scholarly journals A prospective cohort study on lactation status and breastfeeding challenges in mothers giving birth to preterm infants

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Dingding Dong ◽  
Xifang Ru ◽  
Xiaofang Huang ◽  
Tian Sang ◽  
Shan Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preterm Infants ◽  
Multivariate Logistic Regression Analysis ◽  
Tertiary Hospital ◽  
Post Discharge ◽  
Milk Output ◽  
Early Postpartum ◽  
Milk Volume ◽  
Mothers Of Preterm Infants ◽  
Mother’S Own Milk

Abstract Background Mothers of preterm infants face many challenges in breastfeeding, especially regarding lactation. This study aimed to investigate the lactation status and challenges in breastfeeding faced by preterm infants’ mothers. Methods We approached 124 mothers who gave birth to preterm infants between 26 May and 31 October 2018 in a tertiary hospital in China. Lactation status and challenges in breastfeeding on day 7 postpartum, at discharge of infants, 2 weeks post-discharge, and 3 months of corrected age were collected using questionnaires. The area under the receiver operating characteristic (ROC) curve for expressed milk volume on day 7 postpartum for predicting expressed milk volume ≥ 300 mL/d at discharge was calculated. Logistic regression analyses were performed to identify factors associated with delayed lactogenesis II onset and continuation of breastfeeding at 3 months of corrected age. Results Seventy mothers were enrolled, and 51.4% had delayed lactogenesis II. Multivariate logistic regression analysis revealed that older maternal age (aOR = 1.19; 95% CI: 1.01, 1.40) and first live birth (aOR = 4.81; 95% CI 1.43, 16.18) were significant independent predictors of delayed lactogenesis II. Mothers with delayed lactogenesis II had significantly lower expressed milk volume (day 7 postpartum: 160.0 mL vs. 300.0 mL, U = 328.50, p = 0.001; at discharge: 425.0 mL vs. 612.5 mL, U = 372.00, p = 0.005), with a lower proportion of exclusive breastfeeding in their infants (at discharge: 33.3% vs. 69.8%, χ2 = 12.39, df = 1, p < 0.001; 3 months of corrected age: 17.8% vs. 52.8%, χ2 = 11.03, df = 1, p = 0.001). The ROC showed that expressed milk volume > 190 mL/d on day 7 postpartum significantly predicted expressed milk volume ≥ 300 mL/d at discharge. Insufficient human milk was the main reason for breastfeeding discontinuation at 3 months of corrected age. Twins were less likely to continue breastfeeding at 3 months of corrected age (aOR = 0.27; 95% CI 0.09, 0.86). In singleton infants, mother’s own milk ≥50% of total milk uptake at 2 weeks post-discharge (aOR = 32.66; 95% CI 3.00, 355.25) was an independent predictor of continuous breastfeeding at 3 months of corrected age. Feeding complications in infants, poor breastfeeding technique, and low milk output are the main challenges in breastfeeding. Conclusion Interventions to improve early postpartum lactation and breastfeeding techniques may increase breastfeeding adoption in mothers of preterm infants.

scholarly journals A Prospective Study on Lactation Status and Breastfeeding Challenges of Mothers Giving Birth to Preterm Infants

2020 ◽  
Author(s):  
Dingding Dong ◽  
Xifang Ru ◽  
Xiaofang Huang ◽  
Tian Sang ◽  
Shan Li ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Exclusive Breastfeeding ◽  
Multivariate Logistic Regression Analysis ◽  
Post Discharge ◽  
Milk Output ◽  
Early Postpartum ◽  
Total Milk ◽  
Mothers Of Preterm Infants ◽  
A Prospective Study ◽  
Mother’S Own Milk

Abstract BackgroundMothers of preterm infants face challenges in breastfeeding. The aim of the study was to investigate lactation status and challenges in breastfeeding faced by mothers of preterm infants. MethodsMothers giving birth to preterm infants between May 26th 2018 and October 31st 2018 were enrolled. Lactation status and challenges in breastfeeding on day 7 postpartum, at discharge of infants, 2 weeks post-discharge, and 3 months of corrected age (CA 3m) were collected by questionnaires. ResultsSeventy mothers were enrolled, and 51.4% had delayed lactogenesis II. Multivariate logistic regression analysis revealed that cesarean section (OR=3.368, p=0.032), older maternal age (OR=1.189, p=0.008), and primiparity (OR=5.091, p=0.012) were significant independent predictors of delayed lactogenesis II. Mothers with delayed lactogenesis II had significantly lower milk output (day 7 postpartum: 160.0mL vs. 300.0mL, p=0.001; at discharge: 425.0mL vs. 612.5mL, p=0.005) and lower proportion of exclusive breastfeeding (at discharge: 38.9% vs. 70.6%, p=0.008; CA 3m: 12.5% vs. 33.3%, p=0.050). The ROC showed that milk output >190mL/d and >245mL/d on day 7 postpartum significantly predict milk output ≥300mL/d at discharge and exclusive breastfeeding at post-discharge two weeks, respectively. Insufficient human milk was the top reason for breastfeeding discontinuation at CA 3m, and mother’s own milk ≥50% of total milk uptake at postpartum two weeks (OR=5.303, p=0.007) was an independent predictor of continuous breastfeeding at CA 3m. Feeding complications in infants, poor breastfeeding techniques, and low milk output were the top challenges in breastfeeding. ConclusionInterventions to improve early postpartum lactation and breastfeeding techniques may increase breastfeeding adoption in mothers of preterm infants.

scholarly journals Tube Feeding Practices and Transition to Breastfeeding Experiences of Mothers of Preterm Infants at a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110370
Author(s):  
Sphiwe Madiba ◽  
Malmsey Sengane
Keyword(s):  
South Africa ◽  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Tube Feeding ◽  
Feeding Practices ◽  
Tertiary Hospital ◽  
Very Preterm Infants ◽  
Mothers Of Preterm Infants ◽  
Group Interviews

To receive human milk, most preterm infants initially receive the mothers’ expressed milk through a nasogastric tube. However, breast milk feeding the preterm infant and making the transition to direct breast-feeding come with significant challenges. The study explored and described the experiences of mothers of preterm infants regarding initiation and expressing breast milk, tube feeding practices, and transition to breastfeeding during the infants’ stay in a kangaroo care unit (KMC) of an academic hospital in South Africa. Using a qualitative design, focus group interviews were conducted with 38 mothers of preterm infants after discharge from the neonatal intensive care unit (NICU). We analyzed transcripts following the 5 steps for qualitative thematic data analysis. Tube feeding and breastfeeding preterm infants was challenging and exhausting for the mothers. Many described their experiences of initiating expression and sustaining milk supply as negative. They had constant concerns about their ability to produce adequate milk volumes to feed their infants. They had immense dislike of expressing, which they described as physically exhausting, stressful, and painful. Those who had initiated breastfeeding were highly motivated to breastfeed their preterm infants. They described breastfeeding as a positive bonding experience that they derived pleasure from. The mothers’ dislike of expressing was overshadowed by their emotional obligation toward their preterm infants. Although the KMC unit promotes breastfeeding, mothers encountered problems and struggled to initiate expression and sustain milk production. Mothers of extreme and very preterm infants need support to continue with milk expression during the long NICU and KMC stay.

Mother's Own Milk Biomarkers Predict Coming to Volume in Pump-Dependent Mothers of Preterm Infants

2021 ◽  
Vol 228 ◽  
pp. 44-52.e3
Author(s):  
Rebecca Hoban ◽  
Clarisa Medina Poeliniz ◽  
Emily Somerset ◽  
Ching Tat Lai ◽  
Judy Janes ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Mothers Of Preterm Infants ◽  
Mother’S Own Milk

scholarly journals Predictive performance of emergency department-specific variables on COVID-19 pneumonia

2021 ◽  
Author(s):  
HY Tan ◽  
M Yeo ◽  
XY Tay ◽  
M Fung ◽  
R Kumar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Roc Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Predictive Performance ◽  
Tertiary Hospital ◽  
Continuous Variables ◽  
Multivariate Logistic Regression ◽  
Roc Curve Analysis ◽  
Icu Admission

Introduction: The majority of patients with COVID-19 infection do not progress to pneumonia. We report emergency department (ED)-specific variables and evaluate their predictive performance on diagnosis of pneumonia, intensive care unit (ICU) admission and death. Methods: This was a retrospective, single-centre cohort study of confirmed COVID-19 patients admitted to a Singapore tertiary hospital. Primary outcome was diagnosis of COVID-19 pneumonia. Secondary outcomes were ICU admission and/or death. Multivariate logistic regression was used to analyse the predictive performance of ED-specific variables. Accuracy of continuous variables was measured by area under receiver operating characteristic (ROC) curve. Results: 294 patients were included. Patients with pneumonia were older (52.0 years, p < 0.001) and had higher C-reactive protein (CRP; 33.8 mg/L, p < 0.001). Patients with indeterminate chest radiograph (CRX) findings were at risk of pneumonia vs. patients with normal CRX (37.5% vs. 4.3%, p < 0.001). Patients admitted to ICU were older (60.0 years, p < 0.001) and had higher CRP (40.0 mg/L, p < 0.001). Diagnosis of COVID-19 pneumonia was associated with ICU admission and death (30.0% vs 0.39%, p < 0.001). Multivariate logistic regression analysis showed that age (aOR 1.07, p = 0.049), CRP (aOR 1.05, p = 0.006) and CRX findings (aOR 50.00, p < 0.001) had increased odds of pneumonia. ROC curve analysis showed that CRP of 23.3 mg/L was the optimal cut-off for predicting pneumonia. Conclusion: Older age, higher CRP and CRX findings are associated with COVID-19 pneumonia, ICU admission and death. Prospective studies should be undertaken to validate these findings.

scholarly journals Association between Delayed Lactogenesis Ⅱ and Early Milk Volume among Mothers of Preterm Infants

2019 ◽  
Vol 13 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Xiurong Yu ◽  
Jianhua Li ◽  
Xiangyun Lin ◽  
Dandan Luan
Keyword(s):  
Preterm Infants ◽  
Milk Volume ◽  
Mothers Of Preterm Infants

scholarly journals Can Fraction of Inspired Oxygen Predict Extubation Failure in Preterm Infants?

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 30
Author(s):  
Eugenio Spaggiari ◽  
Maria Amato ◽  
Ornella Angela Ricca ◽  
Luigi Corradini Zini ◽  
Ilaria Bianchedi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Preterm Infants ◽  
Logistic Regression Analysis ◽  
Prolonged Mechanical Ventilation ◽  
Multivariate Logistic Regression Analysis ◽  
Extubation Failure ◽  
Multivariate Logistic Regression ◽  
Membrane Rupture ◽  
Inspired Oxygen

Background: Prolonged mechanical ventilation in preterm infants may cause complications. We aimed to analyze the variables affecting extubation outcomes in preterm infants at high risk of extubation failure. Methods: This was a single-center, observational, retrospective study. Extubation failure was defined as survival with the need for reintubation within 72 h. Successfully extubated neonates (group 1) were compared to those with failed extubation (group 2). Multivariate logistic regression analysis evaluated factors that predicted extubation outcomes. Results: Eighty infants with a birth weight under 1000 g and/or gestational age (GA) under 28 weeks were included. Extubation failure occurred in 29 (36.2%) and success in 51 (63.8%) neonates. Most failures (75.9%) occurred within 24 h. Pre-extubation inspired oxygen fraction (FiO2) of 27% had a sensitivity of 58.6% and specificity of 64.7% for extubation failure. Post-extubation FiO2 of 32% had a sensitivity of 65.5% and specificity of 62.8% for failure. Prolonged membrane rupture (PROM) and high GA were associated with extubation success in multivariate logistic regression analysis. Conclusions: High GA and PROM were associated with extubation success. Pre- and post-extubation FiO2 values were not significantly predictive of extubation failure. Further studies should evaluate if overall assessment, including ventilatory parameters and clinical factors, can predict extubation success in neonates.

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