scholarly journals Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245273
Author(s):  
Ragnhild Maastrup ◽  
Ane L. Rom ◽  
Sisse Walloee ◽  
Helle B. Sandfeld ◽  
Hanne Kronborg
Keyword(s):  
Training Program ◽  
Preterm Infants ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
Control Group ◽  
Clinical Practices ◽  
Neonatal Nurses ◽  
Skin Contact ◽  
Postmenstrual Age ◽  
Breastfeeding Rates

Background Early breast milk expression, prolonged skin-to-skin contact, rooming-in, use of test-weighing and minimizing use of pacifiers are positively associated with exclusive breastfeeding of preterm infants, whereas use of nipple shields is negatively associated. Aim To test whether a training program for neonatal nurses with a focus on these six breastfeeding-supportive clinical practices affects the rate of preterm infants exclusively breastfed at discharge to home, the postmenstrual age at establishment of exclusive breastfeeding, and maternal self-reported use of the practice in the neonatal intensive care unit, the. Methods A quasi-experimental multi-centre intervention study from 2016–2019 including a control group of 420 preterm mother-infant dyads, an intervention with a training program for neonatal nurses and implementation of weekly breastfeeding meetings for neonatal nurses, and an intervention group of 494 preterm mother-infant dyads. Results Significantly more preterm infants in the intervention group were exclusively breastfed at discharge to home (66.6%) than in the control group (58.1%) p = 0.008. There was no significant difference in postmenstrual age at establishment of exclusive breastfeeding between control and intervention group (37.5 vs.37.8 weeks, p = 0.073). Compared to the control group the number of infants continuing daily skin-to-skin contact after incubator care increased (83.2% vs. 88.3%, p = 0.035), infants using a nipple shield decreased (61.8% vs. 54.2%, p = 0.029), and the number of mothers initiating breast milk expression before six hours post-partum increased (32.6% vs. 42.4%, p = 0.007). There was a significant correlation between percentage of neonatal nurses participating in the breastfeeding training program and changes in exclusive breastfeeding rates (Pearson Correlation 0.638, p = 0.047). Conclusion Exclusive breastfeeding rates in preterm infants and maternal self-reported use of breastfeeding-supportive practices increased by training neonatal nurses in the six clinical practices. It is important to include all nurses in the breastfeeding training program to ensure positive effect on exclusive breastfeeding rates.

scholarly journals Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isabel Rodríguez-Gallego ◽  
Fatima Leon-Larios ◽  
Cecilia Ruiz-Ferrón ◽  
Maria-de-las-Mercedes Lomas-Campos
Keyword(s):  
Support Groups ◽  
Exclusive Breastfeeding ◽  
Intervention Group ◽  
World Health ◽  
Control Group ◽  
Breastfeeding Initiation ◽  
Primary Health ◽  
Breastfeeding Rate ◽  
Breastfeeding Rates ◽  
The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

scholarly journals Preterm Infant Neurodevelopmental Care Training Program and Mother-Infant Attachment

2019 ◽  
Vol 8 (2) ◽  
pp. 192-197
Author(s):  
Fatemeh Fallah Rostami ◽  
Farin Soleimani ◽  
Mehdi Norouzi ◽  
Nikta Hatamizadeh ◽  
Jamileh Mokhtarinouri ◽  
...  
Keyword(s):  
Preterm Infant ◽  
Training Program ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Infant Attachment ◽  
Significant Difference ◽  
Care Training

Objectives: Preterm birth and admission to the neonatal intensive care unit (NICU) would disrupt mother-infant attachment. Neurodevelopmental care training and support of family programs are essential for the family of such infants. The purpose of this study was to investigate the effect of neurodevelopmental care training program for mothers with preterm infants on mother-infant attachment at one month’s age. Materials and Methods: Study population included all the mothers of preterm infants born in the hospitals of Tehran in 2018. The research was designed as a multicenter cluster clinical trial and four hospitals were randomly selected and divided into intervention and control groups. Before the intervention, the mother-infant attachment was measured by the Maternal-Postnatal Attachment Scale (MPAS). The mothers in the intervention group received a 12-session preterm infant neurodevelopmental care training program while the control group only received the routine care in the unit. Finally, the mother-infant attachment was re-measured in both groups at the one month corrected age. Results: No significant difference was observed in the attachment score before and after the intervention in the control group but the mother-infant attachment score was significantly different in the intervention group (57.75±11.09 vs. 78.27±4.54). Conclusions: The neurodevelopmental care training program was effective and increased the mother-infant attachment rate.

ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

2020 ◽  
Author(s):  
Janet Elizabeth Berrington ◽  
William McGuire ◽  
NIcholas David Embleton
Keyword(s):  
United Kingdom ◽  
Preterm Infants ◽  
Late Onset ◽  
Disease Onset ◽  
Intervention Group ◽  
Control Group ◽  
Bovine Lactoferrin ◽  
The United Kingdom ◽  
Late Onset Sepsis ◽  
The Uk

Previous studies suggested that supplemental bovine lactoferrin (BLF) given to preterm infants (<32 weeks gestation) may reduce late onset sepsis (LOS) and necrotising enterocolitis (NEC), but have been underpowered. The Enteral Lactoferrin in Neonates (ELFIN) study, performed in the United Kingdom (UK), aimed to further address this issue with a well powered double blinded placebo controlled trial of >2200 preterm infants. ELFIN did not demonstrate a reduction in LOS or NEC, or several other clinically important measures. 316 (29%) of 1093 infants in the intervention group developed late-onset sepsis versus 334 (31%) of 1089 in the control group with an adjusted risk ratio of 0·95 (95% CI 0·86–1·04; p=0· 233). Reasons for the differences in ELFIN trial results and other studies may include population differences, the routine use of antifungals in the UK, timing of administration of the lactoferrin in relation to disease onset, or specific properties of the lactoferrin used in different trials. Further exploration is being undertaken in the UK NIHR funded Mechanisms Affecting the Guts of Preterm Infants in Enteral feeding trials (MAGPIE) study, for which results should be available soon.

Effect of a brief training program for primigravid adolescents on parenting self-efficacy and mother-infant bonding in the southeast of Iran

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Zahra Moudi ◽  
Behjat Talebi ◽  
Mahnaz Shahraki Pour
Keyword(s):  
Social Support ◽  
Training Program ◽  
Self Efficacy ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Middle Income ◽  
Brief Training ◽  
Quasi Experimental ◽  
Limited Health

Abstract Background Annually, about 16 million adolescent girls give birth, accounting for 11% of all births worldwide. Ninety-five percent of these births occur in low- and middle-income countries, and previous studies have addressed the need for parenting interventions in developing countries with limited health care resources to improve parenting behaviors. Objective To explore the effect of a brief training program for primigravid adolescents on parenting self-efficacy and mother-infant bonding. Subjects We enrolled 116 married pregnant adolescents. Methods This quasi-experimental study was conducted during August 22, 2016–February 3, 2017. The intervention group received three sessions of training on neonatal care, while the control group received the routine care. We evaluated parenting self-efficacy using the Perceived Maternal Parenting Self-Efficacy (PMP S-E) questionnaire, the mother-infant bonding using the Postpartum Bonding Questionnaire (PBQ) and social support by means of the Multidimensional Scale of Perceived Social Support (MSPSS). The participants were followed up for 1 month. Results The mean ages of the intervention and the control groups were 16.37 ± 0.97 and 16.27 ± 1.12 years, respectively. The intervention group obtained higher self-efficacy and bonding scores compared to the control group. The logistic regression model showed that the second (evoking behaviors) and the third (reading behavior or signaling) subscales of the PMP S-E, the route of delivery and women’s educational levels could predict the mother-infant bonding scores. Conclusion Primigravid adolescents can benefit from brief interventions during pregnancy through improving their parenting self-efficacy and mother-infant bonding.

scholarly journals Studying the Effectiveness of Prevention Training Program of Drug Abuse on Reducing Risk Factors in Soldiers and Staffs

2018 ◽  
Vol 10 (1.SP) ◽  
pp. 20
Author(s):  
Parviz DABAGHI ◽  
Seyyed-Javad HOSSEINI-SHOKOUH ◽  
Reza SHAHRABADI
Keyword(s):  
Risk Factors ◽  
Drug Abuse ◽  
Training Program ◽  
Life Skills ◽  
Intervention Group ◽  
Skills Training ◽  
Demographic Variables ◽  
Control Group ◽  
Significant Difference ◽  
Prevention Training

Background and objective:    Drug abuse is one of the diseases that are highly dependent on individual behaviors and social interactions. This disease can be created in places like military garrisons due to their relationship with such behaviors. Therefore, soldiers and staffs are at risk of drug abuse. The aim of this study was to determine the effect of prevention training program of drug abuse on reducing risk factors in soldiers and staffs in Iran.Methods:In this quasi-experimental interventional study, 392 soldiers and staffs in two military garrisons in Khorasan Razavi (Intervention group 242 and control group 150) were randomly conducted to training program. The data collection tools were questionnaire of identifying people in risk of addiction, life skills questionnaire and demographic variables. The questionnaires were completed as self-report. Educational content was consisted of seven training sessions (60-minute) that only applied in the intervention group. 45 days after the last training session, educational software was distributed as a reminder in the intervention group. The two groups were followed up three months after the intervention. Finally, the data were analyzed using SPSS version 16.Results:  The findings showed that there was no significant difference between the two groups in demographic variables (Pvalue>0.05). The mean scores for risk factors on drug abuse after training program (Depression and feeling of inability, Positive attitude toward drug abuse and Anxiety and fearing of others) were significantly improved in the intervention group (Pvalue<0.05). Also, life skills variables except the problem solving skill (Pvalue>0.05) had a significant change after intervention in the intervention group (Pvalue<0.05).Conclusion:The findings indicated that the prevention training program of drug abuse based on life skills training could reduce the risk factors of drug abuse for soldiers and staffs in military garrisons.

scholarly journals Effect of a breastfeeding educational intervention: a randomized controlled trial

2020 ◽  
Vol 28 ◽  
Author(s):  
Erdnaxela Fernandes do Carmo Souza ◽  
Alfredo Almeida Pina-Oliveira ◽  
Antonieta Keiko Kakuda Shimo
Keyword(s):  
Randomized Controlled Trial ◽  
Educational Intervention ◽  
Exclusive Breastfeeding ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Postpartum Women ◽  
Significance Level ◽  
Randomized Controlled

Objective: to assess the effect of a breastfeeding educational intervention on the counseling provided to postpartum women. Method: this is a randomized controlled trial including 104 postpartum women (intervention group = 52 and control group = 52) from a private hospital, whose educational intervention was based on the pragmatic theory and on the use of a soft-hard technology called Breastfeeding Educational Kit (Kit Educativo para Aleitamento Materno, KEAM). Women were followed-up for up to 60 days after childbirth. Chi-Squared Test, Fischer’s Exact Test, and Generalized Estimating Equation were used, with a significance level of 5% (p-value <0.05). The analyses were performed using the Statistical Package for the Social Sciences, version 24. Results: the postpartum women in the intervention group had fewer breastfeeding difficulties and a higher percentage of exclusive breastfeeding at all time points compared with those in the control group. Conclusion: the educational intervention based on active methodologies and stimulating instructional resources was effective in developing greater practical mastery among postpartum women with regard to adherence and maintenance of exclusive breastfeeding. Registry REBEC RBR – 8p9v7v.

scholarly journals Serial Assessment of Body Fat and Fat-Free Mass Accretion in Very Preterm Infants: A Randomized Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1067-1067
Author(s):  
Ariel Salas ◽  
Maggie Jerome ◽  
Paula Chandler-Laney ◽  
Namasivayam Ambalavanan
Keyword(s):  
Body Composition ◽  
Preterm Infants ◽  
Body Fat ◽  
Intervention Group ◽  
Feeding Practices ◽  
Control Group ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Study Participants ◽  
Serial Assessments

Abstract Objectives To incorporate assessment of body composition in the routine care of preterm infants to guide feeding practices before and after hospital discharge. Methods Very preterm infants with gestational ages between 29 and 32 weeks of gestation were included. Infants with gastrointestinal or neurologic malformations and terminal illness needing to limit or withhold support were excluded. All study participants were eligible for serial assessments of body composition between birth and 32 weeks PMA, at 36 weeks PMA or hospital discharge, and at 3 months of corrected age. Infants randomly assigned to the intervention group had the information about infant body composition available to the clinicians caring for them (including reference data). Infants randomly assigned to the control group also underwent serial assessments, but this information on infant body composition was not shown to the clinicians caring for them. The primary outcome was % body fat (%BF) estimated by air displacement plethysmography. Results Fifty very preterm infants were randomized. Mean birthweight of study participants was 1387 g +/– SD 283 and median gestational age at birth was 30 weeks (IQR: 30 – 31). Sociodemographic characteristics did not differ between groups. Mean %BF between birth and 32 weeks PMA (n = 45) was 6 +/– 4, mean %BF at 36 weeks PMA (n = 35) was 14 +/– 4, and mean %BF at 3 months of corrected age (n = 25) was 20 +/– 4. Mean differences in %BF between the intervention group and the control group were not statistically significant at 36 weeks PMA (−0.8) or 3 months corrected age (−1.2). Similarly, feeding practices during hospitalization did not differ between groups. Growth outcomes did not differ between groups. Conclusions Serial assessments of body composition at birth, 36 weeks PMA, and 3 months corrected age in very preterm infants show increased %BF in both intervention and control groups without an apparent influence of the intervention on feeding practices. While 36 weeks PMA has been a common assessment point for research purposes, body composition assessments may need to be done at earlier intervals in order to make meaningful clinical changes to the infant diet in order to affect body composition later in infancy. Funding Sources UAB OHDRC.

scholarly journals Effect of a Combined Program of Strength and Dual Cognitive-Motor Tasks in Multiple Sclerosis Subjects

2020 ◽  
Vol 17 (17) ◽  
pp. 6397
Author(s):  
Carmen Gutiérrez-Cruz ◽  
F.Javier Rojas-Ruiz ◽  
Juan Carlos De la Cruz-Márquez ◽  
Marcos Gutiérrez-Dávila
Keyword(s):  
Multiple Sclerosis ◽  
Training Program ◽  
Force Measurement ◽  
Intervention Group ◽  
Daily Activities ◽  
Control Group ◽  
Motor Tasks ◽  
Dual Tasking ◽  
Combined Training ◽  
Multiple Sclerosis Patients

This study investigated the effects of a 24-week combined training program (CTP) based on strength exercises and cognitive–motor tasks performed concurrently in participants with multiple sclerosis. A randomized, controlled intervention study was carried out. In total, 31 subjects with a confirmed diagnosis of multiple sclerosis (14 men and 17 women) were stratified and randomized into an intervention group (17 subjects) and a control group (14 subjects). The intervention group completed three weekly training sessions for 24 weeks, while the control group pursued their normal daily activities. In this program, cognitive–motor tasks were completed at once (dual tasking). A 3D photogrammetry connected to a selective attention system designed for dual tasking while walking was used. Ground reaction forces were measured using two force plates, one for sit-to-stand testing, while the other was used for static force measurement. Postural equilibrium was examined using a stabilometric plate based for Romberg test assessment. The 24-week training program for multiple sclerosis patients improved their static peak force by 11% (p < 0 .05), their rate of force development by 36% (p < 0.05), and their balance (p < 0.05). Performance in daily activities such as walking or sitting-to-standing improved significantly in multiple sclerosis participants. CTP training was effective in reducing the dual-task costs of step length (48%) and walking velocity (54%), as compared to a matched control group.

scholarly journals How to Improve the Functional Capacity of Frail and Pre-Frail Elderly People? Health, Nutritional Status and Exercise Intervention. The EXERNET-Elder 3.0 Project

2020 ◽  
Vol 12 (15) ◽  
pp. 6246 ◽  
Author(s):  
Ángel Iván Fernández-García ◽  
Alba Gómez-Cabello ◽  
Ana Moradell ◽  
David Navarrete-Villanueva ◽  
Jorge Pérez-Gómez ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Functional Capacity ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Residual Effects ◽  
Control Group ◽  
Healthy Habits ◽  
Exercise Training Program ◽  
Frail Elderly People

Aging is associated with the impairment of health and functional capacity, and physical exercise seems to be an effective tool in frailty prevention and treatment. The purpose of this study was to present the methodology used in the EXERNET-Elder 3.0 project that aims to evaluate the immediate and residual effects and of a multicomponent exercise training program called Elder-fit on frailty, fitness, body composition and quality of life, and also to analyse a possible dietary intake interaction according to health and metabolic status. A total of 110 frail and pre-frail elders participated in this study and were divided into a control group (CG = 52) and an intervention group (IG = 58). The IG performed a supervised multicomponent exercise training program of 6 months and 3 days per week, which included strength, endurance, balance, coordination and flexibility exercises, while the CG continued with their usual daily activities. Both groups received four speeches about healthy habits along the project. Four evaluations were performed: at baseline, after 3 months of training, at the end of the training program (6 months) and 4 months after the program had ended to examine the effects of detraining. Evaluating the efficacy, safety and feasibility of this program will help to develop efficacious physical interventions against frailty. Further, protocols should be described accurately to allow exercise programs to be successfully replicated.

scholarly journals Effect of early versus standard central line removal on growth of very low birthweight premature infants: a protocol for a non-inferiority randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030167
Author(s):  
Justyna Romańska ◽  
Wojciech Margas ◽  
Renata Bokiniec ◽  
Paweł Krajewski ◽  
Joanna Seliga-Siwecka
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Low Birthweight ◽  
Intervention Group ◽  
Central Line ◽  
Optimal Time ◽  
Control Group ◽  
Very Low Birthweight ◽  
Central Lines ◽  
The Mean

IntroductionUncertainty exists regarding the optimal time for removal of central lines used to provide parenteral nutrition in preterm infants. The aim of this study is to determine whether earlier central line removal is non-inferior to its removal after reaching full enteral intake, in respect to growth outcome of preterm infants.Methods and analysisVery low birthweight premature infants will be recruited. Eligible infants will be randomised in equal proportions between two groups. In the intervention group central lines will be removed when infants reach 100 mL/kg/day of enteral intake. In the control group central lines will be removed when infants reach 140 mL/kg/day of enteral intake (full enteral intake). The primary outcome measure will be the difference between the two groups in weight at 36 weeks’ postmenstrual age. Non-inferiority will be declared if the mean weight of children in the intervention group will be no worse than the mean weight of children from the control group, by a margin of −210 g.Ethics and disseminationThe Bioethics Committee of the Medical University of Warsaw approved the study protocol prior to recruitment. The findings of this trial will be submitted to a peer-reviewed journal (neonatology, paediatrics or nutrition). Abstracts will be submitted to relevant national and international conferences.Trial registration numberNCT03730883.Protocol versionVersion 3. 14.08.2019.

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