Feeding practices of stable term and late preterm neonates born at a Tertiary Hospital in the Philippines during the COVID-19 Pandemic

Objective@#We aimed to evaluate the impact of maternal COVID-19 infection and separation of the mother-baby dyad on feeding practices by determining modes of feeding upon discharge and following up at 2-3 days, 14 days, and 1 month post-discharge.@*Methods@#This was a prospective observational cohort study conducted at the Philippine General Hospital, a tertiary government COVID-19 referral center in Manila. Mothers who delivered between the months of July and August 2021, and whose COVID-19 status was known were followed up on their baby’s mode of feeding at 2-3 days, 14 days, and 1 month post-discharge via phone call. For babies of COVID-19 positive mothers, presence of any symptoms (up to the 14-day time point only) as well as adherence to infection prevention and control practices were also identified.@*Results@#For all time points post-discharge, breastfeeding rates were higher in babies born to COVID-19-negative mothers and in those who were roomed in. However, the differences were not statistically significant. Of the 108 infants, 72.90% remained exclusively breastfed by 1 month of age, with 4.67% formula-fed and 22.43% on mixed feeding. Perception of insufficient milk supply was the most common reason for shifting to formula or mixed feeding. We found a significantly higher direct breastfeeding rate upon discharge in the roomed-in population compared to those admitted to the NICU. Risk factors affecting breastfeeding at 1 month of age was the presence of COVID-19 infection in the mother and mother-baby separation due to NICU admission COVID-19-positive mothers were 66.02% less likely (p=0.016, 95% CI 0.1411 to 0.8183) to still be breastfeeding at 1 month, and separation was not found to be a significant risk factor.@*Conclusions@#Feeding practices can be affected not only by COVID-19 infection in the mother and its attendant difficulties such as prolonged hospital stay and physical and social isolation, but also by limitations in the hospital environment that can have an impact on breastfeeding education, support, and opportunities for mother-child bonding.

Effectiveness of kangaroo mother care in reducing morbidity and mortality among preterm neonates on nasal continuous positive airway pressure: A randomized controlled trial

Background@#Prematurity is a major cause of neonatal death. Continuous positive airway pressure (CPAP) is the recognized initial intervention among preterm neonates in respiratory distress. Kangaroo mother care (KMC) may help improve neonatal outcomes. @*Objective@#To determine the effectiveness of KMC in reducing morbidity and mortality among preterm neonates on CPAP via RAM nasal cannula (nCPAP). @*Methods@#A prospective, non-blinded, randomized controlled trial was conducted on eligible preterm neonates requiring nCPAP due to respiratory distress. They were randomly allocated to either KMC (n=35) or conventional care groups (n=35). Outcome measures included duration of nCPAP and oxygen support, physiologic parameters, morbidity, mortality, and length of hospital stay. @*Results@#The durations of nCPAP and oxygen support were both significantly shorter in the KMC group. Morbidities (air leak syndrome, necrotizing enterocolitis, and late-onset sepsis) were also significantly lower in the KMC group. Although the mortality rate and the hospital stay were lower in the KMC group, these were not statistically significant. @*Conclusion@#KMC effectively decreased the duration of nCPAP and oxygen support, as well as the incidence of neonatal morbidities. There were trends towards reduced mortality and length of hospital stay in the neonates who received KMC.