Influence of Early Lactation Assistance on Inpatient Exclusive Breastfeeding Rates

2020 ◽  
pp. 089033442095796
Author(s):  
Keyaria D. Gray ◽  
Emily A. Hannon ◽  
Elizabeth Erickson ◽  
Ariana B. Stewart ◽  
Charles T. Wood ◽  
...  
Keyword(s):  
Human Milk ◽  
Private Insurance ◽  
Feeding Preference ◽  
Feeding Rates ◽  
Term Infants ◽  
Lactation Consultant ◽  
Childhood Illnesses ◽  
Healthy Infants ◽  
Birth Hospitalization ◽  
Milk Feeding

Background Human milk feeding reduces the incidence and costs of several maternal and childhood illnesses. Initiation and success of human milk feeding are influenced by race, socioeconomic status, and family support. The influence of early in-hospital lactation assistance in breastfeeding success has been not well described. Research aims We aimed to determine how suspected known factors influencing breastfeeding success influence in-hospital human milk feeding rates. Second, we aimed to examine how timing of lactation assistance is related to success of human milk feeding during the newborn hospitalization for healthy infants. Methods We conducted a retrospective cohort study of term infants born between January 1, 2014 and December 31, 2016 at a large tertiary academic hospital. We considered “success” to be 100% human milk feeding during the birth hospitalization, and compared differences in success by demographics, payor, race, and initial feeding preference. Influences of lactation assistance on success were analyzed using multivariable logistic regression. Results Mean success with exclusive human milk feeding among 7,370 infants was 48.9%, ( n = 3,601). Successful participants were more likely to be 39–40 weeks’ gestation (64.9%, n = 2,340), non-Hispanic/non-Latino (80.0%, n = 2,882), and using private insurance (69.2%, n = 2,491). Participants who had early feeding assisted by an International Board Certified Lactation Consultant (IBCLC) before being fed any formula were more likely to be successful than participants who had a feeding assisted by a non-IBCLC nurse (80% vs. 40% respectively). Conclusions Success for exclusive human milk feeding during newborn hospitalization is strongly associated with several factors. Early intervention with IBCLCs can greatly improve breastfeeding success.

scholarly journals Trends in Costs of Birth Hospitalization and Readmissions for Late Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 127
Author(s):  
Rebecca R. Speer ◽  
Eric W. Schaefer ◽  
Mahoussi Aholoukpe ◽  
Douglas L. Leslie ◽  
Chintan K. Gandhi
Keyword(s):  
Preterm Infants ◽  
Private Insurance ◽  
The United States ◽  
Late Preterm ◽  
Term Infants ◽  
Late Preterm Infants ◽  
Hospitalization Costs ◽  
Analysis Of Claims Data ◽  
Mean Cost ◽  
Birth Hospitalization

Background: The objective is to study previously unexplored trends of birth hospitalization and readmission costs for late preterm infants (LPIs) in the United States between 2005 and 2016. Methods: We conducted a retrospective analysis of claims data to study healthcare costs of birth hospitalization and readmissions for LPIs compared to term infants (TIs) using a large private insurance database. We used a generalized linear regression model to study birth hospitalization and readmission costs. Results: A total of 2,123,143 infants were examined (93.2% TIs; 6.8% LPIs). The proportion of LPIs requiring readmission was 4.2% compared to 2.1% of TIs, (p < 0.001). The readmission rate for TIs decreased during the study period. LPIs had a higher mean cost of birth hospitalization (25,700 vs. 3300 USD; p < 0.001) and readmissions (25,800 vs. 14,300 USD; p < 0.001). For LPIs, birth hospitalization costs increased from 2007 to 2013, and decreased since 2014. Conversely, birth hospitalization costs of TIs steadily increased since 2005. The West region showed higher birth hospitalization costs for LPIs. Conclusions: LPIs continue to have a higher cost of birth hospitalization and readmission compared to TIs, but these costs have decreased since 2014. Standardization of birth hospitalization care for LPIs may reduce costs and improve quality of care and outcomes.

Human Milk Feeding Status of Preterm Infants in Neonatal Intensive Care Units in China

2020 ◽  
Vol 36 (2) ◽  
pp. 283-290 ◽  
Author(s):  
Wenjing Peng ◽  
Siyuan Jiang ◽  
Shujuan Li ◽  
Shiwen Xia ◽  
Shushu Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Human Milk ◽  
Intensive Care Units ◽  
Preterm Infants ◽  
Significant Variation ◽  
Neonatal Intensive Care ◽  
Current Status ◽  
Neonatal Intensive Care Units ◽  
Feeding Rates ◽  
Milk Feeding

Background Previous low human milk feeding rates in Chinese neonatal intensive care units of preterm infants were reported. There are no nationwide data on these. Research Aims To investigate the current status of human milk feeding for preterm infants in Chinese units and provide baseline data for future research. Methods A secondary data analysis was conducted from a previously established clinical database including 25 Chinese neonatal intensive care units. All infants born <34 weeks gestation and admitted to participating units from May 2015 to April 2018 were enrolled. Variables analyzed were infant data collected and the human milk feeding practices at participating units were surveyed. Results A total of 24,113 infants were included. The overall and exclusive human milk feeding rates were 58.2% and 18.8%, respectively, which increased significantly during study years. We found that rates of human milk feeding decreased with increase in gestational age and birth weight. There was significant variation in human milk feeding rates among units. Most participating Chinese neonatal intensive care units have taken measures to improve the rates of human milk feeding. Conclusions The human milk feeding rates in Chinese neonatal intensive care units have continued to increase in the past 3 years, but there was significant variation among them. More efforts are needed to further increase the human milk feeding rates in China. Trial registration This study was registered NCT02600195 with clinicaltrials.gov on November 9, 2015.

Intravenous Nitrogen Intake Requirements in Full-Term Newborns Undergoing Surgery

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 493-496
Author(s):  
Stanley H. Zlotkin
Keyword(s):  
Amino Acid ◽  
Human Milk ◽  
Weight Change ◽  
Nitrogen Retention ◽  
Full Term ◽  
Term Infants ◽  
Healthy Infants ◽  
Nitrogen Intake ◽  
Acid Formulation ◽  
Crystalline Amino Acids

To determine the intravenous intake of nitrogen needed to duplicate the weight gain and nitrogen retention observed in healthy infants fed human milk, full-term infants had weight change and nitrogen balance measured postoperatively while they were receiving two different parenteral regimens which provided adequate energy (87 kcal/kg/d) and varying intakes of nitrogen as crystalline amino acids (290 to 579 mg/kg/d) over a six-day period. Weight change was similar to that observed in breast-fed infants (35 g/d) and was independent of nitrogen intake. A significant correlation was observed between nitrogen intake and retention (r = .71, P &lt; .01). Substituting the rate of nitrogen retention observed in thriving full-term infants fed human milk into the regression equation describing the relationship between nitrogen intake and retention, the nitrogen intake required by parenterally fed infants in order to duplicate the accretion rate of their milk-fed counterparts was 280 mg/kg/d. After correcting for individual variation, recommended intravenous amino acid intakes range from 2.3 to 2.7 g/kg/d depending on the commercial amino acid formulation chosen and providing that adequate amounts of energy are concurrently infused.

scholarly journals Longitudinal Changes in the Concentration of Major Human Milk Proteins in the First Six Months of Lactation and Their Effects on Infant Growth

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1476
Author(s):  
Jian Zhang ◽  
Ai Zhao ◽  
Shiyun Lai ◽  
Qingbin Yuan ◽  
Xiaojiang Jia ◽  
...  
Keyword(s):  
Human Milk ◽  
Maternal Education ◽  
Mode Of Delivery ◽  
Milk Proteins ◽  
Protein Composition ◽  
Infant Growth ◽  
Term Infants ◽  
Longitudinal Changes ◽  
Milk Samples ◽  
The Impact

Our knowledge related to human milk proteins is still limited. The present study determined the changes in multiple human milk proteins during the first six months of lactation, investigated the influencing factors of milk proteins, and explored the impact of milk proteins on infant growth. A total of 105 lactating women and their full-term infants from China were prospectively surveyed in this research. Milk samples were collected at 1–5 days, 8–14 days, 1 month, and 6 months postpartum. Concentrations of total protein and α-lactalbumin were measured in all milk samples, and concentrations of lactoferrin, osteopontin, total casein, β-casein, αs−1 casein, and κ-casein were measured in milk from 51 individuals using ultra performance liquid chromatography coupled with mass spectrometry. The concentration of measured proteins in the milk decreased during the first six months of postpartum (p-trend < 0.001). Maternal age, mode of delivery, maternal education, and income impacted the longitudinal changes in milk proteins (p-interaction < 0.05). Concentrations of αs−1 casein in milk were inversely associated with the weight-for-age Z-scores of the infants (1 m: r −0.29, p 0.038; 6 m: r −0.33, p 0.020). In conclusion, the concentration of proteins in milk decreased over the first six months postpartum, potentially influenced by maternal demographic and delivery factors. Milk protein composition may influence infant weights.

Lactation Consultation by an International Board Certified Lactation Consultant Improves Breastfeeding Rates for Mothers With Gestational Diabetes Mellitus

2021 ◽  
pp. 089033442110186
Author(s):  
Laurie Beth Griffin ◽  
Jia Jennifer Ding ◽  
Phinnara Has ◽  
Nina Ayala ◽  
Martha B. Kole-White
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Hospital Discharge ◽  
Exclusive Breastfeeding ◽  
Secondary Analysis ◽  
Feeding Preference ◽  
Lactation Consultant ◽  
Breastfeeding Rates

Background In patients with gestational diabetes, breastfeeding decreases the lifetime risk of Type 2 diabetes by half. Lactation consultation has been shown to increase breastfeeding rates in the general population but has not been assessed in a gestational diabetes population. Research Aims To determine if (1) a postpartum International Board Certified Lactation Consultant (IBCLC) consultation during delivery hospitalization improved inclusive (any) or exclusive breastfeeding rates at hospital discharge and 3 months postpartum in participants with GDM; and if (2) obstetrical providers’ acknowledgement of maternal feeding preference affected the rates of IBCLC consultation for patients. Methods This was a retrospective, comparative, secondary analysis of a prospective cohort ( N = 517) study of women gestational diabetes. Participants who received a IBCLC consultation ( n = 386; 74.5%) were compared to those who did not ( n = 131; 25.5%). Baseline demographics, antepartum characteristics, neonatal information, mode of infant feeding at hospital discharge and 3 months postpartum, and IBCLC consultation during postpartum hospitalization were measured. Results After adjusting for baseline differences, participants who received an IBCLC consultation were more likely to report any breastfeeding at postpartum discharge (aOR 4.87; 95% CI [2.67, 8.86]) and at 3 months postpartum (aOR 5.39; 95% CI [2.61, 11.16]) compared to participants who did not. However, there was no difference in exclusive breastfeeding rates between those who did and did not receive IBCLC consultation. Conclusion Inpatient IBCLC consultation during the immediate postpartum period was associated with improved rates of any breastfeeding in participants with GDM.

Selenium status of term infants fed human milk or selenite-supplemented soy formula

1993 ◽  
Vol 122 (5) ◽  
pp. 739-741 ◽  
Author(s):  
Carolyn E. Johnson ◽  
Anne M. Smith ◽  
Gary M. Chan ◽  
Laurie J. Moyer-Mileur
Keyword(s):  
Human Milk ◽  
Selenium Status ◽  
Term Infants

Breast milk leukocytes

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 769-770
Author(s):  
Jane Pitt
Keyword(s):  
Gastrointestinal Tract ◽  
Breast Milk ◽  
Human Milk ◽  
Apparent Increase ◽  
Human Colostrum ◽  
Available Information ◽  
Portal Of Entry ◽  
Milk Feeding

The apparent increase in frequency of neonatal necrotizing enterocolitis1 and the recognition that the gastrointestinal tract is often the portal of entry in neonatal sepsis2 has renewed interest in breast milk as a source of newborn immunity. Attention has recently focussed on milk leukocytes. The purpose of this commentary is to summarize the available information on this subject and to examine the implications that this knowledge may have on the possible use of human milk-feeding to protect the newborn from infection. Human colostrum and early milk contain 1 to 2 x 106 leukocytes; 80% to 90% of these are monocytic phagocytes and the remainder are lymphocytes.3,4

WEIGHT GAINS IN THE FIRST FOUR WEEKS OF INFANCY: A COMPARISON OF THREE DIETS

PEDIATRICS ◽  
1956 ◽  
Vol 18 (3) ◽  
pp. 362-368
Author(s):  
Ruth T. Gross ◽  
Lincoln E. Moses
Keyword(s):  
Human Milk ◽  
Statistical Methods ◽  
Full Term ◽  
Clinical Judgement ◽  
Careful Selection ◽  
Term Infants ◽  
Weight Gains ◽  
The Many ◽  
Selection Of

Four hundred seven healthy, full-term infants were divided into three groups and fed, respectively, a formula of evaporated milk and water with 5% carbohydrate; human milk; and a special modified evaporated milk designed to simulate human milk. No other foods were added to the diet. A comparison of the three groups was made, based on weight gains from birth to the end of the first 4 weeks. The conclusions refer only to weight gains; no attempt was made to determine the superiority of any particular diet. The data show no significant differences in the 4-week weight gains among the three groups of infants, although sensitive statistical methods could be validly applied to the problem. These methods are explained. The authors wish to emphasize the many variables which must be taken into account in a study of this sort; the necessity for careful selection of valid statistical methods; the importance of critical clinical judgement in the evaluation of the results.

Dietary Nucleotide Effects upon Immune Function in Infants

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 359-363
Author(s):  
Jane D. Carver ◽  
Bernardo Pimentel ◽  
William I. Cox ◽  
Lewis A. Barness
Keyword(s):  
Human Milk ◽  
Immune Function ◽  
Mononuclear Cells ◽  
Killer Cell ◽  
Interleukin 2 ◽  
Nonprotein Nitrogen ◽  
Term Infants ◽  
Group Rate ◽  
Breast Fed ◽  
Normal Immune Function

Nucleotide (NT) nitrogen, a component of nonprotein nitrogen, accounts for approximately 0.1% to 0.15% of the total nitrogen content of human milk. The results of studies in animals indicate that dietary NTs may be required for maintenance of normal immune function. Thirty-seven healthy term infants were either breast-fed (n = 9) or fed SMA formula supplemented with 33 mg of NTs per liter (n = 13, NT+) or standard SMA formula (n = 15; NT-). At 2 months of age, natural killer cell percent cytotoxicity was significantly higher in the breast-fed and NT+ groups compared with the NT- group (41.7 ± 4.7, 32.2 ± 3.4, 21.7 ± 2.2%, respectively). Interleukin-2 production by stimulated mononuclear cells was higher in the NT+ compared with the NT- group at 2 months of age (0.90 ± 0.28 U/mL, 0.27 ± 0.11 U/mL, respectively); neither formula-fed group differed significantly from the breast-fed group. Rate of growth and incidence and severity of infections did not differ significantly among dietary groups. Nucleotides may be a component of human milk that contributes to the enhanced immunity of the breast-fed infant.

Sign in / Sign up

Export Citation Format

Share Document