Pregnancy-Induced Hypertension

Pregnancy-induced hypertension is a high-risk disorder that occurs in about 6% to 8% of pregnancies. In its mild forms, it is also known as preeclampsia and, in severe forms, as eclampsia. Early symptoms include a rise in blood pressure, excess protein in the urine, edema, changes in blood clotting, and nervous system disorders. Very severe effects, including convulsions, can occur in the second and third trimesters. If not controlled, eclampsia eventually damages the liver and kidneys, and both the mother and fetus may die. The population most at risk for this disorder is women over age 35 and those who have had multiple-birth pregnancies. A family history in the mother or father also increases risk, as does a generally inadequate diet, such as too little calcium.

Breastfeeding

Before the 1900s, if a mother didn't breastfeed (nurse) her infant, a substitute nursing mother (wet-nurse) was hired to do it. Formula feeding was fraught with compli­cations, primarily because people did not know the importance of sterilizing formulas against bacteria. Nor did people know much about the nutritional needs of infants. During the early 1900s, the technology of formulas based on cow's milk and methods of feeding improved. From the 1920s and especially in the 1940s, when women worked in armament factories during World War II, more and more babies were fed formula. Throughout the 1950s and early 1960s, interest in breastfeeding further waned. In the 1970s, breastfeeding enjoyed a resurgence, which has since leveled off.

Healthy People 2010 has set a goal of 75% of women nursing their infants at time of hospital discharge, 50% breastfeeding for 6 months, and 25% still breastfeeding at 1 year. The American Dietetic Association and the American Academy of Pediatrics (as well as corresponding Canadian organizations) recommend breastfeeding exclusively for the first 4 months and preferably 6 months, with the continued combination of breastfeeding and infant foods until 1 year. The World Health Organization goes be­yond that to recommend breastfeeding for at least 2 years, supplemented with other foods. Surveys show, however, that only about 55% of North American mothers now nurse their infants in the hospital, and at 4 and 6 months only 33% and 20% are still breastfeeding their infants, respectively. Thus, many women are leaving the hospital breastfeeding, but there is a large dropoff, especially after 2 weeks.

Women who choose to breastfeed usually find it an enjoyable, special time in their lives and their relationship with their new infant. Bottle feeding with an infant for­mula is also safe for infants, If a woman doesn't nurse her child, breast weight returns to normal very soon after birth.