Background. Breast milk is the optimal nutrition for late preterm babies, but mothers of these babies frequently experience difficulties with breastfeeding associated with lactation onset and establishment.Objective. The aim of the study is to examine factors associated with successful breastfeeding of late preterm infants in neonatal hospital.Methods. The retrospective study included medical records of late preterm infants (gestational age of 34–36 weeks) admitted to neonatology department within one calendar year.Maternal and infant factors on exclusive breastfeeding were considered at hospital discharge. Exclusive breastfeeding was defined as absence of any other food or drink, even water, except breast milk (expressed or donor), whereas enteral fluid for rehydration, as well as drops and syrups (vitamins, minerals, medicines) were allowed. Determination of independent predictors was performed via multifactorial binary logistic regression.Results. 84 (41%) of children received exclusive breastfeeding at hospital discharge, others were on formula or mixed feeding. Multifactorial analysis has shown that gestational age of 36 weeks (compared to 34 weeks, odds ratio (OR) 2.16; 95% confidence interval (CI) 1.18–3.98) and breastfeeding onset in 6 first hours of life (OR 2.38; 95% CI 1.19–4.75) were associated with relatively high probability of exclusive breastfeeding at hospital discharge, and twins (OR 0.31; 95% DI 0.15–0.65) — with low probability.Conclusion. Breastfeeding of late preterm babies with maternal milk (expressed milk included) in the first hours of life positively affects the lactation establishment and the provision of exclusively breast milk to these patients in neonatal hospital. The risk group for early cessation of breastfeeding may include late premature infants with gestational age less than 36 weeks and twins.
This review article summarizes current data on malnutrition etiology and pathogenesis in infants. Topical requirements for revealing this condition, its diagnosis and severity assessment via centile metrics are presented. The characteristics of the most common clinical phenotypes of postnatal growth insufficiency in infants (premature infants with different degree of maturation, including patients with bronchopulmonary dysplasia) are described. Differential approaches for malnutrition nutritional correction in these children are presented. The final section of the article describes special nutritional needs for children with congenital heart defects in terms of hemodynamic disorders nature and severity. Modern nutritional strategies for preparation of these patients to surgery and for their postoperative period are presented. The use of high-calorie/high-protein product for malnutrition correction in the most vulnerable patients with described in this review phenotypes is worth noticing.
This review covers modern possibilities of modeling breast milk unique properties to produce infant milk formulas. The main approach of such modelling is to advance the protein composition in the formula to the spectrum of breast milk proteins, primarily α-lactalbumin. This protein has multi-directional protective properties; the organism synthesizes the antibacterial and immunomodulating peptide complex HAMLET (Human Alpha-lactalbumin Made LEthal to Tumor cells, complex of α-lactalbumin and oleic acid) on its basis. The amino acid composition of α-lactalbumin provides mild neuroprotective effect due to sufficient level of tryptophan. Non-protein components of the produced formulas (carbohydrate and fat included) enhance their protective qualities and ensure the prevention of delayed health disorders. This review provides information about the innovative baby food product containing ?-lactalbumin and other bioactive components like those in breast milk.
Background. Protein-calorie deficiency is common multifactorial medical condition in infants. Nutrition therapy of protein-calorie deficiency in premature infants with special medical food is not always quite effective. It can be associated with residual manifestations of overlapping perinatal pathology.Clinical case description. Extremely premature child with severe protein-calorie deficiency in the late period with combined perinatal pathology (perinatal central nervous system damage and bronchopulmonary dysplasia) was administrated with therapeutic highly nutritious (high-protein/high-energy) milk formula according to individual plan. The positive dynamics in clinical manifestations of the main and associated diseases was noted on nutrition therapy.Conclusion. High-calorie and protein-enriched therapeutic formula can effectively correct protein-calorie deficiency in premature infants with associated perinatal pathology in the recovery period (disfunction compensation).
The literature overview on the issue of breastfeeding in neonatal departments, including neonatal intensive care units, is presented. The importance of breastfeeding for newborns with perinatal pathology is justified, as breast milk is vital for these children due to its unique sanogenetic properties. Data on special preventive and therapeutic role of breastfeeding for premature infants is presented. Reasons that complicate the use of breast milk in neonatal hospitals were analyzed (including those related to insufficient bacteriological and virological safety of native breast milk due to methodological errors during its collection and usage). Particular attention was paid to ensuring the breastfeeding safety during new coronavirus infection pandemic. This difficult period has demonstrated and confirmed the expediency of combining two breastfeeding approaches in perinatal centers: use of maternal milk and use of donor breast milk. Another section of review is devoted to modern breast milk processing technologies. Use of electric clinical breast pumps is crucial for promoting and supporting breastfeeding in the perinatal center.
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