Potential effectiveness of integrating human milk banking and lactation support on neonatal outcomes at Pumwani Maternity Hospital, Kenya

We assessed the potential effectiveness of human milk banking and lactation support on provision of human milk to neonates admitted in the newborn unit (NBU) at Pumwani Maternity Hospital, Kenya. This pre-post intervention study collected data from mothers/caregivers and their vulnerable neonates or term babies who lacked sufficient mother's milk for several reasons admitted in the NBU. The intervention included establishing a human milk bank and strengthening lactation support. Preintervention data were collected between 5 October 2018 and 11 November 2018, whereas postintervention data were collected between 4 September 2019 and 6 October 2019. Propensity score-matched analysis was performed to assess the effect of the intervention on exclusive use of human milk, use of human milk as the first feed, feeding intolerance and duration of NBU stay. The surveys included 123 and 116 newborns at preintervention and postintervention, respectively, with 160 newborns (80 in each group) being included in propensity score matched analysis. The proportion of neonates who exclusively used human milk during NBU stay increased from 41.3% preintervention to 63.8% postintervention (adjusted odds ratio [OR]: 2.68; 95% confidence interval [CI]: 1.31, 5.53) and those whose first feed was human milk increased from 55.0% preintervention to 83.3% postintervention (adjusted OR: 5.09; 95% CI: 2.18, 11.88). The mean duration of NBU stay was 27% (95% CI: 5.8%, 44.0%) lower in the postintervention group than in the preintervention group. The intervention did not affect feeding intolerance. Integrating human milk banking and lactation support may improve exclusive use of human milk among vulnerable neonates in a resource limited setting.

Impact of lactation management education on health professionals

BACKGROUND

In 1992, Kenyatta National Hospital Lactation Management Education Centre (KNH LME) was establised in collaboration with the University of Nairobi (UoN) and the Ministry of Health (MoH). The aim of the programme was to train multidisciplinary teams of health professionals in lactation management education.

OBJECTIVE

To determine the performance of doctors, nurses and nutritionists on lactation management education, before and after exposure to the programme.

DESIGN

A descriptive analysis of the pre and post test performance of doctors, nurses and nutritionists on lactation management education.

SUBJECTS

Two hundred and twenty nine health professionals, comprising one hundred and thirty eight nurses, fifty six nutritionists, and thirty five doctors.

RESULTS

The performance of all participants improved significantly (p = <.000) between the pre and post test scores from a mean score of 54.0% in pre test, to a mean score of 72.0% in the post test.

CONCLUSION

Adequate lactation management education content should be included in all preservice medical curricula for all health professionals. In addition, an update of emerging issues in lactation management education must be sustained, in all health institutions as part of continuing education for inservice health professionals.

Nutrition in the management of acquired immunodeficiency syndrome

OBJECTIVE

To highlight the influence of nutrition on the progress of HIV/AIDS and the role and importance of good nutrition in the management of the disease.

STUDY SELECTION

The subject was selected because it is now recognised that nutritional care and support is an essential component of the health care plan and management for people with HIV/AIDS. The subject is especially relevant since few studies have been conducted locally on the effects of nutritional status on the progression of HIV/AIDS. DATA RESOURCES AND DATA SYNTHESIS: A review of current literature selected from local and international scientific journals and books on the subject of nutrition and HIV/AIDS.

DATA EXTRACTION AND SYNTHESIS

Data were developed from the reviewed information extracted from the contribution of different authors who are interested in nutritional management of people with HIV/AIDS. It was then analysed and synthesised into the current article.

CONCLUSION

On the basis of the reviewed information, it is recommended that individuals with HIV/AIDS be given nutrition counselling and support to enable them achieve an adequate nutrient and energy intake for as long as possible. This would enhance the quality of their lives and minimise disease symptoms.

Ageing and nutritional needs

Nutrition is an important aspect of healthful behaviour and a major component of general wellbeing of individuals throughout their life cycle. While the ageing process compromises the body's ability to obtain nutrients from food, nutrition at the same time affects how people age. This article reviews the nutritional needs of the elderly people, from the age of 51 years and above, and highlights factors that can influence their nutritional status. The article concentrates on this age group, since the recommended nutritional requirements are stated from this age and above.