Greetings All, 

Some new studies:  

1) Open access study from Germany: 

Title:  Intranasal breast milk for premature infants with severe intraventricular hemorrhage - an observation.

In:  European Journal of Pediatrics 2018 Nov 1. doi: 10.1007/s00431-018-3279-7. [Epub ahead of print]

https://link.springer.com/article/10.1007%2Fs00431-018-3279-7

Authors:  Keller T, Körber F, Oberthuer A, Schafmeyer L, Mehler K, Kuhr K, Kribs A.

Abstract:  "For nasal application of neurotrophins and mesenchymal stem cells, successful delivery to the brain and therapeutic effects are known from experimental data in animals. Human breast milk contains neurotrophins and stem cells, but gavage tube feeding in preterm infants bypasses the naso-oropharynx. This is a first exploration on additional nasal breast milk and neuromorphological outcome after severe neonatal brain injury. We present a retrospective summary of 31 very low birth weight preterm infants with intraventricular hemorrhage °3/4 from one third-level neonatal center. All were breast milk fed. Sixteen infants additionally received nasal drops of fresh breast milk daily with informed parental consent for at least 28 days. Cerebral ultrasound courses were reviewed by a pediatric radiologist blinded to the intervention. The main outcome measure was severity of porencephalic defects before discharge. Clinical covariates were comparable in both groups. With nasal breast milk, a trend to a lower incidence for severe porencephalic defects (21% vs. 58%) was detected. Incidences were lower for progressive ventricular dilatation (71% vs. 91%) and surgery for posthemorrhagic hydrocephalus (50% vs. 67%).  Conclusion: The hypothesis is generated that early intranasal application of breast milk could have a beneficial effect on neurodevelopment in preterm infants. Controlled investigation is needed.   What is Known: • Successful delivery to the brain and therapeutic effects are known for nasal application of neurotrophins and mesenchymal stem cells from experimental data in animal studies. • Human breast milk contains neurotrophins and stem cells, but gavage tube feeding in preterm infants bypasses the naso-oropharynx. What is New: • This is the first report on additional nasal breast milk application in very low birth weight preterm infants with severe brain injury observing a trend for less severe porencephalic defects. • The hypothesis is generated that nasal breast milk might exert neuroprotective effects in preterm infants."


2)  From The Netherlands:

Title:  Relationship between socioeconomic status and weight gain during infancy: The BeeBOFT study.

In:  PLoS One. 2018 Nov 2;13(11):e0205734. doi: 10.1371/journal.pone.0205734. eCollection 2018.

Authors:  Wang L, van Grieken A, Yang-Huang J, Vlasblom E, L'Hoir MP, Boere-Boonekamp MM, Raat H (The Netherlands) 

https://mhealth.jmir.org/2018/10/e11039/

Abstract:  
"BACKGROUND: Increased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain."

"METHODS: Subjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0-3, 0-6, and 6-12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain."

"RESULTS: On average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0-6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27-0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0-6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain."

"CONCLUSION: Infants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices."


3)  Open access study from China: 

Title:  A Short Message Service Intervention for Improving Infant Feeding Practices in Shanghai, China: Planning, Implementation, and Process Evaluation.

In:  JMIR Mhealth Uhealth 2018 Oct 29;6(10):e11039. doi: 10.2196/11039.

Authors:  Jiang H, Li M, Wen L, Baur LA, He G, Ma X, Qian X.

https://mhealth.jmir.org/2018/10/e11039/

Abstract
"BACKGROUND: Although mobile health (mHealth) has been widely applied in health care services, few studies have reported the detailed process of the development and implementation of text messaging (short message service, SMS) interventions."

"OBJECTIVE: Our study aims to demonstrate the process and lessons learned from a community-based text messaging (SMS) intervention for improving infant feeding in Shanghai, China."

"METHODS: The intervention included planning and development, implementation, and process evaluation. A 3-phase process was adopted during planning and development: (1) a formative study with expectant and new mothers to explore the barriers of appropriate infant feeding practices; (2) a baseline questionnaire survey to understand potential intervention approaches; and (3) development of the text message bank. The text messaging intervention was delivered via a computer-based platform. A message bank was established before the start of the intervention containing information on the benefits of breastfeeding, preparing for breastfeeding, early initiation of breastfeeding, timely introduction of complementary foods, and establishing appropriate feeding practices, etc. An expert advisory committee oversaw the content and quality of the message bank. Process evaluation was conducted through field records and qualitative interviews with participating mothers."

"RESULTS: We found that the text messaging intervention was feasible and well received by mothers because of its easy and flexible access. The weekly based message frequency was thought to be appropriate, and the contents were anticipatory and trustworthy. Some mothers had high expectations for timely response to inquiries. Occasionally, the text messages were not delivered due to unstable telecommunication transmission. Mothers suggested that the messages could be more personalized."

"CONCLUSIONS: This study demonstrates the feasibility and value of text messaging intervention in filling gaps in delivering health care services and promoting healthy infant feeding practices in settings where personal contact is limited."

With best regards,

Debbie

Debra Swank, RN BSN IBCLC
More Than Reflexes Education
Ocala, Florida USA
http://www.MoreThanReflexes.org

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