Water consumption in 0-6-month-old healthy infants and effective factors: A systematic review / Consumo de agua en lactantes sanos de cero a seis meses y factores efectivos: una revisión sistemática

Introduction: Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which may, in turn, affect their nutritional and immune status. Objective: This study was carried out to determine water consumption in 0-6-month-old infants and the factors affecting this consumption. Materials and methods: A literature review was conducted in seven electronic databases (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library, and TÜBITAK) for studies published until April 25, 2022, using the keywords: drinking water, infant, and breastfeeding. Results: The systematic review included 13 studies. Five studies were crosssectional, three were descriptive and quasi-experimental, and the others were case-control and cohort studies. It was reported in the examined studies that 86.2% of the infants were around 6 weeks old, 44 % of the infants were 1 month old, 77% were 3 months old, 2.5% were 4 months old, and 2.5 to 85% of the infants were around 6 months old when they first consumed water. The prominent reasons for making the infants drink water are the thought that they need it and cultural reasons. Conclusions: The exclusive breastfeeding of 0-6-month-old infants is the recommendation of reliable health authorities. Nurses play a key role in implementing this practice. In this systematic review, it was seen that families gave their infants water at varying rates in the 0-6-month period, and the factors affecting this situation were revealed. If nurses determine which factors affect families in terms of the early introduction of fluids, they could be able to plan the necessary education and interventions.

Introducción. La introducción temprana de líquidos y agua afecta la duración de la lactancia, el sistema inmune del lactante y posiblemente hace que los lactantes consuman menos leche materna, lo que a su vez puede afectar su estado nutricional e inmunitario. Objetivo. Este estudio se realizó para determinar el consumo de agua en bebés de cero a seis meses y los factores que inciden en este consumo. Materiales y métodos. Se hizo una revisión de la literatura en siete bases de dato electrónicas (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library y TÜBITAK) para estudios publicados hasta el 25 de abril de 2022, utilizando las palabras clave: agua potable, lactante y lactancia. Resultados. La revisión sistemática incluyó 13 estudios. Cinco fueron estudios transversales, tres fueron descriptivos, cuasiexperimentales y los restantes fueron estudios de casos y controles, y de cohortes. En los estudios examinados se informó que le dieron agua al 86,2 % de los lactantes de seis semanas, al 44 % de los lactantes de un mes, al 77 % de los lactantes de tres meses, al 2,5 % de los lactantes de cuatro meses y al 2,5 % a 85 % de los lactantes de seis meses. Las razones principales para dar agua a los bebés son la idea de que los bebés necesitan agua y razones culturales. Conclusiones. La lactancia materna exclusiva es la recomendación de las autoridades sanitarias para los bebés de cero a seis meses. Las enfermeras juegan un papel clave en la implementación de esta práctica. En esta revisión sistemática se observó que las familias daban agua a sus bebés en proporciones variables durante el período de cero a seis meses y se revelaron los factores que inciden en esta situación. Si las enfermeras determinan qué factores afectan a las familias en cuanto a la introducción temprana de líquidos, podrían planificar las medidas educativas y las intervenciones necesarias.

The Effect of Breastfeeding and an Intensive Breast Milk Nutritional Support Program on Hospitalization Rates for Hyperbilirubinemia in Term Newborns: An Open Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to determine the effect of breastfeeding and intensive breast milk nutritional support program (IBNSP) on hospitalization rates for hyperbilirubinemia in normal term newborns. METHODS: This study's sample consisted of 68 newborn infants (experimental group: 34; control group: 34) born at a university hospital from October 2020 to April 2021. Five steps of breastfeeding and IBNSP were administered to the experimental group for the first 48 h after birth. This program starts at the postpartum first hour and continues until the 48th hour. It includes face-to-face training, practical support on breastfeeding, and one-to-one demonstration and practice methods. The control group received the standard care recommended by the World Health Organization. Both groups' bilirubin levels were measured 24 and 72 h after birth. Participants in both groups were hospitalized for risky (according to bilirubin values) situations. The groups' bilirubin levels and hospitalization rates for hyperbilirubinemia were compared. RESULTS: There was no statistically significant difference between the experimental (5.19 ± 1.27) and the control (5.83 ± 1.52) groups' bilirubin levels at 24 h after birth, (t = -1.881, p = 0.064); however, the control group infants (12.03 ± 3.67 mg/dl) had higher bilirubin levels than the infants in the experimental group 72 h after birth (9.55 ± 2.82 mg/dl) (t = -3.122, p = 0.003). The experimental group's hospitalization rate for hyperbilirubinemia (n: 1, 2.9%) was lower than the control group's rate (n: 8, 23.5%), and this difference was statistically significant (X2 = 6.275, p = 0.014). CONCLUSIONS: Breastfeeding and IBNSP effectively prevent hospitalization for hyperbilirubinemia and reduce newborns' bilirubin levels.

Clinical characteristics of confirmed COVID-19 in newborns: a systematic review.

OBJECTIVE: Aim of this systematic review is to investigate the available evidence describing neonatal outcomes in newborns who have SARS-CoV-2 infection in order to guide prevention of COVID-19 in newborns. METHODS: This is the study protocol for a systematic review. MEDLINE, Web of Science, PubMed, Science Direct, CINAHL, Scopus, Cochrane, TUBITAK databases, and key words of "Newborn" (neonatal OR clinical characteristics newborn OR infants less than 1 month OR infants less than 28 weeks OR Neonate) AND "clinical presentation" (epidemiology OR symptoms OR clinical course OR features) AND "COVID-19" (Coronavirus OR COVID-19 OR Sars-Cov2 OR coronavirus disease 2019 OR Novel Coronavirus OR 2019-nCoV) were searched for this systematic review. Randomized controlled trial, cross-sectional, case-control, and case reports, case reports examining neonatal outcomes in newborns who have SARS-CoV-2 infection were included. Studies were selected according to criteria around the population, intervention, comparator, outcome(s) of interest, and study design (PICOS framework). All citations and full-text articles were searched by independent five authors. The population that newborns with COVID-19 that confirmed within 28 d of birth are included. The interventions included in COVID-19 infection diagnosed via reverse transcription-polymerase chain reaction (RT-PCR) or serological. The primary outcomes were Neonatal clinical outcomes. The methodological quality of the studies was appraised using appropriate tools. Strength of the body of evidence was assessed according to the quality assessment tool for quantitative studies (QATQS). RESULTS: The electronic search identified 1051 records that were examined, after evaluating 35 of them were included in the study. Seven studies were research articles and twenty-eight were case reports. Methodological quality was medium. Most of the clinical characteristics of newborns were respiratory difficulty and secondly fever. Some newborns gastrointestinal (GIS) symptoms in the form of diarrhea and feeding intolerance and abdominal distension were present in 50%. The fatality case did not exist in any newborn due to COVID-19. Death occurred in one case due to prematurity. CONCLUSIONS: The most common symptoms in patients with COVID-19 infection in the neonatal period are respiratory tract symptoms and fever. It has been observed that the COVID-19 infection detected in the neonatal period is not fatal. However, data including more cases are needed.

The effect of nurse support and social support on fatigue experienced by mothers whose children are hospitalized.

The authors' aim in this study was carried out to determine the effect of social support and nurse support on fatigue experienced by mothers whose children were hospitalized. This is a descriptive, analytical and cross-sectional research study. Our study population consisted of all the mothers (n = 198) who had children hospitalized in the pediatric services of the public and training and research hospitals. Data were collected using a questionnaire, Nurse Parent Support Tool, Multidimensional Scale of Perceived Social Support and Brief Fatigue Inventory. Our finding the mothers accompanying their hospitalized children who received adequate nurse support were found to have less maternal fatigue.

Investigation of the Effect of Human Milk Expression Techniques on Milk Content: A Systematic Review.

BACKGROUND: If the mother and infant cannot meet after birth, it is recommended to express milk and give it to the infant. There was evidence indicating that there might be decrease in essential nutrient values in human milk content depending on the expression technique in literature. The goal of this systematic review was to investigate the effect of human milk expression techniques on the macronutrient milk content and establish an evidence base for future studies. METHODS: Studies investigating the effect of human milk expression techniques on milk content were reviewed without year limitations. A literature review was conducted in six electronic databases (MEDLINE, Web of Science, PubMed, ScienceDirect, CINAHL and Cochrane) until 30 May 2021, using the keywords of breast milk expression techniques, milk content and breast milk pumping. RESULTS: From 258 articles initially screened, we included 6 articles in the systematic review. The fat, protein and lactose content of human milk was analyzed in the studies reviewed. It was concluded that there was no significant effect on the protein (9.7-9.8 g/dl and 2.1-2.1 g/dl, respectively) and lactose (6.50-6.53% and 6.1-6.1 g/dl, respectively) content of milk. However, the fat (58.30, 48.81g/l; 2.6-2.2 g/dl) content was affected. CONCLUSIONS: This study investigated the effect of milk expression techniques on the macronutrient content of human milk, and it was concluded that there was no significant effect on the protein and carbohydrate content of milk. However, the fat content was affected. Limitation of this study is that some factors that might affect the content of human milk were not standardized sufficiently in the included studies.

An investigation of the relationship between mother's personality traits, breastfeeding self-efficacy, and perception of insufficient milk supply.

The researchers planned this study as a descriptive-correlational study to determine the relationship between mothers' personality traits, breastfeeding self-efficacy, and perception of insufficient milk supply. This descriptive, cross-sectional, and analytical study involved 429 mothers in Turkey's Sakarya province who applied to a training and research hospital between February-June 2020. It was found that self-control and openness to development affected breastfeeding self-efficacy positively, while neuroticism affected breastfeeding self-efficacy negatively (p < 0.05). Breastfeeding self-efficacy had a significant negative effect on the perception of insufficient milk supply (p < 0.001). Breastfeeding self-efficacy is an important determinant of the amount of milk perceived by mothers.