Prolactin level and breastmilk production among mothers of low-birth-weight Infants admitted to level II Neonatal Intensive Care Unit

Background@#Kangaroo mother care (KMC) has been proven by several studies to promote breastfeeding, but many of the studies focus on the success of exclusive breastfeeding, and less on its galactogenic effects. @*Objective@#We aim to determine the maternal serum prolactin levels and breastmilk volume of mothers who rendered KMC to their infants. @*Materials and Methods@#This is a randomized controlled, open-labeled, interventional study in the Neonatal Intensive Care Unit of a tertiary government hospital. Infants weighing < 2000 grams admitted in NICU Level II, together with medically stable mothers and no contraindication for breastfeeding were simultaneously enrolled. Primary outcome measures were maternal serum prolactin levels and expressed milk volume on day 3 and day 7 postpartum. Two-sample t-test was used to compare groups, and paired t-test to compare within groups. Tests were two-tailed, with a p-value of < 0.05 considered statistically significant. @*Trial Registration@#Australia-New Zealand Clinical Trial Registry ID ACTRN12614000218695 @*Results@#Fifty mother-infant dyads were equally allocated into KMC and control groups (p < 0.001). There was significantly larger milk volume on the third day (29.6 ± 27.8 mL vs 16.3 ± 26.1 mL; p < 0.001) and seventh post-partum day (72.4 ± 62.3 mL vs 47.3 ± 43.8 mL; p < 0.000). There were increased serum prolactin levels compatible with post-partum state. The increase was more evident in the KMC (5244 ± 2702 mIU/L, on the 3rd postpartum day versus 4969 ± 2426 mIU/L, on the 7th postpartum day, p = 0.996) compared to control group (4129 ± 2485 mIU/L on the 3rd postpartum day versus 3705 ± 2731 mIU/L on the 7th postpartum day, p = 0.301). @*Conclusion@#We noted a significantly larger milk volume in the KMC group. There was also a greater increase in the prolactin levels in the KMC group, but this did not reach statistical significance. Further studies should be done to determine mechanism of galactogenesis through KMC.

Neurologic outcome of Filipino children diagnosed with central nervous system infection

@# Neurologic infections are related to chronic and life-long neurologic impairment. We aim to describe the outcomes of Filipino children with neurologic infections upon, and within one year from discharge. This data will be useful in developing programs for the prevention and improvement of outcomes in children with neurologic infections. Methods: This is a multicenter, cross-sectional, retrospective cohort study at six tertiary hospitals across the Philippines within four years (2007-2010). A standardized report form was used to collect clinical profile and outcome using inpatient and outpatient records. Neurologic outcome was classified and staged at 3-, 6-, 9- and 12-months postdischarge. Results: A total of 480 patients were included in the analysis (mean age 4.7 ± 5.3 y), most were bacterial in etiology (275 cases, or 57.3%). Severity of illness on admission (Stage 3, p <0.001) and etiologic agent (viral, p <0.001) were correlated with poor neurologic outcome on discharge. Of the 154 patients that had follow-up, 91 cases were observed to have neurologic deficits (severe, 50; moderate, 29; and mild 12). Twenty patients had improvement of neurologic impairment on subsequent follow-up. Motor deficits (64 cases), cognitive disorders (26 cases) and seizures (17 cases) are the most common neurologic sequela

The burden of congenital rubella syndrome in the Philippines: results from a retrospective assessment

Introduction: In line with the regional aim of eliminating rubella and congenital rubella syndrome (CRS), phased introduction of rubella-containing vaccines (RCV) in the Philippines’ routine immunization programme began in 2010. We estimated the burden of CRS in the country before widespread nationwide programmatic RCV use. Methods: We performed a retrospective chart review in four tertiary hospitals. Children born between 1 January 2009 and 31 December 2014 and identified as possible CRS cases based on the presence of one or more potential manifestations of CRS documented in hospital or clinic charts were reviewed. Cases that met the clinical case definition of CRS were classified as either confirmed (with laboratory confirmation) or probable (without laboratory confirmation). Cases that did not fulfil the criteria for either confirmed or probable CRS were excluded from the analysis. Results: We identified 18 confirmed and 201 probable cases in this review. Depending on the hospital, the estimated incidence of CRS ranged from 30 to 233 cases per 100 000 live births. The estimated national burden of CRS was 20 to 31 cases per 100 000 annually. Discussion: This is the first attempt to assess the national CRS burden using in-country hospital data in the Philippines. Prospective surveillance for CRS and further strengthening of the ongoing measles-rubella surveillance are necessary to establish accurate estimates of the burden of CRS and the impact of programmatic RCV use in the future.