Clinical Trial Details
— Status: Not yet recruiting
Administrative data
| NCT number |
NCT05816408 |
| Other study ID # |
Effect of breast milk feeding |
| Secondary ID |
|
| Status |
Not yet recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
June 1, 2023 |
| Est. completion date |
September 1, 2024 |
Study information
| Verified date |
April 2023 |
| Source |
Assiut University |
| Contact |
Mohamed Mohsen |
| Phone |
01099229464 |
| Email |
m.mohsen.doc[@]gmail.com |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Globally, the estimated preterm birth rate is estimated at 10.6% of all live births, or about
14.8 million infants per year. Breastfeeding is associated with a reduction of risk for
several acute and chronic diseases in women and their infants, and the benefits are
especially important for small, sick and preterm infants. Important benefits of breastmilk
provision for premature and fragile infants including a reduction of the risk for late-onset
sepsis, necrotizing enterocolitis, and ventilator-associated pneumonia.
In 2020, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF)
released The Baby friendly Hospital Initiative (BFHI) for small, sick and preterm newborns.
Based on the evidence put forward in this document,this review outlines the main steps that
health care professionals and facilities can take to support breastfeeding in vulnerable
groups of infants. The objective of this study is to summarize essential steps for healthcare
personnel and health care facilities to improve breastfeeding practices in small, sick and
preterm infants.
Description:
Globally, the estimated preterm birth rate is estimated at 10.6% of all live births, or about
14.8 million infants per year. Breastfeeding is associated with a reduction of risk for
several acute and chronic diseases in women and their infants, and the benefits are
especially important for small, sick and preterm infants. Important benefits of breastmilk
provision for premature and fragile infants including a reduction of the risk for late-onset
sepsis, necrotizing enterocolitis, and ventilator-associated pneumonia.
In 2020, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF)
released The Baby friendly Hospital Initiative (BFHI) for small, sick and preterm newborns.
Based on the evidence put forward in this document,this review outlines the main steps that
health care professionals and facilities can take to support breastfeeding in vulnerable
groups of infants. The objective of this study is to summarize essential steps for healthcare
personnel and health care facilities to improve breastfeeding practices in small, sick and
preterm infants.
Breastfeeding initiation and skin-to-skin care Providers should support all mothers and
infants with immediate skin-to-skin care (SSC) after birth and assist mothers to initiate
breastfeeding (or breastmilk expression and feedings) as soon as possible. A systematic
review and meta-analysis on very early breastfeeding initiation and neonatal mortality in
136,047 infants found that breastfeeding initiation 2_23 h after birth was associated with a
33% higher risk of mortality compared to breastfeeding initiation _1 h after birth, however
potential confounding by factors such as health challenges causing both delayed initiation
and increased mortality needs to be considered.
Skin-to-skin care improves breastfeeding rates in very preterm infants. In infants with
low-birth weight, evidence from a Cochrane review supports the use of skin to skin care for
reduction of both infant mortality and morbidity, especially in low income settings.
Skin-to-skin care helps to stabilize infants' body temperature and blood sugar and helps to
reduce infant procedural pain, even in very preterm neonates.It also stabilizes preterm
infants' respiratory function, which isthought to be guided by the caregiver's cardiac
rhythm. Compared to incubator care, cerebral oxygenation and other physiological parameters
in ventilated preterm infants has not been shown to become more unstable during SSC with
their mothers.Skin-to-skin contact has positive effects on the neonate's microbiome through
population of the neonate's skin with beneficial bacteria and has been shown to decrease the
risk of nosocomial infections. Regular and prolonged SSC can reduce the risk of
hospital-acquired infections, bronchopulmonary dysplasia and cholestasis in a dose-dependent
fashion, even in very preterm infants.
Responsive (on-demand) breastfeeding means following an infant's feeding cues to guide
feeding times. If the infant does not have contraindications to enteral feeding,
breastfeeding or feeding of expressed human milk can be initiated as soon as the infant has
stable vital signs, which most of the time can begin within the first few hours of
life.Because preterm infants are neurologically immature, responsive feeding may not be
possible initially. However,as preterm infants mature, semi-demand feeding can be started,
which means that breastfeeding is initiated in response to infant cues, but ended when the
infant stops suckling.
Exclusive breastfeeding rates for premature infants have been shown to drop significantly
after discharge. Healthcare teams can support families through connecting them to clinical
and community-based referrals after hospital discharge (e.g. paediatricians , lactation
consultants, breastfeeding peer support groups). Beyond referrals, healthcare professionals
should bear in mind that the hospitalization period for small, sick or preterm neonates may
pose challenges to bonding and attachment and parents' confidence as caregivers. Therefore,
preparing parents for bringing fragile infants home is essential.Qualitative studies with
parents of neonates have demonstrated that parents value dialogue and timely communication
with the healthcare team prior to discharge. These studies underline the importance of
including support persons (fathers or partners) in conversations and planning for the
transition home.Preterm infants exclusively breastfed after discharge are at increased risk
of low lean body mass and low bone mineral density, and continued provision of fortifier in
addition to breastfeeding after discharge.
