Breastfeeding and Readmission for Hyperbilirubinemia in Late Preterm and Term Infants in Beirut, Lebanon

Objective: To determine whether exclusive breastfeeding is associated with readmission of jaundiced newborns. Methods: We retrieved medical records of 51 consecutive neonates >35 weeks with jaundice who were readmitted to the hospital, and compared to 164 controls. Data on gender, gestational age, birth weight, mode of delivery, feeding, bilirubin levels and breastfeeding counseling were analyzed. Results: 24% babies were readmitted for hyperbilirubinemia reaching phototherapy level. Early term infants had significantly higher risk for readmission compared to term [OR (95% CI) 2.12 (0.99-4.53); P= 0.05]. The risk of readmission was lower amongst subjects receiving mixed/formula feeding [OR (95% CI) 0.51 (0.26-0.98); P=0.046] odds of readmission decreased for those feeding >8 times per day (OR (95% CI) 0.46 (0.23-0.91); P=0.016], and those who stayed in hospital for more than 2 days after birth [OR (95% CI) 0.95(0.93-0.97); P<0.001]. Conclusions: Ensuring feeding at least 8 times per day and keeping newborns beyond the first 24 hours decreases the chance of readmission.

Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial

INTRODUCTION@#Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump.@*METHODS@#Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein.@*RESULTS@#Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls.@*CONCLUSION@#LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.

Risk factors for delayed breastfeeding initiation based on decision tree model and logistic regression model / 中南大学学报(医学版)

Objective:To determine influential factors for delayed breastfeeding initiation.Methods:Using questionnaires to collect the data of 950 pregnant women and infants' feeding practices in Changsha,Hunan,logistic regression and decision tree model were used to determine influential factors for delayed breastfeeding initiation.Results:Mothers with timely breastfeeding initiation were 594 (62.5％),and those with delayed breastfeeding initiation accounted for 356 (37.5％).Mothers with timely breastfeeding initiation were more likely to use exclusive breastfeeding than those with delayed breastfeeding initiation (P＜0.05).Four risk factors were found by logistic regression model and decision tree model,including cesarean delivery,using feeding-bottle before breastfeeding initiation,falling ill,and vomiting during pregnancy.Receiver operating characteristic curve showed no significant difference in the predictive effect of the 2 models (Z=0.142,P=0.889).Conclusion:Cesarean delivery,using feeding-bottle before initiation of breastfeeding,and poor physical condition during pregnancy exert negatively effects on breastfeeding initiation.Health workers should help mother to timely initiate breastfeeding and enhance their confidence in exclusive breastfeeding.