The impact of cup-feeding or bottle-feeding on weight gain, oxygen saturation, and breastfeeding rates of preterm infants was studied in 34 bottle-fed and 44 cup-fed preterm infants. At initiation of oral feeding, postconceptional age and weight were 37.2 +/- 2.2 weeks and 1676 +/- 83 g for the bottle-fed group (BF) and 37.0 +/- 1.6 weeks and 1637 +/- 40 g for the cup-fed (CF) group, respectively. No significant differences between groups were found with regard to time spent feeding, feeding problems, weight gain, or breastfeeding prevalence at discharge or at 3-month follow-up. Possible beneficial effects of cup-feeding were lower incidence of desaturation episodes (13.6% vs 35.3%, CF vs BF, P = .024) and a higher prevalence of breastfeeding at 3 months among those still breastfeeding at the first follow-up visit (68.4% vs 33.3%, CF vs BF, P = .04).
We investigated the effect of high VT ventilation on adult and newborn rats by examining pulmonary injury and cytokine messenger RNA (mRNA). On the basis of compliance, edema formation, and histology, ventilation with 25 ml.kg(-1) was more injurious to adult rats than newborns. Ventilation with 40 ml kg(-1) minimally affected compliance in newborns but caused death in adults. Ventilation of adults for 30 minutes at 25 ml kg(-1) upregulated the mRNA expression of interleukin (IL)-1beta, IL-6, tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-2 (MIP-2), and IL-10, whereas in newborns such ventilation only increased mRNA expression of MIP-2 and IL-10. When VT was raised to 40 ml kg(-1) in newborns, IL-1beta mRNA levels were additionally increased at 30 minutes, whereas ventilation for 3 hours additionally increased IL-6 and TNF-alpha mRNA. In newborns, the addition of 100% oxygen (O2) to 30 minutes of ventilation blunted the high VT induction of IL-1beta, IL-10, and MIP-2 mRNA expressions, whereas at 3 hours, 100% O2 concentration synergistically increased the mRNAs for TNF-alpha and IL-6. Overall, adult rats are more susceptible to high VT-induced lung injury compared with newborns. In newborns, the inflammatory response is dependent on VT, duration, and supplemental O2. Thus, recommendations for VT limitation based on adult data may be inappropriate for newborns.
Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.
The objective of this study was to evaluate and compare symptoms of anxiety and depression before and after psychological intervention in mothers of babies born preterm with very low birth weight, hospitalized in the Neonatal Intensive Care Unit. Fifty nine mothers, without psychiatric antecedents, were distributed into two groups according to the type of psychological intervention received. Group G1 included 36 mothers who received routine psychological treatment associated with initial structured intake using support materials (video and guidance manual). Group G2 included 23 mothers who received routine psychological intervention without support material. The STAI and BDI, respectively, were used to evaluate maternal indicators of anxiety and depression. The results revealed that both groups showed a reduction in levels of state or trait anxiety and depression after psychological intervention and discharge of the baby from the hospital. In regard to the emotional symptoms at a clinical level, a statistically significant reduction in the level of state-anxiety was verified in G1. The findings confirmed the need for psychological support for mothers of preterm infants and the use of materials focusing on «prematurity» for reduction of the situational anxiety on a clinical level.
To determine the efficacy of cooking food in iron pots to prevent anemia in premature infants, a longitudinal study on iron nutritional status was conducted in preterm, healthy infants from families of low socioeconomic level between mo 4 and 12 of life. The infants were divided randomly into two groups. The study group consisted of 22 infants whose food was cooked in iron pots; the control group consisted of 23 infants whose food was cooked in aluminum pots. Supplemental iron [2 mg/(kg.d)] was recommended from 15 d to 12 mo of age for both groups. At 12 mo of age, the group fed food cooked in iron pots had significantly better hematologic values than the group fed food cooked in aluminum pots. Differences included hemoglobin (116 +/- 16 vs. 103 +/- 20 g/L, P = 0.02), hematocrit (0.35 +/- 0.04 vs. 0.31 +/- 0.05, P = 0.005), mean corpuscular volume (72.1 +/- 10.4 vs. 62.7 +/- 11.1 fL, P = 0.005), free erythrocyte protoporphyrin (0.78 +/- 0.60 vs. 1.46 +/- 0.94 mol/L, P = 0.006) and serum ferritin (median 5 vs. 0 g/L, P = 0.001). No significant differences between groups were observed in serum iron concentration, total iron-binding capacity or transferrin saturation. Iron deficiency anemia (hemoglobin = 110 g/L) was observed in 36.4% (8 of 22) of infants in the group fed food cooked in iron pots and in 73.9% (17 of 23) of the infants fed food cooked in aluminum pots (P = 0.03). These results indicate that the iron added to food cooked in iron pots is bioavailable. However, this increased iron availability was insufficient to satisfy the high iron requirements of this group of preterm infants.
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