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Post-operative Ultrashort Bowel Syndrome in a Term Neonate: One-year Follow-up 一名足月新生儿术后超短肠综合征:一年随访
Q4 Medicine Pub Date : 2024-06-12 DOI: 10.1177/09732179241256749
Kaushaki Shankar, Bhavya Kukreja, Harsh Wardhan, Vipul Saneja, Vishnu Dutta Agrawal
Ultrashort bowel syndrome occurs when the length of the small bowel is below 10–25 cm, or 10% of that expected for age. It is a rare occurrence in neonates; however, when it occurs, it results in high morbidity and mortality. Surviving newborns face a significant detriment in growth and development due to malabsorption of nutrients. A multidisciplinary approach with aggressive parenteral nutrition is the mainstay of management. Our case presented at 20 days of life, with malrotation and midgut volvulus resulting in post-surgical ultrashort bowel syndrome. In spite of being left with only 20 cm of short bowel, the infant survived on conservative management and is thriving well; the infant has been off parenteral nutrition completely since 11 months of age.
超短肠综合征是指小肠长度低于 10-25 厘米,或低于同龄人预期长度的 10%。超短肠综合症在新生儿中很少发生,但一旦发生,就会导致很高的发病率和死亡率。由于营养吸收不良,存活下来的新生儿在生长发育方面会受到严重影响。多学科方法和积极的肠外营养是治疗的主要手段。我们的病例在出生 20 天时出现肠旋转不良和中肠倒流,导致术后超短肠综合征。尽管婴儿只剩下 20 厘米长的短肠,但经过保守治疗后仍存活了下来,并且生长发育良好;婴儿从 11 个月大开始就完全脱离了肠外营养。
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引用次数: 0
Silent Struggles Beyond Breath: Decoding Hemostatic Dynamics and Bleeding in Neonates Affected by Perinatal Asphyxia 呼吸之外的无声挣扎:解码受围产期窒息影响的新生儿的止血动态和出血情况
Q4 Medicine Pub Date : 2024-06-08 DOI: 10.1177/09732179241256757
Vivek K. V, Minakshi Johari
Perinatal asphyxia, a prevalent neonatal challenge, induces significant hemodynamic perturbations leading to life-threatening bleeding. This study aimed to estimate the incidence of hemostatic dysfunction and characterize bleeding events in neonates with perinatal asphyxia. Secondary objectives included evaluating the relationship between specific components of hemostatic parameters and the severity of bleeding events, along with identifying parameters predicting abnormal bleeding. This observational study, spanning 20 months in the NICUs of S. M. S. Medical College and an attached group of hospitals in Jaipur, enrolled 110 neonates with perinatal asphyxia on whom hemostatic testing was done within 24 hours of birth. The presence of one or more of the following—platelet count < 1 lakh/mm³, PT > 20 seconds, INR > 1.5, aPTT > 45 seconds, and fibrinogen < 150 mg/dl—was defined as hemostatic dysfunction. Bleeding events were assessed for up to 96 hours using the Neonatal Bleeding Assessment Tool and graded by the WHO Bleeding Scale. Among 110 neonates, the incidence of initial hemostatic dysfunction was 70%. Fifty-one neonates (46.3%) experienced bleeding, among whom 5 (9.8%) had minor, 21 (41.18%) had moderate, 15 (29.42%) had major, and 10 (19.6%) had severe bleeding events. Forty-seven neonates (42.72%) received at least one blood product transfusion, with fresh frozen plasma (FFP) being the most common (100%). Neonates with perinatal asphyxia exhibit a high incidence of hemostatic dysfunction, signifying an elevated risk of bleeding and transfusion requirements. While routine hemostatic testing identifies dysfunction, predicting bleeding warrants a search for better investigations. This helps in establishing guidelines for early interventions, which is crucial to reduce mortality risks in these neonates.
围产期窒息是新生儿普遍面临的挑战,会引起严重的血流动力学紊乱,导致危及生命的出血。本研究旨在估算围产期窒息新生儿止血功能障碍的发生率,并描述出血事件的特征。次要目标包括评估止血参数的特定成分与出血事件严重程度之间的关系,以及确定预测异常出血的参数。这项观察性研究在斋浦尔 S. M. S. 医学院和附属医院的新生儿重症监护室进行,历时 20 个月,共招募了 110 名患有围产期窒息的新生儿,对他们在出生后 24 小时内进行了止血检测。出现以下一种或多种情况即被定义为止血功能障碍--血小板计数小于 10 万/mm³、PT > 20 秒、INR > 1.5、aPTT > 45 秒、纤维蛋白原小于 150 mg/dl。使用新生儿出血评估工具对长达96小时的出血事件进行评估,并按照世界卫生组织出血量表进行分级。在 110 名新生儿中,最初止血功能障碍的发生率为 70%。51名新生儿(46.3%)发生了出血,其中5名(9.8%)为轻微出血,21名(41.18%)为中度出血,15名(29.42%)为重度出血,10名(19.6%)为严重出血。47名新生儿(42.72%)至少接受了一次血液制品输注,其中最常见的是新鲜冰冻血浆(FFP)(100%)。围产期窒息的新生儿止血功能障碍发生率很高,这意味着出血和输血需求的风险升高。虽然常规止血检测可识别功能障碍,但预测出血需要寻求更好的检查方法。这有助于制定早期干预指南,对降低这些新生儿的死亡风险至关重要。
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引用次数: 0
Kangaroo Mother Care Foundation, India: Champion Organization Focusing on the Essentials 印度袋鼠妈妈护理基金会:关注本质的冠军组织
Q4 Medicine Pub Date : 2024-06-01 DOI: 10.1177/09732179241257728
Shashi N. Vani
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引用次数: 0
Breast Milk Output and Factors Influencing Sustained Feeding with Mother’s Own Milk in Very Preterm Births: A Prospective Observational Study 极早产儿的母乳产出量和影响母乳持续喂养的因素:前瞻性观察研究
Q4 Medicine Pub Date : 2024-06-01 DOI: 10.1177/09732179241254248
Sruthi Nair, Aditi Shroff, Yadalakshmi Raggala, Sai Kiran Deshabotla, Venkatakeshwarlu Varadhelli, T. Oleti
In very low birth weight infants, mother’s own milk (MOM) feeding is an essential part of the bundle of best practices to reduce potentially preventable neonatal morbidities and associated costs. Mothers of preterm infants can have an altered sequence of lactogenesis because of their preterm delivery and mother–infant separation. Healthy mothers with term infants typically experience coming to volume (CTV), that is, MOM volume of ≥ 500 ml/day, by the end of the second week of postpartum. There is paucity of data regarding MOM output in preterm mothers. To assess MOM output and factors influencing MOM volume among mothers delivering <32 weeks during the first two weeks after birth. To determine the proportion of mothers attaining CTV and whether the first two weeks’ MOM volume predicts MOM feeding at discharge and 40 weeks corrected gestational age (CGA). In this prospective observational study conducted at a tertiary care NICU over a period of 18 months, the milk output of the preterm mothers was quantified, and the proportion of infants fed with MOM at discharge and 40 weeks of corrected age was assessed. The median milk output per day at the end of the first and second weeks was 180 IQR (100, 290) ml and 300 IQR (178, 420) ml, respectively. Earlier initiation of kangaroo mother care, higher birth weight of the infant, increase in the frequency of daytime milk expression and non-nutritive suckling (NNS) contributed to increased MOM output per day. The proportion of mothers who came to volume (milk output of ≥500 ml/day) by day 14 was 26 (19%). The proportion of babies on predominant MOM feeding at discharge and at 40 weeks’ follow-up was 96 (72%) and 75 (61.5%) infants, respectively. Mothers who came to volume were more likely to feed MOM at 40 weeks [odds ratio (OR) 5.2 (1.2–23.0)]. Higher birth weight, more frequency of daytime milk expression, earlier initiation of KMC and NNS and longer duration of KMC are factors improving the MOM output. Mothers who came to volume by the first two weeks after birth sustained feeding with MOM till 40 weeks CGA.
对于出生体重极低的婴儿,母乳喂养是最佳喂养方法的重要组成部分,可降低潜在的可预防的新生儿发病率和相关费用。由于早产和母婴分离,早产儿母亲的泌乳顺序可能会发生改变。有足月儿的健康母亲通常会在产后第二周末出现泌乳量增加(CTV),即产妇泌乳量≥ 500 毫升/天。有关早产儿母亲 MOM 排出量的数据很少。目的:评估分娩周数小于 32 周的产妇在产后两周内的 MOM 排出量以及影响 MOM 排出量的因素。确定达到 CTV 的母亲比例,以及头两周的 MOM 量是否可预测出院时的 MOM 喂养量和 40 周矫正胎龄(CGA)。这项前瞻性观察研究在一家三级护理新生儿重症监护室进行,历时18个月,对早产儿母亲的产奶量进行了量化,并评估了出院时和40周矫正胎龄时以MOM喂养的婴儿比例。在第一周和第二周结束时,每天产奶量的中位数分别为 180 IQR (100, 290) ml 和 300 IQR (178, 420) ml。较早开始袋鼠妈妈护理、婴儿出生时体重较高、日间泌乳次数增加以及非营养性吸吮(NNS)都有助于增加母亲每天的泌乳量。到第 14 天,达到母乳量(母乳量≥500 毫升/天)的母亲比例为 26(19%)。在出院时和40周的随访中,以母乳喂养为主的婴儿比例分别为96(72%)和75(61.5%)。40周时,来量产的母亲更有可能喂母乳[几率比(OR)为5.2(1.2-23.0)]。较高的出生体重、较频繁的日间泌乳、较早开始 KMC 和 NNS 以及较长的 KMC 持续时间是提高 MOM 产奶量的因素。在产后两周内开始挤奶的母亲,其母乳喂养一直持续到产后 40 周。
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引用次数: 0
Assessment of Central Catheter Tip Position in Neonates by Ultrasonography Versus X-ray 用超声波和 X 射线评估新生儿中央导管尖端的位置
Q4 Medicine Pub Date : 2024-06-01 DOI: 10.1177/09732179241254245
Prachi Patwal, Chinmay Chetan, Brajendra Singh, Vinayak Madhukar Jedhe, Girish Gupta, S. Patra
Central catheters are frequently inserted in neonatal intensive care units. The tip of these catheters should be in the correct position; otherwise, it may lead to life-threatening complications. X-ray has been universally used as a standard imaging modality to localize the position of central lines. Ultrasonography is an upcoming promising modality. We compared the catheter tip localization using ultrasonography versus X-ray.
新生儿重症监护室经常要插入中心导管。这些导管的尖端位置必须正确,否则可能导致危及生命的并发症。X 射线已被普遍用作确定中心导管位置的标准成像模式。超声造影是即将出现的一种前景广阔的造影方式。我们比较了超声造影与 X 光的导管尖端定位效果。
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引用次数: 0
Effect of Kangaroo Mother Care on Retinopathy of Prematurity in Neonates Less Than 1,800 g or Below 34 Weeks of Gestation 袋鼠妈妈护理对体重不足 1,800 克或妊娠不足 34 周的早产儿视网膜病变的影响
Q4 Medicine Pub Date : 2024-05-16 DOI: 10.1177/09732179241244567
Chetan Singh, Sugandha Arya, H. Chellani, P. Anand, Richa Singhal
KMC (Kangaroo Mother Care) is an established intervention to reduce mortality and morbidity in low birth weight (LBW) neonates. A multitude of risk factors and preventive strategies for ROP (retinopathy of prematurity) have been studied, however, the effect of KMC on ROP has not been reported. This study aims to study the effect of KMC on ROP in neonates with birth weights between 1,000 and 1,800 g. The babies who received effective KMC (>6 hours per 24 hours for three consecutive days) were analysed in the intervention group and those with ineffective KMC were analysed in the control group. Variables significant in univariate analysis were entered into backward regression models in multivariate analysis. Odds ratios and 95% confidence intervals were calculated. P values < .05 are taken as significant. Of 783 neonates enrolled, 66 (8.4%) developed ROP (any stage). The incidence of ROP requiring intervention was 1.02%. Effective KMC reduced the risk of ROP by 95%, RR 0.05 (0.02–0.12) and number needed to treat = 5. The proportion of neonates with ROP in zone 1 and stage 3 was more in the ineffective KMC (42.4% vs. 1.5%) group than in the effective KMC group (51.5% vs. 0%) ( P < .001). Ineffective KMC, gestation <30 weeks, small for gestation, obstetric complications, asphyxia, sepsis, higher initial PEEP and lack of breastfeeding were significant risk factors for developing ROP. KMC, an effective intervention to improve the mortality and morbidity in LBW neonates, was significantly associated with the reduction of any stage ROP and ROP needing intervention, potentially preventing a significant cause of childhood blindness.
袋鼠妈妈护理(Kangaroo Mother Care)是一种成熟的干预措施,可降低低出生体重(LBW)新生儿的死亡率和发病率。目前已对早产儿视网膜病变(ROP)的多种风险因素和预防策略进行了研究,但有关 KMC 对早产儿视网膜病变的影响尚未见报道。本研究旨在研究 KMC 对出生体重在 1,000 至 1,800 克之间的新生儿视网膜病变的影响。干预组分析了接受有效 KMC(连续三天每 24 小时大于 6 小时)的婴儿,对照组分析了接受无效 KMC 的婴儿。单变量分析中的重要变量被纳入多变量分析的后向回归模型中。计算出比值比和 95% 的置信区间。P 值小于 0.05 为显著。在登记的 783 名新生儿中,有 66 名(8.4%)发生了 ROP(任何阶段)。需要干预的 ROP 发生率为 1.02%。有效的 KMC 可将发生 ROP 的风险降低 95%,RR 为 0.05 (0.02-0.12),需要治疗的人数 = 5。与有效 KMC 组(51.5% 对 0%)相比,无效 KMC 组(42.4% 对 1.5%)患 1 区和 3 期 ROP 的新生儿比例更高(P < .001)。KMC无效、妊娠期小于30周、妊娠期小、产科并发症、窒息、败血症、初始PEEP较高和缺乏母乳喂养是发生ROP的重要风险因素。KMC 是改善低体重新生儿死亡率和发病率的有效干预措施,与减少任何阶段的 ROP 和需要干预的 ROP 有显著相关性,有可能预防儿童失明的一个重要原因。
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引用次数: 0
Effect of One-on-one Structured Counselling of Mothers and Family Members Using GALPAC Technique Compared to Standard Counselling on Post-discharge Kangaroo Mother Care and Related Outcomes in Low-birth-weight Infants: A Quasi-randomised Controlled Trial 使用 GALPAC 技术对母亲和家庭成员进行一对一结构化辅导与标准辅导相比,对低出生体重儿出院后袋鼠妈妈护理及相关结果的影响:准随机对照试验
Q4 Medicine Pub Date : 2024-05-16 DOI: 10.1177/09732179241247931
Bhaswati Ghoshal, Sahay Mondal, Meghna Siddhanta, Shyamal Banerjee
Kangaroo mother care (KMC) improves low-birth-weight neonatal survival. It is recommended for low-birth-weight babies in all settings and should be continued at home as well. Counselling of mothers and family members is necessary for successful initiation and continuation of KMC. This study aims to use the greet, ask, listen, praise, advise, check understanding (GALPAC) method of counselling to improve the outcome of home-based KMC. This quasi-randomised controlled trial was done in 266 stable low-birth-weight neonates born in the hospital. In the intervention group, GALPAC counselling was done by trained nurses and paediatricians during the hospital stay, through telephone after discharge and by local ASHA during home visits. The control group received routine counselling during discharge and on follow-up visits by the treating paediatrician. Both groups were examined on the 15th, 30th and 60th day post-discharge for weight changes and were monitored for morbidity, mortality, breastfeeding and continuation of KMC. The neonates were divided randomly in two groups: 132 in the intervention group and 134 in the control group. The basic demographic parameters were comparable in both the groups. On the 15th day of follow-up, breastfeeding rate was 86% in the intervention group and 80% in the control group, morbidity was 13.4% and 15.7%, KMC continuation was 84% and 71.3% and re-admission rate was 6.1% and 7.04%, respectively. By the 60th day, the breastfeeding rate was 67.6% and 55.05%, morbidity 3.8% and 19.1%, KMC continuation 65% and 47% and re-admission rate 1.8% and 20.2% in the intervention and control groups, respectively. Mortality was 11.2% in the control group and 1.8% in the intervention group by the 60th day. Weight gain was more in the intervention group than in the control group (1,055.30 ± 122.46 g and 745.77 ± 99.34 g) by day 60. The outcome of KMC in the intervention group was better in comparison to the control group for all parameters studied. Therefore, one-on-one structured counselling with regular communication and follow-up is an effective intervention to improve maintenance of KMC at home.
袋鼠妈妈护理(Kangaroo Mother Care,KMC)可提高低出生体重新生儿的存活率。建议在所有环境中对低出生体重儿实施袋鼠式护理,并应在家中继续实施。对母亲和家庭成员进行辅导对于成功启动和持续开展 KMC 非常必要。本研究旨在采用 "问候、询问、倾听、表扬、建议、检查理解"(GALPAC)的咨询方法,以提高家庭为基础的 KMC 的效果。这项准随机对照试验的对象是 266 名在医院出生的稳定低体重新生儿。在干预组中,GALPAC 咨询由训练有素的护士和儿科医生在住院期间、出院后通过电话以及当地的 ASHA 在家访时提供。对照组则在出院时和复诊时接受儿科主治医生的常规咨询。两组均在出院后第 15 天、第 30 天和第 60 天接受体重变化检查,并对发病率、死亡率、母乳喂养和继续使用 KMC 进行监测。新生儿被随机分为两组:干预组 132 名,对照组 134 名。两组的基本人口统计学参数相当。随访第 15 天时,干预组的母乳喂养率为 86%,对照组为 80%;发病率分别为 13.4% 和 15.7%;KMC 持续率分别为 84% 和 71.3%;再次入院率分别为 6.1% 和 7.04%。到第 60 天时,干预组和对照组的母乳喂养率分别为 67.6% 和 55.05%,发病率分别为 3.8% 和 19.1%,KMC 持续率分别为 65% 和 47%,再入院率分别为 1.8% 和 20.2%。到第 60 天时,对照组的死亡率为 11.2%,干预组为 1.8%。到第 60 天时,干预组的体重增加幅度大于对照组(分别为 1,055.30 ± 122.46 克和 745.77 ± 99.34 克)。就所有研究参数而言,干预组的 KMC 结果均优于对照组。因此,一对一的结构化辅导、定期沟通和随访是一项有效的干预措施,可改善在家中维持 KMC 的情况。
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引用次数: 0
Epidermolysis Bullosa in an Infant Heterozygous for Mutation in LAMC2 Gene: A Case Report 一名 LAMC2 基因突变杂合子婴儿的表皮松解症:病例报告
Q4 Medicine Pub Date : 2024-05-14 DOI: 10.1177/09732179241249323
G. Milas, Vasiliki Tsolaki, Vasileios Issaris, Stefanos Fragkos, Aakash Pandita
Epidermolysis bullosa is a heterogenous skin disease caused by genes associated with skin integrity and dermal–epidermal adhesion. The four main categories include: epidermolysis bullosa simplex, junctional epidermolysis bullosa, dystrophic epidermolysis bullosa, and kindler syndrome. We report the case of a one-month-old infant who was brought to the emergency department due to complaint of fever and a bullous exanthem. Skin cultures were positive for methicillin-sensitive Staphylococcus aureus and Escherichia coli. Whole exome sequencing revealed mutations in LAMC2 gene. Junctional epidermolysis bullosa is associated with poor prognosis. Healthcare professionals and parents should be educated in a specific way as patients with this condition are in need of special care.
大疱性表皮松解症是由与皮肤完整性和真皮-表皮粘连相关的基因引起的一种异质性皮肤病。主要分为四大类:单纯性表皮松解症、交界性表皮松解症、萎缩性表皮松解症和金勒综合征。我们报告了一例一个月大的婴儿因发烧和大疱性表皮松解症而被送到急诊科的病例。皮肤培养对甲氧西林敏感的金黄色葡萄球菌和大肠杆菌呈阳性。全外显子组测序发现LAMC2基因发生了突变。交界性表皮松解症与预后不良有关。医护人员和家长应接受专门的教育,因为这种疾病的患者需要特殊护理。
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引用次数: 0
Knowledge, Attitude, and Practices Toward Kangaroo Mother Care Among Mothers in a Tertiary Neonatal Care Unit 三级医院新生儿护理病房的母亲对袋鼠妈妈护理的认识、态度和做法
Q4 Medicine Pub Date : 2024-04-22 DOI: 10.1177/09732179241242227
Monalisa Pradhan, Shrutiprajna Kar, Tanushree Sahoo, T. Som, P. Mohanty, U. Devi
Aim: To study the knowledge, attitude, and practices of Kangaroo Mother Care (KMC) among eligible postnatal mothers in the postnatal ward (PNW) and neonatal intensive care unit (NICU) of a tertiary neonatal unit in Eastern India. Methods: A cross-sectional survey was conducted among 100 mothers of low-birth-weight babies in our PNW and NICU. As part of the unit protocol, all mothers of eligible babies were counseled about KMC at first contact verbally as well as by using an informative video on KMC. Data was collected using a structured questionnaire after the routine counseling of the mothers on their first visit after delivery. The analysis of the data was done using appropriate statistics. Results: More than three-fourths (83.2%) of mothers had good knowledge of KMC. A good attitude toward using KMC was found in 91.6% of the mothers. Almost all the mothers (98%) knew the correct KMC position, and 12% of mothers had a previous preterm baby and had given KMC. Many mothers felt the small size of the baby, pain after cesarean section, and central or peripheral intravenous lines in the baby were barriers to KMC. Conclusion: The knowledge regarding KMC among mothers whose babies were admitted into the PNW/NICU was good. Though the attitude toward KMC was good, mothers felt there were multiple barriers to initiating KMC.
目的:研究印度东部一家三级新生儿医院产后病房(PNW)和新生儿重症监护室(NICU)中符合条件的产后母亲对袋鼠妈妈护理(Kangaroo Mother Care,KMC)的认知、态度和实践。调查方法我们在产后病房和新生儿重症监护室对 100 名低出生体重儿的母亲进行了横断面调查。作为病房规程的一部分,所有符合条件的婴儿的母亲在初次接触时都会接受有关 KMC 的口头和视频咨询。在对产后首次就诊的母亲进行常规咨询后,使用结构化问卷收集数据。数据分析采用了适当的统计方法。结果显示超过四分之三(83.2%)的产妇对紧急避孕药具有良好的认识。91.6%的母亲对使用紧急避孕药具持良好态度。几乎所有的母亲(98%)都知道正确的助产姿势,12%的母亲曾有过早产儿并进行过助产。许多母亲认为,胎儿过小、剖宫产后疼痛、胎儿中央或外周静脉注射管是使用 KMC 的障碍。结论在新生儿重症监护病房(PNW/NICU)分娩的母亲对 KMC 的了解程度良好。虽然母亲们对 KMC 的态度良好,但她们认为在进行 KMC 时存在多种障碍。
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引用次数: 0
Mother Support Groups for Raising Awareness in the Community About Kangaroo Mother Care 
and Breastfeeding in the Era of COVID-19: Experiential Learning 在 COVID-19 时代,通过母亲支持小组提高社区对袋鼠妈妈护理和母乳喂养的认识:体验式学习
Q4 Medicine Pub Date : 2024-04-22 DOI: 10.1177/09732179241234517
K. Sameer, S. Nimbalkar, Reshma Pujara, Dipen Patel
Introduction: This article explores the establishment and subsequent challenges faced by a Mother Support Group (MSG) initiated in Gujarat, India, focusing on promoting Kangaroo Mother Care (KMC) and exclusive breastfeeding, particularly amid the COVID-19 era. Methods: The methodology involved adapting to COVID-19 restrictions, utilizing online platforms for training and webinars, and collaborating with ASHA workers for community outreach. The MSG members received training on breastfeeding and KMC, followed by practical demonstrations and community visits. Although initial efforts were promising, the group’s sustainability faltered when key stakeholders withdrew, revealing challenges in maintaining community-driven interventions. Results and discussion: The article underscores the importance of sustained efforts in establishing and retaining parent support groups. The lack of comprehensive data collection limits the ability to evaluate specific outcomes, but we highlight the potential benefits of MSG, including improved breastfeeding practices and KMC adherence. We acknowledge the need for robust frameworks and standard operating procedures to enhance the sustainability of such initiatives, emphasizing the importance of community involvement and leadership in supporting disadvantaged newborns. Conclusion: We draw attention to the complexities of sustaining grassroots initiatives and call for further research to develop effective models that address the unique needs of marginalized communities, particularly regarding the care of preterm newborns.
导言:本文探讨了在印度古吉拉特邦发起的母亲支持小组(MSG)的建立及其面临的挑战,该小组的工作重点是推广袋鼠妈妈护理(Kangaroo Mother Care,KMC)和纯母乳喂养,尤其是在 COVID-19 时代。方法:方法:根据 COVID-19 的限制进行调整,利用在线平台开展培训和网络研讨会,并与 ASHA 工作人员合作开展社区外展活动。MSG 成员接受了母乳喂养和 KMC 方面的培训,随后进行了实际演示和社区访问。尽管最初的努力很有希望,但随着主要利益相关者的退出,该小组的可持续发展出现了问题,这也揭示了在维持社区驱动的干预措施方面所面临的挑战。结果与讨论:文章强调了持续努力建立和保留家长支持小组的重要性。由于缺乏全面的数据收集,评估具体结果的能力受到了限制,但我们强调了 MSG 的潜在益处,包括改善母乳喂养方法和坚持使用 KMC。我们承认有必要建立健全的框架和标准操作程序,以提高此类倡议的可持续性,同时强调社区参与和领导在支持弱势新生儿方面的重要性。结论:我们提请大家注意维持基层倡议的复杂性,并呼吁开展进一步研究,以开发有效模式,满足边缘化社区的独特需求,尤其是早产新生儿护理方面的需求。
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Journal of Neonatology
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