Author: Glenda Blanch
Publisher: Michelle Anderson Publishing
ISBN: 9780855723996
Category : Gastroesophageal reflux
Languages : en
Pages : 231
Book Description
It can be overwhelming for the parents of a child who suffers from reflux, although many people do not understand this. They may think reflux is normal or even trivial, or may think it is just a ' bit of vomiting' or a 'behavioural issue'. Unfortunately, reflux can range in severity enormously, and families can suffer from extreme stress as a result of having a child with reflux. The lack of understanding of the illness and its associated issues means that many families do not receive the support they need.
Reflux Reality
Author: Glenda Blanch
Publisher: Michelle Anderson Publishing
ISBN: 9780855723996
Category : Gastroesophageal reflux
Languages : en
Pages : 231
Book Description
It can be overwhelming for the parents of a child who suffers from reflux, although many people do not understand this. They may think reflux is normal or even trivial, or may think it is just a ' bit of vomiting' or a 'behavioural issue'. Unfortunately, reflux can range in severity enormously, and families can suffer from extreme stress as a result of having a child with reflux. The lack of understanding of the illness and its associated issues means that many families do not receive the support they need.
Publisher: Michelle Anderson Publishing
ISBN: 9780855723996
Category : Gastroesophageal reflux
Languages : en
Pages : 231
Book Description
It can be overwhelming for the parents of a child who suffers from reflux, although many people do not understand this. They may think reflux is normal or even trivial, or may think it is just a ' bit of vomiting' or a 'behavioural issue'. Unfortunately, reflux can range in severity enormously, and families can suffer from extreme stress as a result of having a child with reflux. The lack of understanding of the illness and its associated issues means that many families do not receive the support they need.
The Baby Reflux Lady's Survival Guide
Author: Aine Homer
Publisher:
ISBN: 9781999957490
Category :
Languages : en
Pages : 328
Book Description
The Baby Reflux Lady's Survival Guide was written when it became obvious that there was a continued need in the community for more easily accessible and accurate information about infant reflux, its causes and management. It is THE essential book for any family with a baby who has colic, reflux, and food intolerances and allergies including CMPA.
Publisher:
ISBN: 9781999957490
Category :
Languages : en
Pages : 328
Book Description
The Baby Reflux Lady's Survival Guide was written when it became obvious that there was a continued need in the community for more easily accessible and accurate information about infant reflux, its causes and management. It is THE essential book for any family with a baby who has colic, reflux, and food intolerances and allergies including CMPA.
Breastfeeding and breastfeeding with a baby who has acid reflux
Author: Aurora Brooks
Publisher: BabyDreamers.net
ISBN: 1776982673
Category : Health & Fitness
Languages : en
Pages : 40
Book Description
Breastfeeding and breastfeeding with a baby who has acid reflux is a comprehensive guide that provides valuable information and practical tips for mothers who are breastfeeding their babies with acid reflux. This short read book covers a wide range of topics, from understanding acid reflux in babies to managing stress and self-care for breastfeeding mothers. The book begins with an in-depth explanation of acid reflux in babies, helping mothers understand the condition and its symptoms. It also highlights the benefits of breastfeeding for babies with acid reflux, emphasizing how breast milk can help soothe and alleviate the discomfort caused by the condition. Positioning techniques for breastfeeding are discussed in detail, as proper positioning can make a significant difference in reducing acid reflux symptoms. The book also addresses dietary considerations for breastfeeding moms, providing guidance on foods to avoid and foods that may help alleviate acid reflux symptoms in babies. Managing oversupply and fast let-down is another important topic covered in this book. It offers practical tips on how to regulate milk flow to prevent excessive spitting up and discomfort for the baby. Feeding frequency and duration are also discussed, helping mothers establish a feeding routine that suits their baby's needs. Supporting baby's digestion is crucial when dealing with acid reflux, and this book provides valuable insights on how to do so. It emphasizes the importance of seeking professional support, such as lactation consultant guidance and the role of pediatricians in managing acid reflux. Alternative feeding methods for babies with acid reflux are explored, including paced bottle feeding techniques and specialized bottles designed to reduce reflux symptoms. The book also offers guidance on combining breastfeeding and bottle-feeding, as well as using breast milk in bottles. Transitioning between breast and bottle is a common concern for many breastfeeding mothers, and this book provides practical tips and strategies to make the transition smoother for both the mother and the baby. Self-care for breastfeeding mothers is not forgotten in this book. It emphasizes the importance of managing stress and offers suggestions on how to connect with support groups for additional guidance and emotional support. The book concludes with a section dedicated to frequently asked questions, addressing common concerns and providing answers to help mothers navigate their breastfeeding journey with a baby who has acid reflux. If you have any questions or comments, this book encourages you to reach out and seek the support you need. Breastfeeding and breastfeeding with a baby who has acid reflux is a valuable resource for any mother looking to provide the best care for her baby while managing acid reflux symptoms. This title is a short read. A Short Read is a type of book that is designed to be read in one quick sitting. These no fluff books are perfect for people who want an overview about a subject in a short period of time. Table of Contents Breastfeeding and breastfeeding with a baby who has acid reflux Understanding acid reflux in babies Benefits of breastfeeding for babies with acid reflux Positioning techniques for breastfeeding Dietary considerations for breastfeeding moms Managing oversupply and fast let-down Feeding frequency and duration Supporting baby's digestion Seeking professional support Lactation consultant guidance Pediatrician's role in managing acid reflux Alternative feeding methods for babies with acid reflux Paced bottle feeding techniques Specialized bottles for acid reflux Combining breastfeeding and bottle-feeding Using breast milk in bottles Transitioning between breast and bottle Self-care for breastfeeding mothers Managing stress and self-care Connecting with support groups Frequently Asked Questions Have Questions / Comments?
Publisher: BabyDreamers.net
ISBN: 1776982673
Category : Health & Fitness
Languages : en
Pages : 40
Book Description
Breastfeeding and breastfeeding with a baby who has acid reflux is a comprehensive guide that provides valuable information and practical tips for mothers who are breastfeeding their babies with acid reflux. This short read book covers a wide range of topics, from understanding acid reflux in babies to managing stress and self-care for breastfeeding mothers. The book begins with an in-depth explanation of acid reflux in babies, helping mothers understand the condition and its symptoms. It also highlights the benefits of breastfeeding for babies with acid reflux, emphasizing how breast milk can help soothe and alleviate the discomfort caused by the condition. Positioning techniques for breastfeeding are discussed in detail, as proper positioning can make a significant difference in reducing acid reflux symptoms. The book also addresses dietary considerations for breastfeeding moms, providing guidance on foods to avoid and foods that may help alleviate acid reflux symptoms in babies. Managing oversupply and fast let-down is another important topic covered in this book. It offers practical tips on how to regulate milk flow to prevent excessive spitting up and discomfort for the baby. Feeding frequency and duration are also discussed, helping mothers establish a feeding routine that suits their baby's needs. Supporting baby's digestion is crucial when dealing with acid reflux, and this book provides valuable insights on how to do so. It emphasizes the importance of seeking professional support, such as lactation consultant guidance and the role of pediatricians in managing acid reflux. Alternative feeding methods for babies with acid reflux are explored, including paced bottle feeding techniques and specialized bottles designed to reduce reflux symptoms. The book also offers guidance on combining breastfeeding and bottle-feeding, as well as using breast milk in bottles. Transitioning between breast and bottle is a common concern for many breastfeeding mothers, and this book provides practical tips and strategies to make the transition smoother for both the mother and the baby. Self-care for breastfeeding mothers is not forgotten in this book. It emphasizes the importance of managing stress and offers suggestions on how to connect with support groups for additional guidance and emotional support. The book concludes with a section dedicated to frequently asked questions, addressing common concerns and providing answers to help mothers navigate their breastfeeding journey with a baby who has acid reflux. If you have any questions or comments, this book encourages you to reach out and seek the support you need. Breastfeeding and breastfeeding with a baby who has acid reflux is a valuable resource for any mother looking to provide the best care for her baby while managing acid reflux symptoms. This title is a short read. A Short Read is a type of book that is designed to be read in one quick sitting. These no fluff books are perfect for people who want an overview about a subject in a short period of time. Table of Contents Breastfeeding and breastfeeding with a baby who has acid reflux Understanding acid reflux in babies Benefits of breastfeeding for babies with acid reflux Positioning techniques for breastfeeding Dietary considerations for breastfeeding moms Managing oversupply and fast let-down Feeding frequency and duration Supporting baby's digestion Seeking professional support Lactation consultant guidance Pediatrician's role in managing acid reflux Alternative feeding methods for babies with acid reflux Paced bottle feeding techniques Specialized bottles for acid reflux Combining breastfeeding and bottle-feeding Using breast milk in bottles Transitioning between breast and bottle Self-care for breastfeeding mothers Managing stress and self-care Connecting with support groups Frequently Asked Questions Have Questions / Comments?
Breastfeeding and Medication
Author: Wendy Jones
Publisher: Routledge
ISBN: 135158099X
Category : Medical
Languages : en
Pages : 536
Book Description
Sadly, women often feel they have no alternative but to give up breastfeeding, having been prescribed or purchased medication. In many cases, however, this is unnecessary. This book outlines the evidence base for the use of medication during breastfeeding. Breastfeeding and Medication presents a comprehensive A to Z guide to the most frequently prescribed drugs and their safety for breastfeeding mothers. Evaluating the evidence for interventions and using a simple format for quickly identifying medications that are safe or unsafe to use, it also highlights those drugs where there is inconclusive evidence. Additional contextual information makes this the most complete text for those practitioners who support and treat breastfeeding women. It: provides an overview of the anatomy and physiology of the breast together with hormonal influences to better understand how complications, such as mastitis, arise and inform the approach to their treatment; includes a section on conditions that affect women specifically when they are lactating where prescription of medication may be necessary; discusses the importance of breastfeeding and its advantages, as well as its disadvantages; and explores how to support breastfeeding mothers, and presents a counselling model approach. This new edition contains information on more drugs and a chapter on the management of some chronic conditions which may affect breastfeeding mothers. In most cases there are options to support the mother’s optimal care whilst allowing her to continue to breastfeed her baby as long as she wishes. This is a topic which raises many questions on social media, which informed the choice of conditions to consider. This is an invaluable reference for all health practitioners and volunteers who work with, support and treat breastfeeding women, including lactation consultants, breastfeeding support workers, health visitors, GPs, practice nurses, pharmacists and midwives.
Publisher: Routledge
ISBN: 135158099X
Category : Medical
Languages : en
Pages : 536
Book Description
Sadly, women often feel they have no alternative but to give up breastfeeding, having been prescribed or purchased medication. In many cases, however, this is unnecessary. This book outlines the evidence base for the use of medication during breastfeeding. Breastfeeding and Medication presents a comprehensive A to Z guide to the most frequently prescribed drugs and their safety for breastfeeding mothers. Evaluating the evidence for interventions and using a simple format for quickly identifying medications that are safe or unsafe to use, it also highlights those drugs where there is inconclusive evidence. Additional contextual information makes this the most complete text for those practitioners who support and treat breastfeeding women. It: provides an overview of the anatomy and physiology of the breast together with hormonal influences to better understand how complications, such as mastitis, arise and inform the approach to their treatment; includes a section on conditions that affect women specifically when they are lactating where prescription of medication may be necessary; discusses the importance of breastfeeding and its advantages, as well as its disadvantages; and explores how to support breastfeeding mothers, and presents a counselling model approach. This new edition contains information on more drugs and a chapter on the management of some chronic conditions which may affect breastfeeding mothers. In most cases there are options to support the mother’s optimal care whilst allowing her to continue to breastfeed her baby as long as she wishes. This is a topic which raises many questions on social media, which informed the choice of conditions to consider. This is an invaluable reference for all health practitioners and volunteers who work with, support and treat breastfeeding women, including lactation consultants, breastfeeding support workers, health visitors, GPs, practice nurses, pharmacists and midwives.
Neonatal-perinatal Medicine
Author: Richard J. Martin
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 710
Book Description
The quintessential reference for neonatal-perinatal medicine.
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 710
Book Description
The quintessential reference for neonatal-perinatal medicine.
Acid Reflux in Children
Author: Jamie Koufman
Publisher: Simon and Schuster
ISBN: 194056106X
Category : Health & Fitness
Languages : en
Pages : 232
Book Description
A Parent’s Guide to Reflux in Infants, Children & Teens “Meeting Dr. Jamie Koufman completely changed my life. My symptoms of chronic cough and shortness of breath had been diagnosed since my childhood as asthma. Dr. Koufman identified that I had reflux, not asthma, and guided me step by step how to cure it. I have my life back and I owe it all to Dr. Koufman's insight and help.” -Suze Orman, Host of the Suze Orman Show, CNBC This is an important book that will help change how America eats and guide parents to heal our needlessly sick children and adolescents. There are 80 million infants, children and teens in America, and most have unhealthy diets. Every year, tens of millions are misdiagnosed as having asthma, allergies, nasal congestion, ear infections, chronic cough and croup, when the real problem is acid reflux. A bad diet and childhood obesity are both strongly associated with reflux. So, when a child has a respiratory disease and is not getting better with medical treatment, we believe parents should consider that reflux may be the problem. Why? Because it can be fixed! Reflux is the greatest masquerader of our time. It can be the cause of almost any kind of respiratory symptom or disease. Unlike adults who may have obvious reflux symptoms (indigestion and heartburn), children are almost always “silently refluxing,” and silent means that reflux is mysterious, difficult to diagnose and easy to overlook. Kids with reflux rarely complain of heartburn or indigestion. Respiratory reflux is the missing link between bad diet and many symptoms. Today, respiratory reflux is so common it is almost invisible. Pediatricians and medical specialists often diagnose children with asthma, sinusitis or allergy, when what they really have is reflux. Doctors all too frequently prescribe children antacid medications without beneficial effects. The real villain is not vanquished by pills. Most medications won’t do a thing for children’s reflux symptoms and can sometimes cause more harm than good. Reflux is not only uncomfortable and inconvenient, it’s dangerous. If left untreated, reflux can wreak havoc on a child’s ears, nose, throat, airways, lungs and digestive system. Our successful reflux rehabilitation program is a platform for change, with the long-term goal of health maintenance and disease prevention. And, for overweight children, another benefit of this book’s reflux program is that they will lose weight naturally and slowly with a diet that is simply “lean, clean, green and alkaline.” When we fix a child’s reflux, parents’ knowledge translates to significant dietary changes for the entire family. Out go the juice, soda, chocolate milk and other unhealthy choices. When parents understand that too much acid and sugar in the diet, and eating supper too late in the day has a big negative impact on the family’s health, they act. Their children’s well-being is at stake. Once reflux is identified or even suspected, the fix is more in parents’ control than many realize. Acid Reflux in Children is the revolutionary book for parents who want to help their children lead healthy, active lives, free of acid reflux and the many other symptoms this condition can create. Here’s to our future - HEALTHY CHILDREN!
Publisher: Simon and Schuster
ISBN: 194056106X
Category : Health & Fitness
Languages : en
Pages : 232
Book Description
A Parent’s Guide to Reflux in Infants, Children & Teens “Meeting Dr. Jamie Koufman completely changed my life. My symptoms of chronic cough and shortness of breath had been diagnosed since my childhood as asthma. Dr. Koufman identified that I had reflux, not asthma, and guided me step by step how to cure it. I have my life back and I owe it all to Dr. Koufman's insight and help.” -Suze Orman, Host of the Suze Orman Show, CNBC This is an important book that will help change how America eats and guide parents to heal our needlessly sick children and adolescents. There are 80 million infants, children and teens in America, and most have unhealthy diets. Every year, tens of millions are misdiagnosed as having asthma, allergies, nasal congestion, ear infections, chronic cough and croup, when the real problem is acid reflux. A bad diet and childhood obesity are both strongly associated with reflux. So, when a child has a respiratory disease and is not getting better with medical treatment, we believe parents should consider that reflux may be the problem. Why? Because it can be fixed! Reflux is the greatest masquerader of our time. It can be the cause of almost any kind of respiratory symptom or disease. Unlike adults who may have obvious reflux symptoms (indigestion and heartburn), children are almost always “silently refluxing,” and silent means that reflux is mysterious, difficult to diagnose and easy to overlook. Kids with reflux rarely complain of heartburn or indigestion. Respiratory reflux is the missing link between bad diet and many symptoms. Today, respiratory reflux is so common it is almost invisible. Pediatricians and medical specialists often diagnose children with asthma, sinusitis or allergy, when what they really have is reflux. Doctors all too frequently prescribe children antacid medications without beneficial effects. The real villain is not vanquished by pills. Most medications won’t do a thing for children’s reflux symptoms and can sometimes cause more harm than good. Reflux is not only uncomfortable and inconvenient, it’s dangerous. If left untreated, reflux can wreak havoc on a child’s ears, nose, throat, airways, lungs and digestive system. Our successful reflux rehabilitation program is a platform for change, with the long-term goal of health maintenance and disease prevention. And, for overweight children, another benefit of this book’s reflux program is that they will lose weight naturally and slowly with a diet that is simply “lean, clean, green and alkaline.” When we fix a child’s reflux, parents’ knowledge translates to significant dietary changes for the entire family. Out go the juice, soda, chocolate milk and other unhealthy choices. When parents understand that too much acid and sugar in the diet, and eating supper too late in the day has a big negative impact on the family’s health, they act. Their children’s well-being is at stake. Once reflux is identified or even suspected, the fix is more in parents’ control than many realize. Acid Reflux in Children is the revolutionary book for parents who want to help their children lead healthy, active lives, free of acid reflux and the many other symptoms this condition can create. Here’s to our future - HEALTHY CHILDREN!
Colic Solved
Author: Bryan Vartabedian
Publisher: Ballantine Books
ISBN: 0307483088
Category : Family & Relationships
Languages : en
Pages : 322
Book Description
For generations, doctors have been diagnosing babies with colic, offering little comfort and few solutions to worried, weary parents. But recent medical advances made through cutting-edge technology now reveal that many if not most cases of colic are actually caused by acid reflux. In this revolutionary book, Bryan Vartabedian, a noted pediatric gastroenterologist and the father of two babies with acid reflux, provides hands-on, practical advice about this hidden epidemic–and how to make your own baby happy again. • Recognize the seven signs of reflux in infancy. • Discover the role of milk protein allergy–the other colic. • Learn what, when, and how to feed an irritable baby and the best positions for sleep. • Recognize the role of formula, breast milk, bottle systems, burping, and pacificers in your baby’s fussiness, and irritability. • Understand when and why your baby may need testing for reflux. Weigh the pros and cons of available treatment options. Identify when a specialist is needed and where to find one. Complete with inspiring real-life cases of colic solved, plus tips, sidebars, and illustrations, this essential guide provides real answers to a problem that has been upsetting babies–and parents–for years. Help and hope are at hand! “This is the book for every parent whose young baby is a ‘bundle of misery,’ in pain, and hard to feed, and for that baby’s pediatrician, too.” –Laura Nathanson, M.D., F.A.A.P., author of The Portable Pediatrician “Great news for exhausted parents and for suffering babies! Colic Solved gets to the root of what is making many babies cry, and offers powerful, real-world solutions. This is a must-have book for desperate parents everywhere.” –Alan Greene, MD, FAAP, author of From First Kicks to First Steps and founder of DrGreene.com
Publisher: Ballantine Books
ISBN: 0307483088
Category : Family & Relationships
Languages : en
Pages : 322
Book Description
For generations, doctors have been diagnosing babies with colic, offering little comfort and few solutions to worried, weary parents. But recent medical advances made through cutting-edge technology now reveal that many if not most cases of colic are actually caused by acid reflux. In this revolutionary book, Bryan Vartabedian, a noted pediatric gastroenterologist and the father of two babies with acid reflux, provides hands-on, practical advice about this hidden epidemic–and how to make your own baby happy again. • Recognize the seven signs of reflux in infancy. • Discover the role of milk protein allergy–the other colic. • Learn what, when, and how to feed an irritable baby and the best positions for sleep. • Recognize the role of formula, breast milk, bottle systems, burping, and pacificers in your baby’s fussiness, and irritability. • Understand when and why your baby may need testing for reflux. Weigh the pros and cons of available treatment options. Identify when a specialist is needed and where to find one. Complete with inspiring real-life cases of colic solved, plus tips, sidebars, and illustrations, this essential guide provides real answers to a problem that has been upsetting babies–and parents–for years. Help and hope are at hand! “This is the book for every parent whose young baby is a ‘bundle of misery,’ in pain, and hard to feed, and for that baby’s pediatrician, too.” –Laura Nathanson, M.D., F.A.A.P., author of The Portable Pediatrician “Great news for exhausted parents and for suffering babies! Colic Solved gets to the root of what is making many babies cry, and offers powerful, real-world solutions. This is a must-have book for desperate parents everywhere.” –Alan Greene, MD, FAAP, author of From First Kicks to First Steps and founder of DrGreene.com
BabyCues
Author: Philippa Murphy
Publisher:
ISBN: 9780473296179
Category : Colic
Languages : en
Pages : 231
Book Description
Publisher:
ISBN: 9780473296179
Category : Colic
Languages : en
Pages : 231
Book Description
Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries
Author: U.s. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781500350765
Category : Medical
Languages : en
Pages : 422
Book Description
The purpose of this report is to summarize the literature concerning the relationship of breastfeeding and various infant and maternal health outcomes. Two key questions are addressed: 1. What are the benefits and harms for infants and children in terms of short-term outcomes, such as infectious diseases (including otitis media, diarrhea, and lower respiratory tract infections), sudden infant death syndrome (SIDS) and infant mortality, and longer term outcomes such as cognitive development, childhood cancer (including leukemia), type I and II diabetes, asthma, atopic dermatitis, cardiovascular disease (including hypertension), hyperlipidemia, and obesity, compared among those who mostly breastfeed, mostly formula feed, and mixed feed; and how are these outcomes associated with duration of the type of feeding? Do the harms and benefits differ for any specific subpopulations based on socio-demographic factors? 2. What are the benefits and harms on maternal health short-term outcomes, such as postpartum depression and return to pre-pregnancy weight, and long-term outcomes, such as breast cancer, ovarian cancer, diabetes and osteoporosis, compared among breastfeeding, formula feeding, and mixed feeding, and how are these associated with duration of the type of feeding? Do the harms and benefits differ for any specific subpopulations based on socio-demographic factors?
Publisher: CreateSpace
ISBN: 9781500350765
Category : Medical
Languages : en
Pages : 422
Book Description
The purpose of this report is to summarize the literature concerning the relationship of breastfeeding and various infant and maternal health outcomes. Two key questions are addressed: 1. What are the benefits and harms for infants and children in terms of short-term outcomes, such as infectious diseases (including otitis media, diarrhea, and lower respiratory tract infections), sudden infant death syndrome (SIDS) and infant mortality, and longer term outcomes such as cognitive development, childhood cancer (including leukemia), type I and II diabetes, asthma, atopic dermatitis, cardiovascular disease (including hypertension), hyperlipidemia, and obesity, compared among those who mostly breastfeed, mostly formula feed, and mixed feed; and how are these outcomes associated with duration of the type of feeding? Do the harms and benefits differ for any specific subpopulations based on socio-demographic factors? 2. What are the benefits and harms on maternal health short-term outcomes, such as postpartum depression and return to pre-pregnancy weight, and long-term outcomes, such as breast cancer, ovarian cancer, diabetes and osteoporosis, compared among breastfeeding, formula feeding, and mixed feeding, and how are these associated with duration of the type of feeding? Do the harms and benefits differ for any specific subpopulations based on socio-demographic factors?
Evidence-based Pediatrics and Child Health
Author: Virginia Moyer
Publisher: John Wiley & Sons
ISBN: 1405140259
Category : Medical
Languages : en
Pages : 544
Book Description
Evidence Based Pediatrics and Child Health is a ground-breaking new text on pediatrics and child care management, using evidence based approach. It covers all the major childhood conditions and contains the features of both a handbook and a reference text. Each chapter combines both advice on management and how best to practice evidence based medicine with reviews of all the available evidence in a specific area. The goal of the book is to help pediatricians and others who care for children to provide the best possible care by combining the best, most current evidence with special circumstances of each individual patient.
Publisher: John Wiley & Sons
ISBN: 1405140259
Category : Medical
Languages : en
Pages : 544
Book Description
Evidence Based Pediatrics and Child Health is a ground-breaking new text on pediatrics and child care management, using evidence based approach. It covers all the major childhood conditions and contains the features of both a handbook and a reference text. Each chapter combines both advice on management and how best to practice evidence based medicine with reviews of all the available evidence in a specific area. The goal of the book is to help pediatricians and others who care for children to provide the best possible care by combining the best, most current evidence with special circumstances of each individual patient.