Duration of Exclusive Breastfeeding for Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis

New World Health Organization recommendations for care of preterm or low birth weight infants: health policy

Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all 'health system building blocks' such as infrastructure, commodities, workforce and monitoring.

Funding

Nil.

The use of hydrolyzed formulas as a method of correction of feeding and clinical rehabilitation of infants with atopy signs

Our study showed that in formula-fed babies, the use of mixture X (containing 2'-FL (2'-fucosyllactose) - a type of milk oligosaccharide, as well as carefully studied Bifidobacterium lactis, DHA, ARA, and nucleotides) as the main product for feeding could ensure children's body with all the necessary nutrients. Furthermore, it can minimize the progression of clinical signs of atopic dermatitis and reduce the use of drugs. In addition, there was an improvement in height and weight parameters, proportional development of the child (p<0.05), an increase in the number of erythrocytes (erythrocytes), hemoglobin (Hb), mean cell volume (MCV) (p<0.05), a decrease in the number of leukocytes (WBC) (p<0.05), and leveling of skin signs of atopic dermatitis (AD) (according to SCORAD a decrease from 32.8±5.5 to 16.1±2.2, p<0.05). Based on these results, it is possible to recommend using mixture (X) with a preventive and rational purpose as a product of artificial feeding of children with a hereditary predisposition to allergies.