Donor human milk largely replaces formula-feeding of preterm infants in two urban hospitals.

OBJECTIVE: To determine acceptance of donor human milk (DM) for feeding preterm infants and whether offering DM, alters mothers' milk (MM) feeding. STUDY DESIGN: Infant feeding data were collected from medical records of 650 very preterm infants enrolled between 2006-2011 in two hospital level III neonatal intensive care units (NICUs) in Cincinnati, Ohio. The study was conducted during the implementation of a program offering 14 days of DM. RESULT: From 2006-2011, any DM use increased from 8 to 77% of infants, largely replacing formula for the first 2 weeks of life; provision of MM did not change. DM was more likely to be given in the first 2 weeks of life, if infants never received MM or were >1000 g birth weight, but DM use did not differ by sociodemographic factors. CONCLUSION: Offering DM dramatically increased human milk feeding and decreased formula use, but did not alter MM feeding in hospital.

Leisure-dance instruction for severely and profoundly retarded persons: teaching an intermediate community-living skill.

We evaluated an approach for teaching an intermediate community living skill via a leisure-dance activity to institutionalized severely and profoundly retarded persons. The targeted skill was considered as intermediate in contrast to a community living skill per se because it was based on successful performances of higher functioning, noninstitutionalized retarded persons as opposed to nonhandicapped individuals. Definitions for appropriate dancing were established and then validated through observations of the performance of retarded persons living in the local community. The dance skills were then taught to four participants through serial training in leg movements, arm movements, and coordinated leg and arm movements, plus follow-up trainer supervision. Generalization was also programmed by way of multiple trainers and training settings. Results during structured assessments showed that all four residents acquired the dance skills and that both serial training and follow-up supervision were necessary for skill acquisition. Generalized increases in appropriate dancing at dances attended by the participants and retarded persons from the community were also demonstrated. However, in most cases some active supervision by caregivers was needed to enhance the generalized improvements. Results are discussed in terms of the applicability of this approach for validating goals when training other community-related skills to low-functioning populations.