Individualized breastfeeding support for acutely ill malnourished infants under 6 months old

<p>Re‐establishing exclusive breastfeeding is the cornerstone of the 2013 WHO treatment guidelines for acute malnutrition in infants less than 6 months. However, no studies have investigated guideline implementation and subsequent outcomes in a public hospital setting in Africa. To facilitate...

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Egile Nagusiak: Mwangome, M, Murunga, S, Kahindi, J, Gwiyo, P, Mwasho, G, Talbert, A, Kiige, L, Samburu, B, Mturi, N, Abubakar, A, Jones, C, Berkley, J
Formatua: Journal article
Hizkuntza:English
Argitaratua: Wiley 2019
_version_ 1826278456947638272
author Mwangome, M
Murunga, S
Kahindi, J
Gwiyo, P
Mwasho, G
Talbert, A
Kiige, L
Samburu, B
Mturi, N
Abubakar, A
Jones, C
Berkley, J
author_facet Mwangome, M
Murunga, S
Kahindi, J
Gwiyo, P
Mwasho, G
Talbert, A
Kiige, L
Samburu, B
Mturi, N
Abubakar, A
Jones, C
Berkley, J
author_sort Mwangome, M
collection OXFORD
description <p>Re‐establishing exclusive breastfeeding is the cornerstone of the 2013 WHO treatment guidelines for acute malnutrition in infants less than 6 months. However, no studies have investigated guideline implementation and subsequent outcomes in a public hospital setting in Africa. To facilitate implementation of the WHO 2013 guidelines in Kilifi County Hospital (KCH), Kenya, we developed standard operating procedure (SOP), recruited and trained three breastfeeding peer supporters (BFPS). Between September 2016 and January 2018, the BFPS provided individual breastfeeding support to mothers of infants aged 4 weeks to 4 months admitted to KCH with an illness and acute malnutrition (MUAC&lt;11.0cm OR WAZ &lt;‐2 OR WLZ &lt;‐2). Infants were followed daily while in hospital then every 2 weeks for 6 weeks after discharge with data collected on breastfeeding, infant growth, morbidity and mortality.</p> <p>Of 106 infants with acute malnutrition at admission, 51 met the inclusion criteria for the study. Most enrolled mothers had multiple breastfeeding challenges which were predominantly technique based. Exclusive breastfeeding was 55% at admission and 81% at discharge; at discharge 67% of infants had attained a weight velocity of &gt;5g/kg/day for 3 consecutive days on breastmilk alone. Gains in WLZ and WAZ were generally not sustained beyond 2 weeks after discharge. BFPS operated effectively in an inpatient setting, applying the 2013 updated WHO guidelines and increasing rates of exclusive breastfeeding at discharge. However, lack of continued increase in anthropometric Z scores after discharge suggests the need for more sustained interventions.</p>
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spelling oxford-uuid:7057e244-720c-4edb-a462-8177f730ee022022-03-26T19:36:34ZIndividualized breastfeeding support for acutely ill malnourished infants under 6 months oldJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7057e244-720c-4edb-a462-8177f730ee02EnglishSymplectic Elements at OxfordWiley2019Mwangome, MMurunga, SKahindi, JGwiyo, PMwasho, GTalbert, AKiige, LSamburu, BMturi, NAbubakar, AJones, CBerkley, J<p>Re‐establishing exclusive breastfeeding is the cornerstone of the 2013 WHO treatment guidelines for acute malnutrition in infants less than 6 months. However, no studies have investigated guideline implementation and subsequent outcomes in a public hospital setting in Africa. To facilitate implementation of the WHO 2013 guidelines in Kilifi County Hospital (KCH), Kenya, we developed standard operating procedure (SOP), recruited and trained three breastfeeding peer supporters (BFPS). Between September 2016 and January 2018, the BFPS provided individual breastfeeding support to mothers of infants aged 4 weeks to 4 months admitted to KCH with an illness and acute malnutrition (MUAC&lt;11.0cm OR WAZ &lt;‐2 OR WLZ &lt;‐2). Infants were followed daily while in hospital then every 2 weeks for 6 weeks after discharge with data collected on breastfeeding, infant growth, morbidity and mortality.</p> <p>Of 106 infants with acute malnutrition at admission, 51 met the inclusion criteria for the study. Most enrolled mothers had multiple breastfeeding challenges which were predominantly technique based. Exclusive breastfeeding was 55% at admission and 81% at discharge; at discharge 67% of infants had attained a weight velocity of &gt;5g/kg/day for 3 consecutive days on breastmilk alone. Gains in WLZ and WAZ were generally not sustained beyond 2 weeks after discharge. BFPS operated effectively in an inpatient setting, applying the 2013 updated WHO guidelines and increasing rates of exclusive breastfeeding at discharge. However, lack of continued increase in anthropometric Z scores after discharge suggests the need for more sustained interventions.</p>
spellingShingle Mwangome, M
Murunga, S
Kahindi, J
Gwiyo, P
Mwasho, G
Talbert, A
Kiige, L
Samburu, B
Mturi, N
Abubakar, A
Jones, C
Berkley, J
Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title_full Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title_fullStr Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title_full_unstemmed Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title_short Individualized breastfeeding support for acutely ill malnourished infants under 6 months old
title_sort individualized breastfeeding support for acutely ill malnourished infants under 6 months old
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