Most Cited International Journal of Orthopaedic and Trauma Nursing Articles The most cited articles published since 2012, extracted from Scopus. Ann Butler Maher | Anita J. Meehan | Mary P. O'Sullivan | Monica Schwartz Sellæg | Chris L. Wells | R. N. Malin Malmgren | R. N. Eva Törnvall | R. N. Inger JanssonRamon Z. Shaban | Preben U. Pedersen | Connie Bøttcher Berthelsen | Lap Fung Tsang | Chi Hung Yeung | Chi Chung Tse | Kit Bing Lam | Lai Ping Cheung | Kwok Keung Chu | Chiu Kit Tsang | Chun Kwan Wong | Heung Wah Law | Skip to main content A to Z Health Guide The information shared on our websites is information developed solely from internal experts on the subject matter, including medical advisory boards, who have developed guidelines for our patient content. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail.
Please consult a physician for specific treatment recommendations. Explore articles by related topicYour body can get vitamin D from foods fortified with vitamin D, supplements or from producing it with the help of sunlight. Only a few foods have vitamin D, and you may not be able to meet your own needs and that of your nursing infant through diet alone. Studies have shown that dietary vitamin D supplements increase the amount of vitamin D available to the infant, helping meet the needs of both mother and baby. You should consult your doctor, however, before you add any supplement to your diet. Infants age zero to 12 months need 400 IU of vitamin D daily. A baby that is exclusively breast fed and not given supplements will need to get this from the mother. Females age 14 to 50 years need 600 IU per day, according to the National Institutes of Health’s Office of Dietary Supplements. The same recommendation is made for women who are pregnant or nursing. A 2004 study published in the “American Journal of Clinical Nutrition” indicated that the vitamin D level of a nursing infant was directly correlated to the intake of the mother.
Nursing mothers were given either 2000 or 4000 IU of vitamin D per day for three months. It was found that vitamin D concentrations in the mothers and infants increased substantially in both groups, with a more significant increase with the higher dosage. The amount of vitamin D found in the infants was a reflection of the vitamin D level of the mothers’ breast milk. The researchers contended that 2000 IU of vitamin D per day for nursing mothers would only have limited success in providing adequate vitamin D for infants, suggesting that 4000 IU would go further in meeting the needs of both mother and baby. You can attempt to get your daily vitamin D allowance from foods by paying close attention to your diet. Roughly 3 oz. of cooked salmon will give you 447 IU of vitamin D, while the same amount of mackerel will provide 388 IU, and a large egg has 41 IU. You can find vitamin D fortified milk, yogurt, orange juice, margarine and cereals on grocery shelves. Baby formulas in the United States are all fortified with vitamin D. Fish oils are excellent sources of vitamin D, with 1 tbsp. of cod liver oil having 1,360 IU of vitamin D.
Vitamin D can be toxic to your body when used in excessive amounts. The maximum daily amount, or tolerable upper intake level is 4000 IU per day for women, even while lactating. The upper limit for infants is 1000 IU up to six months, and 1500 IU from seven to 12 months. Use care when taking supplements to avoid toxicity to yourself and your nursing child. The American Academy of Pediatrics suggests that breast fed babies be given 400 IU of vitamin D in supplements until they are weaned and drinking fortified formula. Let your doctor help you define and meet your vitamin D needs and that of your baby. Recommended Vitamins While Breastfeeding 5 Things You Need to Know About What Causes Mucus in Stool Foods to Eat & Natural Remedies for Irritable Bowel & Gastritis How to Cook Boneless Skinless Chicken Breasts in the Crock-Pot What Vitamins to Take for Ages 40 to 45 What Does High Vitamin C While Breast-feeding Do? How to Cook Pork in a Crock-Pot The Importance of Postnatal Vitamins
Safety of Taking B12 While Nursing 3 Ways to Identify Symptoms of Gastritis Inflammation Benefits of Taking Vitamin E While Breastfeeding When Do I Stop Taking Prenatal Vitamins? Calcium Supplements for Breastfeeding Moms Which Vitamins Should You Take After Having a Baby? Should I Take Vitamin C in Powder or Pill Form?Note: This guideline is currently under review. Atopic eczema (AE) or atopic dermatitis (AD) is a dry, itchy, inflammatory, chronic skin disease that typically begins in early childhood, affecting around 30% of children. This condition can worsen and cause intractable pruritus, soreness, infection and sleep disturbance. The onset of eczema is usually before 12 months and it follows a remitting and relapsing course. Most children will "grow out of" eczema before five years of age. There is no cure of AE, however if treated and managed well the disease has less impact on daily living and is less likely to have a negative effect on quality of life for the patient and family.
Following this link to create a personalised Eczema Treatment Plan. The UK Diagnostic Criteria for atopic eczema are: Plus 3 or more of the following: Patient assessment should be undertaken by either a medical officer or an eczema nurse consultant/ practitioner to grade the degree of eczema severity (mild, moderate or severe) and the presence or absence of infection. Use SCORAD (scoring atopic dermatitis) index calculator to calculate the severity score. Eczema Treatments fall into two categories 1. Every day treatments and avoidance of triggers (these treatments are ongoing regardless of the presence or absence of eczema) Avoiding environmental aggravatorsHeat, (clothes, heaters, hot cars, classrooms, hot baths, blankets)Prickly/rough material (wool, sandpits, tags)Dryness of the skinRegular moisturiser; top to toe at least twice a day even if the skin is clear of eczema. Do not double dip in the tub.adding salt, bleach 4% (sodium hypochlorite 4%) for chronic, infected eczema (or as recommended by a health professional) and bath oil.
Face and head should also be wet and the skin should NOT be rinsed.Consider Vitamin D oral supplementation 2. Flaring treatments these treatments should be used as soon as there is a flare (an acute deterioration), such as increasing erythema and itch, and weaned?? when the symptoms are controlled. Topical steroids/anti inflammatories (generally weaker for the face (e.g.hydrocortisone 1% (mild facial eczema), pimecrolimus(elidel cream) (moderate facial eczema) and stronger for the body e.g. advantan or elocon)Tar creams for lichenificationAntibiotics or antivirals for secondary infected. Usually orally however intravenous for severe infected eczema and when septic.Intranasal bactroban if nasal swabs are positive for Staphylococcus Aureus.Wet dressings (apply as soon as possible for severe eczema. For moderate eczema apply within 1-2 days of starting the topical steroids if the eczema has NOT cleared) There are 2 types of wet dressings that can be applied. Either can be recommended and cost the same amount.
This is quicker and easier to apply. Disposable towel and crepe bandage. This stays wetter longer. .au/uploadedFiles/Main/Content/derm/Wet_dressings_A3.pdf)The Wet dressing regime is as follows; Severe eczema QID for 3 days only (Admission or HITH may be referred to assist this acute phase)Then bd for 1 weekThen nightly until the eczema is clear and then recommence nightly if flaring.Moderate eczema Bd for 4 daysNightly until the eczema is clear and then recommence nightly if flaringMild eczema Nightly if needed until clear and then recommence nightly if flaring.Cool compressing (for immediate relief of itch) Apply to itchy areas for 5 -10 minutes, apply a moisturizer post compressingThese are also the wet dressing for the face, and are best applied while awake and when feeding All patients should have an Eczema Treatment Plan completed before they go home. To complete an Eczema Treatment Plan. Secondary bacterial infection of eczema is a common complication, it should be suspected if there is crusting, weeping, erythema, cracks, frank pus or multiple excoriations and increased itch suggest bacterial infection.
The usual organism is Staphylococcus aureus. Secondary herpes simplex 1 infection is characterised by a sudden onset of grouped, small white or clear fluid filled vesicles, satellite or "punch out" lesions, pustules, and erosions. It is often tender, painful and itchy. The principles of managing infected eczema are: Removing the crusts – cool compressing or soaking in the bathCortisone can be applied over open skin and presence of infection, however rove the crusts and weeping FIRSTLY.Bacterial infections:Oral antibiotics (cephalexin or flucloxacillin)IV antibiotics for children that are unwell due to the skin infectionAdd White King bleach (4%) to the cool bath water (29 – 30 degrees). The dilution should be 12 mls per 10 litres of water. The scalp and face should also be washed whilst bathing. Bleach can be added to the bath every dayPool salt can be added. The dilution is 100 grams per 10 litres of waterHerpes simplex virus 1 infected eczema: for best response start within 48 hours of onset of symptoms;
little benefit if treatment is delayed beyond 72 hours unless patient is immunocompromised or has progressive clinical state Oral aciclovirIV aciclovir for severe infections, unwell and febrile patients and threatened eye involvement (refer to opthamology ASAP for eye involvement) (Allergy Skin Prick Testing (SPT) is indicated if: Refer to immunologist, allergist or dermatologist for (SPT) and a dietician if food allergies are proven on SPT or RAST test. Allergy testing and advice Immunology or Allergy Department Family is unable to apply treatment at home Home and community care (HACC)- RCH only Royal District Nursing ServiceClinics are located in Collingwood, Kensington and Broadmeadows. Patients are seen by a nurse consultant within 14 calendar days. Click here for referral form For further assistance the Dermatology Registrars and Nurse Practitioners can be paged via switchboard. Please remember to read the disclaimer. The development of this clinical guideline was coordinated by Emma King, Nurse Practitioner, Dermatology Department.