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The authors investigated whether there was a decline in infants sleeping prone and other modifiable risk factors for sudden infant death syndrome (SIDS) in Germany, where, as in some other countries, no nationwide intervention campaign against the prone sleeping position had been initiated. Data were obtained from parents by mailed questionnaires in two cross-sectional studies in 1991 (n = 3,330) and 1995 (n = 3,124). Prevalence of prone sleeping decreased from 37.6% to 8.7% (p < 0.05) in the German population and from 44.1% to 32.0% (p < 0.05) in the Turkish immigrant population. Parents who laid their infants prone in 1995 were less likely to follow advice from physicians, public media, and other parents (relative risks < 0.5, p < 0.05) and were more likely to have a low educational level, to be <20 years old, to be single parents, to have two or more children, to be raised in West Germany, or to be of Turkish ethnicity. Although the information on prone sleeping being a risk factor for SIDS became known among the population, these data suggest that subgroup-specific public intervention campaigns may be needed to reduce the prevalence of prone sleeping even further in those countries where no nationwide campaign has been initiated.

A study was started a) to assess the incidence self-poisoning in pre-school children and b) to evaluate the impact of an emergency set containing activated carbon and an antifoam. Cooperation was established with the regional legal sickness funds, the regional physician association, and two pharmaceutical companies. Incidence and extent of unintentional self-poisoning among pre-school children are to be determined. The impact of an emergency specimen given to parents of one year old children is evaluated. Families with children aged 1 to 4 year living in boroughs of Berlin are the population at risk. Study period for measuring the incidence is from January 1995 to June 1998. Cases are all accidents of poison ingestion by children of the at-risk-population. Intervention was performed between July 1995 and June 1996. The sets were handed out to parents of children born in 1994. 85% of the selected parents could be interviewed. It was studied whether the behaviour of parents in accidents of poisoning differed between those given an emergency set compared to those who had none. Data were mainly collected by telephone interviews. In this paper the theoretical aspects of the psychological effect of the intervention are discussed.

In 1990 the Innocenti Declaration on promoting breastfeeding was proclaimed in Florence/Italy. It became the subject of resolution 45.34 of the World Health Assembly in 1992. In the Federal Republic of Germany there was no wide-scale mass-media campaign to promote breastfeeding as in other countries. But mother-to-mother support groups, medical services and the newly founded National Breastfeeding Committee supported prolonged breastfeeding in public. The effects of the joint effort could be estimated by comparing the results of two postal surveys in 1991 and 1995. The surveys were conducted in Lower Saxony, North-Rhine-Westphalia and Berlin. A tendency could be shown toward more exclusive breastfeeding. Breastfeeding with supplementary food increased by a factor of 1.3 after adjusting for the variables mother's age, sleeping in parents' room or bed and no-smoking household. In Lower Saxony the increase was by a factor of 1.5 starting from a lower base value. The baby sleeping in the parents' room or in their bed furthered breastfeeding by a factor of 1.5 to 4. Non smoking mothers are 4 times more willing to breastfeed their infants than smoking mothers. German mothers breastfeed their infants two to three times more often than turkish mothers.

This paper deals with the establishment of the National Breastfeeding Committee at the Robert-Koch-Institut and its activities. As the highest level scientific and advisory board for the German Federal Health Ministry the institute obtained permission from the state authorities to carry out a survey of the local health offices. A finding of this survey was that the different health offices apparently place different priorities on advising mothers in regard to breastfeeding. Some health offices offer medical counselling and others indicate that their counselling is carried out by non-medical personnel. In some cases the health offices reported a supply but no demand. We believe that the public health services should at least provide information on breastfeeding counselling in the community and on training opportunities for counsellors. The National Breastfeeding Commission will collect such information and provide it to the health offices and also give advice in the case of problems with regard to breastfeeding.

In this study pregnancy, delivery and the newborn infant of 151 juvenile primiparas and 1034 adolescent primiparas were analyzed and were compared with a group of 3563 primiparas 21, 23 and 25 years of age. Regarding the obstetric history and the intrapartum period there was no increase incidence of complications among the young patients, however we found among the older women an increase in the incidence of operative deliveries. In the postpartum period it was noted that the young primiparas had a higher incidence of postpartum bleeding caused by atonia of the uterus and also an increased incidence of placental complications with a high rate of manual placental extraction and curettages. A positive correlation was found between premature birth and perinatal mortality and the younger the age of the mother. The newborn of the young mothers was also lighter and shorter at birth and had a higher incidence of malformations. This study has shown, that juvenile expectant mothers are a risk group for obstetricians and pediatricians.

Some results from the pregnancy surveillance booklet documentation are discussed in this paper. These results were gained on the basis of data from a representative random sample taken in Rheinland-Pfalz in 1977. Unfortunately, the risk factors section in the pregnancy surveillance booklet does not receive sufficient medical documentation. Apparently, its structure is too complex and its second part is not on the proper place. Contrary to the risk factor check list, which has been answered poorly, the entry of the observations on the course of the pregnancy obviously has carried out regularly. Only half of the pregnant women take advantage of at least 10 preventive medial examinations. Frequency of these examinations and date of the first medical examination in pregnancy depend on social conditions. In case of unfavourable general conditions pregnant women go less often, and later, to the prenatal examinations and the state of health of the new-born child depends on the "social strata" factor. Seen especially from the viewpoint of a greater centralization in obstetrics, the measures taken in prenatal care should be decentralized and varied and should include a revision of the pregnancy surveillance booklet.

On the basis of some statistical data ultrasound cephalometry for the prediction of term is discussed. These data should be considered when providing socalled test-graphs. The usefulness of the author's own standard graph is examined. Prediction with the biparietal diameter is not much less exact than after the rule of Naegele. Accuracy of prediction can be much improved by using both methods together, starting from the averages of both.