scholarly journals Might the Mothers of Premature Babies Feed Them and Devote Some Milk to the Milk Bank?

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Pasqua Anna Quitadamo ◽  
Giuseppina Palumbo ◽  
Liliana Cianti ◽  
Matteo Luigi Napolitano ◽  
Ciro Coviello ◽  
...  
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Psychological Trauma ◽  
Premature Baby ◽  
Single Donor ◽  
Premature Babies ◽  
Milk Bank ◽  
Starting Point ◽  
Healthy Growth

The breast milk is the gold standard food for the feeding of the premature baby: it is the natural way to provide excellent nutritional, immunological, and biological nutriment so as to facilitate a healthy growth and the development of the infants. When the breast milk is not available, the alternative is represented by the donated milk. The mothers of premature infants are important opportunity if we consider the fact that they could devote some milk both because they provide a food which is closer to the needs of the vulnerable category of newborns and because it is, for the mothers, a way to overcome the detachment and the psychological trauma of a premature birth. There are no data on this kind of donation. The aim of the study is to evaluate the contribution of the milk donation to the HMB of CSS by women who gave birth to premature infants of gestational age <35 weeks and to analyze the macronutrient composition of the “preterm” donated milk. The CSS HMB has recruited 659 donors totalling 2236 liters of donated milk over a period of 7 years. 38 donors (5.7%) gave birth to a gestational age <35 weeks. Almost 20% of the donated milk comes from mothers of premature babies and this is a very important fact because it shows the huge potential belonging to this category of mothers. Taking into account the parameter regarding the birth weight, it was found that VLBW mothers contributed for 56% to preterm donation while ELBW mothers contributed for 41%. By evaluating the variable gestational age, about 40% of the average total donation derives from mothers who gave birth before the 25 weeks, while a contribution of 46% is attributable to the category of newborns with a GA between 25 and 32 weeks. Besides, some other exceptional examples can be outlined. Regarding the correlation analysis DM resulted in negative correlation with GA weeks (r=-0.31, p=0.058) and with BW g (r=-0.30, p=0.068) achieving values which are very close to the significance. The comparison between the donor volume averages of the preterm and full-term groups is statistically significant. The composition data are in line with the literature: there is an increase by 18 % in the protein component of the milk deriving from the mothers of the premature infants; the gap in carbohydrates is less significant (5-6%) and the gap in calories is similarly low being only 2% higher than the single donor milk and 11% more than the pooled milk. The data on the lipids line up to single donor term milk, while it grows by 24% compared to the pooled one. The study shows that even at very low or extreme gestational age it is possible to obtain an appropriate production of breast milk. This awareness becomes a fundamental starting point for the activation in a standardized way of all the strategies of promotion and support of food that have proven effective with the HM in NICU.

scholarly journals Pediatric resuscitation, emergencies in pediatrics. Various infusion methods for children

2020 ◽  
pp. 97-99
Author(s):  
T. Erler
Keyword(s):  
Body Weight ◽  
Breast Milk ◽  
Premature Infants ◽  
Premature Birth ◽  
Mortality Rates ◽  
Modern Medicine ◽  
Premature Baby ◽  
Multiple Pregnancies ◽  
Premature Babies ◽  
Great Progress

Background. Medical care for premature babies in Germany is divided into two levels. Perinatal centers of the first level provide care for infants with body weight at birth <1500 g. Perinatal centers of the second level provide care for children whose body weight exceeds 1500 g. In order to be included in the list of first level institutions, the hospital must, among other, be able to pick up children from other institutions in the surrounding region. Mobile incubators are used for this purpose. Such an incubator is a kind of a mobile intensive care unit. In some cases, the incubator is delivered to the desired location by helicopter, but in most cases, specialized road transport is used. Objective. To describe neonatological medical care in Germany. Materials and methods. Analysis of own experience and available literature data on this issue. Results and discussion. In recent years, Germany experiences a decrease in the number of births, which causes the problem of professional training of doctors. Hospitals with the fewest births are closed due to lack of efficiency. Although there are some fluctuations from year to year, in general, the number of premature babies with extremely low birth weight remains approximately constant. Prematurity remains one of the most important problems of modern medicine, as it is accompanied by high mortality rates. The earlier the premature birth is and the lower the body weight is, the higher these rates are. Prematurity is caused by numerous risk factors. Multiple pregnancies are accompanied by the highest risk of premature birth. The presence of twins or triples increases this risk by 7.7 times. Other risk factors include vaginal bleeding in late pregnancy, preeclampsia, and a history of preterm birth. Over the past 20 years, the survival of children born before 32 weeks of pregnancy or weighing <1500 g has increased by almost 20 %. The smallest premature baby born in our clinic is a baby born at 24 weeks of gestation with a body weight of 350 g. Nowadays in Germany, the survival rate of infants born after 24 weeks of gestation is almost 80 %, and after 29 weeks – almost 100 %. It should be noted that maintaining the life of a premature baby from birth to discharge costs 250-300 thousand euros. Bronchopulmonary dysplasia is an important problem of premature infants, especially in case of mechanical lung ventilation (MLV) or joining infections. Up to 40 % of children who die from complications of bronchopulmonary dysplasia can be saved. If possible, MLV and infections should be avoided, premature births should be prevented, so-called neuroprotective ventilation and nasal or mask devices that do not require intubation should be used. Surfactants have made great progress in the management of premature infants. The modern LISA (less invasive surfactant administration) method allows to inject a surfactant into a child’s lungs without intubation. In the early 20th century, 100 % oxygen was used in the resuscitation of newborns, but now we use air (21 % oxygen) or a mixture containing up to 30 % oxygen. To prevent necrotizing enterocolitis, premature infants are prescribed probiotics based on lyophilized lactic acid bacteria and bifidobacteria. Breast milk is an another way to prevent this complication of prematurity. There is a breast milk bank in Potsdam. Conclusions. 1. Prematurity remains one of the most important problems of modern medicine, as it is accompanied by high mortality rates. 2. Multiple pregnancies are accompanied by the highest risk of premature birth. 3. Nowadays in Germany, the survival rate of children born after 24 weeks of gestation is almost 80 %, and after 29 weeks – almost 100 %. 4. Surfactants and the LISA method have made great progress in the management of premature infants. 5. Probiotics and breast milk are prescribed to premature babies to prevent necrotizing enterocolitis.

About the system of rehabilitation of preterm infants within walking distance

2016 ◽  
Vol 7 (2) ◽  
pp. 140-144
Author(s):  
Inga N Surenkova ◽  
Galina A Suslova ◽  
Anna P Skoromets
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Integrated Approach ◽  
Premature Baby ◽  
Medical Rehabilitation ◽  
Walking Distance ◽  
Negative Consequences ◽  
Premature Babies ◽  
The Family

During last five years there was increasing preterm infants, these children were born with a gestational age of 26 weeks and weighing 800 g, with severe combined pathology. Preterm infants came to the nearest polyclinics after the first stage of rehabilitation in hospitals. There are many questions how and when specialists should begin rehabilitation of such children. Specialists observes that is required an integrated approach to the rehabilitation of premature babies by analyzing the development of these children. Considering that children’s polyclinic allows monitoring children till 18 years of age, there is a possibility of observing and assisting these children during longer period. It is also very essential to realize that without an adequate intensive nursery care the negative consequences become irreversible for premature infants. Birth of a premature infant is a severe psychological stress for both parents. Often without completely realizing it, the family begins to live in conditions of high emotional stress. The department of medical rehabilitation must operate with the parents of a premature baby, in order to help them adapting to the new conditions of life. The task of differentiated medical and psychological rehabilitation can be fulfilled only by the district polyclinic in which the child will be observed until the age of 18. In the article considered features of modern rehabilitation of preterm infants in the in ambulatory-polyclinic service.

HYPERGLYCEMIAAS AN INDEPENDENT RISK FACTOR FOR RETINOPATHY OF PREMATURITY (ROP): A COHORT STUDY

2021 ◽  
pp. 54-57
Author(s):  
Kali Shankar Das ◽  
Athokpam Poireiton ◽  
Niladri Sekhar Mandal ◽  
Samim Ahmed
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Blood Glucose ◽  
Premature Infants ◽  
Gestational Age ◽  
Independent Risk Factor ◽  
Logistic Regression Model ◽  
Bivariate Analysis ◽  
Premature Babies ◽  
Average Blood Glucose

OBJECTIVE: Retinopathy of prematurity (ROP) is a severe morbidity that can lead to blindness in premature babies. Neonatal hyperglycemia has been related to the growth of ROP in a variety of studies. However, there aren't many observational trials to show whether hyperglycemia is linked to ROP in the absence of other comorbidities. The aim of this research was to see if hyperglycemia in premature babies is linked to ROP in a different way. STUDY DESIGN: Premature infants (<1500 g or⩽ 32 weeks gestational age) were enrolled in a prospective longitudinal cohort study. All demographic, clinical and laboratory data were collected. Bedside whole-blood glucose concentration was measured every 8 hours daily for rst 7 , days of live. For any glucose reading <50 or>150 mg dl 1 serum sample was sent to the laboratory for conrmation. Hyperglycemia was dened as any blood glucose level⩾ 150 mg dl − 1. ROP patients were compared with non-ROP patients in a bivariate analysis. Variables signicantly associated with ROP were studied in a logistic regression model. RESULT:Atotal of 100 patients were enrolled with gestational age <32weeks and birth weight <1500g. Forty-eight patients (48%) were identied with hyperglycemia. On eye examination, 30 cases (30%) had ROP (19 with stage 1, 10 with stage 2 and 1 with stage 3). There were more cases of ROPin the hyperglycemia group compared with the euglycemia group (45.83% vs 15.38%, P = 0.007). Patients who developed ROP had signicantly higher maximum and average glucose concentrations when compared with non-ROP patients. Multiple factors have been associated with ROP on bivariate analysis, including gestational age, exposure to oxygen, respiratory support and poor weight gain. However, in a logistic regression model including all signicant variables, average blood glucose in the rst week of life was the factor independently associated with ROPwith an odds ratio of: 1.77 (95% condence interval: 1.08 to 2.86), P= 0.024 CONCLUSION: In a prospective cohort study of premature infants, elevated average blood glucose concentrations in the rst week of life is an independent risk factor associated with the development of ROP.

scholarly journals Characteristic of exocrine function of the pancreas in premature newborns

2021 ◽  
pp. 21-25
Author(s):  
A.Sh. Fazylova ◽  
◽  
D.I. Akhmedova ◽  
A.T. Kamilova ◽  
S.S. Khasanova ◽  
...  
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Pancreatic Insufficiency ◽  
Clear Relationship ◽  
Exocrine Function ◽  
Term Infants ◽  
Fecal Elastase ◽  
Early Postnatal Ontogenesis ◽  
Premature Babies ◽  
Study Results

Premature babies in early postnatal ontogenesis are characterized by the immaturity of many functional systems, including the digestive system. The imperfection of the motor-evacuation function of the gastrointestinal tract in them is combined with insufficient activity of the enzyme systems, the peculiarities of the formation of the microbial landscape of the colon, which contributes to the development of digestive dysfunctions and complicates enteral feeding, especially in deeply premature infants. In order to determine the parameters pancreatic elastase (PE) in premature infants, depending on the gestational age and the nature of feeding, 135 newborns were examined (108 premature infants with a gestational age of 22 to 32 weeks and 27 term infants). All children underwent a general clinical examination, as well as a study for PE on the 13–14th day of life, when the volume of enteral nutrition reached 70 percent or more. Analysis of the study results revealed a clear relationship between the degree of prematurity and the severity of pancreatic insufficiency. A clear relationship between fecal elastase indicators and the type of feeding was determined. The most favorable situation is observed in exclusively breastfed children, who have the highest fecal elastase values, which practically do not differ from the control values. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: premature, elastase, pancreatic insufficiency.

scholarly journals Clinical Results of the Implementation of a Breast Milk Bank in Premature Infants (Under 37 Weeks) at the Hospital Universitario del Valle 2018–2020

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2187
Author(s):  
Javier Torres-Muñoz ◽  
Carlos Alberto Jimenez-Fernandez ◽  
Jennifer Murillo-Alvarado ◽  
Sofia Torres-Figueroa ◽  
Juan Pablo Castro
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Premature Infants ◽  
Odds Ratio ◽  
Neonatal Intensive Care ◽  
Clinical Results ◽  
Human Breast Milk ◽  
Milk Bank ◽  
Exploratory Data ◽  
Milk Banks

Breast milk is widely recognized as the best source of nutrition for both full term and premature babies. We aimed to identify clinical results of the implementation of a breast milk bank for premature infants under 37 weeks in a level III hospital. 722 neonates under 37 weeks, hospitalized in the Neonatal intensive care unit (ICU), who received human breast milk from the institution’s milk bank 57% (n = 412) vs. mixed or artificial 32% (n = 229), at day 7 of life. An exploratory data analysis was carried out. Measures of central tendency and dispersion were used, strength of association of odds ratio (OR) and its confidence intervals (95% confidence interval (CI)). 88.5% had already received human milk before day 7 of life. Those who received human milk, due to their clinical condition, had 4 times a greater chance of being intubated (OR 4.05; 95% CI 1.80–9.11). Starting before day 7 of life decreases the opportunity to develop necrotizing enterocolitis by 82% (adjusted odds ratio (ORa) 0.18; 95% CI 0.03–0.97), intraventricular hemorrhage by 85% (ORa 0.15; 95% CI 0.06–0.45) and sepsis by 77% (ORa 0.23; 95% CI 0.15–0.33). Receiving human milk reduces the probability of complications related to prematurity, evidencing the importance that breast milk banks play in clinical practice.

scholarly journals The recombinant human erythropoietin therapy for extremely and very low birth weight infants

2019 ◽  
Vol 18 (2) ◽  
pp. 75-82 ◽  
Author(s):  
D. R. Sharafutdinova ◽  
E. N. Balashova ◽  
O. V. Ionov ◽  
A. R. Kirtbaya ◽  
J. M. Golubtsova ◽  
...  
Keyword(s):  
Body Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Recombinant Human Erythropoietin ◽  
Very Low Birth Weight ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Human Erythropoietin ◽  
Premature Babies ◽  
Anemia Of Prematurity

Anemia of prematurity is a common pathology in premature infants. The prevalence of anemia of prematurity is inversely proportional to the gestational age and body weight at birth. The pathogenetic importance of impaired erythropoietin (EPO) production in anemia of prematurity provides the rationale for therapy with erythropoiesis stimulating agents (ESAs) including recombinant EPO. A comparative analysis of the effectiveness of different regimens of recombinant human erythropoietin in extremely and very low birth weight infants (ELBW and VLBW) was studied. Research has been set as a prospective analysis of 133 VLBW and ELBW infants (in the period from December 2017 to February 2019). Gestational age (GA) of the children ranged from 26 to 33 weeks, of these, GA of 75 children (56%) was 30 weeks or less. Depending on the treatment of anemia of prematurity all infants were divided into 5 groups: group 1 (n = 26) – premature babies who were prescribed ESAs since 3 day of life 200 IU/kg 3 times per week subcutaneously; group 2 (n = 21) – premature babies who were prescribed ESAs since 3 day of life 400 IU/kg 3 times per week subcutaneously; group 3 (n = 37) – premature babies who were prescribed ESAs since 8 day of life 200 IU/kg 3 times per week subcutaneously; group 4 (n = 18) – premature babies who were prescribed ESAs since 8 day of life 400 IU/kg 3 times per week subcutaneously; group 5 (n = 31) premature infants who did not receive treatment with recombinant human erythropoietin (control group). Subgroups of children of gestational age ≤ 30 weeks were identified in each group. The groups and subgroups did not differ significantly in gestational age, weight, birth length, and Apgar score at 1 and 5 minutes of life, p > 0.05. Also, there were no statistically significant differences in the age of the 1st transfusion, the frequency and total volume of transfusions, the duration of respiratory therapy, the duration of hospitalization, including treatment in NICU, body weight and age at discharge. The frequency of retinopathy of prematurity stage ≥ 3, periventricular leukomalacia, bronchopulmonary dysplasia of moderate and severe severity, intraventricular hemorrhages of varying severity, necrotizing enterocolitis was not statistically significant in the study groups and subgroups. Statistically significant differences in the concentration of hemoglobin in the peripheral blood of premature infants were revealed at discharge. In the control group, children had a lower level of hemoglobin at discharge (94 g/l) compared with the groups with early appointment of ESAs (109 g/l and 107 g/l in groups 1 and 2, respectively, P0-1 = 0.048 and P0-2 = 0.047) due to newborn GA ≤ 30 weeks. It is preferable to use of the drug ESAs at a dose of 200 IU/kg 3 p/week p/, starting from the 3rd day of life. The effectiveness of erythropoietin therapy, the time of its start and various treatment regimens remain controversial issues that require further study. The study was approved by the Independent Ethics Committee of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.

THE BREAST MILK BANK AS A COMMUNITY PROJECT

PEDIATRICS ◽  
1955 ◽  
Vol 16 (2) ◽  
pp. 264-269
Author(s):  
E. Robbins Kimball ◽  
Elizabeth Jones ◽  
Myrtle E. Lewis ◽  
Ethel R. Kolb
Keyword(s):  
Breast Milk ◽  
Hospital Stay ◽  
Breast Feeding ◽  
Premature Infants ◽  
Length Of Hospital Stay ◽  
Community Project ◽  
Milk Bank

1. The management of breast feeding is outlined. 2. The organization of our breast milk bank as operated by Evanston Hospital and Junior League volunteers is described. 3. The establishment of a breast milk bank has enabled us to increase the number of premature infants fed breast milk threefold. Their weights and length of hospital stay are presented.

scholarly journals Decrease in the Use of Parenteral Fluids in Premature Infants from 31 to 34 Weeks of Gestation at Birth

2021 ◽  
Author(s):  
Angela Hoyos ◽  
Pablo Vasquez-Hoyos
Keyword(s):  
Breast Milk ◽  
Premature Infants ◽  
Demographic Characteristics ◽  
Fluid Restriction ◽  
Z Score ◽  
Premature Babies ◽  
Oral Fluids ◽  
Before And After ◽  
Low Incidence ◽  
Second Period

Introduction: Some of the practices in medicine are carried out of habit without proven benefits. This is the case of premature babies from 31 to 34 weeks of gestation who are always given parenteral fluids, even though this practice has been associated with an increase incidence of infection. In 2017, we started a protocol of parenteral fluid restriction. To administer nutrition/fluids, we used oral fluids by suction if this was possible or otherwise by oral/nasogastric tube at volumes of 15-20 mL intake every 3 hours, with 5 mL increments every 12-24 hours until 200 mL/K/day was achieved, always using breast milk when possible.Material and methods: The present study sought to compare cases before and after this new policy. For this work, we review all premature babies between 31-34 weeks of gestation discharged home in two periods of time, the first from 01/01/2012 to 12/31/2017 and the second from 01/01/2018 to 08/31/2021. The number of cases with and without parenteral fluids (PF), the incidence of infection, the weight at admission and discharge, and the fall in the weight Z score between birth and discharge were compared. Both the anthropometric and outcome variables were compared using the different statistical methods according to each variable.Results: 725 cases were found with the described characteristics. The groups before and after the intervention did not show significant differences in their general demographic characteristics. A lower use of PF was observed in the second period from 348 cases (79%) to 70 (24%), p &lt;0.001 and fewer days of use (4.1 days/case vs 1.3, p &lt;0.0001) of PF. The weight at discharge and the change in weight Z-score were the same in both groups. Infections went from three cases to zero but it was not statistically significant. There were no complications due to less use of PF.Discussion: This study showed that the use of PF is not associated with significant changes in outcomes of interest, which reinforces that its use does not generate any benefit for the patient. Larger number of cases is required to detect differences in low incidence events such as infections.

scholarly journals ASSOCIATIONS BETWEEN MATERNAL METABOLIC RISK FACTORS AND BIRTH OF OVERWEIGHT PREMATURE BABY

2021 ◽  
Vol 21 (2) ◽  
pp. 82-86
Author(s):  
A.V. Sliusarieva
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Gestational Age ◽  
Premature Baby ◽  
Metabolic Risk Factors ◽  
High Density Lipoproteins ◽  
Metabolic Risk Factor ◽  
Metabolic Risk ◽  
Relative Contribution ◽  
Premature Babies

The relative contribution of individual metabolic risk factors and their clusters in pregnant women to the birth of premature infants, who are too large for their gestational age, is not fully understood. The aim of this study is to find the correlation between individual metabolic risk factors and their clusters in pregnant women and the birth of premature newborns, which are too large for their gestational age. This retrospective study included 84 preterm infants. The following metabolic risk factors were assessed in mothers of the children: the presence of overweight / obesity before pregnancy, weight gain during pregnancy, high blood pressure during pregnancy, as well as the growing level of triglycerides immediately after childbirth, high-density lipoproteins, cholesterol, and hyperglycemia. Adverse effects in children included delivery route, neonatal asphyxia, respiratory failure syndrome, and jaundice. The odds ratios were calculated for both an individual metabolic risk factor and their combination using logistic regression analysis. Metabolic risk factors such as hypertension, diabetes and dyslipidemia were significantly associated with the birth of premature babies, who are too large for their gestational age after adjustment for other factors. In a cohort of premature babies, no reliable relationship was found between obesity and the birth of children, who are too large for their gestational age. Children whose mothers have three metabolic risk factors at the same time, as a rule, are more likely (OR = 7.39, 95% CI 2.72-20.11) to be born too large for their gestational age. Pregnant women with a combination of metabolic risk factors for preterm birth are more likely to give birth to babies, who are large for their gestational age.

scholarly journals Penelitian pada Kebutuhan Bank Susu Patuh Syariah Kepada Bayi Prematur di Malaysia

2019 ◽  
Vol 5 (1) ◽  
pp. 9
Author(s):  
Normadiah Daud ◽  
Nadhirah Noordin ◽  
Zurita Mohd Yusof ◽  
Nur Hidayah Ashar ◽  
Paramitha Amelia Kusumawardhani
Keyword(s):  
Breast Milk ◽  
Medical Science ◽  
Optimal Growth ◽  
Formula Milk ◽  
Premature Babies ◽  
Milk Bank ◽  
Mother's Milk ◽  
Mother’S Milk ◽  
The Government ◽  
Milk Banks

Breast milk (ASI) is the best and most perfect source of nutrition for babies, especially premature babies. ASI contains complete nutrients for optimal growth and development in terms of mental and physical aspects of the baby, especially in the first six months of life. The features and advantages of mother's milk not only recognized in Islam have even been recognized by researchers from medical, science and lactation experts. The writing of this article aims to discuss the need for sharia compliant milk banks for premature babies. This study uses a qualitative approach using content analysis methods that focus on the textbooks, books, journals, articles and reports. The results of the discussion found that mother's milk contained many of the benefits needed by premature babies. When compared with formula milk, the nutritional content of breast milk is much better. There are several reasons why breastfeeding is now the main requirement in Malaysia, one of them is for premature babies. With this, the government seeks to meet ASI's needs by establishing a shariah compliant milk bank for mothers with breastfeeding problems. The results of the discussion found that Islam not only acknowledged the efficacy of ASI, it also emphasized the problem of maternal and adolescent mahram relationships. Therefore, the established milk bank must be in accordance with the guidelines set by the jurisprudence and the schools of Imam Shafi'i. In addition to needs, milk banks also provide benefits for Muslims by seeing an increase in premature baby birth statistics in Malaysia. It is in this condition of the emergency phase that a compliant sharia milk bank needs to be established. The milk bank that will be established can avoid the occurrence of problems overlapping the mahram according to the principle of Maqasid al-Shari'ah in the maintenance of implantable mahram purity.

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