Breastfeeding Medicine最新文献

Background: Feeding difficulties in premature infants often delay the transition to breastfeeding, prolong hospitalization, and impact oral motor development. While non-nutritive finger feeding (NNFF) has been studied in maternal care, limited evidence exists on paternal involvement. This randomized controlled trial examined the effect of father-administered NNFF on breastfeeding transition, sucking success, and hospitalization outcomes in premature infants.

Methods: This single-blind, parallel-group randomized controlled trial was conducted in a Level III NICU in eastern Turkey. Sixty-seven premature infants born at 29-32 weeks of gestation and their fathers were randomized into intervention (n = 34) and control (n = 33) groups. Fathers in the intervention group performed standardized NNFF for 5 minutes, three times daily over 7 consecutive days. The control group received routine care without NNFF. Primary outcome was time to first successful breastfeeding. Secondary outcomes included sucking success (LATCH scores) and hospitalization duration. Statistical analyses included t-tests, Mann-Whitney U tests, repeated measures ANOVA, and logistic regression.

Results: The intervention group achieved earlier breastfeeding initiation (9.65 ± 5.78 versus 13.88 ± 6.27 days, p = 0.005), faster breastfeeding acceptance (8.94 ± 5.59 versus 12.61 ± 5.74 days, p = 0.010), and shorter hospitalization (11.79 ± 7.19 versus 15.85 ± 6.76 days, p = 0.021). Logistic regression confirmed the predictive value of NNFF on breastfeeding initiation, hospital stay, and LATCH scores.

Conclusion: Father-led NNFF is a safe, feasible intervention that accelerates breastfeeding transition, improves early sucking success, and reduces hospitalization in premature infants.

Background: Breast milk is the optimal source of nutrition for newborns, especially preterm infants, and its temperature during feeding may influence both physiological stability and clinical outcomes. Although individual studies suggest potential benefits of warmed milk, evidence remains inconsistent and has not been comprehensively synthesized.

Objective: To systematically review and analyze the effects of administering breast milk at different temperatures on physiological responses, feeding tolerance, and clinical outcomes in newborns.

Methods: This systematic review and meta-analysis followed the Cochrane Handbook (version 6.0) and PRISMA guidelines. A comprehensive search of nine databases (CINAHL, CENTRAL, Web of Science, PubMed, Scopus, ScienceDirect, ERIC, EBSCO, OVID) was conducted for studies published between 2010 and 2025 in English. Data extraction and risk of bias assessment were performed independently by two reviewers using RoB-2 and ROBINS-I tools. Meta-analyses were conducted using Stata 16.0, applying fixed- or random-effects models based on I² heterogeneity values.

Results: Five studies involving 373 infants met the inclusion criteria. Meta-analyses revealed no statistically significant effects of breast milk temperature on heart rate, oxygen saturation, or body temperature at 5 or 30 minutes after feeding. A small short-term decrease in body temperature (5 minutes post-feeding) was noted in the intervention group, but this was not sustained. Time to achieve full enteral feeding was also not significantly different between groups. Heterogeneity was substantial for several outcomes (I² > 85%). Risk of bias ranged from low to serious across included studies.

Conclusions: Current evidence indicates that administering breast milk at different temperatures does not produce clinically meaningful differences in short-term physiological parameters or clinical outcomes in newborns. Milk at room temperature, near-body temperature, or alternative warming methods appears to be equally well tolerated.

Background: Diaper dermatitis (DD) is a very common problem in infants between 1 and 6 months. While it rarely causes long-lasting problems, it can cause serious short-term problems for both infants and parents. Accordingly, this study compared the effect of breast milk and diaper rash cream containing Hamamelis virginiana (12 mg/100 g) on the healing process in 0-6 month-old infants with DD. Methods: This randomized, single-blinded trial was conducted with 60 infants aged 0-6 months diagnosed with DD. Participants were assigned to either the breast milk group (BG) or the comparison group (CG) receiving Hamamelis virginiana cream. Demographic characteristics and DD severity were assessed using a structured demographic questionnaire and the validated Assessment of the Severity of Uncomplicated DD in Infants Scale. Statistical analyses included Shapiro-Wilk, Mann-Whitney U, Wilcoxon signed rank, Chi-square, and Fisher's exact tests. Significance was set at p < 0.05. Results: Before the intervention, the mean scale score was 5.17 ± 0.46 in the BG, 2.83 ± 1.37 in the CG, which was a statistically significant difference. After the intervention, there was a significant decrease in the mean scale score in the BG to 0.03 ± 0.18, whereas the mean decrease was smaller in the CG (1.53 ± 1.11). The difference in the mean scale scores between the groups was statistically significant (p < 0.001). Furthermore, the postintervention mean scale score of the BG was significantly lower than that of the CG. However, baseline severity differences limit direct comparison of treatment efficacy. Conclusions: Topically applied breast milk appears to be a safe, accessible, and cost-effective option for treating uncomplicated DD, with greater improvement than cream containing Hamamelis virginiana. However, baseline severity differences limit direct comparison. Further studies using block randomization are recommended.

Background: Low-Intensity Focused Ultrasound (LIFU) may enhance tissue recovery and support breastfeeding post-aspiration. Methods: A total of 60 patients were randomly assigned to either a control group or a treatment group. Fifty-six participants completed the study, with two dropouts per group. The control group received ultrasound-guided aspiration and antibiotics for 3 days, while the treatment group additionally received LIFU therapy. Recovery of tissue structure at the abscess site was assessed. The primary outcome was the recovery time of breast tissue via ultrasound imaging. Secondary outcomes included pain scores, time for disappearance of local induration and abscess cavity, breastfeeding self-efficacy scores, breastfeeding rates, and repeat aspiration rates. Findings: The treatment group exhibited a significantly shorter recovery time for breast tissue compared to the control group. Induration disappearance time was also reduced in the treatment group. Significant differences in pain scores were noted 1 week post-surgery. Breastfeeding self-efficacy scores improved significantly in the treatment group at 2 weeks and 2 months post-surgery. Higher breastfeeding maintenance rates and lower cessation rates were observed in the treatment group. Discussion: The use of LIFU therapy appears to enhance tissue repair and support breastfeeding post-aspiration, offering a promising treatment option for lactating women with breast abscesses. Conclusion: LIFU treatment effectively promotes tissue repair, reduces recovery time, and improves breastfeeding outcomes after breast abscess aspiration. The Clinical Trial registration number: ChiCTR2200060973 (registration date: June 14, 2022). Version Date: 22 May 2025.

Objectives: Mothers of preterm infants who experience mother-infant separation frequently face increased challenges with lactation. This study aims to analyze the critical window for coming to volume (CTV) and its associated risk factors in pump-dependent mothers and to investigate the predictive value of postpartum expressed milk volume for the feeding method at discharge in preterm infants. Study Design: A prospective observational study was conducted between July 2020 and February 2021. Lactation diaries kept by mothers of preterm infants admitted to a neonatal intensive care unit in Guangzhou, China, were collected during this period. Binary multivariable Logistic regression, time-series analysis, Spearman correlation analysis, and K-Prototype cluster analysis were employed to investigate the critical window for CTV and its risk factors. The area under the receiver operating characteristic curves were used to evaluate the ability of expressed milk volume during postpartum days 8-14 to predict the feeding method at discharge for preterm infants. Results: Data from 1,232 diary days completed by 88 mothers were analyzed. 51.14% of mothers of preterm infants failed to CTV. Unscheduled pumping, a lower average pumping frequency on postpartum day 1-7, a lower average expressed breast milk volume on postpartum day 1-7, and a small intra-session bilateral volume discrepancy were identified as independent risk factors for no-CTV. During postpartum days 3-7, both pumping frequency and milk volume increased progressively. The frequency and volume of pumping between postpartum days 3 and 7 positively correlated with the milk volume on postpartum day 14. Clustering analysis based on early postpartum pumping behaviors identified two groups: High-Frequency Timed Group (HFTG) and Low-Frequency Untimed Group. The HFTG exhibited higher pumping frequency and milk volume, indicating a greater likelihood of achieving CTV. The expressed breast milk volume on postpartum day 8 significantly predicted the feeding method at discharge (Area Under the ROC Curve [AUC] [95% confidence interval]: 0.831 [0.746-0.916]), with no statistically significant difference in predictive performance compared to volumes on days 9-14 (p > 0.05). Conclusion: Postpartum days 3-7 represent the critical window for CTV among mothers of preterm infants, during which pumping behavior directly influences CTV. Postpartum day 8, as the first day following the critical window, provides an early and effective prediction of feeding outcomes at discharge.

Background: Collodion baby syndrome (CBS) is a rare neonatal dermatological disorder characterized by a restrictive membrane covering the infant's skin, impairing thermoregulation, increasing infection risk, and causing significant pain. Early parent-infant bonding and breastfeeding are challenging due to the fragile skin barrier, with limited evidence on safe approaches to enable these critical interventions. This report explores the use of sterile polyethylene wrap to facilitate kangaroo care (KC) and breastfeeding in a neonate with CBS. Materials and Methods: A full-term female newborn diagnosed with CBS was admitted to the NICU in stable condition. Skin was encased by a shiny, tight membrane with mild ectropion. Initial management included humidified incubator care, fluid and electrolyte monitoring, and topical emollients. From day two, KC was initiated using sterile polyethylene wrap as a protective barrier to prevent skin trauma. Pain was assessed systematically using the EDIN and N-PASS scales at baseline, during, and after KC sessions. Results: Kangaroo care sessions under polyethylene wrap were safely conducted with continuous cardiorespiratory monitoring. Both pain scales demonstrated a significant reduction in pain scores during KC compared to baseline. The polyethylene wrap maintained thermal stability and skin integrity while allowing safe breastfeeding and enhancing parental bonding. No adverse events or infections occurred and the neonate was discharged with good clinical condition after progressive skin healing. Conclusion: Sterile polyethylene wrap is a feasible, safe, and effective method to enable early kangaroo care and breastfeeding in neonates with CBS, addressing the unique challenges of skin fragility and pain management. This approach supports optimal pain control, thermal stability, and parental bonding, bridging medical care with psychosocial needs. Further studies are warranted to establish standardized protocols for this vulnerable population.

Objectives: Breast milk is an ideal food for newborns born term and preterm. The short-term storage of human milk (HM) involves freezing at low temperatures; however, its effects on macronutrients remain unclear. The macronutrients in HM are generally thought to be unaffected by short-term freezing. This study aimed to analyze the impact of freezing HM from preterm infants at -20°C for 5 days on macronutrient content. Methods: HM samples were collected from 54 mothers of preterm infants. Each sample was divided into three aliquots and stored at -20°C for 1 and 5 days. After thawing and homogenization, energy and macronutrient contents were measured using a HM infrared spectroscopy analyzer. Results: We analyzed 162 samples (from 54 mothers of preterm infants). Mean baseline concentrations in fresh milk were protein 1.55 ± 0.61 g/100 mL, carbohydrates 6.87 ± 0.81 g/100 mL, fat 4.29 ± 2.16 g/100 mL, and energy 75.9 ± 27.3 kcal/100 mL. Freezing at -20°C reduced protein to 1.33 ± 0.35 g/100 mL after 24 hours and 1.21 ± 0.38 g/100 mL after 5 days (14.2% and 21.9% decrease, p < 0.001), fat to 3.23 ± 1.15 g/100 mL and 3.04 ± 1.40 g/100 mL (24.7% and 29.1% decrease, p < 0.001), and energy to 64.3 ± 12.8 kcal/100 mL and 61.7 ± 16.1 kcal/100 mL, respectively (p < 0.001); carbohydrate content remained unchanged (p = 0.41). Conclusions: Freezing HM at -20°C for 5 days can significantly reduce critical nutrients, including fat and protein, suggesting the need for individualized fortification strategies to ensure optimal growth in preterm infants.

Objective: In the present study, the effects of prayer frequency and knowledge of prayer on breastfeeding self-efficacy were examined for the first time while controlling for variables such as psychological resilience and method of delivery. Method: For this purpose, a sample of 232 women was analyzed by using multiple linear regression analysis. Results: The results indicate that regular prayer has a higher level of positive impact on breastfeeding self-efficacy, that it is a stronger predictor in comparison with psychological resilience, and that this effect is pronounced among Muslim mothers. Conclusion: These insights could inform interventions aimed at improving breastfeeding practices by incorporating spiritual dimensions alongside psychological support.

Introduction: Subjective social status (SSS), which describes one's perceived hierarchical rank, may provide a more accurate prediction of health than traditional socioeconomic measures. The specific relationship between SSS and breastfeeding outcomes is understudied. Our objectives were to: (1) investigate factors associated with SSS, (2) assess the relationship between prenatal SSS and any or exclusive breastfeeding at 3 and 6 months, and (3) evaluate the relationship between prenatal SSS and breastfeeding duration. Methods: Overall, 2,870 participants from the Canadian Healthy Infant Longitudinal Development birth cohort data were included. Prenatal SSS was self-ranked at 18 weeks' gestation using the MacArthur Scale and categorized as low (1-5), moderate (6-7), and high (8-10) SSS. Any and exclusive breastfeeding were categorized at 3 and 6 months postpartum, along with breastfeeding duration. Multivariable logistics and linear regression were conducted. Results: After adjusting for race, education, income, marital status, employment, and parity, the odds of exclusive breastfeeding at 3 months were 1.51 times higher [95% confidence interval (CI): 1.18, 1.94] in the high SSS group than in the low SSS group. The likelihood of any breastfeeding at 6 months was 1.45 times higher [95% CI: 1.10, 1.92] in the moderate SSS group than the low SSS group. Women with high SSS breastfed for approximately 42 days longer than women with low SSS. Conclusion: SSS was associated with exclusive breastfeeding at 3 months, any breastfeeding at 6 months, and breastfeeding duration. SSS may offer a more patient-centered indicator of health, informing targeted interventions for individuals at risk of suboptimal breastfeeding outcomes.