Infant Health Research

Miscellaneous

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This section covers a range of recent studies related to feeding, relationship building and infant health.

Trauma-informed care in the newborn intensive care unit: promoting safety, security and connectedness

This review applies the principles of trauma-informed care, within the framework of the Polyvagal Theory as described by Porges, to care for the NICU baby, the baby’s family and their professional caregivers, emphasizing the importance of social connectedness among all. The Polyvagal Theory explains how one’s unconscious awareness of safety, danger or life threat (neuroception) is linked through the autonomic nervous system to their behavioral responses. Using techniques of trauma-informed care, as explained by the Polyvagal Theory, with both babies and their parents in the NICU setting will help to cement a secure relationship between the parent-infant dyad, redirecting the developmental trajectory toward long-term health and well-being of the baby and all family members.

Sanders M and Hall S (2018) Trauma-informed care in the newborn intensive care unit: promoting safety, security and connectedness. Journal of Perinatology, 38(1), pp.3–10

The challenges of medically complex breastfed children and their families: A systematic review

Despite medically complex infants and children being a group that could benefit most from continued breastfeeding, breastfeeding duration and exclusivity are lower among more complex paediatric populations. This systematic review aimed to understand the challenges of breast/chestfeeding the medically complex child and to establish the gaps in healthcare provision that act as barriers to optimal infant and young child feeding. Findings affirm the lack of consistent high-quality care for lactation support in paediatric settings and reinforce the need for further focused research in this area.

Hookway, LLewis, JBrown, AThe challenges of medically complex breastfed children and their families: A systematic reviewMatern Child Nutr2021;e13182. https://doi.org/10.1111/mcn.13182

Breastfeeding promotes early neonatal regulatory T-cell expansion and immune tolerance of non-inherited maternal antigens

Research led by the University of Birmingham and Birmingham Women’s and Children’s NHS Foundation Trust has revealed new insight into the biological mechanisms of the long-term positive health effects of breastfeeding in preventing disorders of the immune system in later life, with data showing that exposure of the neonate to maternal cells through breastfeeding acts to drive the maturation of Tregs and ‘tolerizes’ the neonate towards non-inherited maternal antigens.

HL Wood et al. Breastfeeding promotes early neonatal regulatory T cell expansion and immune tolerance of non‐inherited maternal antigens. Allergy. First published: 12 January 2021 doi.org/10.1111/all.14736

January – March 2019 research round up

Infant Feeding expert and blogger Analytical Armadillo has produced a round up of 45 infant feeding-related studies, published between January and March 2019. Ranging from a meta-analysis of the effects of kangaroo care on preterm infants, to racial inequalities in breastfeeding, the document provides a concise summary of each study.

Research round up (April 2019)

Stroking modulates noxious-evoked brain activity in human infants

This study of 32 infants explored whether touch can reduce noxious-evoked brain activity, following previous studies of adults showing that touch of C fibre sensory neurons is pleasant and can reduce pain perception. Researchers found that stroking prior to an experimental noxious stimulus or clinical heel lance can attenuate noxious-evoked brain activity in infants. They conclude that C-tactile fibres may represent a biological target for non-pharmacological interventions that modulate pain in early life, and said that further research is needed to ascertain whether this simple tactile intervention is effective in modulating pain in the context of other clinical procedures and in preterm infants.

Gursul, D, Goksan, S, Hartley, C, et al, (2018). Stroking modulates noxious-evoked brain activity in human infants. Current Biology, doi.org/10.1016/j.cub.2018.11.014

Comparison of breast milk compositions among mothers delivering small-for-gestational age, appropriate-for-gestational age, and large-for-gestational age infants

This study of 75 milk samples found that the carbohydrate (CHO) composition of breastmilk in mothers of infants who were small-for-gestational age (SGA) was significantly lower than that in mothers of appropriate-for-gestational age (AGA) infants – but this was not found to have any clinical significance. In addition, no significant correlation was found between maternal BMI, gestational age, and CHO.

Phattraprayoon, N, Kraisonsin, N, and Kanjanapattanakul, W, (2018). Comparison of breast milk compositions among mothers delivering small-for-gestational age, appropriate-for-gestational age, and large-for-gestational age infants. Breastfeeding Medicine, doi.org/10.1089/bfm.2018.0043

Domperidone increases breast milk production in mothers of premature babies

This systematic review of five randomised controlled trials found that domperidone increased mean daily expressed milk volume by 88ml/day amongst women feeding expressed breastmilk to their premature babies. Further studies are needed to explore this and examine any other possible side effects.

Grzeskowiak, L, Smithers, L, et al, (2018). Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: A systematic review and meta-analysis. BJOG.

Older research 

  • Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed

Flint, A, et al. Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD005092. DOI: 10.1002/14651858.CD005092.pub3

  • A review of adverse reactions in infants from medications in breastmilk

Anderson, P.O., Manoguerra, A.S. & Valdes, V. (2015). A Review of Adverse Reactions in Infants From Medications in Breastmilk. Clinical paediatrics, doi: 10.1177/0009922815594586

  • Breastfeeding and reduced risk of liver disease in adolescence

Ayonrinde, O T et al (2016), Maternal obesity and duration of breastfeeding influence the risk of nonalcoholic fatty liver disease in adolescents, EASL LiverTree, 125715

  • Nutrient and food intakes in early life and risk of childhood fractures

Handel, M.N., Heitmann, B.L. & Abrahamsen, B. (2015). Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis. American Journal of Clinical Nutrition, doi: 10.3945/ajcn.115.108456

  • Breastfeeding and Risk of Rheumatoid Arthritis

Chen, H. et al (2015). Breastfeeding and Risk of Rheumatoid Arthritis: A Systematic Review and Metaanalysis. The Journal of Rheumatology; doi: 10.3899/jrheum.150195

 

Related research and further reading

Infant health research: Meta-Analyses

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The Lancet: Increasing breastfeeding worldwide could prevent over 800,000 child deaths every year

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The impact of breastfeeding on maternal and child health: Acta Paediatrica special issue

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