cases the newborns had their umbilical cords clamped within ten seconds of delivery. The other 168 had them clamped after at least three minutes had passed. 为了测试他延长与胎盘连接时间对婴儿健康有好处的想法，安德森医生和同事招募了334名产妇。这些产妇都不吸烟，她们体内的胎儿也很健康。当这些孕妇分娩时，她们的助产士随机进行这两种不同的分娩程序。166位新生儿在出生后的十秒钟就被剪断了脐带。而其他的168位新生儿在出生后三分钟之后才被剪断脐带。 When the children were four months old, Dr Andersson re-examined them and took a blood sample. Those babies whose umbilical clamps had been applied after three minutes had, on average, iron levels 45% higher than those whose cords had been clamped immediately. Put another way, only 0.6% of them were anaemic, compared with 5.7% of the rapidly clamped. 当这些婴儿四个月大时，安德森医生对他们再做了一次检查并取了血样。那些分娩三分钟后才被剪断脐带的婴儿体内的铁含量平均比那些一分娩就被剪断脐带的婴儿高45%。换句话说，前者只有0.6%的贫血，后者则有5.7%。 Rapid clamping of the umbilicus, then, seems to cause one child in 20 to become anaemic, at least in the early months of its life. Any experiment of this sort needs to be repeated, of course, to check it is correct. But if it is, then the burden of proof in the matter of when to cut the cord will have shifted from those who would cut late to those who would cut early. The cost of doing so would seem negligible; the benefit, great. 快速剪断脐带好像会导致5%的儿童至少在年少时贫血。当然，我们还需要重复进行这种实验来验证他是否正确。但是如果这个理论是正确的话，那么关于何时剪断脐带的举证责任将会从那些很晚之后才剪断脐带的人转移到那些很早就剪断脐带的人们身上。这么做的代价微乎其微，而益处却多多。 from the print edition-Science and technology http://article.yeeyan.org/view/247090/229669 Study: Infant formula ads reduce breastfeeding 研究显示：婴儿配方奶粉广告导致母乳喂养率降低 MANILA, Philippines – The World Health Organization said a study has found that Filipino mothers who have been influenced by advertisements or their doctors to use infant formula are two to four times more likely to feed their babies with those products. 菲律宾马尼拉——世界卫生组织称，一项研究发现，受广告和医生影响的母亲使用婴儿配方奶粉喂养婴儿的可能性是使用自己的乳汁喂养婴儿的2-4倍。 The study appears to support the Philippines' decision to limit advertising for infant formula, which can discourage mothers from breast-feeding that provides health benefits for newborns. 这项研究似乎支持菲律宾限制婴儿配方奶粉的广告的决定，这样的广告诱使母亲放弃有利于新生儿健康成长的母乳喂养。 Published by the Social Science and Medicine Journal in September and released this week, the study said those mothers were 6.4 times more likely to stop breast-feeding babies within one year of age — a step that raises risks of illness and death for the infant. 于本周发行的9月份的《社会科学和医学》杂志刊登了这项研究，研究显示，那些受广告诱惑的母亲在婴儿一岁前停止母乳喂养的可能性高出其他母亲5.4倍——增加婴儿患病和死亡风险的一步。 Breast milk significantly reduces infant mortality, according to international health experts, who recommend that mothers exclusively breast-feed for the first six months and continue breast-feeding, supplemented by solid foods, until their babies are 2 years old. 国际健康专家称，母乳在减少婴儿死亡率方面起着至关重要的作用。专家建议，婴儿的头六个月仅用母乳喂养，六个月以后到二岁之前，母乳再加一些固体食物喂养。 The International Code of Marketing of Breast-Milk Substitutes, sponsored by the World Health Organization and UNICEF, is not legally binding. It is up to individual countries to implement the code by enacting their own laws. 由世界卫生组织和联合国儿童基金会发起的母乳代用品销售国际守则不具有法律效力，它的执行依托于各个国家自己颁布的法律。 The Philippine study wanted to examine if marketing for breast milk substitutes was to blame for a drop in breast-feeding in the Southeast Asian country, one of several where multinational companies fought a legal battle for the right to aggressively sell baby formulas. 为在包含菲律宾在内的几个国家大举销售婴儿配方奶粉，一些跨国公司通过打官司来取得权益。菲律宾的研究旨在调查这个东南亚国家母乳喂养率的降低是否应归咎于母乳代用品的营销。 When the Philippine government tried to tighten its advertising laws for milk products, the companies took it to court. 在菲律宾政府努力加强乳制品广告法时，这些跨国公司将菲律宾政府告上了法庭。 The Supreme Court ruling in October 2007 upheld the Department of Health's mandate to regulate advertising of breast milk substitutes. It prohibited all health and nutrition claims but failed to support a full advertising ban, citing freedom of speech. 最高法院在2007年10年月作出裁决，支持卫生部关于控制母乳代用品广告的限制令。基于言论自由，它并不完全禁止母乳代用品的广告，但是不允许宣传健康和营养。 WHO data show exclusive breast-feeding rates for Filipino babies up to four months old dropped from 47.3 percent in 1998 to 40.1 percent in 2008. 国际卫生组织调查数据显示，菲律宾婴儿从出生到4个月间，纯母乳喂养率从1998年47.3%降到2008年的40.1%。 Four of the six authors of the study are from the WHO, led by the organization's medical officer Howard Sobel. They conducted a household survey between April and December 2006 and focus groups in April-May 2007. 这项研究由世界卫生组织的卫生官员霍华德•索伯领导，且六位研究人员中的四位来自世界卫生组织。在2006年4月至12间，他们进行家庭调查，在2007年4月到5月间，进行群体调查。 According to their findings, 59.1 percent of the mothers recalled an infant formula advertisement message and one-sixth reported a doctor recommended using formula. Those who recalled an ad message were twice as likely to feed their babies infant formula, while whose advised by a doctor where four times as likely to do so. 这项研究发现，59.1%的母亲记得一条婴儿配方奶粉的广告信息，1/6的母亲说，医生曾建议使用婴儿配方奶粉。那些记得一条广告信息的母亲使用婴儿配方奶粉喂养婴儿的可能性高出一倍，而那些被医生劝说的可能性要高出3倍。 "Despite poverty and extra strain on household income associated with formula use, 41.1 percent of the infants and young children were fed formula," the authors said. “尽管使用婴儿配方奶粉加重了家庭经济负担，但41.1%的婴幼儿仍在食用，”研究人员说。 The WHO says addition of formula leads to decreased stimulation from suckling and its reflex for breast milk production. Not breast-feeding also was associated with a 5.8 times increased risk of all-cause deaths in the first two months of life, with risks elevated up to the second year, it says. 世界卫生组织称，婴儿配方奶粉的添加致使吮吸刺激减少和泌乳反射降低，在刚出生的2个月里，非母乳哺育婴儿因各种原因引起的死亡风险是母乳喂养婴儿的5.8倍。 The authors said that despite the WHO's adoption in 1981 of the International Code of Marketing Breast Milk Substitutes to curtail unethical marketing promotions, few countries have fully implemented the code's ban on advertising or other forms of promotion. 研究人员说，为减少不道德的市场推广，在1981年世界卫生组织采用了母乳代用品销售国际守则，但只有为数极少的国家全面实施了守则在广告或其他形式的推广上的禁令，。 Alex V. Castro III, executive director of the Infant Pediatric Nutrition Association of the Philippines that groups infant formula makers, said the association fully supports breast-feeding. 菲律宾婴儿儿科营养学会对婴儿配方奶粉制造商进行分类，这个组织的常务董事亚历克斯•卡斯特罗三世说，该学会完全支持母乳喂养。 He said their members have been diligently complying with the Philippines' adaptation of the WHO's milk code, including prohibitions in advertising. He said no advertisement has been allowed without approval of an interagency headed by the Department of Health. 他说，他们的成员一直克尽职守地遵循菲律宾对世界卫生组织的母乳代用品销售守则的国内标准，包括广告方面的禁令，不经由卫生部牵头的相关各部门的批准，广告是不会放行的。 PAGE 10