scholarly journals Randomized controlled trial of 4 compared with 6 mo of exclusive breastfeeding in Iceland: differences in breast-milk intake by stable-isotope probe

2012 ◽  
Vol 96 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Jonathan CK Wells ◽  
Olof H Jonsdottir ◽  
Patricia L Hibberd ◽  
Mary S Fewtrell ◽  
Inga Thorsdottir ◽  
...  
2020 ◽  
Author(s):  
Yun Zhou ◽  
Jiaying Ni ◽  
Chenchen Zhou ◽  
Ying Chen ◽  
Julian Little ◽  
...  

Abstract Background Direct breastfeeding hasmultiple health benefits. Some mothers need to express their breasts when directly breast feeding is unavailable after delivery . However, there is insufficient evidence regarding an effective method of breast milk expression in the absence of an infant's suction. We aimed to investigate the effects of different methods of breast milk expression on breastfeeding initiation, efficacy of breast milk extraction, and on the rate of exclusive breastfeeding at 6 months. Methods In this open-label, randomized controlled trial, the participants of mother-infant dyads separated immediately after birth for at least 6 hrs were recruited and randomly assigned (1:1:1) into three groups: (1) hand expression of breast milk; (2) sequential electrical breast pumping: and (3) simultaneous electrical breast pumping. The two primary outcome measures were the time required for initiation of breastfeeding and the milk volume expressed in a 10-minute session (direct breastfeeding in hand expression group) at 3 days and at 6 weeks; a secondary outcome was the proportion of exclusive breastfeeding at 4 and 6 months. Analysis was according to intention-to-treat. Results Between 2018 and 2019, we recruited 226 participants, of whom 154 were randomized. The time to breastfeeding initiation showed no difference between the three groups. At 3 days and at 6 weeks, the volume of breast milk produced by 10 minutes of sequential pumping or simultaneous pumping was less than that of hand pumping before direct breastfeeding, while the volume did not differ significantly between the two pumping groups. However, simultaneous breast pumping was more effective than sequential pumping both in volume and saving time in women who had established breastfeeding. The rate of exclusive breastfeeding at 4 months was 21.0%, and at 6 months 10.6%, and did not differ between the three methods of breast milk expression. Conclusions Hand expression, sequential breast pumping, or simultaneous breast pumping in absence of immediate infant suction after birth did not show differences on the time required to initiate breastfeeding, or on the rate of exclusive breastfeeding at 4 and 6 months. Trial registration This trial was registered with www.chictr.org.cn (ChiCTR1800018193) on 4 September 2018.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Minoo Fallahi ◽  
Seyed Masoud Shafiei ◽  
Naeeme Taslimi Taleghani ◽  
Maryam Khoshnood Shariati ◽  
Shamsollah Noripour ◽  
...  

Abstract Background Most premature and very low birthweight infants cannot tolerate breast milk feeding in the first few days of life and are deprived of its benefits. This study evaluates the clinical outcomes of administering breast milk cell fractions to neonates with a birthweight of ≤1800 g. Methods We conducted a randomized controlled trial on 156 infants in the neonatal intensive care unit of Mahdieh Maternity Hospital in Tehran, Iran, from May 2019 to April 2020. All neonates with a birthweight ≤1800 g were enrolled and divided into intervention and control groups using stratified block randomization. Neonates in the intervention group received the extracted breast milk cell fractions (BMCFs) of their own mother’s milk after being centrifuged in the first 6 to 12 h after birth. The control group received routine care, and breastfeeding was started as soon as tolerated in both groups. Study outcomes were necrotizing enterocolitis (NEC), death, and in-hospital complications. Results We divided participants into two groups: 75 neonates in the intervention group and 81 neonates in the control group. The mean birthweight of neonates was 1390.1 ± 314.4 g, and 19 (12.2%) neonates deceased during their in-hospital stay. The incidence of NEC was similar in both groups. After adjustment for possible confounders in the multivariable model, receiving BMCFs were independently associated with lower in-hospital mortality (5 [26.3%] vs. 70 (51.1%]; odds ratio (OR): 0.24; 95% confidence interval [CI] 0.07, 0.86). Also, in a subgroup analysis of neonates with birthweight less than 1500 g, in-hospital mortality was significantly lower in the intervention group (4 [9.5%] vs. 13 [30.2%]; OR: 0.24; 95% CI 0.07, 0.82). There were no differences in major complications such as bronchopulmonary dysplasia and retinopathy of prematurity between the two groups. No adverse effects occurred. Conclusions Our research demonstrated a significantly lower mortality rate in neonates (with a birthweight of ≤1800 g) who received breast milk cell fractions on the first day of life. Since this is a novel method with minimal intervention, we are looking forward to developing and evaluating this method in larger studies. Trial registration IIranian Registry of Clinical Trials. Registered 25 May 2019, IRCT20190228042868N1.


Author(s):  
Erdnaxela Fernandes do Carmo Souza ◽  
Alfredo Almeida Pina-Oliveira ◽  
Antonieta Keiko Kakuda Shimo

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.


2017 ◽  
Vol 9 (02) ◽  
pp. 1
Author(s):  
Adinda Putri Sari Dewi ◽  
Djaswadi Dasuki ◽  
Farida Kartini

Penelitian ini bertujuan untuk Mengetahui efek pijat punggung sebagai salah satu cara dalam meningkatkan produksi ASI pada ibu pasca bedah sesar. Desain Penelitian yang digunakan adalah Randomized Controlled Trial. Teknik Pengambilan sampel dengan simple random sampling dengan jumlah sampel sebanyak 27 responden pada masing-masing kelompok (intervensi dan kontrol). Analisis bivariat menggunakan chi square dengan tingkat kemaknaan p<0,05, analisis multivariat menggunakan regresi logistik untuk mengidentifikasi variabel perancu terhadap produksi ASI pasca bedah sesar. Hasil Penelitian menunjukan adanya perbedaan produksi ASI antara kelompok intervensi dan kelompok kontrol dengan RR sebesar 1,9 (95%CI: 1,097-3,291). Paritas dan frekuensi menyusui mempunyai hubungan yang bermakna dengan produksi ASI pada ibu pasca bedah sesar.Usia ibu, obesitas, waktu rawat gabung tidak memiliki hubungan yang bermakna dengan produksi ASI.


2019 ◽  
Vol 58 (5) ◽  
pp. 534-540 ◽  
Author(s):  
Laura R. Kair ◽  
Valerie J. Flaherman ◽  
Tarah T. Colaizy

Background. Pasteurized donor human milk (DHM) use for healthy newborns is increasing; however, no studies have explored its effect on breastfeeding outcomes. Patients and Methods. We enrolled 60 healthy, term breastfeeding newborns with ≥4.5% weight loss in the first 36 hours in a randomized controlled trial. Thirty newborns were randomly assigned to early limited-volume DHM supplementation and 30 newborns to exclusive breastfeeding. Mothers were surveyed at 1 week and 1, 2, and 3 months regarding the mode of infant feeding. Comparing infants randomized to DHM supplementation with those exclusively breastfeeding, there was no significant difference in the proportion using formula at 1 week (21% vs 7%, P = .15), nor in the proportion of any breastfeeding (79% vs 90%, P = .30) or breastfeeding without formula at 3 months (62% vs 77%, P = .27). Conclusion For newborns with ≥4.5% weight loss in the first 36 hours, early limited-volume supplementation with DHM is unlikely to have a significant favorable impact on breastfeeding outcomes.


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