Oil massage in neonates: an open randomized controlled study of coconut versus mineral oil.

INTRODUCTION: Oil massage for newborns is reported to improve weight gain by better thermoregulation. A role for transcutaneous absorption has also been suggested. AIMS AND OBJECTIVES: This study was undertaken to compare the effect of massage with coconut oil versus mineral oil and placebo (powder) on growth velocity and neuro-behavior in well term and preterm babies. STUDY DESIGN: Open Randomized Controlled trial. SETTING: The Premature unit and the postnatal wards of a major teaching hospital in a metropolitan city. MATERIAL AND METHODS: Intramural preterm appropriate for gestational age babies weighing between 1500 to 2000 grams and term births weighing more than 2500 grams fulfilling the inclusion criteria constituted the two gestation age categories studied. Babies in each group were randomized to receive massage with either coconut oil, mineral oil or with placebo. Oil massage was given by a trained person from day 2 of life till discharge, and thereafter by the mother until 31 days of age, four times a day. Babies were followed up daily till discharge and every week after discharge for anthropometry. Neuro-behavioral outcome was assessed by the Brazelton Score at baseline, day 7 and on day 31. RESULTS: Coconut oil massage resulted in significantly greater weight gain velocity as compared to mineral oil and placebo in the preterm babies group; and in the term baby group, as compared to the placebo. Preterm infants receiving coconut oil massage also showed a greater length gain velocity compared to placebo group. No statistically significant difference was observed in the neurobehavioral assessment between all three subgroups in term babies as well as in preterm babies.

Transcutaneous absorption of oil in preterm babies--a pilot study.

This study was conducted to determine transcutaneous absorption of oil in preterm neonates. A mixture of coconut oil and Meadowfoam oil which contains unique fatty acids, which acted as marker fatty acids was applied to the skin of babies. One mL blood was collected before and one hour after post oil application. Both pre and post oil application serum samples were hydrolysed and derivatised with 2-phenyl hydrazine hydrochloride in order to detect fatty acids by HPLC analysis on C-8 column. None of the pre oil application serum sample showed the presence of the marker fatty acids. The post oil application serum sample of all the 12 babies showed the presence of marker fatty acids of Meadowfoam oil which indicates transcutaneous absorption of oil in preterm babies.

Feasibility of kangaroo mother care in Mumbai.

OBJECTIVE: The purpose of this study was to determine the feasibility and acceptability of kangaroo care in a tertiary care hospital in India. METHODS: A randomized controlled trial was performed over one year period in which 89 neonates were randomized into two groups kangaroo mother care (KMC) and conventional method of care (CMC). RESULTS: Forty-four babies were randomized into KMC group and 45 to CMC. There was significant reduction in KMC vs CMC group of hypothermia (10/44 vs 21/45, p-value < 0.01), higher oxygen saturations (95.7 vs 94.8%, p-value < 0.01) and decrease in respiratory rates (36.2 vs 40.7, p-value < 0.01). There were no statistically significant differences in the incidence of hyperthermia, sepsis, apnea, onset of breastfeeding and hospital stay in two groups. 79% of mothers felt comfortable during the KMC and 73% felt they would be able to give KMC at home. KMC is feasible, as mothers are already admitted in hospitals and are involved in the care of newborn. CONCLUSION: KMC is a simple and feasible intervention; acceptable to most mothers admitted in hospitals. There may be benefits in terms of reducing the incidence of hypothermia with no adverse effects of KMC demonstrated in the study. The present study has important implications in the care of LBW infants in the developing countries, where expensive facilities for conventional care may not be available at all place.

Effects of tactile-kinesthetic stimulation in preterms: a controlled trial.

BACKGROUND: To determine the effects of tactile-kinesthetic stimulation to preterms on physiologic parameters, physical growth and behavioral development. DESIGN: Controlled trial. SETTING: The premature unit (growing nursery) of a large, teaching hospital. SUBJECTS: 48 well preterms with birth weights between 1000-2000 grams. INTERVENTION: The neonates were systematically allocated into test and control groups. Test babies received tactile-kinesthetic stimulation in the form of a structured baby massage from day 3 to term corrected age. They were observed for changes in vital parameters (heart rate, respiration, temperature and oxygen saturation) during the first few days of stimulation in hospital. Thereafter, massage was continued at home. Changes in weight, length and head circumference and neuro-behavior (Brazelton Neuro-Behavioral Assessment Scale) were assessed in both groups before, during and after the study period. RESULTS: An increase in heart rate (within physiologic range) was seen in the test group during stimulation. This group also showed a weight gain of 4.24 g/day more than controls, which was statistically significant. On the Brazelton Scale the test group showed statistically significant improved scores on the "orientation", "range of state", "regulation of state" and "autonomic stability" clusters at follow-up. No significant complications were noted. A positive correlation was found between the duration of stimulation in days and the weight gain in grams but this did not reach statistical significance. CONCLUSIONS: Tactile-kinesthetic stimulation when administered to well, preterm infants has a beneficial effect on growth and behavioral development with no adverse effects on physiologic parameters.

Hepatic hemangioendothelioma of infancy with congestive cardiac failure--report of a case.

A case of infantile hemangioendothelioma of the liver is reported in a 18 day-old male neonate. The neonate presented with CHF. He had hepatomegaly, but lacked the third component of the classical triad i.e. cutaneous hemangiomas. The S.A.F.P levels were raised to 920 ng/ml, though rise is rare in infantile hemangioendothelioma and led to the clinical diagnosis of hepatoblastoma. A left hepatic resection was performed, the histology showed a type I pattern of the tumor. This is known to be associated with a good prognosis. The baby is well post resection for a follow up period of six months.

Lactation management clinic-positive reinforcement to hospital breastfeeding practices.

Supportive breastfeeding policies in the hospital constitute the foundation for initiation of successful breastfeeding by mothers, constant reinforcement and support to all lactating mothers is however essential to maintain lactation. The objective, methodology and outcome of the Lactation Management Clinic which constitutes a hospital-based mother support group is described. The study was carried out over a period of 2 1/2 years and 519 mothers had attended this clinic. Analysis of the data revealed that at the time of the 1st visit to the clinic, 65.9% mothers had already started supplementary top feeds and the commonest reason encountered was mother's own assessment of inadequate milk seen in 73.6% mothers. Two-thirds (66.9%) of babies in our study were roomed in right from the first day of life, 75.3% of babies had received colostrum and 67.1% babies had not received any prelacteal feeds and yet faced problems at lactation. Mother and infant evaluation revealed no complications with 86.5% mothers and with 54.5% babies. Local breast problems were detected in 19.3% mothers. Faulty positioning was observed in 47.2% patients. Psychological support to mothers was the most important form of therapy given. Seventy eight per cent mothers practiced exclusive breastfeeding subsequently while 21.2% of mothers were partially successful in lactation. Only 3 mothers had lactation failure.