Breastfeeding Difficulties Research Articles

Development of aids to relieve vulvodynia during the postpartum period.

Postpartum women live with a low quality of life due to pain caused by episiotomy and perineal laceration. In particular, they endure pain when sitting for long periods of time to breastfeed. The purpose of this study is to develop a sitting aid to alleviate postpartum vulvodynia. This study was conducted in the following four phases from July 2017 to May 2019. They are: material selection and molding, cleaning and disinfection testing, pressure distribution measurement testing, and trial testing by postpartum women. The main material was a 100% polypropylene object with a three-dimensional reticular fiber spring structure and fiber density of 3.8 kg/m2. As a result, a sitting aid that withstands washing and disinfection well in the medical field and is breathable. It had moderate resilience and elasticity and reduced pressure on the seating surface for women weighing approximately 45 kg and 55 kg, but we were skeptical about its use for women weighing more than that. The completed sitting aid is noninvasively effective in improving the quality of life of many postpartum women, but the density and thickness of the main material should be reexamined to meet the needs of women in a wider weight range. In addition, a self-administered questionnaire survey of trial users revealed that some women did not experience relief from vulvodynia even after using the sitting aid. Such women also had physical problems such as discomfort in the lower back, difficulty breastfeeding, and difficulty standing up. For women with multiple physical problems, individual causes should be addressed.

The interplay between emotional and breastfeeding difficulties in first-time mothers

ABSTRACT Aim/Background Both mental maternal health and breastfeeding difficulties impact maternal and infant health. The present study analyses the association between psychosocial and breastfeeding variables and maternal mental health. Design/Methods The participants were 107 first-time mothers from Chile. Sociodemographic variables and breastfeeding difficulties were assessed at 6 weeks postpartum. Depression and anxiety symptoms, parental self-efficacy, and perceived social support were measured using validated, self-report questionnaires at 6 weeks and 5 months postpartum. This study is a secondary analysis of an intervention trial. Results 76% of the women reported having experienced some breastfeeding difficulty in the first postpartum weeks. The number of breastfeeding difficulties was associated with maternal mental health symptoms at 6 weeks postpartum and parental self-efficacy at both assessment times. Women who did not experience breastfeeding difficulties presented significantly fewer depressive (t(102) = 2.5, p = .015) and anxiety symptoms (t(50) = 2.3, p = .028) at 6 weeks postpartum than those who did. Mothers who exclusively breastfed at 5 months postpartum presented significantly higher parental self-efficacy (t(94) = 2.4, p = .044). A higher number of breastfeeding difficulties and low perceived social support contributed to higher depressive symptoms (R2 = .30; F(3,103) = 14.6, p < .001), anxiety symptoms (R2 = .32, F(3.103) = 17.27, p < .001) and lower parental self-efficacy at 6 weeks postpartum (R2 = .39; F(2,103) = 9.4, p < .001). Conclusion Breastfeeding difficulties and social support are associated with fewer mental health symptoms and higher parental self-efficacy during early postpartum in first-time mothers.

Enrollment and use of a peer counselor mHealth texting program to support breastfeeding in low-income people: A pilot study in the District of Columbia.

To describe the characteristics of postpartum people who did and did not enroll in a breastfeeding peer-counselor mobile health (mHealth) texting program as well as the issues raised through 2-way texting with peer counselors. Pilot intervention study involving two Special Supplemental Nutrition Programs for Women Infants and Children (WIC) sites in the District of Columbia over 1 year. WIC recipients. Descriptive statistics, comparison of recipients who enrolled or not and qualitative content analysis of text messages. A breastfeeding peer counselor texting program entitled BfedDC involving routine 1-way programmed messages and 2-way texting capacity for recipients to engage with peer counselors. Among our sample (n=1642), nearly 90% initiated breastfeeding. A total of 18.5% (n=304) enrolled in the BfedDC texting program, of whom 19.7% (n=60) utilized the 2-way texting feature. Message content covered seven content themes and included inquiries about expressing human milk, breastfeeding difficulties, breastfeeding frequency and duration, appointments and more. Although enrollment was relatively low in BfedDC, benefits included 1-way supportive texts for breastfeeding and the ability to 2-way text with peer counselors. This program aligns with the Surgeon General's Call to Action to Support Breastfeeding and promotes breastfeeding equity in low-income people.

Case report: Congenital multidrug-resistant tuberculosis

Congenital multidrug-resistant tuberculosis (MDR-TB) is a rare disease with high mortality. We report a case of a neonate girl with congenital MDR-TB. The infant's mother underwent in vitro fertilization–embryo transfer and did not show any symptoms prior to delivery. After the 14th day of life, the infant had a fever and worsening difficulty breathing despite antibiotic treatment. She was then confirmed to have congenital MDR-TB and received ventilation and anti-TB treatment. When the infant's TB was diagnosed, her mother was screened for TB and found to have MDR-TB, affecting both her lungs and reproductive system. They both recovered and were discharged from the hospital, with anti-TB treatment ongoing.

Stunted girl: A heartbreaking case report of underdiagnosed and untreated posterior ankyloglossia

Stunted girl: A heartbreaking case report of underdiagnosed and untreated posterior ankyloglossia

NBCAL violation of products that compete with breastfeeding on the social network Instagram.

The article aims to identify NBCAL violations and analyze the content of messages posted on the Instagram social network. This qualitative-quantitative study consisted of a convenience sample of profiles identified through specific terms preceded by the hashtag symbol (#). Data were collected for two months by trained researchers using a structured questionnaire. We calculated the product promotion frequency that characterized violation of the NBCAL per category and manufacturer. The messages were analyzed using the content analysis technique. We identified 64 personal accounts of mothers with violations in 89 products, mainly food (n = 72), dairy compounds (54.2%), and infant formulas (45.8%) were the most publicized. Two thematic categories emerged from the posted texts, one related to the quality of the products and the other about breastfeeding difficulty, especially low milk production. The study identified NBCAL violations on the Instagram social network, alerting the need to recognize digital marketing to include it in the rules imposed by the Norm in the virtual context, considering the capillarity of social networks in disseminating information to the public in question.

Pelatihan Perawatan Luka Putting Susu pada Ibu Menyusui di Ruang Nifas Puskesmas Tosiba

Breastfeeding is ineffective because both mother and baby have difficulty breastfeeding. Lack of knowledge about proper care and the dangers of nipple abrasions lead to complications of breast inflammation (mastitis), abscesses and even infections. Preventive efforts in optimizing breastfeeding success were carried out through nipple wound care training at the Tosiba Health Center for 35 breastfeeding mothers. The purpose of the activity is to implement the tridarma of higher education in the form of training so that the knowledge and skills of mothers in caring for nipples increase in the hope that the breastfeeding process takes place safely without complications. The service method goes through three stages, namely filling out questionnaires, discussing the material and direct practice for breastfeeding mothers. The results of the training increased knowledge from 35% to 78%, while the performance was 10% to 65%. Conclusion The science and techniques of nipple care are very important for expectant mothers and nursing mothers to maintain hygiene, strengthen nipples, reduce the risk of wounds during breastfeeding and avoid infection, as well as smooth milk production and breastfeeding babies well. Inter-related cooperation in Puskesmas as a follow-up to training, for the implementation of activities that are beneficial especially for the health of mothers during breastfeeding.

Ankyloglossia in newborns: incidence and breastfeeding follow-up at 1 and 6 months.

Ankyloglossia is an anatomical variation of the lingual frenulum that negatively interferes with the functionality of the tongue. This condition can affect breastfeeding negatively. The aim of this study is to assess the prevalence of ankyloglossia among healthy babies born in Siena Hospital and the correlation between ankyloglossia and breastfeeding difficulties. We performed an observational prospective study conducted on healthy and breastfed newborns born in Siena Hospital in the period between January and June 2022. The evaluation of lingual frenulum in the first few days of life was performed by Martinelli's Lingual Frenulum Protocol with scores for Infants (MLFPI), while the clinical assessment of breastfeeding initiation was performed by the Breastfeeding Observation and Evaluation Form according to WHO-UNICEF guidelines. We also compared the reliability in predicting breastfeeding of a tool that measured the features of the tongue frenulum: the Bristol Tongue Assessment Tool (BTT). Breastfeeding at one and six months of babies' age was assessed by telephone interview, and information among children's nutrition, weight growth and difficulties found in breastfeeding was also collected. This study was approved by the Pediatric Ethics Committee for Clinical Trials of the Tuscany Region. One hundred and ninety infants were included in the study; 21 (11.05%) had a MLFPI score ≥13. Data at one month of age showed a statistically higher MLFPI score (P value <0.001) in babies with breastfeeding difficulties (median score 13.0, IQR 5.5-14), than in those without (median score 5.0, IQR 2.0-7.5). Data at 6 months of age showed a similar difference in babies with and without breastfeeding difficulties (median 12.0, IQR 4.0-14.0 vs. 5.0, IQR 2.0-8.0 respectively). A MLFPI score ≥13 is positively associated with breastfeeding difficulties at 1 and 6 months. Also, the BTT was positively a risk factor for problems in breastfeeding at 1 and 6 months. A high MLFPI score is a risk factor of breastfeeding difficulties. In these cases, a referral to experienced personnel is advisable: they can provide the emotional and professional support to the mother-child dyad, and/or refer for surgical evaluation and frenotomy. In our cohort, the usefulness of either MLFPI score or BTT was evident in predicting breastfeeding difficulties; the rate of surgical removal of the frenulum was nonetheless low.

Management of newborns and healthcare workers exposed to isoniazid-resistant congenital tuberculosis in the neonatal intensive care unit

Management of newborns and healthcare workers (HCWs) exposed to congenital tuberculosis (TB) in the neonatal intensive care unit (NICU) has been reported rarely. To outline a contact investigation process for individuals exposed to congenital TB in the NICU and investigate nosocomial transmission. Additionally, to assess the efficacy and safety of window prophylaxis in exposed newborns. A baby, born at a gestational age of 28+ 1 weeks, was diagnosed with isoniazid-resistant congenital TB on the 39th day of admission to the level IV NICU. Newborns and HCWs exposed cumulatively for ≥8h underwent contact investigation and follow-up for a year. Eighty-two newborns underwent contact investigation. All newborns displayed normal chest X-rays, and 42 hospitalized newborns tested negative for acid-fast bacilli stain and Xpert® MTB/RIF assay in their endotracheal sputum or gastric juices. Eighty received window prophylaxis: six of 75 on rifampin experienced mild adverse events, and none of the five on levofloxacin. After 12 weeks, five (6.1%) had a positive tuberculin skin test, all of whom had already received the Bacillus Calmette-Guérin vaccine and tested negative on TB interferon-gamma releasing assay. Of 119 exposed HCWs, three (2.5%) were diagnosed with latent TB infection and completed a four-month rifampin therapy. There was no active TB disease among exposed newborns and HCWs during a one-year follow-up. Timely diagnosis of congenital TB is crucial for minimizing transmission among exposed neonates and HCWs in the NICU setting. In cases of isoniazid-resistant index patients, even premature newborns may consider the use of rifampin or levofloxacin for window prophylaxis.

Connections beyond the tongue: A scoping review on ankyloglossia and its influence on breastfeeding

Breastfeeding is considered the best source of nutrition for babies. Ankyloglossia, or tongue tie, is an alteration in the lingual frenulum that can interfere with this process. AimTo explore the potential factors related to ankyloglossia that influence breastfeeding, for both infant and mother. MethodScoping review, following the JBI steps, in the Cochrane, CINAHL, Embase, LILACS, Pubmed and BDENF databases. A total of 1174 articles were found. Results46 articles made up the study sample, comprising four themes: (1) Maternal experience; (2) Epidemiology; (3) Infant difficulties; (4) Breastfeeding interventions and changes. ConclusionAnkyloglossia was associated with breastfeeding difficulties and its assessment was more effective when two or more instruments were used. Frenotomy was relatively effective for resuming breastfeeding. The production of knowledge about the relationship between ankyloglossia and breastfeeding helps nurses to update scientific evidence.

Two babies, two bonds: Frequency and correlates of differential maternal-infant bonding in mothers of twins.

We assessed prevalence and correlates of differential maternal-infant bonding (i.e., experiencing a stronger bond with one baby vs. the other) in mothers of twins, focusing on aspects of maternal mental health, well-being, and pregnancy/birth that have been previously linked with maternal-infant bonding. Participants (N=108 American women, 88.89% White, 82.41% non-Hispanic, aged 18-45, who gave birth to twins in the past 6-24weeks) were recruited from postpartum support websites. Participants completed a Qualtrics survey assessing pregnancy/birth history, symptoms of depression and anxiety, sleep, stress, romantic relationship satisfaction, and postpartum bonding. Twenty-six participants (24.07%) reported a bonding discrepancy. These participants endorsed higher symptoms of depression and anxiety, lower relationship satisfaction, lower average postpartum bonding, higher general and parenting stress, and longer pregnancy (all ps>.05). Greater degree of bonding discrepancy correlated with more depression, higher parenting stress, longer pregnancy, and lower relationship satisfaction (all ps>.05). Mothers of twins may benefit from postpartum mental health support, stress management strategies, and interventions to improve bonding. Future work should assess the role of breastfeeding difficulties, delivery method, birth-related trauma, infant regulatory capacity, and temperament. Longitudinal studies will help test cause and effect and potential long-term repercussions of maternal-infant bonding discrepancies.

‘Breastfeeding exclusivity, difficulties, and support in the first days after hospital discharge: A correlational study’

ObjectiveGlobal breastfeeding rates are not optimal, and the early postpartum period represents a critical time for breastfeeding initiation. The Baby-Friendly Hospital Initiative endeavours to provide mothers with evidence-based breastfeeding support in birth hospitals. This study examined factors associated with breastfeeding exclusivity and breastfeeding difficulties in the first days after being discharged from Baby-Friendly designated hospital. The adequacy of breastfeeding support and maternal preferences for optimal support were also reported. Study designA non-experimental correlational study was conducted between May 2021 and October 2022. A total of n = 80 breastfeeding mothers completed a semi-structured questionnaire within two weeks of discharge from Baby-Friendly hospital in Finland. The questionnaire included demographic and obstetric background information and six questions on breastfeeding exclusivity, breastfeeding difficulties, and breastfeeding support. Descriptive statistical analysis and multivariate binary logistic regression analysis were performed. ResultsThe mean age of the mothers was 30.6 years (SD 5.4), and half of the mothers were primiparas (49 %). Most mothers gave birth vaginally (85 %) to a full-term infant (84 %). Most (85 %) had made some prenatal plans for breastfeeding, and the median planned duration of breastfeeding was 12 months. Half of the infants (53 %) received supplemental milk while in the hospital. Most mothers (81 %) were exclusively breastfeeding after hospital discharge. Mothers whose infants received supplemental milk in the hospital had an increased odds of non-exclusive breastfeeding (aOR 16.5 [CI 95 % 1.7–156.7], p 0.015). Approximately one-third of the mothers (39 %) experienced breastfeeding difficulties. Primiparous mothers had increased odds of experiencing breastfeeding difficulties (aOR 3.41 [CI 95 % 1.2–9.8], p 0.023). Mothers who received adequate postnatal breastfeeding support in birth hospital had decreased odds of experiencing breastfeeding difficulties (aOR 0.16 [CI 95 % 0.03–0.8], p 0.026). Mothers were mainly satisfied with breastfeeding support, although timelier access to support was preferred after hospital discharge. ConclusionAdequate in-hospital postnatal breastfeeding support, including avoidance of non-medical supplementation, contributes to successful breastfeeding after hospital discharge in terms of more exclusive breastfeeding and fewer breastfeeding difficulties. Primiparous mothers need emphasized support to mitigate breastfeeding difficulties. Timelier access to breastfeeding support after discharge is needed.

Natal Teeth: A Rare Case Report and Management Strategies

Background: The occurrence of teeth at birth is a rare phenomenon that can pose challenges for bothparents and health care professionals.Case presentation: A 30-year-old primigravida presented at 41 weeks in latent labor. She progressedwell and delivered by spontaneous vertex delivery, a live female infant, 3700 g with an Apgar score of 8and 10 at 1 and 5 minutes, respectively. On examination, two natal teeth were observed in themandibular anterior region. Vitamin K was administered to the infant after birth. The following day, it wasnoted that the baby had difficulty breastfeeding, and the mother reported bruising of the nipples and painwhile breastfeeding. A pediatric dentist noted that the teeth had severe mobility and planned forextraction. Extraction was performed under topical anesthetic gel successfully. Follow-up visits revealednormal breastfeeding with associated infant weight gain, and the gums had healed well.Conclusion: The occurrence of teeth at birth is a rare phenomenon that can pose challenges for bothparents and health care professionals. It is a culture-bound phenomenon that can cause parents to denytheir baby love and affection. Healthcare professionals need to be aware of this condition in order tocounsel the parents and manage the baby appropriately.

The Influence of Breastfeeding Technique Education on the Effectiveness of Postpartum Mothers in Breastfeeding in the Working Area of the Tanjung Kota Sungai Penuh Health Center, Indonesia

Breastfeeding is the best way to feed a baby. However, many postpartum mothers experience difficulty in breastfeeding. Education about correct breastfeeding techniques can help postpartum mothers breastfeed effectively. This study aims to determine the effect of education on breastfeeding techniques on the effectiveness of postpartum mothers in breastfeeding in the working area of the Tanjung Kota Sungai Penuh Health Center, Indonesia. This research used a quasi-experimental design with a pre-test and post-test with a control group design. A total of 60 postpartum mothers were randomly divided into two groups, namely the intervention group (n=30), who received education on breastfeeding techniques, and the control group (n=30), who did not receive education. The effectiveness of breastfeeding was measured using a questionnaire. Data were analyzed using the Mann-Whitney U test. The results showed that there was a significant difference between the intervention group and the control group in terms of the effectiveness of breastfeeding after the intervention (p=0.001). Education on breastfeeding techniques has been proven to be effective in increasing the effectiveness of postpartum mothers in breastfeeding.

Common maternal health problems and their correlates in early post-partum mothers.

Mothers experience a wide range of maternal health problems after childbirth, which in turn, affect their well-being and ability to care for their newborn. These problems may be influenced by factors such as mode of delivery or socio-economic status. This study aims to investigate the prevalence of common maternal health problems and their correlates in a public primary healthcare institution in Singapore. This was a cross-sectional study, based on a self-administered questionnaire. A total of 373 mothers (mean age 31.9 years) who accompanied their infants for their 4- to 8-week development assessments at a public primary care clinic in Singapore completed a self-administered questionnaire from June 2021 to December 2021. The questionnaire assessed demographic factors, mode of delivery, number of children, number of individuals providing significant help, and the frequency of common physical and mental maternal health problems using a 5-point Likert-type scale. The five most common maternal health problems were fatigue (77.7%), lower back pain (59.3%), Caesarean wound pain (54.3%), upper back pain (53.0%) and vaginal pain (41.2%). The prevalence of depression and anxiety was 22.0% and 11.3%, respectively. With respect to the symptoms' correlates, pain on passing urine was more frequent after assisted vaginal deliveries than all other forms of deliveries (all pairwise p < 0.01), and pain on passing motion was more frequent in vaginal deliveries than in Caesarean deliveries (all pairwise p < 0.05). Mothers having a larger number of children more frequently experienced headaches (β = 0.17, SE = 0.05, p = 0.002) and less frequently experienced breastfeeding difficulties (β = -0.28, SE = 0.08, p < 0.001). Mothers experienced a high prevalence of maternal health problems in multiple domains during the first 8 weeks after childbirth. Mode of delivery and number of children were associated with increased prevalence of certain problems. Mothers' physical and mental well-being should be investigated early after delivery and addressed with adequate treatments and resources.

APLIKASI TEORI CHERYL T BECK DALAM ASUHAN KEPERAWATAN PADA KASUS DEPRESI POST PARTUM

This study explores postpartum depression using the Beck theory. Factors such as anxiety, stress, and breastfeeding difficulties form the framework of analysis. Applied nursing care includes clinical evaluation, understanding thought patterns, therapeutic relationship development, education, and cognitive interventions. While the Beck theory focuses on cognitive aspects, there are weaknesses such as generalization and a lack of attention to social, environmental, and biological aspects.

Management of natal tooth of a 2 months old infant: a case report

Natal and neonatal teeth are the type of supernumerary tooth which have various myths and superstitions associated with it. Natal teeth are the teeth which appear at the time of the birth whereas neonatal teeth appear within one month of life. Presence of natal teeth often risks the aspiration of teeth by infant and the mother also has difficulty in breast feeding and comes with the complaint of the same. The present case report of 2-month-old infant describes the management of natal teeth present in mandibular arch with mobility. After the consent of parents, the extraction of the shell-like tooth was done immediately and hemostasis was achieved. The follow up was carried out after 1 week to examine the normal healing of extraction site.  

Interdisciplinary Management of an Adolescent Cleft Patient with Skeletal Class III Malocclusion: A Case Report

Cleft lip and palate are the most frequently observed congenital abnormalities affecting the maxillofacial region. They can occur isolated or together in various combinations. These deformities are also associated with features found in over 300 recognised syndromes. Additionally, there are several problems, including social limitations, such as difficulties in breastfeeding resulting in failure to grow properly, speech abnormalities, hearing loss, misalignment of teeth, significant facial abnormalities, and serious aesthetic, psychological, and psychosocial challenges. Treatment modalities involve a number of specialists, such as Maxillofacial and Plastic surgeons, Anaesthetists, Orthodontists, Restorative dentists, Paediatric dentists and Prosthodontists, who collaborate to determine the best treatment plan based on the site of the defect and the patient's age. The present case report discusses the treatment and management of a 16-year-old female patient who presented with cleft lip and palate, along with skeletal class III malocclusion, hypodontia, multiple decayed teeth and dental malformation. The patient had missing lateral incisors and canines in the maxillary arch, along with carious maxillary central incisors. The purpose of this article is to report the multidisciplinary management of a unilateral cleft lip and palate patient with class III malocclusion, utilising orthognathic surgery, as well as, incorporating endodontic and prosthodontic corrections.

Infection of Fetal Membranes with Mycobacterium tuberculosis and Tissue Processing to Isolate RNA for Expression Analysis.

This chapter outlines the methodology employed to infectthe chorionic and amniotic membranes with Mycobacterium tuberculosis during pregnancy. Particularly, congenital tuberculosis, a rare and serious condition associated with cases in neonates and reactivation of latent tuberculosis in pregnant mothers, is interesting to study. Understanding the mechanisms of infection and the response of fetal membranes is crucial for developing effective treatments in these cases, which will promote better neonatal and maternal health in situations of tuberculosis during pregnancy. Establishing a standardized infection model in the chorioamniotic membranes is imperative, followed by a treatment protocol for isolating both cellular and mycobacterial RNA. This will enable the expression analysis during the maternal-fetal interface interaction with M. tuberculosis. The proposed methodology might be invaluable for qRT-PCR, microarrays, and sequencing research.

Congenital tuberculosis: report of one case

La tuberculosis (TB) es una de las principales enfermedades infecciosas a nivel mundial y sigue siendo un grave problema de salud pública en muchos países. La Organización Mundial de la Salud (OMS) estima que un tercio de la población está infectada con TB y la tasa de infección aumenta casi un 1% por año. Esta revisión tiene como objetivo exponer la identidad de la tuberculosis congénita rara y fatal si no se trata y resaltar las características clínicas y la dificultad de diagnóstico y la conciencia entre los pediatras para realizar un manejo terapéutico inmediato desde el inicio de la sospecha. Este estudio se propone detectar que el pronóstico es malo para los recién nacidos, seguido de una evolución fatal cuando el diagnóstico se retrasa. Se presenta a continuación el caso de un recién nacido de sexo masculino de 24 días de vida por parto cesárea, por RPM nacido de una madre que presentó infección por SARS-COV-2 14 días previos al parto. A los 5 días de post parto adormecimiento y debilidad de miembros inferiores, sin síntomas respiratorios, posteriormente fiebre de 5 días de evolución, con diagnóstico de TB cerebral sin síntomas respiratorios, RN con fiebre y tos de 3 días, hepatomegalia de 4.5 cm, sin adenopatías. Ecografía abdominal dentro de parámetros normales, ecocardiograma con despegamiento pericárdico laminar, ecografía cerebral, ecografía abdominal fondo de ojo dentro de parámetros normales. Radiografía de tórax mostró infiltrado nodulillar difuso bilateral compatible con diseminación miliar tuberculosa. Al ingreso se inició cobertura antibiótica con Cefotaxima más Ampicilina a dosis meníngea. Analítica laboratorial al ingreso perfil hepático alterado, glóbulos blancos en rango, presentó granulaciones toxicas 3% y reactantes de fase aguda aumentados. Se realizó punción lumbar con cultivo de LCR negativo para gérmenes comunes y micobacterias por lo cual se descendió antibioticoterapia a completando 9 días totales. En muestras seriadas durante 3 días de líquido gástrico tinción de Ziehl-Neelsen BAAR +++ en las 3 muestras, GENEXPERT M. tuberculosis detectado y secreción traqueal tinción de BAAR +++. Inició terapia antibacilar H10/R20/Z20/E20. Durante su internación presenta alteración de perfil hepático por lo cual se ajusta dosis H5/R10/Z15/E15 en conjunto con Piridoxina. Durante tratamiento antibacilar a los 10 meses presentó en ecografía abdominal múltiples calcificaciones en hígado y ecografía cerebral de control con dilatación leve de los ventrículos laterales en ambos lados. Al finalizar tratamiento al examen físico se constató hígado a 2 cm RCD al año de vida, crecimiento y desarrollo normal para la edad, controles oftalmológicos y auditivos sin hallazgos patológicos. El recién nacido recibió 2 meses de HRZE y 10 meses de HR completando 12 meses totales de tratamiento en conjunto con Piridoxina hasta 10 días posterior a la suspensión de antibacilares y la madre recibió 4 meses de HRZE y 8 meses de HR completando 12 meses de tratamiento antibacilar.