Preterm newborns at Kangaroo Mother Care: a cohort follow-up from birth to six months

OBJECTIVE:To evaluate clinical outcomes, growth and exclusive breastfeeding rates in premature infants assisted by Kangaroo Mother Care at birth, at discharge and at six months of life.METHODS: Prospective study of a premature infants cohort assisted by Kangaroo Mother Care in a tertiary public maternity in Northeast Brazil with birth weight ≤1750g and with clinical conditions for Kangaroo care.RESULTS: The sample was composed by 137 premature infants, being 62.8% female, with average birth weight of 1365±283g, average gestational age of 32±3 weeks and 26.2% were adequate for gestational age. They have been admitted in the Kangaroo Ward with a median of 13 days of life, weighing 1430±167g and, at this time, 57.7% were classified as small for corrected gestational age. They were discharged with 36.8±21.8 days of chronological age, weighing 1780±165g and 67.9% were small for corrected gestational age. At six months of life (n=76), they had an average weight of 5954±971g, and 68.4% presented corrected weight for gestational age between percentiles 15 and 85 of the World Health Organization (WHO) weight curve. Exclusive breastfeeding rate at discharge was 56.2% and, at six months of life, 14.4%.CONCLUSIONS: In the studied sample, almost two thirds of the children assisted by Kangaroo Mother Care were, at six months of life, between percentiles 15 and 85 of the WHO weight curves. The frequency of exclusive breastfeeding at six months was low.

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Effect of Kangaroo Mother Care on the Likelihood of Breastfeeding from Birth up to 6 Months of Age: A Meta-analysis

Acta Medica Philippina ◽

10.47895/amp.v55i9.3754 ◽

2021 ◽

Vol 55 (9) ◽

Author(s):

Angelica Joyce A. Gacutno-Evardone ◽

Fay S. De Ocampo ◽

Maria Esterlita T. Villanueva-Uy

Keyword(s):

Exclusive Breastfeeding ◽

Primary Outcome ◽

Meta Analysis ◽

Kangaroo Mother Care ◽

World Health ◽

Randomized Controlled ◽

Trial Quality ◽

Breastfeeding Rate ◽

Health Organization ◽

Review Manager

Background. One of the World Health Organization (WHO) nutrition target by 2025 is 50% exclusive breastfeeding rate among infants until age 6 months. Kangaroo mother care (KMC) known to increase breastfeeding rates, especially in preterm and low birth weight (LBW) infants. Objectives. This study determined the effect of KMC to the rate of exclusive breastfeeding among preterm and LBW infants at 6 months of age. Methods. Conducted searches in MEDLINE and CENTRAL databases, likewise hand searched local publications December 1996 until June 2018. Included several randomized controlled trials and prospective observational studies comparing KMC and conventional care among preterm and LBW infants. The primary outcome was exclusive breastfeeding of infants at six months of age. Two authors independently assessed trial quality and extracted data the statistical analysis applied using Review Manager version 5.3. Results. Identified nine eligible trials involving 1,202 neonates. All studies had low-to-moderate risk of bias. KMC significantly noted to increase the likelihood of exclusive breastfeeding by 1.9 times at birth up to 6 months (OR 1.93 [1.18,3.17], p=0.009). Conclusion. KMC can increase exclusive breastfeeding among preterm and LBW infants from birth up to 6 months of age.

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Shunt infection in the first year of life

Journal of Neurosurgery Pediatrics ◽

10.3171/2013.4.peds12616 ◽

2013 ◽

Vol 12 (1) ◽

pp. 44-48 ◽

Cited By ~ 12

Author(s):

Meysam A. Kebriaei ◽

Mohammadali M. Shoja ◽

Steven M. Salinas ◽

Kristina L. Falkenstrom ◽

Eric A. Sribnick ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Birth Weight ◽

Surgical Procedures ◽

Gestational Age ◽

Shunt Infection ◽

Csf Shunt ◽

Average Weight ◽

Shunt Insertion ◽

Average Birth Weight

Object Children younger than 1 year of age are unique in their physiology and comorbidities. Reports in the literature suggest that the risk factors for shunt infection may be different in this population compared with older children. Importantly, these infants often have other congenital malformations requiring various surgical interventions, which impose an additional risk of infection. Methods In the 3-year period between 2008 and 2010, 270 patients underwent initial CSF shunt placement during the 1st year of life. Clinical characteristics, hospital course, and shunt infections were prospectively recorded in the practice and hospital electronic medical record. Special attention was given to types and timing of other invasive procedures and their relationship with shunt infection. Results The average gestational age was 33.6 weeks, and the average birth weight was 2333 g. The average weight at the time of shunt insertion was 4281 g. Prior to shunt insertion, 120 patients underwent 148 surgical procedures, including ventricular access device insertion (n = 63), myelomeningocele closure (n = 37), and cardiac procedures (n = 11), among others. In the 12-month period after shunt insertion, 121 of the 270 patients underwent 135 surgical procedures, which included 79 CSF shunt revisions. Shunt infection occurred in 22 patients, and organisms were identified in 20 cases. Univariate analysis showed that of the very prematurely born infants (gestational age < 30 weeks), those who underwent preshunt cardiac surgery and any surgical procedures within 30 days after the shunt insertion were at a greater risk of shunt infection. In multivariate analysis, preshunt cardiac surgery and surgical procedures within 30 days postshunt placement were significant risk factors independent of gestational age, birth weight, and history of shunt revisions. Conclusions The results of this study suggest that surgical procedures within 30 days after shunt insertion and preshunt cardiac surgery are associated with a greater risk of shunt infection in children in whom these devices were inserted during the 1st year of life.

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Early Breastfeeding Cessation Among Post-partum Women: A Prospective Observational Study

10.21203/rs.3.rs-101568/v1 ◽

2020 ◽

Author(s):

Abeer Salem Al Shahrani ◽

Hessah Mamdouh Hushan ◽

Noura Khalid Binjamaan ◽

Wajd Abdulrahman Binhuwaimel ◽

Jawaher Jazaa Alotaibi ◽

...

Keyword(s):

Exclusive Breastfeeding ◽

Maternal Age ◽

Post Partum ◽

Mode Of Delivery ◽

Bottle Feeding ◽

University Hospital ◽

World Health ◽

Breastfeeding Rate ◽

Breastfeeding Cessation ◽

Health Organization

Abstract Background: The World Health Organization (WHO) recommends that breastfeeding is initiated within an hour of birth and breastfeeding exclusively is performed for the first six months. However, the exclusive breastfeeding rate is dropping in most countries. In this study, we aimed to assess the breastfeeding cessation rate during the early post-partum period. Moreover, we aimed to prospectively identify the risk factors for early breastfeeding cessation during hospitalization and after discharge.Methods: This prospective study included all post-partum women who had given birth to full term, singleton, and healthy newborns and were breastfeeding at discharge from Mar – Jun 2020 at King Abdullah bin Abdulaziz University Hospital (KAAUH) in Riyadh, Saudi Arabia. With an instrument that was designed based on previous studies, data were collected at the time of admission and 10 – 14 days and 6 – 8 weeks post-partum.Results: This study included 136 mothers. The mean age of the participants was 29.5 ±5.07 years, and the majority of the participants had a bachelor’s degree and were unemployed. A total of 37.5% of the participants were exclusively breastfeeding their newborns for the first two weeks; however, this rate later dropped to 19%. However, bottle feeding was performed by two-thirds of the participants for the first 2 weeks, and this rate increased to 80.9% at 6 – 8 weeks post-partum. Many factors, such as maternal age, the mode of delivery and previous breastfeeding experience, were strongly associated with breastfeeding. Bottle feeding was associated with maternal age as well as employment status.Conclusions: This study reported an unacceptably low exclusive breastfeeding rate within the first two months post-partum. Multiple factors were strongly associated with breastfeeding, and some of them were modifiable. Moreover, more attention should be given to mothers who have a high risk for early breastfeeding cessation, such as employed mothers.Trial registration: Not applicable

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Fundus Examination of 23,861 Newborns by Digital Imaging in Ningbo

Journal of Ophthalmology ◽

10.1155/2021/6620412 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Delin Liu ◽

Jiao Zheng ◽

Yi Lu

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Premature Infants ◽

Gestational Age ◽

Digital Imaging ◽

Full Term ◽

Delivery Mode ◽

Average Birth Weight ◽

Ocular Abnormalities ◽

Term Newborns

Purpose. To perform fundus examinations of full-term and premature infants to identify common congenital ocular diseases and determine the incidence and additional risk factors in Ningbo, China. Methods. Fundus examinations were performed on newborns between January 2017 and July 2020 in Ningbo using a RetCam3 or PanoCam LT wide-field digital imaging system. The neonates’ birth weight, gestational age, gender, delivery mode, oxygen intake, and other conditions were recorded. We compared the incidence of ocular abnormalities in both full-term newborns and premature infants. Results. There were 23,861 newborns in this study comprising 12,605 (52.8%) male and 11,256 (47.2%) female infants, 20,938 full-term babies, and 2,923 premature babies. The average gestational age was 37.9 ± 5.6 weeks, and the average birth weight was 3,189 ± 417 g. Overall, we found ocular abnormalities in 6,645 (27.8%). The most common abnormality in full-term newborns was retinal hemorrhage (RH), which we found in 3,827 (18.3%) cases. Other diseases identified included familial exudative vitreoretinopathy (FEVR), retinoblastoma (RB), and congenital cataracts. The delivery method had a significant impact on the incidence of neonatal RH ( P < 0.001 ). Retinopathy of prematurity (ROP) was observed in 617 newborns accounting for 21.1% of all screened premature infants. Logistic analysis showed that gestational age and birth weight were important risk factors for ROP ( P < 0.001 ). For treatable diseases, such as ROP, FEVR, congenital cataract, glaucoma, and RB, early identification allows for active treatment or referral to a specialized hospital for further treatment. Conclusion. Early examination and prompt treatment of ocular disorders in newborns are important to avoid lifelong visual impairment. Eye examinations should be performed during the neonatal period and at regular follow-up visits.

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Message of the WHO Representative to the Philippines

Acta Medica Philippina ◽

10.47895/amp.v55i9.4855 ◽

2021 ◽

Vol 55 (9) ◽

Author(s):

Rabindra Abeyasinghe

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Exclusive Breastfeeding ◽

The Philippines ◽

Kangaroo Mother Care ◽

World Health ◽

Outpatient Basis ◽

Close Monitoring ◽

Child Deaths ◽

The World

Globally, an estimated 2.4 million children died in their first month of life in 2019. This translated to 6,700 newborn deaths every day, and accounted for 47% of all child deaths under the age of 5 years. The world has made substantial progress in child and newborn survival since 1990. However, 75% of newborn deaths continue to occur in the first week of life and about 1 million newborns die within their first 24 hours of life. In the Philippines, an estimated 63,000 of 1.7 million children born in 2019 died before their fifth birthday, with half occurring among newborns. Preterm birth, intrapartum-related complications such as birth asphyxia, infections and birth defects, caused most neonatal deaths in 2019. While child deaths decreased by one-half between 1990 and 2018, newborn mortality declined at half that rate. Along with asphyxia and sepsis, complications of prematurity are the main causes of newborn deaths. Preterm (< 37 weeks gestation) and low birth weight (LBW) (<2500 g) babies have immature immune and organ systems, low fat reserves and reduced muscle mass, placing them at a much higher risk for hypothermia, infection, and death, compared to babies born with normal weight. Kangaroo mother care (KMC) is a technique of caring for preterm and LBW babies which consists of keeping them in skin-to-skin contact (SSC) on the chest of the mother (or other family members), as early and as long as possible, exclusive breastfeeding, and early discharge from the hospital with close monitoring on an outpatient basis. KMC has been demonstrated to reduce mortality in small babies by almost half compared to conventional incubator-based neonatal intensive care. Other benefits include prolonged duration of exclusive breastfeeding and better growth rates. Thus, the World Health Organization (WHO) recommends KMC for babies less than or equal to 2,000 grams. We also support widespread calls to introduce, accelerate, and sustain quality KMC implementation. It is with this note that I congratulate the Kangaroo Mother Care Foundation Philippines, and the research authors for all their original scientific papers on KMC. The publication of these studies, present added evidence that KMC is a cost-efficient, readily available, effective strategy for saving the lives of babies born either prematurely, or with low birth weight for age. Rabindra Abeyasinghe, MD, MSc, DTM&H (Public Health) WHO Representative to the Philippines

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PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽

10.1542/peds.8.4.570 ◽

1951 ◽

Vol 8 (4) ◽

pp. 570-572

Keyword(s):

Premature Infants ◽

The United States ◽

World Health ◽

Multiple Birth ◽

Expert Committee ◽

Medical Social Work ◽

Incidence And Mortality ◽

Health Nursing ◽

Health Organization ◽

Intrinsic Variable

IN THE summary of the report of the Expert Committee on Prematurity of the World Health Organization, published in this column in February 1951, Dr. Ethel Dunham indicated the concern of the Expert Committee in regard to uniformity of information on the incidence and mortality of prematurity. The need for uniformity is particularly urgent in a field where there are so many intrinsic variable factors. It has been shown time and again that the ability of a premature infant to survive, under the best of care, is closely correlated with the birth weight, which in itself reflects the stage of maturity. In turn, the stage of maturity at a given weight is affected by sex, race, and whether the child is a single or one of a multiple birth. Uniformly, at a particular stage of maturity, male infants are larger than female, single births are larger than multiple births and, in the United States, white babies are larger than Negro babies. These considerations underline the danger of misinterpretation of so-called over-all rates for the incidence of prematurity and for the mortality of premature infants. For example, at any given weight, Negro premature infants are probably more mature and consequently have a better chance of surviving.

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Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314547 ◽

2018 ◽

Vol 104 (3) ◽

pp. F242-F247 ◽

Cited By ~ 4

Author(s):

Chonnikant Visuthranukul ◽

Steven A Abrams ◽

Keli M Hawthorne ◽

Joseph L Hagan ◽

Amy B Hair

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Birth Weight ◽

Human Milk ◽

Premature Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Insulin Level ◽

Metabolic Outcomes ◽

Catch Up

ObjectiveTo compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.DesignPremature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12–15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18–22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.ResultsOf 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs −0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.ConclusionsSGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

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Eruption chronology of the first deciduous teeth in children born prematurely with birth weight less than 1500g

Revista Paulista de Pediatria ◽

10.1590/s0103-05822014000100004 ◽

2014 ◽

Vol 32 (1) ◽

pp. 17-23 ◽

Cited By ~ 6

Author(s):

Pedro Garcia F. Neto ◽

Mario Cicero Falcao

Keyword(s):

Birth Weight ◽

Nutritional Status ◽

Premature Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Deciduous Teeth ◽

Appropriate For Gestational Age ◽

Eruption Age ◽

Student’S T ◽

Student’S T Test

Objective: To describe the eruption chronology of the first deciduous teeth in premature infants with birth weight less than 1500g and to compare it according to gender and nutritional status at birth. Methods: Longitudinal study including 40 low birth weight premature infants of both genders. The tooth was considered erupted when the crown went through the gum and became part of the oral environment. The comparison of the eruption chronology in relation to gender and among children appropriate or small for gestational age was done by Student's t-test, being significant p<0.05. Results: The eruption of the first tooth (teeth) occurred, on average, with 11.0±2.1 months of chronological age and with 9.6±1.9 months corrected for prematurity. The first erupted teeth were the lower central incisors. The average eruption for males was 9.7±1.9 and, for females, 9.5±1.9 months, both corrected for prematurity (p=0.98). The average eruption in children with birth weight appropriate for gestational age was 10.1±1.4 months; for small for gestational age, it was 9.4±2.2, also corrected for prematurity (p=0.07). Conclusions: The average eruption age of the first teeth, corrected for prematurity, was 9.6 months. Sex and nutritional status at birth did not change the eruption chronology.

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Breast Feeding versus Formula Feeding and Diarrheal Diseases in Infants and Children- A Review

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i1.21033 ◽

2014 ◽

Vol 32 (1) ◽

pp. 26-30 ◽

Cited By ~ 1

Author(s):

MUH Begum

Keyword(s):

Breast Feeding ◽

Exclusive Breastfeeding ◽

Diarrheal Disease ◽

Formula Feeding ◽

Infants And Children ◽

World Health ◽

Human Breast Milk ◽

Diarrheal Diseases ◽

Health Organization ◽

In Infants And Children

The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) emphasize the value of breastfeeding for mothers as well as children. Both recommend exclusive breastfeeding for the first six months of life. Human breast milk is the healthiest form of milk for babies. Breastfeeding promotes health and helps to prevent diseases including diarrheal diseases. It contains all nutrients including antibodies (IgA),and lactoferrin, that potentially prevent infection and diarrhea in infants and children. Studies conducted in both developed and under developed nations have found that breast feeding is associated with significantly ( upto 64%) less diarrheal disease and the protective effect of breast feeding does not persist beyond two months after breast feeding is stopped. On the other hand, formula fed infants are found an upto 80% increased in the risk of developing diarrhea compared to breast fed infants and there is significantly more diarrheal disease in formula fed infants. Infection may be attributable to contamination of bottles, teats, milk, and food in infants who are not exclusively breastfed. Exclusive breastfeeding for the first six months of life and there after complementary feedings while breastfeeding continues for up to two years of age or beyond, enthusiastic support and involvement from clinicians, obstetricians and pediatricians, are essential in breastfeeding vs formula feeding issue and to reduce incidence of diarrheal diseases in infants and children. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21033 J Bangladesh Coll Phys Surg 2014; 32: 26-30

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Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China

10.21203/rs.2.18645/v2 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Zhiying Duan ◽

Yingxi Zhao ◽

Sarah Williams ◽

Stephen Wall ◽

...

Keyword(s):

Breast Milk ◽

Preterm Infants ◽

Exclusive Breastfeeding ◽

Kangaroo Mother Care ◽

Late Preterm ◽

Feeding Practice ◽

Late Preterm Infants ◽

Breastfeeding Rate ◽

Milk Feeding

Abstract Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not were enrolled in the “No KMC group”. Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 hours before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR=2.15 (1.53-3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR=1.61 (1.15-2.25)), be exclusive breast milk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breastfeeding method at follow-up (OR=2.09 (1.44-3.02)). Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.

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