Effect of mother-infant early skin-to-skin contact on breastfeeding status: a randomized controlled trial

To evaluate the effect of mother-infant early skin-to-skin contact on breastfeeding behavior of infants. A randomized controlled trial. The study was conducted in the Department of Obstetrics of Pakistan Institute of Medical Sciences, Islamabad, from November to December 2009. Eligible mothers were assessed for the successful breastfeeding by using IBFAT tool. The time to initiate the first feed, time to effective breastfeeding, maternal satisfaction with the care provided, preference for the same care in future and level of exclusive breastfeeding at the age of one month were also noted. The data was compared by using X[2] and t-test. Significant p-value was taken as < 0.05. A total of 183 mother-infant pairs [92 in skin-to-skin care [SSC] group and 91 in conventional care [CC] group] were analyzed for breastfeeding behavior of the infants. The first breastfeed was 26.25% more successful in SSC group [58.8% in SSC group as compared to 32.5% in CC group with p-value of 0.001]. In SSC group, the mean time to initiate first breastfeed was 61.6 minutes shorter than CC group [40.62 vs. 101.88; p < 0.001]. Mean time to achieve effective breastfeeding was 207 minutes earlier in SSC group [149.69 vs. 357.50; p < 0.001]. The level of satisfaction in the mothers of SSC group was significantly high as compared to controls [56% vs. 6.2%]. Similarly, 53.8% mothers of SSC group showed preference for similar care in future as compared to 5% in CC group. In SSC group 85.3% infants were exclusively breastfed at one month as compared to 65.7% in CC group [p=0.025]. Maternal-infant early skin-to-skin contact significantly enhanced the success of first breastfeed and continuation of exclusive breastfeeding till one month of age. It also reduced the time to initiate first feed and time to effective breastfeeding

Ophthalmia neonatorum

To measure the frequency of ophthalmia neonatorum among all babies born in MCH Center, PIMS [Pakistan Institute of Medical Sciences], Islamabad, in one month's time and to determine their causative organisms. An observational study. The MCH Center, PIMS, during the month of November 2008. All babies born from 1st to 30th November, 2008 in the MCH Center, PIMS, Islamabad, Pakistan were included in the study. All babies were examined for signs of conjunctivitis on days 1, 3, 7, 14, 21 and 28 of life. Conjunctival swabs were taken for gram staining and culture from those with clinical diagnosis of conjunctivitis. Frequency of known maternal and neonatal risk factors for the disease were assessed. Proportions were compared using chi-square test with significance at p <0.05. Seventeen percent of the 1010 babies developed conjunctivitis. Staphylococcus aureus [65% of all positive cultures] was the most common causative organism. No case of gonococcus was isolated. Meconium stain liquor [p=0.004] and caesarain section [p <0.001] were found to be the most frequent associated conditions in conjunctivitis. There was a high frequency of neonatal conjunctivitis, with Staphylococcus aureus as the most common causative agent. Poor hygienic conditions and practices could be an important risk factor in Pakistan

study of neonatal aerobic bacterial septicemia

Septicaemia is an important cause of morbidity and mortality in neonates. A study was done at the Pakistan institute of Medical Sciences [PIMS], Islamabad to identify the commonly responsible aerobic bacteria causing septicaemia and finding their sensitivity to antimicrobials which could help in reducing mortality and morbidity in neonates. During one year [November 1991 to October 1992], 81 clinically suspected cases of neonatal septicaemia were investigated by performing blood culture. Forty-five organisms were isolated from 44 blood culture positive cases. Klebsiella was the most frequent and isolated from 28 patients [62%] followed by staphylococcus coagulase-negative [8.9%], staphylococcus aureus [6.7%] and Escherichia cloi [6.7%]. One case each of Pseudomonas aeruginosa, Proteus mirabilis and Salmonella spp. was isolated. Klebsiella pneumoniae were multiple-drug resistant. They were sensitive to amikacin [89%], ceftazidime [70%] and cefotaxime [52%]. Other isolates also demonstrated a similar pattern of sensitivity