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Jara J, Alba C, Del Campo R, Fernández L, Sáenz de Pipaón M, Rodríguez JM, Orgaz B. Linking preterm infant gut microbiota to nasograstric enteral feeding tubes: exploring potential interactions and microbial strain transmission. Front Pediatr 2024; 12:1397398. [PMID: 38952433 PMCID: PMC11215057 DOI: 10.3389/fped.2024.1397398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction Preterm birth is a growing problem worldwide. Staying at a neonatal intensive care unit (NICU) after birth is critical for the survival of preterm infants whose feeding often requires the use of nasogastric enteral feeding tubes (NEFT). These can be colonized by hospital-associated pathobionts that can access the gut of the preterm infants through this route. Since the gut microbiota is the most impactful factor on maturation of the immune system, any disturbance in this may condition their health. Therefore, the aim of this study is to assess the impact of NEFT-associated microbial communities on the establishment of the gut microbiota in preterm infants. Material and methods A metataxonomic analysis of fecal and NEFT-related samples obtained during the first 2 weeks of life of preterm infants was performed. The potential sharing of strains isolated from the same set of samples of bacterial species involved in NICU's outbreaks, was assessed by Random Amplification of Polymorphic DNA (RAPD) genotyping. Results In the samples taken 48 h after birth (NEFT-1 and Me/F1), Staphylococcus spp. was the most abundant genera (62% and 14%, respectively) and it was latter displaced to 5.5% and 0.45%, respectively by Enterobacteriaceae. Significant differences in beta diversity were detected in NEFT and fecal samples taken at day 17 after birth (NEFT-3 and F3) (p = 0.003 and p = 0.024, respectively). Significant positive correlations were found between the most relevant genera detected in NEFT-3 and F3. 28% of the patients shared at least one RAPD-PCR profile in fecal and NEFT samples and 11% of the total profiles were found at least once simultaneously in NEFT and fecal samples from the same patient. Conclusion The results indicate a parallel bacterial colonization of the gut of preterm neonates and the NEFTs used for feeding, potentially involving strain sharing between these niches. Moreover, the same bacterial RAPD profiles were found in neonates hospitalized in different boxes, suggesting a microbial transference within the NICU environment. This study may assist clinical staff in implementing best practices to mitigate the spread of pathogens that could threaten the health of preterm infants.
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Affiliation(s)
- J. Jara
- Department of Galenic Pharmacy and Food Science, School of Veterinary Sciences, University Complutense of Madrid (UCM), Madrid, Spain
| | - C. Alba
- Department of Nutrition and Food Science, School of Veterinary Sciences, University Complutense of Madrid (UCM), Madrid, Spain
| | - R. Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital and Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - L. Fernández
- Department of Galenic Pharmacy and Food Science, School of Veterinary Sciences, University Complutense of Madrid (UCM), Madrid, Spain
| | - M. Sáenz de Pipaón
- Department of Neonatology, La Paz University Hospital of Madrid, Madrid, Spain
- Department of Pediatrics, Autonoma University of Madrid, Madrid, Spain
| | - J. M. Rodríguez
- Department of Nutrition and Food Science, School of Veterinary Sciences, University Complutense of Madrid (UCM), Madrid, Spain
| | - B. Orgaz
- Department of Galenic Pharmacy and Food Science, School of Veterinary Sciences, University Complutense of Madrid (UCM), Madrid, Spain
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Phillips R, VanNatta D, Chu J, Best A, Ruiz P, Oswalt T, Wooldridge D, Fayard E. Breastfeeding Practice Before Bottle-Feeding: An Initiative to Increase the Rate of Breastfeeding for Preterm Infants at the Time of Neonatal Intensive Care Unit Discharge. Crit Care Nurs Clin North Am 2024; 36:251-260. [PMID: 38705692 DOI: 10.1016/j.cnc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Preterm babies who received 72 hours of breastfeeding practice before introducing a bottle had significantly higher rates of breastfeeding at the time of neonatal intensive care unit (NICU) discharge than did babies who were introduced to bottle-feeding with or before breastfeeding during the first 72 hours of oral feeding or babies who were primarily bottle-fed. There were no statistical differences in corrected gestational age (CGA) at birth, first oral feeding, or full oral feeds, in days from first to full oral feeds, or in CGA or days of life at NICU discharge.
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Affiliation(s)
- Raylene Phillips
- Loma Linda University Children's Hospital, Neonatology Division, 11175 Campus Street, CP 11121, Loma Linda, CA 92350, USA; Loma Linda University School of Medicine, Department of Pediatrics, Division of Neonatology, 11175 Campus Street, Loma Linda, CA 92350, USA; Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
| | - Dawn VanNatta
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Jenny Chu
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Allison Best
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Pamela Ruiz
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Tonya Oswalt
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Dianne Wooldridge
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Elba Fayard
- Loma Linda University Children's Hospital, Neonatology Division, 11175 Campus Street, CP 11121, Loma Linda, CA 92350, USA; Loma Linda University School of Medicine, Department of Pediatrics, Division of Neonatology, 11175 Campus Street, Loma Linda, CA 92350, USA; Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
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Carcavalli L, Rocha IA, Valentim AF, Penido MG, Parlato EM, Pordeus IA, Serra-Negra JM. Difference of Socioeconomic Factors among Mothers of Preterm and Full-Term Infant. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bonnet C, Blondel B, Piedvache A, Wilson E, Bonamy AKE, Gortner L, Rodrigues C, van Heijst A, Draper ES, Cuttini M, Zeitlin J. Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study. MATERNAL AND CHILD NUTRITION 2018; 15:e12657. [PMID: 30136374 DOI: 10.1111/mcn.12657] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/28/2018] [Accepted: 07/04/2018] [Indexed: 12/16/2022]
Abstract
Breastfeeding confers multiple benefits for the health and development of very preterm infants, but there is scarce information on the duration of breastfeeding after discharge from the neonatal intensive care unit (NICU). We used data from the Effective Perinatal Intensive Care in Europe population-based cohort of births below 32 weeks of gestation in 11 European countries in 2011-2012 to investigate breastfeeding continuation until 6 months. Clinical and sociodemographic characteristics were collected from obstetric and neonatal medical records as well as parental questionnaires at 2 years of corrected age. Among 3,217 ever-breastfed infants, 34% were breastfeeding at 6 months of age (range across countries from 25% to 56%); younger and less educated mothers were more likely to stop before 6 months (adjusted relative risk [aRR] <25 years: 0.68, 95% CI [0.53, 0.88], vs. 25-34 years; lower secondary: 0.58, 95% CI [0.45, 0.76] vs. postgraduate education). Multiple birth, bronchopulmonary dysplasia (BPD), and several neonatal transfers reduced the probability of continuation but not low gestational age, fetal growth restriction, congenital anomalies, or severe neonatal morbidities. Among infants breastfeeding at discharge, mixed versus exclusive breast milk feeding at discharge was associated with stopping before 6 months: aRR = 0.60, 95% CI [0.48, 0.74]. Low breastfeeding continuation rates in this high-risk population call for more support to breastfeeding mothers during and after the neonatal hospitalization, especially for families with low socio-economic status, multiples, and infants with BPD. Promotion of exclusive breastfeeding in the NICU may constitute a lever for improving breastfeeding continuation after discharge.
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Affiliation(s)
- Camille Bonnet
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, 75014, France
| | - Béatrice Blondel
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, 75014, France
| | - Aurélie Piedvache
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, 75014, France
| | - Emilija Wilson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anna-Karin Edstedt Bonamy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ludwig Gortner
- Department of Neonatology, Pediatric Center, Justus Liebig University Giessen, Giessen, Germany
| | - Carina Rodrigues
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Arno van Heijst
- Department of Neonatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, 75014, France
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Say B, Simsek GK, Canpolat FE, Oguz SS. Effects of Pacifier Use on Transition Time from Gavage to Breastfeeding in Preterm Infants: A Randomized Controlled Trial. Breastfeed Med 2018; 13:433-437. [PMID: 29912580 DOI: 10.1089/bfm.2018.0031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Nonnutritive sucking (NNS) has been identified as having many benefits for preterm infants. NNS may improve the efficacy of oral feeding, reduce the length of time spent in orogastric (OG) tube feeding, and shorten the length of hospital stays for preterm infants. AIM This study aimed to assess the effect of pacifiers on preterm infants in the transition from gavage to oral feeding, their time to discharge, weight gain, and time for transition to full breastfeeding. METHODS A prospective, randomized controlled trial was conducted in our center. Ninety infants were randomized into two groups: a pacifier group (PG) (n = 45) and a control group (n = 45). Eligibility criteria included body weight less than or equal to 1,500 g, gestational age (GA) younger than 32 weeks, tolerating at least 100 kcals/kg/day by OG feeding, growth parameters appropriate for GA, and a stable clinical condition. RESULTS Mean GAs were 29.2 ± 1.86 versus 28.4 ± 1.84 weeks (p = 0.46), and birth weights were 1,188.2 ± 272 versus 1,112.8 ± 267 g (p = 0.72) in the PG and CG groups, respectively. The time for transition to full oral feeding (38 ± 19.2 days), time to transition to full breastfeeding (38.1 ± 20 days), and time to discharge (48.4 ± 19.2 days) in the PG were significantly shorter compared with the control group (49.8 ± 23.6, 49.1 ± 22, 65.3 ± 30.6 days, respectively) (p < 0.05). For preterm infants with gastrointestinal motility disturbance, similar symptoms (regurgitation, vomiting, abdominal distension) (n = 6, 22%) in the PG were significantly lower than the control group (n = 21, 77.8%) (p < 0.05). CONCLUSION In this study, we determined that the method of giving pacifiers to preterm infants during gavage feeding reduced the infants' transition period to oral feeding and the duration of hospital stay. In addition, the pacifiers could be used during gavage feeding and in the transition from gavage to oral/breastfeeding in preterm infants to encourage the development of sucking ability.
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Affiliation(s)
- Birgul Say
- 1 University of Health Sciences, Division of Neonatology, Derince Education and Training Hospital , Kocaeli, Turkey
| | - Gulsum Kadioglu Simsek
- 2 University of Health Sciences, Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital , Ankara, Turkey
| | - Fuat Emre Canpolat
- 2 University of Health Sciences, Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital , Ankara, Turkey
| | - Serife Suna Oguz
- 2 University of Health Sciences, Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital , Ankara, Turkey
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Moles L, Gómez M, Jiménez E, Bustos G, de Andrés J, Melgar A, Escuder D, Fernández L, Del Campo R, Rodríguez JM. Bacterial Diversity of the Gastric Content of Preterm Infants during Their First Month of Life at the Hospital. Front Nutr 2017; 4:12. [PMID: 28459051 PMCID: PMC5394887 DOI: 10.3389/fnut.2017.00012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/29/2017] [Indexed: 12/26/2022] Open
Abstract
Studies focused on the stomach microbiota are relatively scarce, and most of them are focused on the adult population. The aim of this work is to describe the bacterial communities inhabiting the gastric content (GC) of preterm neonates. For that purpose, GC samples were collected weekly from a total of 13 preterm neonates during their first month of life within their hospital stay. Samples were analyzed by using both culture-dependent and -independent techniques. The former allowed the isolation of bacteria belonging mainly to the genera Enterococcus, Staphylococcus, Streptococcus, Serratia, Klebsiella, and Escherichia. The cultured dominant species in the GC samples during all the hospitalization period were Enterococcus faecalis and Staphylococcus epidermidis. Multilocus sequence typing (MLST) analysis revealed the presence of high-risk clonal complexes associated with the hospital environment, which may colonize enteral feeding tubes. Similarly, the 16S rRNA sequencing showed that Streptococcus, Staphylococcus, Lactobacillus, Enterococcus, Corynebacterium, and Propionibacterium were the dominant genera present at 75% of the gastric samples. However, the genera Serratia, Klebsiella, and Streptococcus were the most abundant. Own mother's milk (OMM) and donor milk (DM) were collected after their pass through the external feeding tubes to assess their bacterial content. OMM and DM had a similar bacterial pattern to GC. Based on these data, the GC of preterm neonates is dominated by Proteobacteria and Firmicutes and harbors high-risk bacterial clones, which may colonize enteral feeding tubes, and therefore the feeds that pass through them.
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Affiliation(s)
- Laura Moles
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Marta Gómez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Esther Jiménez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain.,ProbiSearch, S.L., Tres Cantos, Madrid, Spain
| | - Gerardo Bustos
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, Madrid, Spain.,Red de Salud Materno-Infantil y del Desarrollo (SAMID), Barakaldo, Spain
| | - Javier de Andrés
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Ana Melgar
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, Madrid, Spain.,Red de Salud Materno-Infantil y del Desarrollo (SAMID), Barakaldo, Spain
| | - Diana Escuder
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, Madrid, Spain.,Red de Salud Materno-Infantil y del Desarrollo (SAMID), Barakaldo, Spain
| | - Leónides Fernández
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain.,ProbiSearch, S.L., Tres Cantos, Madrid, Spain
| | - Rosa Del Campo
- Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain.,Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain.,Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Miguel Rodríguez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain.,ProbiSearch, S.L., Tres Cantos, Madrid, Spain
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Abstract
OBJECTIVE The aim of the study was to evaluate the potential colonization of nosocomial bacteria in enteral feeding systems and its effect on early gut colonization of preterm neonates. METHODS Mother's own milk, donor milk, and preterm formula samples obtained after passing through the external part of the enteral feeding tubes were cultured. In addition, meconium and fecal samples from 26 preterm infants collected at different time points until discharge were cultured. Random amplification polymorphism DNA and pulse field gel electrophoresis were performed to confirm the presence of specific bacterial strains in milk and infant fecal samples. RESULTS Approximately 4000 bacterial isolates were identified at the species level. The dominant species in both feces from preterm infants and milk samples were Staphylococcus epidermidis, S aureus, Enterococcus faecalis, E faecium, Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli. All of them were present at high concentrations independently of the feeding mode. Random amplification polymorphism DNA and pulse field gel electrophoresis techniques showed that several bacteria strains were found in both type of samples. Furthermore, scanning electron microscopy revealed the presence of a dense bacterial biofilm in several parts of the feeding tubes and the tube connectors. CONCLUSIONS There is a sharing of bacterial strains between the neonates' gastrointestinal microbiota and the feeding tubes used to feed them.
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Ziadi M, Héon M, Aita M. A Critical Review of Interventions Supporting Transition from Gavage to Direct Breastfeeding in Hospitalized Preterm Infants. ACTA ACUST UNITED AC 2016. [DOI: 10.1053/j.nainr.2016.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Improving preterm infant outcomes: implementing an evidence-based oral feeding advancement protocol in the neonatal intensive care unit. Adv Neonatal Care 2014; 14:346-53. [PMID: 24979099 DOI: 10.1097/anc.0000000000000099] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The ability of a preterm infant to exclusively oral feed is a necessary standard for discharge readiness from the neonatal intensive care unit (NICU). Many of the interventions related to oral feeding advancement currently employed for preterm infants in the NICU are based on individual nursing observations and judgment. Studies involving standardized feeding protocols for oral feeding advancement have been shown to decrease variability in feeding practices, facilitate shortened transition times from gavage to oral feedings, improve bottle feeding performance, and significantly decrease the length of stay (LOS) in the NICU. PURPOSE This project critically evaluated the implementation of an oral feeding advancement protocol in a 74-bed level III NICU in an attempt to standardize the process of advancing oral feedings in medically stable preterm infants. METHODS A comprehensive review of the literature identified key features for successful oral feeding in preterm infants. RESULTS Strong levels of evidence suggested an association between both nonnutritive sucking (NNS) opportunities and standardized feeding advancement protocols with successful oral feeding in preterm infants. These findings prompted a pilot practice change using a feeding advancement protocol and consisted of NNS and standardized oral feeding advancement opportunities. Time to exclusive oral feedings and LOS were compared pre- and postprotocol implementation during more than a 2-month evaluation period. CONCLUSIONS Infants using NNS and the standardized oral feeding advancement protocol had an observed reduction in time to exclusive oral feedings and LOS, although statistical significance was not achieved.
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State of the science: a contemporary review of feeding readiness in the preterm infant. J Perinat Neonatal Nurs 2014; 28:51-8; quiz E3-4. [PMID: 24476652 DOI: 10.1097/jpn.0000000000000011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oral feeding readiness has been described by researchers in the neonatal intensive care unit, and research has continued on this topic for many years. The purpose of this narrative review is to identify research and practice guidelines related to oral feeding readiness in preterm infants that have occurred during the last decade. The introduction and mastery of oral feeding is a major developmental task for the preterm infant that is often a prerequisite for discharge from the neonatal intensive care unit. Having a better understanding of the evidence supporting the development of this skill will help the practicing nurse choose appropriate interventions and the researcher to develop trajectories of research that continue to increase our knowledge in this important practice area.
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White A, Parnell K. The transition from tube to full oral feeding (breast or bottle) – A cue-based developmental approach. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jnn.2013.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Crestani AH, Souza APRD, Beltrami L, Moraes ABD. Analysis of the association among types of breastfeeding, presence of child development risk, socioeconomic and obstetric variables. JORNAL DA SOCIEDADE BRASILEIRA DE FONOAUDIOLOGIA 2013; 24:205-10. [PMID: 23128167 DOI: 10.1590/s2179-64912012000300004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Accepted: 09/30/2011] [Indexed: 11/21/2022]
Abstract
PURPOSE To investigate the association among types of breastfeeding, presence of child development risk, socioeconomic and obstetric variables. METHODS The sample was composed of 182 mother-child dyades. Data were collected through an initial interview about breastfeeding; obstetric, socioeconomic, demographic and psychosocial aspects; and mother-child interaction analysis by the Child Development Risk Inventory. The data were organized in categories related to breastfeeding, presence or absence of child development risk, obstetric and socioeconomic variables, and were analyzed in Statistica 9.0 software for statistical analysis. RESULTS The mixed breastfeeding type shows statistical correlation between presence of child development risk as well as to variables such as prematurity, low weight, birth intercurrences and mother's domestic profession. CONCLUSION The results show that factors such as low weight, prematurity and presence of birth intercurrences can be associated to mixed breastfeeding, even if the mothers present physical and time availability for breastfeeding. These variables can be associated to mother-child initial interactions detected by Child Development Risk Inventory.
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Affiliation(s)
- Anelise Henrich Crestani
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
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13
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Godfrey JR, Lawrence RA. Toward optimal health: the maternal benefits of breastfeeding. J Womens Health (Larchmt) 2012; 19:1597-602. [PMID: 20677994 DOI: 10.1089/jwh.2010.2290] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Research indicates that feeding preterm infants at the breast is physiologically less stressful than bottle-feeding. Poor sucking reflexes make it difficult to initiate breastfeeding for these high-risk infants. Mothers need to understand the difficulties of breastfeeding, as well as the advantages for herself and her baby. It is important for nurses to be well educated on how preterm infants are breastfed and how to best support the mother through her experience. The nurse must focus on caring for the infant as well as fostering the mother-infant connection to promote breastfeeding. A mother will need continual support, encouragement, and advice from the nurse, while teaching her baby how to breastfeed.
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Zachariassen G, Faerk J, Grytter C, Esberg B, Juvonen P, Halken S. Factors associated with successful establishment of breastfeeding in very preterm infants. Acta Paediatr 2010; 99:1000-4. [PMID: 20151950 DOI: 10.1111/j.1651-2227.2010.01721.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To describe feeding practices at hospital discharge in relation to characteristics of the very preterm infants (VPI) and their mothers. METHODS Design. Prospective hospital-based registration of very preterm infants born with a gestational age < or =32 weeks in Denmark during 2004-2008. Subjects. Healthy mothers and VPI without diseases causing eating disabilities at discharge. RESULTS A total of 478 VPI were registered. At discharge, 60% were exclusively breastfed, 35% were exclusively bottlefed, and 5% were both breast- and bottle-fed. Mothers of high social class (p = 0.000) and 'not smoking' (p = 0.003) were significantly more often breastfeeding their preterm infant(s) at discharge. Single births infants tended more often to be breastfed (p = 0.09). Infant age at discharge and duration of hospitalization did not influence breastfeeding at discharge. Increase in weight z-score from birth to discharge was largest in the bottlefeeding-group compared with the breastfeeding-group (p = 0.000) probably as a result of feeding practice the last week(s) of hospitalization. CONCLUSION Breastfeeding can successfully be established in very preterm infants. Mothers of low social classes, smokers, multiple birth and very preterm infants with low weight for age may need extra attention in breastfeeding establishing policies.
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Affiliation(s)
- G Zachariassen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
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Berger I, Weintraub V, Dollberg S, Kopolovitz R, Mandel D. Energy expenditure for breastfeeding and bottle-feeding preterm infants. Pediatrics 2009; 124:e1149-52. [PMID: 19933725 DOI: 10.1542/peds.2009-0165] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We hypothesized that resting energy expenditure (REE) would be higher after breastfeeding than after bottle-feeding. METHODS Nineteen preterm infants (gestational age: 32 weeks) in stable condition who were nourished entirely with their mothers' breast milk were assigned randomly to feeding either by bottle or at the breast. Each infant served as his or her own control subject. REE was measured for 20 minutes after feeding. Breast milk quantity was evaluated with prefeeding and postfeeding weighing. REE values for bottle-feeding and breastfeeding were compared with paired t tests. RESULTS Contrary to our null hypothesis, the group's mean REE values after bottle-feeding and breastfeeding were very similar (284.7 +/- 26.8 kJ/kg per day [68.3 +/- 6.4 kcal/kg per day] vs 282.6 +/- 28.5 kJ/kg per day [67.5 +/- 6.8 kcal/kg per day]; not significant). The duration of feeding was significantly longer for breastfeeding than for bottle-feeding (20.1 +/- 7.9 vs 7.8 +/- 2.9 minutes; P < .0001). CONCLUSION There was no significant difference in REE when infants were breastfed versus bottle-fed. Longer feeding times at the breast did not increase REE. We speculate that it is safe to recommend feeding at the breast for infants born at >32 weeks when they can tolerate oral feeding.
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Affiliation(s)
- Irit Berger
- Department of Neonatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Meyers D. Toward optimal health: maternal benefits of breastfeeding. [An interview with David Meyers by Jodi R. Godfry]. J Womens Health (Larchmt) 2009; 18:1307-10. [PMID: 19702480 DOI: 10.1089/jwh.2009.1646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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