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BackgroundOptimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia.MethodsThe study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother’s breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1–4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors.ResultsMost mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed  at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20–39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9–3.8, P <0.001 and AOR = 2.5, 95%CI 2.1–3.0, P <0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period.ConclusionsOur findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.

Background:Duplication of the pituitary gland (DPG) is a rare craniofacial developmental anomaly occurring during blastogenesis with postulated etiology such as incomplete twinning, teratogens, median cleft face syndrome or splitting of the notochord. The complex craniocaudal spectrum of blastogenesis defects associated with DPG is examined with an illustrative case.Case Description:We report for the first time in the medical literature some unique associations with DPG, such as a clival encephalocele, third cerebral peduncle, duplicate odontoid process and a double tongue with independent volitional control. This patient also has the previously reported common associations such as duplicated sella, cleft palate, hypertelorism, callosal agenesis, hypothalamic enlargement, nasopharyngeal teratoma, fenestrated basilar artery and supernumerary teeth. This study also reviews 37 cases of DPG identified through MEDLINE literature search from 1880 to 2011. It provides a detailed analysis of the current case through physical examination and imaging.Conclusion:The authors propose that the developmental deformities associated with duplication of pituitary gland (DPG) occur as part of a developmental continuum, not as chance associations. Considering the fact that DPG is uniquely and certainly present throughout the spectrum of these blastogenesis defects, we suggest the term DPG-plus syndrome.

Monolayer cultures of human calcitonin-secreting cells (C-cells) have been derived from medullary thyroid carcinomas. The cultures were prepared from cell suspensions obtained by enzymatic digestion of surgical specimens of the tumor. Human calcitonin (hCT) secretion by these cells was studied using a specific radioimmunoassay for the hormone. The cultures could be used for reproducible secretion studies up to 40 days after their initiation; they demonstrated a linear rate of hormone secretion in the basal state for at least 4 h. Calcium, pentagastrin, and prostaglandin E2 (PGE2) each produced a marked increase (up to 7-fold) in hormone secretion. Magnesium had no apparent secretory effect; and compared to PGE2, PGF2alpha had only a small secretory effect. In addition to responding to specific secretagogues shown to regulate calcitonin secretion in vivo, the secretory effects of each of the secretagogues could be raipdly reversed. Therefore, these cultures of human C-cells exhibit secretory responses which are quantitatively and qualitatively similar to C-cells in vivo. Accordingly, such cultures provide a useful model to study the regulation of calcitonin secretion in human C-cells.