Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low B...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115266/?tool=EBI |
| _version_ | 1797695939615391744 |
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| author | Katherine E. A. Semrau Rana R. Mokhtar Karim Manji Shivaprasad S. Goudar Tisungane Mvalo Christopher R. Sudfeld Melissa F. Young Bethany A. Caruso Christopher P. Duggan Sarah S. Somji Anne C. C. Lee Mohamed Bakari Kristina Lugangira Rodrick Kisenge Linda S. Adair Irving F. Hoffman Friday Saidi Melda Phiri Kingsly Msimuko Fadire Nyirenda Mallory Michalak Sangappa M. Dhaded Roopa M. Bellad Sujata Misra Sanghamitra Panda Sunil S. Vernekar Veena Herekar Manjunath Sommannavar Rashmita B. Nayak S. Yogeshkumar Saraswati Welling Krysten North Kiersten Israel-Ballard Kimberly L. Mansen Stephanie L. Martin Katelyn Fleming Katharine Miller Arthur Pote Lauren Spigel Danielle E. Tuller Linda Vesel |
| author_facet | Katherine E. A. Semrau Rana R. Mokhtar Karim Manji Shivaprasad S. Goudar Tisungane Mvalo Christopher R. Sudfeld Melissa F. Young Bethany A. Caruso Christopher P. Duggan Sarah S. Somji Anne C. C. Lee Mohamed Bakari Kristina Lugangira Rodrick Kisenge Linda S. Adair Irving F. Hoffman Friday Saidi Melda Phiri Kingsly Msimuko Fadire Nyirenda Mallory Michalak Sangappa M. Dhaded Roopa M. Bellad Sujata Misra Sanghamitra Panda Sunil S. Vernekar Veena Herekar Manjunath Sommannavar Rashmita B. Nayak S. Yogeshkumar Saraswati Welling Krysten North Kiersten Israel-Ballard Kimberly L. Mansen Stephanie L. Martin Katelyn Fleming Katharine Miller Arthur Pote Lauren Spigel Danielle E. Tuller Linda Vesel |
| author_sort | Katherine E. A. Semrau |
| collection | DOAJ |
| description | Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge. |
| first_indexed | 2024-03-12T03:18:33Z |
| format | Article |
| id | doaj.art-d593615599be408d9c9aca415ce6b177 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:18:33Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-d593615599be408d9c9aca415ce6b1772023-09-03T14:06:50ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0134Facility-based care for moderately low birthweight infants in India, Malawi, and TanzaniaKatherine E. A. SemrauRana R. MokhtarKarim ManjiShivaprasad S. GoudarTisungane MvaloChristopher R. SudfeldMelissa F. YoungBethany A. CarusoChristopher P. DugganSarah S. SomjiAnne C. C. LeeMohamed BakariKristina LugangiraRodrick KisengeLinda S. AdairIrving F. HoffmanFriday SaidiMelda PhiriKingsly MsimukoFadire NyirendaMallory MichalakSangappa M. DhadedRoopa M. BelladSujata MisraSanghamitra PandaSunil S. VernekarVeena HerekarManjunath SommannavarRashmita B. NayakS. YogeshkumarSaraswati WellingKrysten NorthKiersten Israel-BallardKimberly L. MansenStephanie L. MartinKatelyn FlemingKatharine MillerArthur PoteLauren SpigelDanielle E. TullerLinda VeselGlobally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115266/?tool=EBI |
| spellingShingle | Katherine E. A. Semrau Rana R. Mokhtar Karim Manji Shivaprasad S. Goudar Tisungane Mvalo Christopher R. Sudfeld Melissa F. Young Bethany A. Caruso Christopher P. Duggan Sarah S. Somji Anne C. C. Lee Mohamed Bakari Kristina Lugangira Rodrick Kisenge Linda S. Adair Irving F. Hoffman Friday Saidi Melda Phiri Kingsly Msimuko Fadire Nyirenda Mallory Michalak Sangappa M. Dhaded Roopa M. Bellad Sujata Misra Sanghamitra Panda Sunil S. Vernekar Veena Herekar Manjunath Sommannavar Rashmita B. Nayak S. Yogeshkumar Saraswati Welling Krysten North Kiersten Israel-Ballard Kimberly L. Mansen Stephanie L. Martin Katelyn Fleming Katharine Miller Arthur Pote Lauren Spigel Danielle E. Tuller Linda Vesel Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania PLOS Global Public Health |
| title | Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania |
| title_full | Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania |
| title_fullStr | Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania |
| title_full_unstemmed | Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania |
| title_short | Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania |
| title_sort | facility based care for moderately low birthweight infants in india malawi and tanzania |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115266/?tool=EBI |
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