Breastfeeding the 'healthy' near-term infants after laryngeal mask airway or traditional resuscitation methods.

BACKGROUND: The influence of delivery room resuscitation practice on neonatal breastfeeding pattern is largely not data driven, and clinical experience is insufficient to indicate the impact of available management methods.

AIM: This cohort observational study investigated weather laryngeal mask airway (LMA) rather conventional positive pressure resuscitation devices, face mask (FM), or endotracheal-tube (ETT) would influence breastfeeding pattern in the near-term infants triaged to regular newborn nursery.

METHODS: We identified through 18,641 birth records (from 2002 to 2006), 921 (4.9%) records of near-term infants of 34-36 6/7 weeks' gestation, 710 (77.1%) triaged to regular newborn nursery. Among those, 52/710 (7.3%) required positive pressure resuscitation at birth, inclusive of LMA (29, 55.7%), bag-face mask (FM, 19, 36.5%), and endo-tracheal tube (ETT, 4, 7.6%), respectively. Fifty non-resuscitated near-term infants were used as controls.

RESULTS: Anthropometrical and clinical characteristics of resuscitated near-term study groups were comparable to controls. LMA was more frequently employed at birth to resuscitate near-term infants triaged to regular newborn nursery (OR; 95% CI 17.16; 5.34-55.14), whereas ETT was less frequently utilized (OR; 95% CI 0.11; 0.02-0.55). Although LMA and ETT resuscitation methods did not influence breastfeeding rate at discharge with respect to controls, FM resuscitation was associated with both the lowest breastfeeding rate (OR; 95% CI 3.20; 1.07-9.57) and the more frequently formula-feeding (OR; 95% CI 7.23; 1.58-32.92), and bottle-feeding use (OR; 95% CI 4.20; 1.30-13.49) at discharge.

CONCLUSION: LMA is an effective and safe alternative to more conventional forms of airway management in near-term infants needing resuscitation at birth. Other studies are needed to clarify the potential advantages of the LMA on breastfeeding.