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Feeding And Preterm infant

Luise V Marino, Carol Fudge, Freya Pearson, Mark John Johnson
To improve the postdischarge growth of exclusively breastfed preterm infants, born weighing ≤1.8 kg, by using breast milk fortifier (BMF) supplements postdischarge until 48 weeks' gestational age. A quality improvement (QI) project involving plan-do-study-act (PDSA) cycles. A tertiary surgical neonatal unit. Preterm infants weighing ≤1.8 kg at birth. We completed four PDSA cycles to develop and improve an electronic patient information sheet to promote the use BMF beyond discharge. Safety, feasibility and attitudes of parents to home BMF were assessed using questionnaires...
December 14, 2018: Archives of Disease in Childhood
Jacquelyn Grev, Marie Berg, Roger Soll
BACKGROUND: Inflammation may contribute to preterm birth and to morbidity of preterm infants. Preterm infants are at risk for alterations in the normal protective microbiome. Oral probiotics administered directly to preterm infants have been shown to decrease the risk for severe necrotizing enterocolitis (NEC) as well as the risk of death, but there are safety concerns about administration of probiotics directly to preterm infants. Through decreasing maternal inflammation, probiotics may play a role in preventing preterm birth and/or decreasing the inflammatory milieu surrounding delivery of preterm infants, and may alter the microbiome of the preterm infant when given to mothers during pregnancy...
December 12, 2018: Cochrane Database of Systematic Reviews
Chandra Kumar Natarajan, Mari Jeeva Sankar, Ramesh Agarwal, Ashok Deorari, Vinod Paul
OBJECTIVE: To evaluate the feeding performance of infants with bronchopulmonary dysplasia (BPD) on paladai. METHODS: This cross-sectional study was performed in a level III neonatal unit in North India from March through August 2012. Nineteen infants (27-32 wk of gestation) were enrolled; 9 in BPD group (oxygen requirement for at least 28 d) and 10 in 'No BPD' group. Paladai feeding (PF) sessions were video recorded for 3 d serially, at first successful (FSF) at postnatal age of ≥28 d and follow up feeding (FUF) at 40 ± 2 wk...
December 13, 2018: Indian Journal of Pediatrics
Gopal Agrawal, Sanjay Wazir, Surender Kumar, Bir Singh Yadav, Manish Balde
Objectives: The objective of this study was to show the effects of routine vs. selective fortification of human milk (HM) on short-term growth and metabolic parameters. Methods: Single-centre retrospective pre-post cohort study in India. Preterm infants ≤32 weeks' gestation and weighing ≤1500 g were included. Routine fortification: pre-fixed feed volume (100 ml/kg/day in our unit) at which fortification was done. Selective fortification: feed volume was gradually optimized till 180-200 ml/kg/day...
December 12, 2018: Journal of Tropical Pediatrics
Romana C Mayer, Kathrine R Tan, Julie R Gutman
Background: Malaria during pregnancy increases the risk of maternal and fetal complications. There are very limited options available for prophylaxis in pregnant travelers. Atovaquone-Proguanil (AP or Malarone®) is an effective and well-tolerated antimalarial medication, but is not recommended for use in pregnancy due to limited data on safety. Passively reported adverse event data may provide additional information on the safety of AP during pregnancy. Methods: We analyzed adverse event data on pregnancy and birth outcomes following accidental exposures to AP during pregnancy passively reported to GlaxoSmithKline LLC (GSK) between May 13, 1997 and August 15, 2017...
December 13, 2018: Journal of Travel Medicine
Kathryn A Hasenstab, Saira Nawaz, Ivan M Lang, Reza Shaker, Sudarshan R Jadcherla
OBJECTIVE: Aims were to: 1) examine pharyngo-esophageal and cardio-respiratory responses to provoking pharyngeal stimuli, and 2) determine potential contributory factors impacting heart rate (HR) changes to provide insight into cardio-respiratory events occurring in preterm infants. METHODS: Forty-eight neonates (29 males, born at 27.7 ± 0.5 wks; Mean ± SEM) pending discharge on full oral feeds were studied at 38.7 ± 0.2 wks postmenstrual age using concurrent pharyngo-esophageal manometry, electrocardiography, respiratory inductance plethysmography, and nasal airflow thermistor...
December 13, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
Itziar Estalella, Jaione San Millán, María José Trincado, Amaia Maquibar, Lorea Martínez-Indart, Miguel San Sebastián
BACKGROUND: Late-preterm infants show lower breastfeeding rates when compared with term infants. Current practice is to keep them in low-risk wards where clinical guidelines to support breastfeeding are well established for term infants but can be insufficient for late-preterm. OBJECTIVE: The aim of this study was to evaluate an intervention supporting breastfeeding among late-preterm infants in a maternity service in the Basque Country, Spain. METHODS: The intervention was designed to promote parents' education and involvement, provide a multidisciplinary approach and decision-making, and avoid separation of the mother-infant dyad...
December 4, 2018: Women and Birth: Journal of the Australian College of Midwives
Zoë-Marie Ellis, Hui Shan Grace Tan, Nicolas D Embleton, Per Torp Sangild, Ruurd M van Elburg
BACKGROUND: High feed osmolality (or osmolarity) is often suggested to be linked with adverse gastrointestinal events in preterm infants. AIM: To systematically review the literature on milk feed osmolality and adverse gastrointestinal events in newborn and low birthweight infants and animals. METHODS: MEDLINE, Embase, CAB Abstracts, Current Contents, BIOSIS Previews and SciSearch were searched from inception to May 2018 to identify potentially relevant studies...
December 6, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Marzena Drozd-Dąbrowska, Renata Trusewicz, Maria Ganczak
Despite a number of studies on the risk factors of developmental delay (DD) in children conducted in developed countries, Polish data are scarce, which hinder an early diagnosis and initiation of prevention/control measures. Objective: To assess selected risk factors of DD in infants. A case-control survey was conducted in 2017⁻2018 on 50 infants (≤1 year old) with DD and 104 healthy controls from three outpatient clinics in Szczecin, Poland. Data were collected using an anonymous questionnaire distributed among mothers...
December 2, 2018: International Journal of Environmental Research and Public Health
Maria L Giannì, Elena Bezze, Lorenzo Colombo, Camilla Rossetti, Nicola Pesenti, Paola Roggero, Patrizio Sannino, Salvatore Muscolo, Laura Plevani, Fabio Mosca
Limited data are available on complementary feeding in preterm infants, who show increased nutritional needs and are at risk of altered postnatal growth. The aim of this study was to investigate the timing and content of complementary feeding in a cohort of late preterm infants. We conducted a prospective, observational study, including mothers who had given birth to infants admitted to level I or II of care with a gestational age between 34 and 36 weeks. Mothers were contacted at 3, 6 and 12 months after delivery by phone calls and were asked about their infant's mode of feeding and the timing and schedule of the introduction of different solid foods types...
December 2, 2018: Nutrients
Sanja Zivanovic, Alexandra Scrivens, Raffaella Panza, Peter Reynolds, Nicola Laforgia, Kevin N Ives, Charles C Roehr
AIM: To evaluate the effectiveness of nasal high-flow therapy (nHFT) as primary respiratory support for preterm infants with respiratory distress syndrome (RDS) in two tertiary neonatal units. METHODS: A retrospective outcome analysis of initial respiratory support strategies was performed in two tertiary neonatal units in the UK: John Radcliffe Hospital (JRH), Oxford and St Peter's Hospital (SPH), Chertsey. Infants born between 28+0 and 36+6 weeks gestational age (GA) between May 2013 and June 2015 were included...
December 4, 2018: Neonatology
Ufuk Çakır, Cuneyt Tayman
Background It is known that thyroid hormones have effects on bone development. In particular, the effect of thyroid hormones on osteopenia of prematurity (OOP) has not been examined in preterm infants. Our study aimed to examine the relationship between OOP and congenital hypothyroidism (CH) in preterm infants. Methods Very low birth weight infants (VLBW, <1500 g) were included in the study. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were measured on postnatal day 5. Serum calcium, phosphorus and alkaline phosphatase (ALP) levels were studied as standard screening parameters for OOP at postnatal week 4...
December 4, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Daniel Tomé
Glutamate (Glu), either as one of the amino acids of protein or in free form, constitutes up to 8-10% of amino acid content in the human diet, with an intake of about 10-20 g/day in adults. In the intestine, postprandial luminal Glu concentrations can be of the order of mM and result in a high intra-mucosal Glu concentration. Glu absorbed from the intestinal lumen is for a large part metabolized by enterocytes in various pathways, including the production of energy to support intestinal motility and functions...
2018: Annals of Nutrition & Metabolism
Eric W Reynolds, Debbie Grider, Rhonda Caldwell, Gilson Capilouto, Abhijit Patwardhan, Richard Charnigo
Objectives: The objective of this study is to describe swallow:breath interaction (SwBr) and phase of respiration incident to swallow (POR) during non-nutritive suck in infants with bronchopulmonary dysplasia and determine if speech-language intervention can modify the characteristics of non-nutritive suck in these infants. Methods: Logistic regression models were used to describe SwBr and POR in 16 low-risk preterm (LRP) infants and 43 infants with bronchopulmonary dysplasia...
September 2018: Journal of Nature and Science
Beatriz Salamanca-Zarzuela, María Elena Infante López, Carlos Alcalde Martín
Phenylketonuria (PKU) is an autosomal recessive inborn error of phenylalanine (phe) metabolism caused by a deficiency in the enzyme phenylalanine hydroxylase that converts phe into tyrosine. If left untreated, PKU results in increased phe concentrations in the blood and in the brain, which cause severe intellectual disability, epilepsy, and behavioral problems. These disorders can be prevented if a diet low in phe is introduced. This report focuses on a preterm newborn (gestational age 29 wk) with adequate weight (1290 g) and no family history of PKU...
August 20, 2018: Nutrition
Junxiu Liu, Jihong Liu, Edward A Frongillo, Nansi S Boghossian, Bo Cai, Haiming Zhou, Linda J Hazlett
OBJECTIVE: The purpose of this study was to examine the trajectories of body mass index (BMI) in the first year of life and their determining factors. METHODS: We used data from the Infant Feeding Practices Survey II restricted to children with 2 or more time points of BMI data during follow-up visits within the first year of life (n = 2320). Latent class growth analysis was used to identify distinct BMI trajectories. Using multinomial logistic regression, we examined the prenatal and early life determinants of the identified trajectories...
November 30, 2018: American Journal of Human Biology: the Official Journal of the Human Biology Council
Bing Ma, Elias McComb, Pawel Gajer, Hongqiu Yang, Mike Humphrys, Adora C Okogbule-Wonodi, Alessio Fasano, Jacques Ravel, Rose M Viscardi
Intestinal barrier immaturity, or "leaky gut," is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. However, the impact of intestinal microbiota development on intestinal mucosal barrier maturation has not been evaluated in this population. In this study, we investigated a longitudinally sampled cohort of 38 preterm infants < 33 weeks gestation monitored for intestinal permeability (IP) and fecal microbiota during the first 2 weeks of life. Rapid decrease in IP indicating intestinal barrier function maturation correlated with significant increase in community diversity...
2018: Frontiers in Microbiology
Vijay Gupta, Grace Rebekah, Yesudas Sudhakar, Sridhar Santhanam, Manish Kumar, Niranjan Thomas
OBJECTIVE: To optimize growth in very low birth weight (VLBW) infants, human milk fortification is standard of care in neonatal units of high income countries. However, commercial fortifiers may not be available or it may be too expensive in resource limited settings. As an alternative to using human milk fortifiers, we studied the effects of milk fortification with an infant formula on growth and biochemical parameters of very low birth weight (VLBW) infants Methods: We undertook a prospective, randomized controlled trial in the neonatal unit of a tertiary care hospital in south India...
November 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
Joris H J van Sadelhoff, Dimitra Mastorakou, Hugo Weenen, Bernd Stahl, Johan Garssen, Anita Hartog
Free amino acids (FAAs) in human milk are indicated to have specific functional roles in infant development. Studies have shown differences between human milk that is expressed at the beginning of a feed (i.e., foremilk) and the remainder of the milk expressed (i.e., hindmilk). For example, it is well established that human hindmilk is richer in fat and energy than foremilk. Hence, exclusively feeding hindmilk is used to enhance weight gain of preterm, low birthweight infants. Whether FAAs occur differently between foremilk and hindmilk has never been reported, but given their bioactive capacities, this is relevant to consider especially in situations where hindmilk is fed exclusively...
November 26, 2018: Nutrients
Leónides Fernández, Lorena Ruiz, Josué Jara, Belén Orgaz, Juan M Rodríguez
Studies carried in the last years have revealed that human milk contains a site-specific microbiota and constitutes a source of potentially beneficial bacteria to the infant gut. Once in the infant gut, these bacteria contribute to the assembly of a physiological gut microbiota and may play several functions, contributing to infant metabolism, protection against infections, immunomodulation or neuromodulation. Many preterm neonates are fed with pasteurized donor's human milk (DHM) or formula and, therefore, are devoid of contact with human milk microbes...
2018: Frontiers in Microbiology
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