scholarly journals Factors Influencing Breast Milk Fat Loss during Administration in the Neonatal Intensive Care Unit

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1939
Author(s):  
Mattias Paulsson ◽  
Lena Jacobsson ◽  
Fredrik Ahlsson
Keyword(s):  
Intensive Care Unit ◽  
Breast Milk ◽  
Milk Fat ◽  
Neonatal Intensive Care ◽  
Tube Feeding ◽  
Feeding Method ◽  
Fat Loss ◽  
Factors Influencing ◽  
Before And After ◽  
True Protein

The objective of this study was to investigate factors influencing fat loss during tube feeding of breast milk to preterm infants. An experimental study with 81 feeding simulations was performed, with nine continuous infusions in each of six modalities: Horizontal Higher, Horizontal Matched, Horizontal Lower, Tilted Higher, Tilted Matched, and Tilted Lower, and for comparison, 27 bolus feedings: nine flushed with air, nine with water, and nine that were not flushed, done at matched height. Each simulation utilized 16 mL of breast milk given over four hours. Continuous infusions were given with a flow rate of 4 mL/h. Bolus was given as 8 mL over the course of 15–20 min every other hour. Analysis for fat, true protein, carbohydrate, total solids, and energy was performed before and after each simulation. The percent of macronutrient loss was compared between all simulations. Continuous infusion resulted in an average fat loss of 40%. Bolus feedings resulted in an average fat loss of 11% (p ≤ 0.001). Considerable fat loss is seen during continuous tube feeding. Neither height in relation to the infant nor tilting of the pump reduce fat loss. To limit fat loss, the bolus feeding method should be utilized.

Effectiveness of Breast Massage on Expression of Breast Milk among Mothers of Neonates admitted in Neonatal Intensive Care Unit

2016 ◽  
Vol 8 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Lekha Viswanath ◽  
A Divya ◽  
Anju Philip
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Breast Milk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Pain Scale ◽  
Breast Milk Expression ◽  
Breast Milk Production ◽  
Before And After ◽  
The Mean

ABSTRACT Massaging the breast may help a postnatal mother to improve breast milk production, alleviate breast engorgement and facilitate breast milk expression. The purpose of the present study was to identify the effect of breast massage on breast milk expression in terms of volume of breast milk expressed, pain during breast milk expression and experience of breast milk expression among mothers of neonates admitted in neonatal intensive care unit (NICU). Materials and methods The quasi-experimental study was conducted among 30 postnatal mothers whose babies were admitted in NICU, selected as a sample of convenience. The design used was time series research design. After the pretest, breast massage was taught to the mothers by the investigator. Breast massage was performed for 10 minutes prior to each expression. The practice of breast massage and breast milk expression is observed by the investigator using a checklist during the next expression. Volume of breast milk expressed and pain during breast milk expression were assessed three times before and after the intervention using a standardized measuring cup and numerical pain scale respectively. The experience of breast milk expression was assessed before and after intervention using breast milk expression experience measure. Analysis was done using mean, frequency, percentage and paired t-test. Major findings The results show that the mean pretest volume of milk expressed in milliliters was 7.33 ± 4.86, which increased to 15.56 ± 8.38 (t = 4.22, p = 0.001) after the intervention. The mean pretest pain score was 7.50 ± 1.42 which decreased to 5.01 ± 1.37 (t = 11.73, p = 0.001) after the intervention. The experience of breast milk expression in post-test 37.6 ± 3.88 was significantly higher than pretest 28.4 ± 4.73 (t = 11.25, p = 0.001). Conclusion The study findings conclude that the breast massage is effective in increasing the volume of expressed breast milk, reducing the pain during breast milk expression and improving the experience of breast milk expression. How to cite this article Divya A, Viswanath L, Philip A. Effectiveness of Breast Massage on Expression of Breast Milk among Mothers of Neonates Admitted in Neonatal Intensive Care Unit. J South Asian Feder Obst Gynae 2016;8(1):21-24.

scholarly journals Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asli Okbay Gunes ◽  
Emre Dincer ◽  
Nilgun Karadag ◽  
Sevilay Topcuoglu ◽  
Guner Karatekin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Breast Milk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Study Group ◽  
Intake Rate ◽  
Informed Consent Form ◽  
Group 2

Abstract Objectives To find out if the expressed breast milk delivery rate to neonatal intensive care unit (NICU) for babies who were hospitalized for any reason other than COVID-19, and exclusive breastfeeding (EB) rates between discharge date and 30th day of life of those babies were affected by COVID-19 pandemic. Methods Babies who were hospitalized before the date first coronavirus case was detected in our country were included as control group (CG). The study group was divided into two groups; study group 1 (SG1): the mothers whose babies were hospitalized in the period when mother were asked not to bring breast milk to NICU, study group 2 (SG2): the mothers whose babies were hospitalized after the date we started to use the informed consent form for feeding options. The breast milk delivery rates to NICU during hospitalization and EB rates between discharge and 30th day of life were compared between groups. Results Among 154 mother-baby dyads (CG, n=50; SG1, n=46; SG2, n=58), the percentage of breast milk delivery to NICU was 100%, 79% for CG, SG2, respectively (p<0.001). The EB rate between discharge and 30th day of life did not change between groups (CG:90%, SG1:89%, SG2:75.9; p=0.075). Conclusions If the mothers are informed about the importance of breast milk, the EB rates are not affected by the COVID-19 pandemic in short term, even if the mothers are obligatorily separated from their babies. The breast milk intake rate of the babies was lowest while our NICU protocol was uncertain, and after we prepared a protocol this rate increased.

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.

An In-Service Educational Package Improves Alarm Management in the Neonatal Intensive Care Unit (NICU): Before and After Study

2021 ◽  
pp. 097321792110512
Author(s):  
Suryaprakash Hedda ◽  
Shashidhar A. ◽  
Saudamini Nesargi ◽  
Kalyan Chakravarthy Balla ◽  
Prashantha Y. N. ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Response Time ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Alarm Management ◽  
Educational Package ◽  
Before And After ◽  
Before And After Study

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs

Liberal versus Indicated Maternal Oxygen Supplementation in Labor: A Before-and-After Trial

2018 ◽  
Vol 35 (11) ◽  
pp. 1057-1064 ◽  
Author(s):  
Sean Blackwell ◽  
Mesk Alrais ◽  
Farah Amro ◽  
Rachel Wiley ◽  
Patricia Heale ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Supplemental Oxygen ◽  
Oxygen Supplementation ◽  
Before And After ◽  
Clinically Significant ◽  
Nicu Admission ◽  
Singleton Pregnancies

Background Although supplemental oxygen (SO2) is routinely administered to laboring gravidas, benefits and harms are not well studied. Objective This article compares strategies of liberal versus indicated SO2 therapy during labor on cesarean delivery (CD) rate and neonatal outcomes. Study Design A controlled, before-and-after trial of laboring women with term, singleton pregnancies. During an initial 8-week period, maternal SO2 was administered at the discretion of the provider followed by an 8-week period where SO2 was to be given only for protocol indications. Results Our study included 844 women. There was no difference in number of women receiving SO2 (53% liberal vs. 50% indicated; p = 0.33). For those receiving SO2, there was no difference in SO2 duration (median, 89 minutes [interquartile range, 42–172] vs. 87 minutes [36–152]; p = 0.42). There were no differences in overall CD rate (20% vs. 17%; p = 0.70), CD for nonreassuring fetal status, or use of intrauterine resuscitative measures. There were more 5-minute APGAR < 7 in the indicated group, but no difference in umbilical artery pH < 7.1 or neonatal intensive care unit (NICU) admission. Conclusion Approximately half of women receive SO2 intrapartum regardless of a strategy of liberal or indicated oxygen use. There were no clinically significant differences in outcomes between strategies.

Sign in / Sign up

Export Citation Format

Share Document