Early provision of oropharyngeal colostrum leads to sustained breast milk feedings in preterm infants

Snyder, Ruth; Herdt, Aimee; Mejias-Cepeda, Nancy; Ladino, John; Crowley, Kathryn; Levy, Philip

doi:10.1016/j.pedneo.2017.04.003

Cited by 48 publications

(47 citation statements)

References 34 publications

(39 reference statements)

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“…The practice of providing early application of oropharyngeal colostrum has been proposed as a protective strategy prior to introduction to enteral breast milk feeds. A non‐randomised controlled cohort study by Snyder et al . found that the early provision of oropharyngeal colostrum through enteral feeds was significantly associated with continued provision of breast milk feeds at 6 weeks of age ( P = 0.03) and through discharge ( P < 0.01).…”

Section: Resultsmentioning

confidence: 99%

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

Hilditch

Howes

Dempster

et al. 2019

J Paediatrics Child Health

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Breast milk is the preferred form of nutrition for all infants and has been shown to reduce morbidity and improve health outcomes in preterm infants. However, mothers of preterm infants face many challenges initiating and sustaining breastfeeding within the neonatal unit. This scoping review examines evidence-based practices which aim to improve breastfeeding rates in preterm infants at the time of hospital discharge. A literature review identified 17 articles which are included in this review. Supporting evidence was found for the implementation of kangaroo mother care and/or skin-to-skin care, peer counsellors, provision of oropharyngeal colostrum in early infancy and use of donor human milk banks. However, overall it is apparent that high quality research including systematic review and data synthesis in the form of meta-analysis is required in this area to reach sound conclusions regarding recommendations of different interventions. This scoping review provides an important foundation for further research into this area.Key words: breastfeeding or breast milk or growth; clinical improvement or quality improvement or gold standard or guideline; intensive care units, neonatal; nutritional outcome.Human breast milk is the recommended source of nutrition for all infants. 1 Breast milk contains nutrients and immune factors which promote growth and overall long-term health 2,3 Breastfed infants are less susceptible to inflammatory disorders, infection and may have reduced incidence of cardiovascular disease in adult life. 4-7 Benefits specific to preterm infants 8 include the promotion of intestinal maturation, improved feed tolerance, improved growth 7 and reduced severity of complications of prematurity such as necrotising enterocolitis. [9][10][11] Despite the overwhelming evidence that breast milk is beneficial for preterm infants, breastfeeding rates within Australian neonatal units remain low. 7 The neonatal unit environment presents unique challenges to breastfeeding, with mothers often having to establish and maintain a breast milk supply without the direct assistance of their babies. Other barriers to breastfeeding success include limited support from health-care professionals, perceived lack of breast milk supply, lack of privacy for expressing milk, and the stress of having a preterm infant in neonatal intensive care and inadequate information regarding the benefits of breast milk. 12,13 Multiple evidence-based interventions to improve breastfeeding rates have been explored.In this narrative review, we considered the structured clinical question 'In a preterm infant (born <37 weeks' gestation) admitted to a neonatal unit, what evidence-based practices, compared to standard care, have been shown to improve the use of breast milk and breastfeeding rates upon discharge and up to 6 months of age?' DefinitionsBreastfeeding was defined as any administration of breast milk by any method (tube, breast, alternative, such as bottle or syringe). Search Strategy and OutcomeMedline, Embase, Maternity and Infant Care,...

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Section: Resultsmentioning

confidence: 99%

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

Hilditch

Howes

Dempster

et al. 2019

J Paediatrics Child Health

View full text Add to dashboard Cite

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“…Premature infants often suffer from stomach retention, abdominal distension and vomiting due to immature digestive system [19]. Gastric retention, also known as gastric emptying delay, the results showed that the residual gastric fluid extracted from the stomach before feeding was more than 50% of the previous feeding.…”

Section: Colostrums Oral Intervention Can Accelerate the Process Of Nmentioning

confidence: 99%

The Effects of Colostrum on Gastrointestinal Function and Related Diseases in Premature Infants: A Comprehensive Meta-Analysis of Randomized Controlled Trials

Tang¹,

Yao²,

Shi³

2018

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Aim: To systematically evaluate the effects of colostrum intervention on gastrointestinal function and related diseases in premature infants. Methods: A randomized controlled trial was conducted in the Cochrane Library, PubMed, EBSCO, CINAHL, Embase, Medline, CBMDISC, CNKI, Wan Fang and VIP databases on the effects of colostrum and oral intervention on gastrointestinal function and related diseases in premature infants. Literature screening, quality evaluation and data extraction were conducted, and data analysis was conducted using Revman 5.3. Results: A total of 7 references were included, including 392 subjects. The combined results showed that: colostrum can effectively reduce the incidence of nosocomial infection [RR = 0.42, 95% CI (0.25, 0.73), P = 0.002]. Conclusion: Colostrums oral intervention can effectively reduce the incidence of nosocomial infection in premature infants. However, there was no advantage in feeding intolerance, necrotizing enters colitis and length of hospital stay.

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“…Mothers held neonatologists’ breastfeeding recommendations in high regard, even when specifics of why and how milk expression and at-breast feeds might proceed were not discussed (“ I’m just kind of doing what nurses and doctors tell me to do”). Notably, no women had attempted human milk oral care or were aware of the potential benefits of this practice prior to initiation of oral feeds ( 15 , 16 ).…”

Section: Resultsmentioning

confidence: 99%

Winging it: maternal perspectives and experiences of breastfeeding newborns with complex congenital surgical anomalies

et al. 2018

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Objective To describe the experience of breastfeeding (inclusive of breast milk expression/pumping, provision of breast milk via devices, and at-breast feeding) among mothers of newborns with complex congenital surgical anomalies and the contexts under which pro-breastfeeding behaviors and attitudes are facilitated or compromised. Study Design We used qualitative description to analyze 23 interviews conducted with 15 mothers of newborns undergoing surgery for gastrointestinal, cardiac, or neural tube defects. Results Breastfeeding experiences were characterized by naivety regarding the importance and rationale for exclusive breast milk feedings and best practices to facilitate milk supply maintenance and transition to at-breast feeds. Maternal breastfeeding views and behaviors were impacted by indeterminate prenatal plans to breastfeed/provide breast milk, limited prior breastfeeding exposure and knowledge, and gaps in postnatal lactation support. Conclusion Future research should investigate methods to improve exclusive breast milk feeding and facilitate transitions to at-breast feeds among mothers of newborns with surgical congenital anomalies, with consideration of identified barriers.

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Early provision of oropharyngeal colostrum leads to sustained breast milk feedings in preterm infants

Abstract: OC application for VLBW infants is safe and practical in a neonatal intensive care unit setting and is associated with increased rates of breast milk feeding.

Cited by 48 publications

References 34 publications

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

The Effects of Colostrum on Gastrointestinal Function and Related Diseases in Premature Infants: A Comprehensive Meta-Analysis of Randomized Controlled Trials

Winging it: maternal perspectives and experiences of breastfeeding newborns with complex congenital surgical anomalies

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