Breastfeeding Medicine最新文献

{"title":"Effect of Fucile Oral Motor Stimulation Protocol on Feeding Performance in Preterm Infants: Systematic Review and Meta-Analysis.","authors":"Golnoosh Golmohammadi, Mozhgan Asadi, Kowsar Baghban, Farhad Sakhai, Faezeh Asadollahpour","doi":"10.1089/bfm.2025.0031","DOIUrl":"https://doi.org/10.1089/bfm.2025.0031","url":null,"abstract":"<p><p><b><i>Background:</i></b> Full oral feeding (FOF) is a critical milestone in preterm infants, often delayed because of immature feeding coordination. The Fucile oral motor stimulation protocol aims to address these challenges and enhance feeding progression. To evaluate the effectiveness of the Fucile oral motor stimulation protocol in reducing the transition time to FOF, shortening hospital stays, and improving feeding-related outcomes in preterm infants. <b><i>Methods:</i></b> A systematic review and meta-analysis was conducted following the PRISMA guidelines (PROSPERO: CRD42022369514). Databases, including PubMed, Scopus, Web of Science, CENTRAL, and CINAHL (1990-2024), were searched. Randomized controlled trials comparing the Fucile protocol with control interventions in preterm infants (<37 weeks of gestation) were included. Outcomes included transition time to FOF, hospital stay length, weight at discharge, and milk transfer rate. Risk of bias (RoB 2) and evidence certainty (Grading of Recommendations Assessment, Development, and Evaluation) were evaluated. <b><i>Results:</i></b> Nineteen trials (1,031 infants) showed that the Fucile protocol significantly reduced transition time to FOF (mean difference [MD]: -5.77 days; 95% confidence interval [CI]: -6.64 to -4.90) and hospital stay duration (MD: -6.47 days; 95% CI: -8.41 to -4.53) with moderate-certainty evidence. <b><i>Conclusion:</i></b> The Fucile protocol accelerates feeding milestones and reduces hospital stays for preterm infants, providing moderate-certainty evidence to support its clinical use. However, methodological limitations, including small sample sizes and risk of bias, underline the need for larger, high-quality trials to confirm these findings and refine clinical guidelines. These results suggest the potential of integrating oral motor stimulation into neonatal intensive care unit practices to enhance feeding outcomes and optimize care for preterm infants.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pump Matters: An Educational Bundle to Promote a Predominant Mother's-Own-Milk Diet in Very Low Birthweight Infants.","authors":"Johnae D Snell, Laura A Gollins, Joseph L Hagan, Kristina Tucker, Gina Marrinucci, Anne Debuyserie, Amy B Hair","doi":"10.1089/bfm.2025.0008","DOIUrl":"https://doi.org/10.1089/bfm.2025.0008","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Mothers of very low birthweight (VLBW) infants rely on frequent, effective pumping for breast milk production. While hospital-grade breast pumps aid in mother's-own-milk (MOM) provision, accessing them after maternal discharge can be difficult. <b><i>Methods:</i></b> This quasi-experimental study assessed the impact of a bundled intervention on percentages of MOM and oral immune therapy (OIT) intake in the first 28 days of life (DOL) of VLBW infants admitted to a tertiary neonatal intensive care unit. The bundle included breastfeeding education, neonatal provider support, and a free 1-month hospital-grade breast pump rental for home use. <b><i>Results:</i></b> There were 102 infants enrolled, split into retrospective (<i>n</i> = 50) and prospective (<i>n</i> = 52) groups. While median %OIT intake was significantly higher in the prospective group (71.9% [interquartile range-IQR: 56, 78.2] versus 41.1% [IQR: 9.1, 60.7]; <i>p</i> ≤ 0.001), %MOM was not significantly increased after adjusting for race. More prospective infants received higher doses (≥90%) of MOM (71% versus 50%; <i>p</i> = 0.042), while more retrospective infants received lower doses (<5%) of MOM (18% versus 4%; <i>p</i> = 0.027). Black infants in the retrospective group received a lower median %MOM (69.1% [IQR: 3, 98.2] versus 93.9% [IQR: 68, 98.8] in non-Black infants; <i>p</i> = 0.388), but a significantly higher median %MOM in the prospective group (99.1% [IQR: 98, 100] versus 97.5% [IQR: 51, 99.5] in non-Black infants; <i>p</i> = 0.041). <b><i>Conclusion:</i></b> Bundled interventions including providing free hospital-grade breast pumps for home use may result in increased %OIT received and more VLBW infants receiving higher doses of MOM in the first 28 DOL. It may also help diminish existing racial disparities in %MOM intake.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early, Unplanned Lactation Cessation: Perspectives from a Breastfeeding Medicine Physician.","authors":"Anne R Eglash","doi":"10.1089/bfm.2025.0105","DOIUrl":"https://doi.org/10.1089/bfm.2025.0105","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report of an Unexpected Cause of Noisy Breathing: Breast Pump Membrane as an Esophageal Foreign Body in an Infant.","authors":"Olivia Ginty, Gabrielle Pundaky, Jennifer Lam, Mehdi Qiabi, Tara Mullowney, Scott McKillop, Ian Ross, Julie Strychowsky","doi":"10.1089/bfm.2025.0083","DOIUrl":"https://doi.org/10.1089/bfm.2025.0083","url":null,"abstract":"<p><p><b><i>Background:</i></b> Due to their nonspecific symptoms, foreign bodies in the aerodigestive tract (FBA) are often misdiagnosed as respiratory conditions, especially when unwitnessed, posing significant risks for morbidity and mortality in the pediatric population. <b><i>Case Presentation:</i></b> We report a case of an otherwise healthy 4-month-old, predominantly breastfed infant with episodic \"honking\" breathing, choking with feeds, and a 2-month history of recurrent croup episodes requiring emergency services and an hospital admission. After referral to pediatric otolaryngology/respirology, a flexible laryngoscopy revealed a diagnosis of mild laryngomalacia, inconsistent with the severity of symptoms. A formal airway evaluation was performed, including supraglottoplasty. <b><i>Results:</i></b> Unexpectedly, extraluminal pulsatile tracheal compression was found, with correlating computed tomography findings of an innominate artery variation and a paraesophageal abnormality. This abnormality appeared as a fluid-filled density between the esophagus and trachea on magnetic resonance imaging, without patency to the esophagus on Upper GI series. Differential diagnoses included vascular malformation, esophageal diverticulum, and bronchogenic/foregut duplication cyst. Although evaluation with echoendoscopy was considered, collaboration with general/thoracic surgery for a flexible esophagoscopy revealed a 2-cm breast pump membrane embedded in a pseudo-diverticulum with a sealed esophageal perforation, which concluded with successful object removal via forceps. The patient's respiratory symptoms have resolved; however, persistence of the pseudo-diverticulum on follow-up imaging and endoscopy warrants ongoing surveillance. <b><i>Conclusion:</i></b> This case demonstrates the challenging diagnosis of a breast pump membrane as an unexpected esophageal FBA, compounded by nonspecific respiratory symptoms and the membrane's near-radiolucency on standard imaging. The exhibited multidisciplinary, collaborative approach was fundamental for the complication-free removal of the membrane.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxicology Screening for Marijuana and Impact on Breast Milk Feeding Policies in Neonatal Intensive Care Units.","authors":"Sarra Bae, Erin M Schofield, Natalie L Davis","doi":"10.1089/bfm.2025.0064","DOIUrl":"https://doi.org/10.1089/bfm.2025.0064","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Tetrahydrocannabinol (THC), the major psychoactive marijuana cannabinoid, can be transferred to neonates via maternal breast milk (MBM) feeds, but available literature on the safety of concomitant breastfeeding and THC use is inconsistent. This study aimed to assess neonatal intensive care unit (NICU) policies related to toxicology screening and provision of MBM from THC-positive mothers. We hypothesized variation in policies exists across the nation and may be associated with state legalization status. <b><i>Methods:</i></b> Cross-sectional survey of U.S. NICU policies related to: (1) toxicology screening of mother-baby dyads and (2) MBM feeding limitations based on THC screening status. We assessed the impact of THC legalization status on the various MBM limitations. <b><i>Results:</i></b> Of 187 NICUs surveyed, 79% performed selective toxicology screening based on risk factors, clinical concerns, or provider discretion. Of those that specifically addressed THC exposure and MBM feeding policies, 60% had at least one limitation to MBM feeds, ranging from preventing any MBM feeding during NICU admission to limiting MBM until mother tested negative for THC. We found no significant association between state legalization status and MBM limitations. NICU and nursery policies differed in 33% of institutions. <b><i>Conclusions:</i></b> Substantial variation exists in NICU policies regarding toxicology screening and MBM limitations related to THC. These inconsistent policies are based not on THC legalization status but rather on the location of delivery. More research is needed on the effect of THC exposure on neonates, but we could limit inconsistent care by following current national medical organization guidelines of education and shared decision-making with mothers.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Supplement or Not to Supplement-That Is the Question.","authors":"Elien Rouw","doi":"10.1089/bfm.2025.0113","DOIUrl":"https://doi.org/10.1089/bfm.2025.0113","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding in the First Weeks Postpartum. Challenges and Realities.","authors":"Arthur I Eidelman","doi":"10.1089/bfm.2025.0123","DOIUrl":"https://doi.org/10.1089/bfm.2025.0123","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and Breast Milk Transfer to Infants of Subcutaneous Extended-Release Buprenorphine for the Treatment of Individuals with Opioid Use Disorder.","authors":"Antoinette Nelson-Rodriguez, Kelley Saia, Xin Xie, Jeremiah Momper, Davida M Schiff, Elisha M Wachman","doi":"10.1089/bfm.2025.0045","DOIUrl":"https://doi.org/10.1089/bfm.2025.0045","url":null,"abstract":"<p><p><b><i>Background:</i></b> Extended-release buprenorphine (XR BUP) is commonly used for individuals with opioid-use disorder (OUD), however, with limited experience in pregnancy. <i>N</i>-methyl-2-pyrrolidone (NMP), an excipient of monthly XR BUP formulations, is a developmental toxicant. No information is available on pharmacokinetics or breast milk transfer in lactating individuals receiving XR BUP. <b><i>Methods:</i></b> Samples of maternal plasma, infant plasma, and breast milk were collected from lactating individuals between 0 and 6 months postpartum receiving monthly XR BUP. All samples were analyzed for BUP and NMP concentrations using a validated liquid chromatography-tandem mass spectrometry assay. <b><i>Results:</i></b> Three lactating individuals provided a total of nine maternal plasma, six infant plasma, and five breast milk samples. Mean BUP concentrations were 6.0 ng/mL (standard deviation [SD] 1.6) in maternal plasma, 8.9 ng/mL (SD 6.6) in breast milk, and below the lower limit of quantitation for all infant plasma samples. We estimated the relative infant dose (RID) of BUP to be 1%. NMP was detectable in maternal plasma (mean 5.43 μg/mL, SD 4.56) and breast milk (mean 3.83 μg/mL, SD 5.07) only from samples measured between 1 and 5 hours after dosing. NMP was not detected in infant plasma. <b><i>Conclusions:</i></b> Among lactating individuals receiving XR BUP, BUP was present in low levels in maternal plasma (similar to nonlactating individuals on XR BUP) and breast milk of lactating individuals receiving XR BUP (similar to lactating individuals on sublingual BUP), resulting in a low RID. NMP passes into breast milk, however, was not present in infant plasma. Additional data are needed before definitive conclusions can be made.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informational Sources About Breastfeeding Associated with Breastfeeding Initiation: Insights into Racial Disparities.","authors":"Kaeli C Johnson, Rohit Baal Balasundaram, Idara N Akpan, Stacey B Griner","doi":"10.1089/bfm.2024.0283","DOIUrl":"10.1089/bfm.2024.0283","url":null,"abstract":"<p><p><b><i>Background:</i></b> Breastfeeding provides essential nutrition and disease protection for infants while reducing the risk of type 2 diabetes and breast cancer in mothers. Despite these benefits, significant racial and ethnic disparities exist in breastfeeding initiation, particularly among Black women. This study examines racial differences in the receipt of breastfeeding information from varying sources and their association with breastfeeding initiation. <b><i>Methods:</i></b> Data were obtained from the Phase 8 Core Pregnancy Risk Assessment Monitoring System for 2016-2020 (<i>n</i> = 163,724). The analysis focused on comparing the likelihood of breastfeeding initiation (yes/no) across racial groups and the impact of receiving breastfeeding information from varying clinical (mother's doctor/nurse/baby's doctor, etc.) and social sources (support group/family/friends, etc.). Univariate and multivariable analysis was conducted in SAS 9.4. <b><i>Results:</i></b> Black women consistently exhibited lower odds of breastfeeding initiation compared with other racial groups, across all informational sources. The study found that while information from both clinical and social sources increased breastfeeding initiation overall, Black women remained less likely to initiate breastfeeding than White women (<i>p</i> < 0.0001). <b><i>Conclusion:</i></b> Systemic barriers, including racism and bias in health care, contribute to the racial disparities in breastfeeding initiation. Culturally tailored interventions and improved health care provider training are necessary to address these gaps. Future efforts should aim to bridge the divide between clinical and social breastfeeding information sources to improve breastfeeding rates among minority women.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"296-302"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admitted when Breastfeeding: Impact and Experiences of Hospital Care.","authors":"Anna Llupià, Anna Fité, Alba Lladó, Laia Aguilar, Joaquim Puig","doi":"10.1089/bfm.2023.0310","DOIUrl":"10.1089/bfm.2023.0310","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study analyzes the impact and experiences of hospitalization for any reason on breastfeeding women. <b><i>Methods:</i></b> Cross-sectional online survey (November 2019-March 2020). Adults admitted to a Spanish hospital for at least one night, when actively breastfeeding, were included. The questionnaire aimed at assessing breastfeeding, breast complications, and support and perceived health care workers' attitudes to breastfeeding. <b><i>Results:</i></b> Of the 266 included participants, 70 (26%) stopped breastfeeding during hospitalization, and 13 (5%) interrupted it permanently. A total of 24 (10%) participants reported that hospitalization meant problems for later breastfeeding, and 67 (25%) reported experiencing breast complications. The most common negative comment was that the child was too old to be breastfed (median age, 15 months [interquartile range (IQR) 11-25]). Problems for later breastfeeding due to the hospitalization were more likely if breastfeeding was interrupted (odds ratio [OR] 3.68, 95% confidence interval [CI] 1.32-10.5) or breast problems were experienced (OR 4.11, 95% CI 1.51-11.7). Problems were less likely when patients felt encouraged (OR 0.38, 95% CI 0.21-0.69) and hospitalized in a surgical inpatient area (OR 0.15, 95% CI 0.03-0.65). <b><i>Conclusions:</i></b> Hospitalizations can cause breastfeeding and breast problems. Hospital services must update protocols to integrate breastfeeding into usual care.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"320-326"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}