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Breastfeeding and Smoking

Yıl 2021, Cilt: 30 Sayı: 3, 150 - 157, 30.09.2021
https://doi.org/10.17827/aktd.854101

Öz

It is desired to increase breastfeeding rates at national and international level. However, maternal smoking during the lactation period, which has negative effects on breastfeeding, is common both in our country and in Europe. Smoking during the breastfeeding period of the mother is directly related to the inhibition of the milk let-down reflex and the decrease in milk production. Maternal smoking during lactation causes changes in infants' sleep/wake patterns, deterioration of the pro-oxidant-antioxidant balance of breast milk, and low iodine-based breast milk transfer. In addition, in the babies of smoker mothers; bad taste from breast milk, restlessness, possibility of getting respiratory system infections such as pneumonia, asthma, bronchitis, risk of sudden infant death syndrome tendency to colic and obesity are more higher. Some mothers who smoke believe that it is safer to give formula than to breastfeed. In addition, there are mothers who ask questions such as whether smoking spoils the quality and taste of my milk, what can I do to make smoking less harmful to my baby, I smoke, can I breastfeed my baby in clinical practice. Medical staff Ali should be aware of the effects of nicotine exposure on infants of breastfeeding and smoking mothers during breastfeeding education and counseling, and should pay enough attention to this issue. Healthcare professionals should seize every opportunity to increase interest in breastfeeding, to raise awareness of the harm caused by cigarette exposure in the newborn, and to encourage smoking cessation.For this reason, the aim of this review is to review the literature on breastfeeding and smoking.

Kaynakça

  • Ocaktan C, Uyar Hazar H. İnsüline bağımlı diyabeti olan ve diyabeti olmayan kadınların emzirmeye ilişkin görüş ve uygulamalarının karşılaştırılması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2019;8(1):70-81.
  • Smokefree Women. Smoking & Your Baby. Available from: https://women.smokefree.gov/pregnancy-motherhood/quitting-while-pregnant/smoking-your-baby. Accessed: 31 December 2020
  • Ahmed F, Jean- Baptiste J, Thompson A, Nwokorie U, Nya GE, Bassey GO. Effects of maternal tobacco smoking on breastmilk composition and infant development: a literature review. J Bacteriol Mycol Open Access 2019;7(5):107-10. doi: 10.15406/jbmoa.2019.07.00254.
  • Ogbonna JC. Risk of maternal smoking on breastfed ınfants and the development of otitis media (Doktora tezi). USA, WaldenUniversitesi, 2016.
  • Primo CC, Ruela PBF, Brotto LDA, Garcia TR, Lima EF. Effects of maternal nicotine on breastfeeding infants. Rev Paul Pediatr. 2013;31(3):392-7. doi: 10.1590/S0103-05822013000300018.
  • Bachour P, Yafawi R, Jaber F, Choueiri E, Abdel-Razzak Z. Effects of smoking, mother’sage, body mass ındex, and parity number on lipid, protein, and secretory immunoglobulin a concentrations of human milk. Breastfeed Med. 2012;7(3):179-188. doi: 10.1089/bfm.2011.0038.
  • La Leche League GB. Smoking and Breastfeeding. Available from: https://www.laleche.org.uk/smoking-breastfeeding/. Accessed: 31 December 2020
  • La Leche League International. Smoking and Breastfeeding. Available from: https://www.llli.org/breastfeeding-info/smoking-and-breastfeeding/. Accessed: 31 December 2020
  • Napierala M, Mazela J, Merritt TA, Florek E. Tobacco smoking and breastfeeding: Effect on the lactation process, breast milk composition and infant development. A critical review. Environ Res. 2016; 151: 321–338. doi: 10.1016/j.envres.2016.08.002.
  • Kublay G, Terzioğlu F, Karatay G. Gebelik ve Sigara. 1. Baskı. Ankara: Klasmat Matbaacılık, 2008.
  • Mello PRB, Pinto GR, Botelho C. The influence of smoking on fertility, pregnancy and lactation. J Pediatr. 2001;77(4):257-264. doi: 10.2223/jped.232.
  • Pregnancybirth&baby. Smoking and pregnancy. Available from: https://www.pregnancybirthbaby.org.au/smoking-and-pregnancy. Accessed: 31 December 2020
  • Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli et al.. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015;13(327):1-7. doi:10.1186/s12967-015-0690-y.
  • Özcebe H. Çocuklar ve sigara. 1. Baskı. Ankara: Klasmat Matbaacılık, 2008.
  • Lawrence R, Schaefer C. Recreational drugs. In Drugs During Pregnancy and Lactation, 2nd ed (Schaefer C, Peters P, Miller RK):797-804. Elsevier London, Academic Press, 2007.
  • AAP (American Academy of Pediatrics ), ACOG (AmericanCollage of Obstetricians and Gynaecologists). Medications and Breastfeeding. In Breastfeeding Handbook for Physicians, 2nd ed (Eds Schanler RJ, Krebs NF, Mass SB): 175-178. AAP, 2014.
  • Lisboa CP, Oliveira E, Moura EG. Obesity and endocrine dysfunction programmed by maternal smoking in pregnancy and lactation. Front Physiol. 2012;437(3):1-9. doi: 10.3389/fphys.2012.00437.
  • Mennella JA, Yourshaw LM, Morgan LK. Breastfeeding and smoking: Short-term effects on infant feeding and sleep. Pediatrics. 2007;120(3):497-502. doi: 10.1542/peds.2007-0488.
  • La Leche League Türkiye. Sigara içen anneler bebeklerini emzirebilir mi? Erişim adresi: http://www.lllturkiye.org/2015/10/sigara-icen-anneler-bebeklerini.html. Erişim Tarihi: 31 Aralık 2020.
  • NationalInstitutes of Health (NIH). Cigarettes and other tobacco products drug facts. Available from: https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products. Accessed: 31 December 2020
  • United Nations International Children's Emergency Fund (UNICEF). Babies and mothers worldwide failed by lack of investment in breastfeeding. Available from: https://www.unicef.org/turkey/en/press-releases/babies-and-mothers-worldwide-failed-lack-investment-breastfeeding. Accessed: 31 December 2020.
  • TC Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. 2014 - 2017 Stratejik planı. Erişim adresi: https://hsgm.saglik.gov.tr/depo/kurumsal/plan-ve-faaliyetler/2014-2017-stratejik-plan.pdf. Erişim Tarihi: 31 December 2020
  • Dalzell J, Rogerson E, Martindale L. Supporting the continuation of breastfeeding. In Breastfeeding: Contemporary Issues in Practice and Policy, 1st: 91-116. New York : CRC Press, 2010.
  • Liu J, Rosenberg KD, Sandoval AP. Breastfeeding duration and perinatal cigarette smoking in a population-based cohort. Am J Public Health. 2006;96(2):309-314. doi: 10.2105/AJPH.2004.060798.
  • Lawrence RA, Lawrence RM. Medical complications of the mother. In Breastfeeding: A Guide for the Medical Profession, 8th: 559-627. Mosby, 2005.
  • British Medical Association (BMA). Smoking and reproductive life: The impact of smoking on sexual, reproductive and child health. Available from: https://www.rauchfrei-info.de/fileadmin/main/data/Dokumente/Smoking_ReproductiveLife.pdf. Accessed: 31 December 2020
  • Australian Breastfeeding Association (ABA). Breastfeeding and smoking. Available from: https://www.breastfeeding.asn.au/bfinfo/breastfeeding-and-smoking. Accessed: 31 December 2020
  • Women's Mental Health. Smoking While Breastfeeding: What Are the Risks? Available from: https://womensmentalhealth.org/posts/smoking-while-breastfeeding-what-are-the-risks/. Accessed: 31 December 2020
  • Women's Mental Health. You Asked: Is Smoking While Breastfeeding Safe? Availablefrom: https://womensmentalhealth.org/posts/asked-smoking-breastfeeding-safe/. Accessed: 31 December 2020
  • Breastfeedingnetwork. Smoking, Smoking Cessation and Breastfeeding. Available from: https://www.breastfeedingnetwork.org.uk/smoking/. Accessed: 31 December 2020
  • Zagierski, Szlagatys-Sidorkiewicz A, Jankowska A, Krzykowski G, Korzon M, Kaminska B. Maternal smoking decreases antioxidative status of human breast milk. J Perinatol. 2012;32:593–597. doi:10.1038/jp.2011.156.
  • Canıvet CA, Östergren P, Jakobsson IL, Dejın-Karlsson E, Hagander BM. Infantile colic, maternal smoking and infant feeding at 5 weeks of age. Scand J Public Health. 2008;36:284–91. doi: 10.1177/1403494807086981.
  • Bülbül HS, Ceyhun AG. Pasif sigara içiciliği. Türk Aile Hekimliği Dergisi. 2006;10(3):123-128.
  • American Academy of Pediatrics: Committee on Drugs. The transfer of drug sand other chemicals ınto human milk. Pediatrics. 2001;108(3):776-89. doı: 10.1542 / peds.108.3.776
  • Laurberg P, Nøhr SB, Pedersen KM, Fuglsang E. Iodine nutrition in breast-fed infants is impaired by materna lsmoking. J Clin Endocrinol Metab. 2004;89(1):181–187. doi: org/10.1210/jc.2003-030829.
  • Agostoni C, Marangoni F, Grandi F, Lammardo AM, Giovannini M, Riva E et al.. Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation. Eur J Clin Nutr. 2003;57:1466–1472. doi: 10.1038/sj.ejcn.1601711.
  • Hale TW. Hale’s Medications & Mothers’ Milk™ 2019. New York: Springer Publishing, 2019. doi: 10.1891/9780826150356.
  • Özata Ö, Kazkayası M. Sigaranın kulak burun boğaz hastalıklarının medikal ve cerrahi tedavisi üzerine etkileri. KBB-Forum. 2010;9(2):40-46.
  • Murphy TF. Otitis media, bacterial colonization, and the smoking parent. Clin Infect Dis. 2006;42(7):904-906. doi:10.1086/500942.
  • Yavuz H, Çakmak Ö, Yılmazer C, Özlüoğlu L. Otitis media. STED. 2000; 9(10). Erişim Linki: http://www.ttb.org.tr/STED/sted1000/2.html.
  • Oktar MA. Kliniğimizde son altı yıldır izlenen menenjit olgularının değerlendirilmesi (Uzmanlık tezi). İstanbul, T.C. Sağlık Bakanlığı Şişli Etfal Eğitim ve Araştırma Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, 2006.
  • Orhon FS. İnfantil kolik tanı ve tedavisinde güncel yaklaşımlar. Journal of Ankara University Faculty of Medicine. 2016;69 (3):160-66. doi:10.1501/Tıpfak_000000938.
  • Bruin JE, Gerstein HC, Holloway AC. Long-term consequences of fetal and neonatal nicotine exposure: A criticalreview. Toxicol Sci. 2010;116(2):364-74. doi: 10.1093/toxsci/kfq103.
  • Royal Collage of Obstetricians and Gynaecologists (RCOG). Smoking and pregnancy. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-smoking-in-pregnancy.pdf. Accessed : 31 December 2020
  • Amerikan Pediatri Akademisi (AAP). E-Cigarette Use During Pregnancy & Breastfeeding FAQs. Available from: https://www.healthychildren.org/English/ages-stages/prenatal/Pages/E-Cigarette-Use-During-Pregnancy-Breastfeeding.aspx. Accessed: 31 December 2020
  • National Health Service (NHS). Smoking cessation in pregnancy policy and guideline. Available from: https://www.northdevonhealth.nhs.uk/wp-content/uploads/2018/07/Smoking-Cessation-in-Pregnancy-Policy-and-Guideline-V.pdf. Accessed: 31 December 2020

Emzirme ve Sigara

Yıl 2021, Cilt: 30 Sayı: 3, 150 - 157, 30.09.2021
https://doi.org/10.17827/aktd.854101

Öz

Ulusal ve uluslarası düzeyde emzirme oranları artırılmak istenmektedir. Ancak emzirme üzerine olumsuz etkileri olan laktasyon döneminde maternal sigara kullanımı hem ülkemizde hem de Avrupa da yaygındır. Annenin emzirme döneminde sigara kullanımı, süt inme refleksinin engellenmesi, süt üretiminin azalması ve sütten erken kesilme ile doğrudan bağlantılı olup, bebeklerin uyku/uyanıklık düzeninin değişmesine, anne sütünün pro-oksidan-antioksidan dengesinin bozulmasına, anne sütünün uzun zincirli çoklu doymamış yağ asitlerinin miktarının azalmasına, düşük iyot kaynaklı anne sütü transferine neden olmaktadır. Bunların yanı sıra sigara içen annelerin bebeklerinde; anne sütünden kötü tat alma, huzursuzluk, ani bebek ölümü sendromu riski, pnömoni, astım, bronşit gibi solunum sistemi enfeksiyonlarına yakalanma olasılığı, kolik olma ve obeziteye eğilim daha yüksektir. Sigara kullanmakta olan bazı anneler emzirmek yerine formül maması vermenin daha güvenli olduğuna inanmaktadır. Bunun yanı sıra klinik uygulamalarda; sigara içiyorum bebeğimi emzirebilir miyim?, sigara içmek sütümün kalitesini ve tadını bozar mı?, sigaranın bebeğime daha az zarar vermesi için neler yapabilirim? şeklinde sorular yönelten annelere de rastlanmaktadır. Emzirme eğitimi ve danışmanlığı sırasında sağlık personeli; emziren ve sigara içen annelerin bebeklerinde nikotin maruziyetinin etkilerinin farkında olarak bu konuya yeterince önem vermelidir. Emzirmeye olan ilgiyi artırmak, sigara maruziyetinin yenidoğanda oluşturduğu zararlar konusunda farkındalık sağlamak ve sigara bırakmaya teşvik etmek için sağlık personeli her fırsatı değerlendirmelidir. Bu derlemenin amacı emzirme ve sigara konusundaki literatürü inceleyerek bilgilerimizi gözden geçirmektir.

Kaynakça

  • Ocaktan C, Uyar Hazar H. İnsüline bağımlı diyabeti olan ve diyabeti olmayan kadınların emzirmeye ilişkin görüş ve uygulamalarının karşılaştırılması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2019;8(1):70-81.
  • Smokefree Women. Smoking & Your Baby. Available from: https://women.smokefree.gov/pregnancy-motherhood/quitting-while-pregnant/smoking-your-baby. Accessed: 31 December 2020
  • Ahmed F, Jean- Baptiste J, Thompson A, Nwokorie U, Nya GE, Bassey GO. Effects of maternal tobacco smoking on breastmilk composition and infant development: a literature review. J Bacteriol Mycol Open Access 2019;7(5):107-10. doi: 10.15406/jbmoa.2019.07.00254.
  • Ogbonna JC. Risk of maternal smoking on breastfed ınfants and the development of otitis media (Doktora tezi). USA, WaldenUniversitesi, 2016.
  • Primo CC, Ruela PBF, Brotto LDA, Garcia TR, Lima EF. Effects of maternal nicotine on breastfeeding infants. Rev Paul Pediatr. 2013;31(3):392-7. doi: 10.1590/S0103-05822013000300018.
  • Bachour P, Yafawi R, Jaber F, Choueiri E, Abdel-Razzak Z. Effects of smoking, mother’sage, body mass ındex, and parity number on lipid, protein, and secretory immunoglobulin a concentrations of human milk. Breastfeed Med. 2012;7(3):179-188. doi: 10.1089/bfm.2011.0038.
  • La Leche League GB. Smoking and Breastfeeding. Available from: https://www.laleche.org.uk/smoking-breastfeeding/. Accessed: 31 December 2020
  • La Leche League International. Smoking and Breastfeeding. Available from: https://www.llli.org/breastfeeding-info/smoking-and-breastfeeding/. Accessed: 31 December 2020
  • Napierala M, Mazela J, Merritt TA, Florek E. Tobacco smoking and breastfeeding: Effect on the lactation process, breast milk composition and infant development. A critical review. Environ Res. 2016; 151: 321–338. doi: 10.1016/j.envres.2016.08.002.
  • Kublay G, Terzioğlu F, Karatay G. Gebelik ve Sigara. 1. Baskı. Ankara: Klasmat Matbaacılık, 2008.
  • Mello PRB, Pinto GR, Botelho C. The influence of smoking on fertility, pregnancy and lactation. J Pediatr. 2001;77(4):257-264. doi: 10.2223/jped.232.
  • Pregnancybirth&baby. Smoking and pregnancy. Available from: https://www.pregnancybirthbaby.org.au/smoking-and-pregnancy. Accessed: 31 December 2020
  • Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli et al.. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015;13(327):1-7. doi:10.1186/s12967-015-0690-y.
  • Özcebe H. Çocuklar ve sigara. 1. Baskı. Ankara: Klasmat Matbaacılık, 2008.
  • Lawrence R, Schaefer C. Recreational drugs. In Drugs During Pregnancy and Lactation, 2nd ed (Schaefer C, Peters P, Miller RK):797-804. Elsevier London, Academic Press, 2007.
  • AAP (American Academy of Pediatrics ), ACOG (AmericanCollage of Obstetricians and Gynaecologists). Medications and Breastfeeding. In Breastfeeding Handbook for Physicians, 2nd ed (Eds Schanler RJ, Krebs NF, Mass SB): 175-178. AAP, 2014.
  • Lisboa CP, Oliveira E, Moura EG. Obesity and endocrine dysfunction programmed by maternal smoking in pregnancy and lactation. Front Physiol. 2012;437(3):1-9. doi: 10.3389/fphys.2012.00437.
  • Mennella JA, Yourshaw LM, Morgan LK. Breastfeeding and smoking: Short-term effects on infant feeding and sleep. Pediatrics. 2007;120(3):497-502. doi: 10.1542/peds.2007-0488.
  • La Leche League Türkiye. Sigara içen anneler bebeklerini emzirebilir mi? Erişim adresi: http://www.lllturkiye.org/2015/10/sigara-icen-anneler-bebeklerini.html. Erişim Tarihi: 31 Aralık 2020.
  • NationalInstitutes of Health (NIH). Cigarettes and other tobacco products drug facts. Available from: https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products. Accessed: 31 December 2020
  • United Nations International Children's Emergency Fund (UNICEF). Babies and mothers worldwide failed by lack of investment in breastfeeding. Available from: https://www.unicef.org/turkey/en/press-releases/babies-and-mothers-worldwide-failed-lack-investment-breastfeeding. Accessed: 31 December 2020.
  • TC Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. 2014 - 2017 Stratejik planı. Erişim adresi: https://hsgm.saglik.gov.tr/depo/kurumsal/plan-ve-faaliyetler/2014-2017-stratejik-plan.pdf. Erişim Tarihi: 31 December 2020
  • Dalzell J, Rogerson E, Martindale L. Supporting the continuation of breastfeeding. In Breastfeeding: Contemporary Issues in Practice and Policy, 1st: 91-116. New York : CRC Press, 2010.
  • Liu J, Rosenberg KD, Sandoval AP. Breastfeeding duration and perinatal cigarette smoking in a population-based cohort. Am J Public Health. 2006;96(2):309-314. doi: 10.2105/AJPH.2004.060798.
  • Lawrence RA, Lawrence RM. Medical complications of the mother. In Breastfeeding: A Guide for the Medical Profession, 8th: 559-627. Mosby, 2005.
  • British Medical Association (BMA). Smoking and reproductive life: The impact of smoking on sexual, reproductive and child health. Available from: https://www.rauchfrei-info.de/fileadmin/main/data/Dokumente/Smoking_ReproductiveLife.pdf. Accessed: 31 December 2020
  • Australian Breastfeeding Association (ABA). Breastfeeding and smoking. Available from: https://www.breastfeeding.asn.au/bfinfo/breastfeeding-and-smoking. Accessed: 31 December 2020
  • Women's Mental Health. Smoking While Breastfeeding: What Are the Risks? Available from: https://womensmentalhealth.org/posts/smoking-while-breastfeeding-what-are-the-risks/. Accessed: 31 December 2020
  • Women's Mental Health. You Asked: Is Smoking While Breastfeeding Safe? Availablefrom: https://womensmentalhealth.org/posts/asked-smoking-breastfeeding-safe/. Accessed: 31 December 2020
  • Breastfeedingnetwork. Smoking, Smoking Cessation and Breastfeeding. Available from: https://www.breastfeedingnetwork.org.uk/smoking/. Accessed: 31 December 2020
  • Zagierski, Szlagatys-Sidorkiewicz A, Jankowska A, Krzykowski G, Korzon M, Kaminska B. Maternal smoking decreases antioxidative status of human breast milk. J Perinatol. 2012;32:593–597. doi:10.1038/jp.2011.156.
  • Canıvet CA, Östergren P, Jakobsson IL, Dejın-Karlsson E, Hagander BM. Infantile colic, maternal smoking and infant feeding at 5 weeks of age. Scand J Public Health. 2008;36:284–91. doi: 10.1177/1403494807086981.
  • Bülbül HS, Ceyhun AG. Pasif sigara içiciliği. Türk Aile Hekimliği Dergisi. 2006;10(3):123-128.
  • American Academy of Pediatrics: Committee on Drugs. The transfer of drug sand other chemicals ınto human milk. Pediatrics. 2001;108(3):776-89. doı: 10.1542 / peds.108.3.776
  • Laurberg P, Nøhr SB, Pedersen KM, Fuglsang E. Iodine nutrition in breast-fed infants is impaired by materna lsmoking. J Clin Endocrinol Metab. 2004;89(1):181–187. doi: org/10.1210/jc.2003-030829.
  • Agostoni C, Marangoni F, Grandi F, Lammardo AM, Giovannini M, Riva E et al.. Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation. Eur J Clin Nutr. 2003;57:1466–1472. doi: 10.1038/sj.ejcn.1601711.
  • Hale TW. Hale’s Medications & Mothers’ Milk™ 2019. New York: Springer Publishing, 2019. doi: 10.1891/9780826150356.
  • Özata Ö, Kazkayası M. Sigaranın kulak burun boğaz hastalıklarının medikal ve cerrahi tedavisi üzerine etkileri. KBB-Forum. 2010;9(2):40-46.
  • Murphy TF. Otitis media, bacterial colonization, and the smoking parent. Clin Infect Dis. 2006;42(7):904-906. doi:10.1086/500942.
  • Yavuz H, Çakmak Ö, Yılmazer C, Özlüoğlu L. Otitis media. STED. 2000; 9(10). Erişim Linki: http://www.ttb.org.tr/STED/sted1000/2.html.
  • Oktar MA. Kliniğimizde son altı yıldır izlenen menenjit olgularının değerlendirilmesi (Uzmanlık tezi). İstanbul, T.C. Sağlık Bakanlığı Şişli Etfal Eğitim ve Araştırma Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, 2006.
  • Orhon FS. İnfantil kolik tanı ve tedavisinde güncel yaklaşımlar. Journal of Ankara University Faculty of Medicine. 2016;69 (3):160-66. doi:10.1501/Tıpfak_000000938.
  • Bruin JE, Gerstein HC, Holloway AC. Long-term consequences of fetal and neonatal nicotine exposure: A criticalreview. Toxicol Sci. 2010;116(2):364-74. doi: 10.1093/toxsci/kfq103.
  • Royal Collage of Obstetricians and Gynaecologists (RCOG). Smoking and pregnancy. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-smoking-in-pregnancy.pdf. Accessed : 31 December 2020
  • Amerikan Pediatri Akademisi (AAP). E-Cigarette Use During Pregnancy & Breastfeeding FAQs. Available from: https://www.healthychildren.org/English/ages-stages/prenatal/Pages/E-Cigarette-Use-During-Pregnancy-Breastfeeding.aspx. Accessed: 31 December 2020
  • National Health Service (NHS). Smoking cessation in pregnancy policy and guideline. Available from: https://www.northdevonhealth.nhs.uk/wp-content/uploads/2018/07/Smoking-Cessation-in-Pregnancy-Policy-and-Guideline-V.pdf. Accessed: 31 December 2020
Toplam 46 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derleme
Yazarlar

Hale Uyar Hazar 0000-0002-1236-6929

Sinem Gültekin 0000-0002-1236-6929

Yayımlanma Tarihi 30 Eylül 2021
Kabul Tarihi 9 Haziran 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 30 Sayı: 3

Kaynak Göster

AMA Uyar Hazar H, Gültekin S. Emzirme ve Sigara. aktd. Eylül 2021;30(3):150-157. doi:10.17827/aktd.854101