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Vizzari G, Morniroli D, D’Auria A, Travella P, Bezze E, Sannino P, Rampini S, Marchisio P, Plevani L, Mosca F, Giannì ML. Feeding Difficulties in Late Preterm Infants and Their Impact on Maternal Mental Health and the Mother-Infant Relationship: A Literature Review. Nutrients 2023; 15:2180. [PMID: 37432319 PMCID: PMC10180855 DOI: 10.3390/nu15092180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
Late preterm infants constitute the largest subset of premature infants and are more likely to experience feeding issues leading to delayed oral feeding independence and low breastfeeding rates. Considering the increased parental concern about their infants' nutrition and growth, we performed a literature review to provide an update on the feeding challenges faced by late preterm infants and the impact of these issues on maternal mental health and the mother-infant relationship. Based on our findings, late preterm infants have a high prevalence of feeding difficulties which need to be addressed by targeted support interventions to promote breastfeeding success and the establishment of a harmonious dyadic interaction between the mother and her infant, all of which contribute to the prevention of altered feeding behavior later in life. There is still a need for additional research to develop a standardized and shared strategy that can be proven to be effective. Should this be accomplished, it will be possible to offer appropriate support for mothers, encourage the oral skills and maturation of late preterm infants, and improve the relationship quality within the dyad.
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Affiliation(s)
- Giulia Vizzari
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Arianna D’Auria
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Paola Travella
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Elena Bezze
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Patrizio Sannino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Serena Rampini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Paola Marchisio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
| | - Fabio Mosca
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
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Fassino B, Ferrario S, Sorrentino G, Adamini I, Pesenti N, Fumagalli M, Mosca F, Plevani L. Hospital-acquired skin lesions in the neonatal intensive care unit: A retrospective analysis of temporal trends and quality improvement strategies. J Pediatr Nurs 2023; 70:40-46. [PMID: 36796303 DOI: 10.1016/j.pedn.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE Skin lesions in neonatal population are an emerging problem deserving attention from health care professionals. The purpose of this study is to retrospectively assess the incidence of hospital-acquired skin lesions during a 6-year period and to describe the characteristics of infants who developed them. DESIGN AND METHODS This was a retrospective observational study conducted in a university-tertiary care center between 2015 and 2020. A descriptive analysis of the observed skin lesions is presented according to 2 time periods: 1) the implementation phase of a quality improvement program (2015-2019) and 2) the postimplementation phase (2020). RESULTS Our findings showed an apparent increase in the incidence of all reported skin lesions throughout the study period. Pressure injuries were the most frequently reported skin lesions showing an increasing incidence over time which, however, was paralleled by a reduction in their severity. Among pressure injuries, device-related injuries were the most commonly observed (56.6% and 62.5% in the two periods, respectively) with nasal continuous positive airway pressure-related injuries accounting for 71.7% and 56.0% of lesions, respectively, and mainly affecting the nose root. The occipital area was the most frequently involved site in cases of conventional pressure injuries. CONCLUSION Infants admitted to Neonatal Intensive Care Units may be at high risk of developing skin lesions. The adoption of appropriate preventative as well as treatment interventions could be effective in reducing the severity of pressure injuries. PRACTICE IMPLICATIONS The implementation of quality improvement strategies may contribute to prevent skin injuries or lead to their early detection.
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Affiliation(s)
- Barbara Fassino
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy.
| | - Silvia Ferrario
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy.
| | - Gabriele Sorrentino
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy.
| | - Ileana Adamini
- Healthcare Professions Department Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy.
| | - Nicola Pesenti
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy; Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology, and Public Health, University of Milano-Bicocca, 20126 Milan, Italy.
| | - Monica Fumagalli
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy; University of Milan, Department of Clinical Sciences and Community Health, via Festa del Perdono 7, 20122 Milan, Italy.
| | - Fabio Mosca
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy; University of Milan, Department of Clinical Sciences and Community Health, via Festa del Perdono 7, 20122 Milan, Italy.
| | - Laura Plevani
- NICU Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122 Milan, Italy.
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Bezze EN, Morniroli D, Farneti M, Sannino P, Marinello R, Bettinelli ME, Santini G, Plevani L, Marchisio P, Mosca F, Giannì ML. Corrigendum to "Nurses in family pediatric practices: A survey of the health protection agency of the Metropolitan City of Milan" [J Pediatr Nurs. 2021 Jan-Feb;56:1-6]. J Pediatr Nurs 2022; 63:172. [PMID: 34376290 DOI: 10.1016/j.pedn.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Elena Nicoletta Bezze
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy.
| | - Daniela Morniroli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy
| | - Martina Farneti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy
| | - Patrizio Sannino
- Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, Via Francesco Sforza 28, 20122 Milan, Italy
| | - Roberto Marinello
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, Milan, Italy
| | - Maria Enrica Bettinelli
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, Milan, Italy
| | - Germana Santini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Via Commenda 9, 20122 Milan, Italy; Department of Pathophysiology and Trasplantion, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Via Commenda 12, 20122 Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, Milan, Italy
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Consales A, Colombo L, Zanotta L, Morniroli D, Sannino P, Rampini S, Piccoli G, Donghi M, Marchisio P, Mosca F, Plevani L, Giannì ML. Pilot Feasibility Study of a Hospital-Based Post-Natal Educational Intervention on New Mothers in a BFHI-Compliant Tertiary Referral Center for Neonatal Care. Int J Environ Res Public Health 2022; 19:ijerph19042020. [PMID: 35206209 PMCID: PMC8871806 DOI: 10.3390/ijerph19042020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
The immediate post-partum period offers a valuable opportunity for parental education on various health topics. The aim of this study was to pilot test the feasibility in a tertiary referral center for neonatal care of a post-natal educational intervention (the Diary) designed to provide mothers with basic information concerning newborn care and breastfeeding. Furthermore, we aimed to evaluate its effect on exclusive breastfeeding rates at discharge and at 48 h post-discharge, and on maternal perceived support during hospital stay, compared to standard care. A single-center two-phase interventional study was carried out from 1 December 2018 to 2 June 2019. The Diary was given to mothers enrolled in Phase 2, together with the Nurse-Parent Support Tool (NPST). The Diary-NPST couples analyzed were 269. The Diaries filled out and returned were 62.2%. Overall, mothers rated the information received through the Diary as "clear and comprehensive". Exclusive breastfeeding rates at discharge resulted in being higher in Phase 1 than in Phase 2 (80.6% vs. 72.5%, p = 0.04), whereas no difference emerged in terms of exclusive breastfeeding rates at 48 h. In both phases, the median NPST total score (4.05) was high. In conclusion, we propose a new instrument of in-hospital post-natal maternal education and, in line with the current literature, we support well-designed written educational materials to promote mothers' knowledge and satisfaction with post-partum hospital assistance. Further studies that are multicentric and with a longer follow-up period are needed to evaluate the potential impact of the Diary on exclusive breastfeeding duration.
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Affiliation(s)
- Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
- Correspondence: ; Tel.: +39-0255032907
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Serena Rampini
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Giulia Piccoli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Michaela Donghi
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Paola Marchisio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Pediatric Unit, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
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Mallardi D, Piemontese P, Liotto N, Colombo RM, Dodaro A, Schiavello A, Tabasso C, Plevani L, Bezze E, Menis C, Roggero P, Mosca F. New Operating Approach to Limit Bacillus Cereus Contamination of Donor Human Milk. J Hum Lact 2022; 38:102-107. [PMID: 33745375 DOI: 10.1177/08903344211002563] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Domenica Mallardi
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pasqua Piemontese
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nadia Liotto
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosaria M Colombo
- 9339 Unit of Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Dodaro
- 9339 Unit of Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Chiara Tabasso
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Plevani
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Bezze
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Menis
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paola Roggero
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Fabio Mosca
- 9339 NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
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Tommasi V, Vercesi G, Sannino P, Bassola B, Plevani L, Cilluffo S, Lusignani M. [The use of International Classification for Nursing Practice (ICNP) in pediatric and neonatal settings: literature review]. Prof Inferm 2021; 74:195-204. [PMID: 35363954 DOI: 10.7429/pi.2021.744195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Literature reports that the use of Standardized Nursing Terminology contributes to a better implementation of nursing care and patients' safety and to do research. ICNP is an international and combinatorial standard terminology proposal by ICN, adaptable to different settings, among which paediatric and neonatal. METHODS A literature review on different databases (Medline/Pubmed, CINAHL, Embase, Web of Science and Scopus) was conducted to investigate the use of ICNP in professional practice in paediatric and neonatal settings. RESULTS 44 papers were included in the review; 33 of which focused on the paediatric setting while 11 on the neonatal setting. It is evident ICNP is usable in both settings, permitting to describe nursing care to different age groups, in-hospital, out-of-hospital and in specific clinical situations. DISCUSSION ICNP is up to the task of describing nursing care, implementing nursing care plans, analysing types of nursing care for management aims, studying concepts or specific pediatric or neonatal situations. ICNP is adaptable to different nursing frameworks and models. Few studies analyses ICNP implementation or effectiveness in clinical settings. Additional research is needed to verify ICNP effectiveness in paediatric and neonatal settings and to implement contextual catalogues.
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Affiliation(s)
- Valentina Tommasi
- PhD Candidate, Universita' degli Studi di Roma Tor Vergata; Professore a contratto MED45, Infermiera, AGOM Niguarda, Corso di Laurea in Infermieristica, Universita' degli Studi di Milano, Milano;
| | - Giulia Vercesi
- Studente Laurea Scienze Infermieristiche e Ostetriche, Universita' degli Studi di Milano; Infermiera Pediatrica, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Patrizio Sannino
- Infermiere, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, Milan, Italy; ID ORCID: https://orcid.org/0000-0002-4719-3386.EMail:
| | - Barbara Bassola
- PhD, Professore a contratto MED45, Infermiera Tutor, AGOM Niguarda, Corso di Laurea in Infermieristica, Universita' degli Studi di Milano, Milano; ID ORCID: https://orcid.org/0000-0001-8860-4893.
| | - Laura Plevani
- Infermiere, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milano.
| | - Silvia Cilluffo
- PhD Student, Universita' degli Studi di Roma Tor Vergata; Professore a contratto MED45, Infermiera Tutor, AGOM Niguarda, Corso di Laurea in Infermieristica, Universita' degli Studi di Milano, Milano; ID ORCID: https://orcid.org/0000-0003-2756-9929.
| | - Maura Lusignani
- Professore Associato, Universita' degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, Universita' degli Studi di Milano; Direttore Didattico del Corso di Laurea in Infermieristica, AGOM Niguarda, Milano; ID ORCID: https://orcid.org/0000-0002-5389-9879
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Morniroli D, Consales A, Colombo L, Bezze EN, Zanotta L, Plevani L, Fumagalli M, Mosca F, Giannì ML. Exploring the Impact of Restricted Partners' Visiting Policies on Non-Infected Mothers' Mental Health and Breastfeeding Rates during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18126347. [PMID: 34208247 PMCID: PMC8296174 DOI: 10.3390/ijerph18126347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
Changes in perinatal care occurring during the coronavirus disease 2019 (COVID-19) pandemic may negatively affect mothers' mental health and breastfeeding. This study, performed between April and May 2020, aimed to investigate the effect of restricted partners' visiting policies on non-infected mother's anxiety symptoms, the perceived postpartum support, and the breastfeeding outcomes at discharge. A cross-sectional study was conducted in a neonatal tertiary referral center in northern Italy during Italy's lockdown. We enrolled mothers with a negative nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), adequate oral and written comprehension of the Italian language, and absence of underlying maternal or neonatal clinical conditions. Maternal anxiety levels were assessed through the State-Trait Anxiety Inventory-Form Y (STAI-Y). Maternal perception of staff's support was evaluated by the Nurse Parent Support Tool (NPST). A STATE-A (concurrent emotional state after a specific situation) score ≥ 40 was considered indicative of clinically significant symptoms of anxiety. A total of 109 mothers completed the study. Mean STATE-A score was ≥40 in 42% of mothers, and median NPST score was 4.23. Mothers separated from their partner had a mean STATE-A score ≥ 40 in a higher percentage of cases than those who were not (51% vs. 30%, p = 0.03) and a lower perception of caregiver support. A NPST score ≤4.23, partner 's absence during the hospital stay and primiparity were independently associated with a STATE-A score ≥ 40. Breastfeeding rates at discharge were not influenced by maternal anxiety levels and partner's restricted policies. Instead, they were influenced by mode of delivery, a well-known risk factor, and pre-pandemic intention to breastfeed. Our study demonstrates the positive impact of a partner's presence on maternal mental health and perception of caregiver support.
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Affiliation(s)
- Daniela Morniroli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
| | - Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-025503-2907
| | - Lorenzo Colombo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
| | - Elena Nicoletta Bezze
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
| | - Lidia Zanotta
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
| | - Laura Plevani
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
| | - Monica Fumagalli
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, 20122 Milan, Italy; (D.M.); (L.C.); (E.N.B.); (L.Z.); (L.P.); (M.F.); (F.M.); (M.L.G.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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8
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Lavizzari A, Falgari R, Pesenti N, Colnaghi M, Colombo L, Zanotta L, Sannino P, Plevani L, Mosca F. Heart-rate agreement between ECG and a new, wireless device during early skin-to-skin contact. Acta Paediatr 2021; 110:1803-1809. [PMID: 33484017 DOI: 10.1111/apa.15769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/26/2020] [Accepted: 01/19/2021] [Indexed: 11/26/2022]
Abstract
AIM To assess the agreement of heart rate (HR) between the new device - a fabric jacket for neonates, with integrated sensors detecting ECG signals and a Bluetooth connection to a computer (ComfTech, HOWDY) - and the clinical reference, ECG, during the skin-to-skin contact (SSC) in the first 2 h after birth, for the potential use of early detection of Sudden and Unexpected Postnatal Collapse (SUPC). METHODS We enrolled newborns ≥35+0 weeks of gestation, with Apgar score >8 at 5 min in a prospective, observational study in the delivery room, excluding infants with need for resuscitation, clinical instability or major malformations. We assessed HR within 20 min after birth by both devices simultaneously: the index test ComfTech HOWDY and the standard ECG (Vita Guard VG 3100, Getemed). We compared HR between the two methods at 0, 15, 30, 45, 60, 90 and 120 min by the Bland-Altman plot. RESULTS We included 60 infants. The mean difference between the methods was -1.3 bpm, 95%LoA -12.4 to 9.7 bpm. Spearman rank correlation coefficient ρ = -0.06. CONCLUSION ComfTech HOWDY presents reliable agreement with the ECG and might assist in identifying infants at risk for SUPC.
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Affiliation(s)
- Anna Lavizzari
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Roberta Falgari
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Nicola Pesenti
- Division of Biostatistics Department of Statistics and Quantitative Methods Epidemiology and Public Health University of Milano‐Bicocca Milan Italy
| | - Mariarosa Colnaghi
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Patrizio Sannino
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoDirezione Professioni sanitarie Milan Italy
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
| | - Fabio Mosca
- Fondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoNeonatal Intensive Care Unit Milan Italy
- Department of Clinical Sciences and Community Health University of Milan Milan Italy
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9
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Morniroli D, Consales A, Riverso L, Colombo L, Bezze EN, Sannino P, Zanotta L, Marchisio P, Mosca F, Plevani L, Giannì ML. Post-partum Hospital Stay and Mothers' Choices on Breastfeeding and Vaccines: A Chance We Should Not Miss. Front Public Health 2021; 9:625779. [PMID: 34123985 PMCID: PMC8193677 DOI: 10.3389/fpubh.2021.625779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/04/2021] [Indexed: 11/15/2022] Open
Abstract
Parents' education and knowledge regarding major topics of children's health, such as nutrition and vaccines, have a paramount role. However, breastfeeding rates in first year of life are lower than recommended, and vaccine hesitancy is progressively spreading. To reverse this harmful trend, healthcare professionals are challenged to promote correct health information. This study aimed to assess newly mothers' knowledge of breastfeeding and vaccinations, and education received on both topics during hospital stay. We performed a cross-sectional survey in the Postnatal Unit of our Center. Mothers of full-term babies with a birthweight >2,500 g were enrolled. Two different questionnaires, one about breastfeeding and one about vaccines, were proposed to the 140 enrolled mothers. Ninety-nine percent of mothers enrolled were aware of breastfeeding benefits, and 92% felt adequately supported by maternity staff. Less than 25% stated to have received sufficient information regarding breastfeeding. Only 20% of mothers received information about vaccines during hospital stay. Healthcare providers were identified as primary, secondary, and tertiary source of information on vaccines by 55, 15, and 30% of mothers, respectively. Healthcare professionals are crucial in informing and educating mothers on breastfeeding and vaccinations. Post-partum hospital stay could be the right time for this critical responsibility.
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Affiliation(s)
- Daniela Morniroli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luana Riverso
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | | | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lidia Zanotta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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10
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Crippa BL, Consales A, Morniroli D, Lunetto F, Bettinelli ME, Sannino P, Rampini S, Zanotta L, Marchisio P, Plevani L, Giannì ML, Mosca F, Colombo L. From dyad to triad: a survey on fathers' knowledge and attitudes toward breastfeeding. Eur J Pediatr 2021; 180:2861-2869. [PMID: 33779804 PMCID: PMC8346446 DOI: 10.1007/s00431-021-04034-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Fathers are known to impact breastfeeding outcomes. We aimed to explore paternal knowledge and attitude toward breastfeeding, and possible association with breastfeeding rates at discharge. In this cross-sectional study, we enrolled 200 fathers of healthy term neonates. At discharge, fathers were asked to rate their degree of agreement to 12 items on a 5-point Likert scale. A total score was obtained from their answers. Univariate binary logistic regression analysis was used to verify if the total score was predictive of exclusive breastfeeding at discharge. A multivariable logistic regression model was then used to adjust for possible confounders. ROC analysis was performed, and a Youden's total score cut-off value was determined to define total score's performance in predicting exclusive breastfeeding at discharge. Fathers showed a solid knowledge of maternal (87%) and neonatal (98%) benefits of breastfeeding, skin-to-skin (99.5%), rooming-in (79%), and responsive feeding (67.5%); conversely, only 51% knew about the recommended use of pacifiers. Fathers felt personally involved in babies' feeding in 79% of cases. An association was found between total score and exclusive breastfeeding at discharge at univariate (OR: 1.07, p = 0.04) but not at multivariable analysis (OR: 1.07, p = 0.067). ROC analysis was not statistically significant (AUC 0.58, p = 0.083).Conclusion: By using a novel instrument aimed at quantifying fathers' knowledge and overall attitude toward breastfeeding, this study underlines the importance of including fathers in the promotion of breastfeeding. Expanding the classic mother-baby dyad to a more modern mother-father-baby triad may impact breastfeeding outcomes at discharge. What is known: • Social support plays a major role in improving breastfeeding outcomes. • Fathers may greatly influence initiation and duration of breastfeeding; the more they know, the more helpful they can be. What is new: • A multidisciplinary team created a structured questionnaire aimed at quantifying fathers' knowledge and attitude toward breastfeeding. • The association between a higher questionnaire total score and exclusive breastfeeding rates at discharge highlights the importance of including fathers in the promotion of breastfeeding, as part of the breastfeeding team.
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Affiliation(s)
- Beatrice Letizia Crippa
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Alessandra Consales
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Flavia Lunetto
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maria Enrica Bettinelli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Rampini
- Direzione Professioni Sanitarie, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Università degli Studi di Milano, 20122 Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
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11
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Vizzari G, Morniroli D, Consales A, Capelli V, Crippa BL, Colombo L, Sorrentino G, Bezze E, Sannino P, Soldi VA, Plevani L, Mosca F, Giannì ML. Knowledge and attitude of health staff towards breastfeeding in NICU setting: are we there yet? An Italian survey. Eur J Pediatr 2020; 179:1751-1759. [PMID: 32424743 DOI: 10.1007/s00431-020-03678-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/24/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
The benefits of human milk in preterm infants, a population at high risk for developing adverse outcomes for which breast milk is a protective factor, are widely acknowledged. However, preterms' admission in a neonatal intensive care unit (NICU) and newborn's clinical conditions have been described as significant barriers, leading to lower rates of breastfeeding initiation and duration. Healthcare workers play a crucial role in encouraging breastfeeding. We conducted a cross-sectional survey among nurses working in six Italian NICUs, exploring their knowledge and attitude towards breastfeeding. Although the majority of nurses had a specific breastfeeding education, our results show still some variations among answers regarding aspects of breastfeeding support in this setting. Specifically, family-centered care, transition feeding to the breast, and skin-to-skin practice, despite being extensively addressed by the Neo Baby-Friendly Hospital Initiative, are the items that highlighted a range of answers that could result in conflicting information to mothers.Conclusion: By underlining the gaps of knowledge and attitude towards breastfeeding of nurses working in NICUs, this study provides an insight into what needs to be improved, with the aim of promoting higher rates of breastfeeding in the preterm population. What is Known: • Breastfeeding is particularly challenging in the preterm population, despite its universally recognized health benefits. • Improving healthcare professionals' knowledge and attitude towards breastfeeding has been shown to be crucial for promoting breastfeeding in NICUs. What is New: • Our results provide useful insight into nurses' knowledge and attitude towards breastfeeding in NICU settings. • By acknowledging strengths and weaknesses highlighted by this study, tailored strategies could be developed to improve health staff breastfeeding education and support to parents in NICU settings.
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Affiliation(s)
- Giulia Vizzari
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, Milan, Italy
| | - Daniela Morniroli
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy.
| | - Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, Milan, Italy.,NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Valentina Capelli
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Beatrice Letizia Crippa
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Lorenzo Colombo
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Gabriele Sorrentino
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Elena Bezze
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122, Milan, Italy
| | - Valeria Andrea Soldi
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Laura Plevani
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, Milan, Italy.,NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda, 19, Milan, Italy.,NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122, Milan, Italy
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12
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Consales A, Crippa BL, Cerasani J, Morniroli D, Damonte M, Bettinelli ME, Consonni D, Colombo L, Zanotta L, Bezze E, Sannino P, Mosca F, Plevani L, Giannì ML. Overcoming Rooming-In Barriers: A Survey on Mothers' Perspectives. Front Pediatr 2020; 8:53. [PMID: 32154198 PMCID: PMC7049781 DOI: 10.3389/fped.2020.00053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 02/05/2020] [Indexed: 02/01/2023] Open
Abstract
Background: The importance of rooming-in in promoting breastfeeding initiation and continuation within the 10 Steps for Successful Breastfeeding is widely acknowledged. However, adherence to this practice by healthcare facilities is lower than that of other Steps. A deeper knowledge of maternal rooming-in experience has been advocated to identify the most effective rooming-in policies, thus enabling mothers to have a positive experience when practicing it in the postpartum period. Aim: To investigate maternal knowledge of rooming-in and the most frequently encountered barriers and possible facilitators of adherence to the practice, according to their experience. Study Design and Methods: We enrolled mothers who delivered healthy term or late preterm infants during the month of January 2019 in a tertiary referral center for neonatal care in Milan, Italy. At discharge, a structured interview about mothers' rooming-in experience was administered by healthcare professionals. Basic subjects' characteristics and mode of feeding were recorded. Results: The enrolled population included 328 mothers and 333 neonates. The great majority of mothers knew of rooming-in and 48.2% practiced it continuously. The 86.3% of mothers was aware of the beneficial effects of rooming-in; promotion of mother-infant bonding, increased confidence in taking care of the baby and ability to recognize baby's feeding cues were the most frequently cited, whereas improving breastfeeding was reported by a limited number of mothers, unless they were asked a specific question about it. The main reported obstacles were fatigue (40.5%) and cesarean section related difficulties (15.5%); night was the most critical time of the day for rooming-in. Strategies suggested by mothers for improving rooming-in were increased assistance to the dyad, organizational and structural changes and the possibility to have a family member during the night. Additionally, mothers who adhered to rooming-in practice continuously during hospital stay had a higher exclusive breastfeeding rate at discharge compared to mothers who did not. Conclusions: Our study contributes to a deeper knowledge of maternal rooming-in experience in an Italian tertiary maternity. We underline the importance of providing a tailored support to the mother-infant dyad in order to overcome rooming-in barriers perceived by mothers and promote a positive rooming-in experience.
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Affiliation(s)
- Alessandra Consales
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Beatrice Letizia Crippa
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Jacopo Cerasani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniela Morniroli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Martina Damonte
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Epidemiology Unit, Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lidia Zanotta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Elena Bezze
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Patrizio Sannino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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13
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Giannì ML, Lanzani M, Consales A, Bestetti G, Colombo L, Bettinelli ME, Plevani L, Morniroli D, Sorrentino G, Bezze E, Zanotta L, Sannino P, Cavallaro G, Villamor E, Marchisio P, Mosca F. Exploring the Emotional Breastfeeding Experience of First-Time Mothers: Implications for Healthcare Support. Front Pediatr 2020; 8:199. [PMID: 32457856 PMCID: PMC7221017 DOI: 10.3389/fped.2020.00199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/02/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Among breastfeeding determinants, the unique emotional breastfeeding experience has been poorly explored. The present study aimed to investigate the emotional breastfeeding experience in a cohort of first-time mothers. Materials and methods: We conducted a prospective observational study that enrolled primiparas having delivered singleton healthy term newborns, and exclusively breastfeeding at hospital discharge. At 3 months post-delivery mothers accessed an online questionnaire investigating their emotional breastfeeding experience. The chi-squared test was used to assess the association between the feelings experienced during breastfeeding and feeding outcomes at 3 months. Results: Out of the 421 enrolled mothers, 273 (65%) completed the questionnaire. At 3 months post-delivery exclusive breastfeeding was reported by a 66% of mothers, a 19% reported complementary feeding, and a 15% of mothers reported exclusive formula feeding. Breastfeeding experience was described as positive by 62% of mothers although breastfeeding difficulties were reported by 80% of the mothers. The mothers that had experienced fear, sadness, anger or concern during breastfeeding showed a significant higher exclusive formula feeding rate at 3 months post-delivery than those who did not (25.5 vs. 12.8%, p = 0.021; 28.6 vs. 13.4%, p = 0.02; 40 vs. 13.4%, p = 0.005; 20.5 vs. 11.8%, p = 0.049, respectively). An 85% of mothers stated that their breastfeeding experience was different from what they would have expected, blaming for this discrepancy the occurrence of difficulties during breastfeeding and the complexity of breastfeeding itself (50%), pain experience (8%), being dependent from the baby (6%), and breastfeeding failure (11%). A total of 25% of mothers, however, reported they found breastfeeding to be a much more positive experience than what they had expected. Conclusion: Breastfeeding care should include a tailored emotional support of first time-mothers in addition to the implementation of their breastfeeding knowledge and skills.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marta Lanzani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Alessandra Consales
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanna Bestetti
- Dipartimento di Scienze Umane per la Formazione "Riccardo Massa," Università di Milano-Bicocca, Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | | | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Gabriele Sorrentino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Elena Bezze
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Patrizio Sannino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Milan, Italy
| | - Giacomo Cavallaro
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Eduardo Villamor
- Department of Pediatrics, Maastricht University Medical Center (MUMC+), School for Oncology and Developmental Biology (GROW), Maastricht, Netherlands
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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14
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Amodeo I, Pesenti N, Raffaeli G, Sorrentino G, Zorz A, Traina S, Magnani S, Russo MT, Muscolo S, Plevani L, Mosca F, Cavallaro G. Robotic Therapy: Cost, Accuracy, and Times. New Challenges in the Neonatal Intensive Care Unit. Front Pharmacol 2019; 10:1431. [PMID: 31849676 PMCID: PMC6901951 DOI: 10.3389/fphar.2019.01431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 11/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The medication process in the Neonatal Intensive Care Unit (NICU), can be challenging in terms of costs, time, and the risk of errors. Newborns, especially if born preterm, are more vulnerable to medication errors than adults. Recently, robotic medication compounding has reportedly improved the safety and efficiency of the therapeutic process. In this study, we analyze the advantages of using the I.V. Station® system in our NICU, compared to the manual preparation of injectable drugs in terms of accuracy, cost, and time. Method: An in vitro experimental controlled study was conducted to analyze 10 injectable powdered or liquid drugs. Accuracy was calculated within a 5% difference of the bottle weight during different stages of preparation (reconstitution, dilution, and final product). The overall cost of manual and automated preparations were calculated and compared. Descriptive statistics for each step of the process are presented as mean ± standard deviation or median (range). Results: The median error observed during reconstitution, dilution, and final therapy of the drugs prepared by the I.V. Station® ranged within ±5% accuracy, with narrower ranges of error compared to those prepared manually. With increasing preparations, the I.V. Station® consumed less materials, reduced costs, decreased preparation time, and optimized the medication process, unlike the manual method. In the 10 drugs analyzed, the time saved from using the I.V. Station® ranged from 16 s for acyclovir to 2 h 57 min for teicoplanin, and cost savings varied from 8% for ampicillin to 66% for teicoplanin. These advantages are also capable of continually improving as the total amount of final product increases. Conclusions: The I.V. Station® improved the therapeutic process in our NICU. The benefits included increased precision in drug preparation, improved safety, lowered cost, and saved time. These advantages are particularly important in areas such as the NICU, where the I.V. Station® could improve the delivery of the high complexity of care and a large amount of intravenous therapy typically required. In addition, these benefits may lead to the reduction in medication errors and improve patient and family care; however, additional studies will be required to confirm this hypothesis.
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Affiliation(s)
- Ilaria Amodeo
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Nicola Pesenti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Genny Raffaeli
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gabriele Sorrentino
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Zorz
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Traina
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Magnani
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Teresa Russo
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Salvatore Muscolo
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Plevani
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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15
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Bettinelli ME, Bezze E, Morasca L, Plevani L, Sorrentino G, Morniroli D, Giannì ML, Mosca F. Knowledge of Health Professionals Regarding Vegetarian Diets from Pregnancy to Adolescence: An Observational Study. Nutrients 2019; 11:nu11051149. [PMID: 31126037 PMCID: PMC6566389 DOI: 10.3390/nu11051149] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 11/16/2022] Open
Abstract
The number of people adopting vegetarian diets is constantly increasing, and many among them are young parents who decide to share their diet with their children. The aim of this study was to investigate health professionals' knowledge regarding the adoption of vegetarian diets from pregnancy to adolescence. A cross-sectional survey was conducted. The administered questionnaire, which was based on the recommendations of the most up-to-date guidelines, included two macro areas: The first investigated the sociodemographic and professional profile of the interviewees and the second addressed the knowledge of the participants regarding vegetarian diets. A total of 418 health professionals in Italy were interviewed, of whom 65.8% were nursing staff. Among the participants, 79.9% had not attended a nutrition course in the previous five years. A correct definition of a vegetarian/vegan diet was provided by 34.1% of the participants. The answers regarding knowledge of nutrients were correct in 20% of cases, whereas correct answers to questions assessing knowledge of the risk and benefits of a vegetarian diet and the adoption of a vegetarian diet throughout the life cycle were given by 45% and 39.4% of the participants, respectively. A significant correlation between the items of the second macro area that investigated the knowledge and dietary habits of the participants was found for seven items. The results of the study indicate that health professionals do not have complete and exhaustive knowledge about vegetarian diets and lack information on health outcomes and the adoption of a vegetarian diet throughout the different life cycles and nutrients. Improving pre- and in-service learning opportunities in vegetarian nutrition for health professionals is strongly advisable.
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Affiliation(s)
- Maria Enrica Bettinelli
- Department of Clinical Sciences and Community Health, University of Milan, via San Barnaba 8, 20122 Milan, Italy.
| | - Elena Bezze
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Laura Morasca
- Department of Clinical Sciences and Community Health, University of Milan, via San Barnaba 8, 20122 Milan, Italy.
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Gabriele Sorrentino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, via San Barnaba 8, 20122 Milan, Italy.
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, via San Barnaba 8, 20122 Milan, Italy.
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
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16
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Tambani E, Giannì ML, Bezze EN, Sannino P, Sorrentino G, Plevani L, Morniroli D, Mosca F. Exploring the Gap Between Needs and Practice in Facilitating Breastfeeding Within the Neonatal Intensive Care Setting: An Italian Survey on Organizational Factors. Front Pediatr 2019; 7:276. [PMID: 31380322 PMCID: PMC6657368 DOI: 10.3389/fped.2019.00276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction: The system-level factors of the neonatal intensive care unit work environment contribute to breastfeeding promotion in the preterm population. The aim of this study was to investigate the operative policies related to breastfeeding support in a sample of Italian Neonatal Intensive Care Units. Materials and Methods: A multicenter cross-sectional survey was conducted, including a sample of 17 head nurses. The items of the questionnaire investigated the following areas: breastfeeding policies, staff education, family centered care, and breastfeeding promotion and support both in the neonatal intensive care units and after discharge. Results: Written breastfeeding policies were available for staff in all the neonatal intensive care units, most commonly addressing procedures related to skin-to-skin contact, human milk expression, and preterm infant breastfeeding. Most of the neonatal intensive care units correctly advised the mothers to initiate milk expression within 6 h from delivery and to pump milk at least 6 times/days. Breastfeeding training for the nursing staff was planned in the majority of the neonatal intensive care units although according to different schedules. With regard to the family centered care implementation, time restrictions were present in seven neonatal intensive care units, mostly occurring during the night shift, and the morning hours concomitantly with medical rounds. Moreover, in the majority of the investigated neonatal intensive care units, the parents were asked to leave the ward when their infant underwent a major invasive procedure or during the nurse/physician shift change report. With regard to breastfeeding promotion and support, eight neonatal care units had a multidisciplinary team with several health care professionals and 10 provided information about community-based support services. Most of the units assessed breastfeeding after discharge. Conclusion: Based on the present findings, enrolled Neonatal Intensive Care Units appear to provide breastfeeding-supportive environments with special regard to breastfeeding policies, milk expression practices, interprofessional collaboration, and continuity of care. Health care professionals should exert efforts to ensure continuous and updated breastfeeding staff education and promote parent-infant closeness and family centered care.
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Affiliation(s)
- Elisabetta Tambani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Patrizio Sannino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, Milan, Italy
| | - Gabriele Sorrentino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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17
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Giannì ML, Bezze E, Colombo L, Rossetti C, Pesenti N, Roggero P, Sannino P, Muscolo S, Plevani L, Mosca F. Complementary Feeding Practices in a Cohort of Italian Late Preterm Infants. Nutrients 2018; 10:nu10121861. [PMID: 30513799 PMCID: PMC6316424 DOI: 10.3390/nu10121861] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 12/30/2022] Open
Abstract
Limited data are available on complementary feeding in preterm infants, who show increased nutritional needs and are at risk of altered postnatal growth. The aim of this study was to investigate the timing and content of complementary feeding in a cohort of late preterm infants. We conducted a prospective, observational study, including mothers who had given birth to infants admitted to level I or II of care with a gestational age between 34 and 36 weeks. Mothers were contacted at 3, 6 and 12 months after delivery by phone calls and were asked about their infant’s mode of feeding and the timing and schedule of the introduction of different solid foods types. A total of 49 mothers and 57 infants completed the study. The mean postnatal age of the introduction of complementary foods was 5.7 ± 0.7 months. Low energy and/or low protein-dense foods were first introduced in most infants. Fruit as the first type of complementary food in the infant’s diet was associated with a 1.6-month advance in initiating complementary feeding. The present findings provide further insight into complementary feeding practices in late preterm infants and underline the need for specific recommendations addressing this vulnerable population.
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Affiliation(s)
- Maria L Giannì
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy.
| | - Elena Bezze
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Lorenzo Colombo
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Camilla Rossetti
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Nicola Pesenti
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Paola Roggero
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy.
| | - Patrizio Sannino
- S.I.T.R.A. Basic Education Sector, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy.
| | - Salvatore Muscolo
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Laura Plevani
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Commenda 12, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122 Milan, Italy.
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18
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Raffaeli G, Canesi F, Conigliaro F, Ghirardello S, Vanzati M, Baracetti C, Fumagalli M, Ciralli F, Schena F, Pesenti N, Plevani L, Mosca F, Cavallaro G. Is the new, noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO? Heart Lung 2018; 47:638-645. [DOI: 10.1016/j.hrtlng.2018.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/11/2018] [Indexed: 01/23/2023]
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19
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Gianni ML, Bezze EN, Sannino P, Baro M, Roggero P, Muscolo S, Plevani L, Mosca F. Maternal views on facilitators of and barriers to breastfeeding preterm infants. BMC Pediatr 2018; 18:283. [PMID: 30149811 PMCID: PMC6112147 DOI: 10.1186/s12887-018-1260-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background The supply of breast milk to preterm infants tends to occur at a lower rate than that recorded among term infants. We aimed to investigate the facilitators of and barriers to breastfeeding during hospital stay according to the experiences of mothers that gave birth to premature infants requiring admission to neonatal intensive care unit. Methods A cross-sectional questionnaire survey was conducted. Mothers who had delivered a newborn with a gestational age ≤33 weeks requiring intensive care, entered the study. Basic subjects’ characteristics and infant feeding practices were also recorded. Results A total of 64 mothers were enrolled, leading to a total of 81 infants. At discharge, any breastfeeding was recorded in 66% of infants, with 27% of those infants being exclusively breastfed. Any infant was exclusively fed directly at the breast. Most mothers experienced adequate support during their infant’s hospitalization and reported satisfaction with breastfeeding. Almost all mothers felt that feeding their infant human milk was beneficial for the infant’s health. Thirty percent of the mothers reported that they had experienced some obstacles to breastfeeding. Specifically, infants born to mothers who experienced difficulties in pumping breast milk (OR = 4.6; CI 1.5–13.9) or in providing an adequate amount of milk to the infant (OR = 3.57; CI 1.1–11.5) were at higher risk of being fed with formula at discharge. Conclusions On the basis of the present results, health care professionals should target their efforts to optimize breastfeeding support for mothers of premature infants admitted to level III care, especially by improving breast milk production and endorsing direct breastfeeding.
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Affiliation(s)
- Maria Lorella Gianni
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy.
| | - Elena Nicoletta Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122, Milan, Italy
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122, Milan, Italy
| | - Michela Baro
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Salvatore Muscolo
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
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20
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Fumagalli M, Cinnante CM, Calloni SF, Sorrentino G, Gorla I, Plevani L, Pesenti N, Sirgiovanni I, Mosca F, Triulzi F. Clinical safety of 3-T brain magnetic resonance imaging in newborns. Pediatr Radiol 2018; 48:992-998. [PMID: 29594440 DOI: 10.1007/s00247-018-4105-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/21/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The effects and potential hazards of brain magnetic resonance imaging (MRI) at 3 T in newborns are debated. OBJECTIVE Assess the impact of 3-T MRI in newborns on body temperature and physiological parameters. MATERIAL AND METHODS Forty-nine newborns, born preterm and at term, underwent 3-T brain MRI at term-corrected age. Rectal and skin temperature, oxygen saturation and heart rate were recorded before, during and after the scan. RESULTS A statistically significant increase in skin temperature of 0.6 °C was observed at the end of the MRI scan (P<0.01). There was no significant changes in rectal temperature, heart rate or oxygen saturation. CONCLUSION Core temperature, heart rate and oxygen saturation in newborns were not affected by 3-T brain MR scanning.
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Affiliation(s)
- Monica Fumagalli
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Claudia Maria Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Gabriele Sorrentino
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Gorla
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Laura Plevani
- Nursing coordinator S.I.T.R.A. Basic Education Sector-Neonatology and Neonatal Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Pesenti
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Ida Sirgiovanni
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabio Mosca
- NICU, Department of Clinical Sciences & Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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21
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Raffaeli G, Ghirardello S, Vanzati M, Baracetti C, Canesi F, Conigliaro F, Gentilino V, Macchini F, Fumagalli M, Ciralli F, Pesenti N, Passera S, Neri S, Franzini S, Leva E, Plevani L, Mosca F, Cavallaro G. Start a Neonatal Extracorporeal Membrane Oxygenation Program: A Multistep Team Training. Front Pediatr 2018; 6:151. [PMID: 29896465 PMCID: PMC5986935 DOI: 10.3389/fped.2018.00151] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/08/2018] [Indexed: 12/01/2022] Open
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) is a complex life-saving support for acute cardio-respiratory failure, unresponsive to medical treatment. Emergency events on ECMO are rare but require immediate and proficient management. Multidisciplinary ECMO team members need to acquire and maintain over time cognitive, technical and behavioral skills, to safely face life-threatening clinical scenarios. Methods: A multistep educational program was delivered in a 4-year period to 32 ECMO team members, based on guidelines from the Extracorporeal Life Support Organization. A first traditional module was provided through didactic lectures, hands-on water drills, and laboratory animal training. The second phase consisted of a multi-edition high-fidelity simulation-based training on a modified neonatal mannequin (SimNewB®). In each session, participants were called to face, in small groups, ten critical scenarios, followed by debriefing time. Trainees underwent a pre-test for baseline competency assessment. Once completed the full training program, a post-test was administered. Pre- and post-test scores were compared. Trainees rated the educational program through survey questionnaires. Results: 28 trainees (87.5%) completed the full educational program. ECMO staff skills improved from a median pre-test score of 7.5/18 (IQR = 6-11) to 14/18 (IQR = 14-16) at post-test (P < 0.001, Wilcoxon rank test). All trainees highly rated the educational program and its impact on their practice. They reported high-fidelity simulations to be beneficial to novice learners as it increased self-confidence in ECMO-emergencies (according to 100% of surveyed), theoretical knowledge (61.5%) and team-work/communicative skills (58%). Conclusions: The multistep ECMO team training increased staff' knowledge, technical skills, teamwork, and self-confidence, allowing the successful development of a neonatal respiratory ECMO program. Conventional training was perceived as relevant in the early phase of the program development, while the active learning emerged to be more beneficial to master ECMO knowledge, specific skills, and team performance.
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Affiliation(s)
- Genny Raffaeli
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ghirardello
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Mara Vanzati
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Chiara Baracetti
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Francesco Canesi
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.,Betamed Perfusion Service, Rome, Italy
| | - Federica Conigliaro
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.,Betamed Perfusion Service, Rome, Italy
| | - Valerio Gentilino
- Department of Pediatric Surgery, Ospedale Filippo Del Ponte Varese, Varese, Italy.,Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Macchini
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Fumagalli
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabrizio Ciralli
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Nicola Pesenti
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Sofia Passera
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Simona Neri
- Pediatric Anesthesiology and Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Franzini
- Pediatric Anesthesiology and Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ernesto Leva
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Plevani
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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22
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Giannì ML, Sannino P, Bezze E, Plevani L, Esposito C, Muscolo S, Roggero P, Mosca F. Usefulness of the Infant Driven Scale in the early identification of preterm infants at risk for delayed oral feeding independency. Early Hum Dev 2017; 115:18-22. [PMID: 28843138 DOI: 10.1016/j.earlhumdev.2017.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Very preterm infants frequently experience difficulties in achieving feeding independency. The availability of feeding assessment instruments has been recommended to evaluate an infant's readiness for oral feeding and enable preterm infants' caregivers to document each infant's feeding readiness and advancements. AIMS To investigate the implementation of the Infant Driven Scale in neonatal intensive care units and to identify a cut off value associated with delayed feeding independency. STUDY DESIGN Prospective, observational, single-centre study. SUBJECTS A total of 47 infants born at a gestational age≤32weeks, consecutively admitted to a tertiary neonatal unit between July 2015 and March 2016. OUTCOMES MEASURES The infant's feeding readiness and the postmenstrual age at achievement of feeding independency. RESULTS Mean postmenstrual age at feeding independency was 35.6±1.34weeks. A linear regression analysis showed that a score≤8 at 32weeks of postmenstrual age was associated with a delay of 1.8weeks in achieving feeding independency. CONCLUSION The Infant Driven Scale appears to be a useful additional instrument for the assessment of preterm infants' oral feeding readiness and the early identification of the infants at risk for delayed feeding independency.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milan, Italy.
| | - Elena Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milan, Italy.
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Chiara Esposito
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Salvatore Muscolo
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
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Sorrentino G, Fumagalli M, Milani S, Cortinovis I, Zorz A, Cavallaro G, Mosca F, Plevani L. The impact of automatic devices for capillary blood collection on efficiency and pain response in newborns: A randomized controlled trial. Int J Nurs Stud 2017; 72:24-29. [DOI: 10.1016/j.ijnurstu.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/29/2017] [Accepted: 04/04/2017] [Indexed: 01/12/2023]
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Giannì ML, Sannino P, Bezze E, Comito C, Plevani L, Roggero P, Agosti M, Mosca F. Does parental involvement affect the development of feeding skills in preterm infants? A prospective study. Early Hum Dev 2016; 103:123-128. [PMID: 27591506 DOI: 10.1016/j.earlhumdev.2016.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/05/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Feeding difficulties frequently occur in preterm infants, thus contributing to delayed growth and hospital discharge. AIMS To evaluate the effect of Kangaroo mother care implementation and parental involvement in infants' feeding on the timing of achievement of full oral feeding in preterm infants. STUDY DESIGN Prospective, observational, single-centre study. SUBJECTS A total of 81 infants born at a gestational age ≤32weeks, consecutively admitted to a tertiary neonatal unit between June 2014 and May 2015. OUTCOME MEASURES The timing of the achievement of full oral feeding of preterm infants. RESULTS Full oral feeding was achieved at a mean postmenstrual age of 35.5±2.1weeks. A multiple linear regression analysis showed that a low birth weight, the occurrence of bronchopulmonary dysplasia, and the need for gastrointestinal surgical procedures were associated with a higher postmenstrual age at achievement of full oral feedings. By contrast, the earlier that parents fed their infants and the earlier that Kangaroo mother care was started, the lower the postmenstrual age at the achievement of full oral feeding. CONCLUSIONS These findings indicate that an early start of Kangaroo mother care and early parental involvement in infants' feeding positively affect the achievement of independent oral feeding.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milano, Italy.
| | - Elena Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milano, Italy.
| | - Carmela Comito
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Massimo Agosti
- Neonatologia e Terapia Intensiva Neonatale, Polo Universitario F. Del Ponte, Viale Borri 54, 21100, Varese, Italy.
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
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Giannì ML, Bezze E, Sannino P, Stori E, Plevani L, Roggero P, Agosti M, Mosca F. Facilitators and barriers of breastfeeding late preterm infants according to mothers' experiences. BMC Pediatr 2016; 16:179. [PMID: 27821185 PMCID: PMC5100217 DOI: 10.1186/s12887-016-0722-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/28/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Late preterm infants account for the majority of preterm births. They are at an increased risk of neonatal mortality and morbidity and are less likely to initiate breastfeeding and to be exclusively breastfed at discharge compared to infants born at term. The aim of this study was to identify the facilitators and barriers to breastfeeding during hospital stays according to the experiences of mothers of late preterm infants. METHODS We conducted a cross-sectional questionnaire survey. Mothers who intended to breastfeed and had given birth to a newborn admitted to level I and II care, with a gestational age of 34 0/7 to 36 6/7 weeks, were enrolled. Sociodemographic data, neonatal variables, mode of feeding and feeding status at discharge were also collected. RESULTS A total of 92 mothers who had given birth to 121 infants were enrolled. At discharge, any human milk was fed to 94 % of infants, with exclusively human milk being fed in 43 % of cases; exclusively formula was fed to 6 % of infants. In the multivariate analysis, having expressed breast milk was independently associated with an increased risk of being fed with either any human milk or formula only (OR = 2.73, 95 % CI 1.05-7.1, p = 0.039), whereas being encouraged to practice kangaroo mother care tended to have a protective effect (OR = 0.46, 95 % CI 0.2-1.06, p = 0.07). CONCLUSIONS Based on the present findings, health care professionals should strive to fully implement breastfeeding support for mothers of late preterm infants who intend to breastfeed, in particular optimizing breast milk expression and promoting kangaroo mother care. Further studies are needed to gain further insight into the complex interplay of the factors that modulate breastfeeding outcome in late preterm infants.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy.
| | - Elena Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122, Milan, Italy
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122, Milan, Italy
| | - Elena Stori
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
| | - Massimo Agosti
- Neonatologia e Terapia Intensiva Neonatale, Polo Universitario F. Del Ponte, Viale Borri 54, 21100, Varese, Italy
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122, Milan, Italy
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Sannino P, Giannì ML, De Bon G, Fontana C, Picciolini O, Plevani L, Fumagalli M, Consonni D, Mosca F. Support to mothers of premature babies using NIDCAP method: a non-randomized controlled trial. Early Hum Dev 2016; 95:15-20. [PMID: 26900776 DOI: 10.1016/j.earlhumdev.2016.01.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/26/2015] [Accepted: 01/18/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is based on preterm infant's observation during hospitalization and considers infant's behavior as the key to evaluate the level of neurobehavioral maturation. OBJECTIVES To evaluate the effectiveness of NIDCAP program on mother's support and infant development. STUDY DESIGN Non-randomized controlled study, including 43 infants of 32 weeks gestation receiving either a Standard Care (SC) or NIDCAP assessment. The Nurse Parent Support Tool (NPST) was given to mothers before discharge to evaluate the support given by NICU staff. Infants' motor, visual and auditory development was investigated by a neurofunctional assessment (NFA) at term and at 3 months. The effect of NIDCAP assessment on length of hospital stay and feeding status at discharge were also evaluated. RESULTS Mothers in the NIDCAP group awarded higher scores in the majority of the NPST items than mothers in the SC group. NFA at term resulted to be normal in a significant higher percentage of infants that underwent NIDCAP, while no difference could be detected at 3 months. CONCLUSIONS NIDCAP is an effective program to promote mothers' involvement in infants' care, that, in turn, could endorse infants' neurofunctional development in the short term.
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Affiliation(s)
- Patrizio Sannino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Milano, Italy.
| | - Maria Lorella Giannì
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Giovanna De Bon
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Camilla Fontana
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Odoardo Picciolini
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Laura Plevani
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Monica Fumagalli
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Epidemiology Unit, Department of Preventive Medicine, Via San Barnaba 8, 20122 Milan, Italy.
| | - Fabio Mosca
- NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via Della Commenda 12, 20122 Milano, Italy.
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Giannì ML, Sannino P, Bezze E, Plevani L, di Cugno N, Roggero P, Consonni D, Mosca F. Effect of co-morbidities on the development of oral feeding ability in pre-term infants: a retrospective study. Sci Rep 2015; 5:16603. [PMID: 26558841 PMCID: PMC4642327 DOI: 10.1038/srep16603] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/13/2015] [Indexed: 11/18/2022] Open
Abstract
Pre-term infants frequently experience difficulties in attaining independent oral feeding, thus delaying the achievement of an adequate nutritional status and hospital discharge. The aim of this retrospective, single-centre, observational study was to investigate the effect of co-morbidities on the timing of the achievement of full oral feeding in pre-term infants. The neonatal and feeding data of 84 infants born at a gestational age of <32 weeks were collected, and the effect of co-morbidities on the achievement of feeding independence was evaluated using multiple linear regression analysis. The mean postmenstrual age at the time of the achievement of full oral feeding was 36.7 ± 3.68 weeks (range 33–53) weeks. The multiple linear regression analysis showed that a low birth weight, the occurrence of bronchopulmonary dysplasia, and the need for gastrointestinal surgical procedures were independently associated with a higher postmenstrual age at achievement of full oral feedings.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milano, Italy
| | - Elena Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milano, Italy
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy
| | - Nathalie di Cugno
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Epidemiology Unit, Via San Barnaba 8, 20122 Milan, Italy
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy
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Giannì ML, Roggero P, Amato O, Orsi A, Garbarino F, Garavaglia E, Poletti B, Plevani L, Mosca F. Intervention for promoting breast milk use in neonatal intensive care unit: a pilot study. J Matern Fetal Neonatal Med 2013; 27:475-8. [PMID: 23796208 DOI: 10.3109/14767058.2013.818971] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The health benefits provided by breast milk are significant in preterm infants. Despite recommendations, rates of breastfeeding in preterm infants are lower than in term infants. The aim of this study was to evaluate the efficacy of a multidisciplinary intervention in promoting any breastfeeding in preterm infants at discharge. METHODS A prospective non-randomized interventional cohort study was conducted. One hundred and twenty-two preterm infants constituted the historical group. A multidisciplinary intervention was performed including staff training and setting up and implementation of a written breastfeeding procedure. RESULTS One hundred and ten preterm infants were enrolled in the intervention group. The percentage of infants fed human milk at discharge was 69 and 62 in the intervention group and in the historical group, respectively. The percentage change from any breastfeeding at full enteral feeding attainment to formula feeding at discharge was lower in the intervention group than in the historical group (-9 versus -23). Belonging to the intervention group and having at least one stress factor during pregnancy were independently associated with any breast milk feeding at discharge. CONCLUSIONS The multidisciplinary intervention performed appears to be effective in promoting any breastfeeding in preterm infants at discharge.
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Affiliation(s)
- Maria Lorella Giannì
- Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan , Milan , Italy
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Affiliation(s)
- S Muscolo
- Pediatric nurse, Neonatology and neonatal intensive care, Fondazione Ca' Granda, Ospedale Maggiore Policlinico IRCCS Milano, Italy.
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Affiliation(s)
- P Sannino
- Tutor Corso di Laurea Infermieristica Pediatrica, Università degli Studi di Milano Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Italy.
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