Alternative Feeding Methods Research Articles

Survey of Breastfeeding and Colostrum knowledge and Practices Among Moroccan Women: a hospital-based study

Objective In this study, our aim was to explore the knowledge and practice of breastfeeding and colostrum among Moroccan women. Material and methods this is a cross-sectional study. Data was collected from a sample of 100 Moroccan women through a 16-question questionnaire. Results and discussion The results revealed that a significant portion (74%) of the sample, had already made the decision to breastfeed before their pregnancies. Additionally, an overwhelming majority, 98% of the participants, fed their newborns with colostrum, reflecting a widespread acceptance and understanding of its importance with only a small minority opting for alternative feeding methods. Conclusion To promote better breastfeeding practices, it is crucial to address the knowledge gaps through targeted educational interventions that emphasize the importance of colostrum and provide accurate information particularly among women and expectant mothers. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1159-1167

Sensory-Motor-Oral Stimulation Combined with Early Sucking During the Mandibular Distraction Osteogenesis Process in Children with Robin Sequence.

To describe the findings of children with Robin Sequence (RS) who received sensory-motor-oral stimulation combined with early sucking during mandibular distraction osteogenesis (MDO), compared with children who did not receive the intervention. A quasi-experimental study. Setting: A tertiary public hospital. Patients: Children with RS referred to MDO. A historical group from the same population but managed according to the institution's standard protocol (no sucking) served as a control group. Interventions: Sensory-motor-oral stimulation, including sucking, starting 24 h after MDO (intervention group). Main Outcome Measure: Our hypothesis is that sensory-motor-oral stimulation, including sucking during the DOM process, do not negatively affect surgical outcomes. Twenty-nine children were included. Eight (72.7%) of the 11 patients in the intervention group and 13 (72.2%) of the 18 controls had MDO complications, with no significant difference between the groups (p = 1.000). The most common surgical outcome was antibiotic therapy for surgical site infection (76.2%). Six months after MDO, 22 (75.9%) children attained full oral feeding or associated with alternative feeding methods. The intervention group did not have higher complication rates, from a surgical point of view, than control group. The protocol adopted by some centers that contraindicates sucking during MDO should be revised to consider the benefits of such stimulation. Keywords: Pierre Robin Syndrome, deglutition, therapeutics, child development.

The Ethics of Ancient Lactation and the Cult of the Perfect Breastfeeding Mother.

Breastfeeding is a key issue found in ancient sources that resonates with public debates today, affecting women in different parts of the world and of all social classes. The aim of this research was to identify breastfeeding narratives in ancient medical and philosophical texts from the 1st to the 6th century CE that address ethical issues in the medical management and social perception of new mothers. We examined 15 literary sources and one funerary inscription on lactation and critically evaluated the ancient idea of the perfect breastfeeding mother versus the non-breastfeeding mother. We then discussed our historical data in terms of objectivity and significance in relation to contemporary attitudes towards motherhood and lactation, e.g., (1) the cult of the perfect, breastfeeding mother in contemporary lactation education and (2) the onset of conditions which may affect normal breastfeeding, such as dysphoric milk ejection reflex (D-MER), breastfeeding aversion response (BAR) or post-partum depression. The analysis of the results showed that in both ancient and contemporary postnatal health care: (1) good mothering is associated with breastfeeding and (2) alternative feeding methods are acknowledged, but never as the best, natural option. Finally, our analysis shows that public health policies on breastfeeding and mothers' own knowledge of their bodies are contested between nursing theories, social expectations and economic factors.

Exploring the Factors Affecting Speech and Language Pathologists’ Decision to Transition from Oral to Non-Oral Feeding in Patients with Dysphagia: A Qualitative Study

Aim: Speech and language pathologists (SLP) make decisions regarding the use of alternative feeding methods when oral feeding presents a vital risk for the dysphagia patients or when the patient’s food intake is deficient. This decision affects the lives of patients from physiological, psychological, and social aspects. The decision mechanisms of SLPs involve the medical status of the patient and evaluation results. This study aims to explore factors influencing the decision of SLPs to transition from oral to non-oral feeding.
 Material and Methods: Our study was conducted with a phenomenological design. Nine SLPs who had experience working with dysphagia patients participated in semi-structured interviews. Data were coded on the MAXQDA program using a thematic analysis approach. 
 Results: Six main themes were constructed. In addition to the medical status of the patients, participants described giving importance to the reactions of patients and relatives, the moment of explaining their decision to the patient, interactions with other professionals, work environments, experiences and educational backgrounds, and the assessments and therapies patients underwent.
 Conclusion: The decision mechanisms of SLPs regarding feeding are not only affected by the physiological condition of the patient, but also by factors regarding patient relatives, the SLP’s personal approaches, communication with other professionals, the assessment process, and therapy implementation. Non-oral feeding decisions are also linked to their clinical experience and educational backgrounds. It is recommended that SLPs think multi-dimensionally about feeding transitions and give critical importance to their decision processes.

Exploring Advancements in the Treatment of Amyotrophic Lateral Sclerosis: A Comprehensive Review of Current Modalities and Future Prospects.

Amyotrophic lateral sclerosis (ALS) is a fatal and incurable disease requiring a multidisciplinary treatment approach and a collaborative therapeutic effort. A combination of both upper and lower motor neuron degeneration ultimately leads to respiratory failure, similar to other dementia-type neurodegenerative diseases. The aim of this paper is to pioneer current ALS research by carrying out a narrative literature review of the current treatment modalities of the disease. Through these efforts, we hope to condense the most pertinent information regarding current treatments and enhance the management of ALS patients as a whole, giving these patients a better quality of life as the search for a cure continues. We used a Pubmed search strategy and specific MeSH terms for the selection of the literature articles using the keywords "ALS," "new treatment," "treatment," and "symptomatic treatment." A combination of pharmaceutical interventions, psychological support, and physical rehabilitation has been most effective in enhancing the quality of life of patients with ALS (PALS). Among potential pharmacological therapies, only a few have been approved by the US Food and Drug Administration(FDA) to be used to treat ALS and its symptoms. Other treatment modalities being considered include gene therapy, cellular therapy, psychological therapy, physical therapy, and speech therapy, alongside robotics, alternative feeding methods, and communication devices.

A Comparison of Slow Infusion Intermittent Feeding versus Gravity Feeding in Preterm Infants: A Randomized Controlled Trial.

The transition to full enteral feeding is important for ensuring adequate growth in preterm infants. The aim of this study was to investigate the effects of two different intermittent feeding methods on the transition to full enteral feeding in preterm infants. A prospective, randomized controlled study was conducted in a neonatology and perinatology center. Preterm infants with a gestational age between 24 + 0/7 and 31 + 6/7 were included in this study. They were divided into two groups: the SIF (slow infusion feeding) group and the IBF (intermittent bolus feeding) group. In the SIF group, feed volumes were administered over one hour using an infusion pump through an orogastric tube, with feeding occurring every three hours. The IBF group received enteral feeding using a gravity-based technique with a syringe through an orogastric tube, completed within 10 to 30 min. The primary outcome was the achievement of full enteral feeding and the occurrence of feeding intolerance. A total of 103 infants were enrolled in the study (50 in SIF and 53 in IBF). The time to achieve full enteral feeding did not differ significantly between the two groups (p = 0.20). The SIF group had significantly fewer occurrences in which gastric residual volume exceeded 50% (p = 0.01). Moreover, the SIF group had a significantly shorter duration of non-per-oral (NPO) status than the IBF group (p = 0.03). It is our contention that the use of the SIF method as an alternative feeding method is appropriate for infants with feeding intolerance and those at high risk of feeding intolerance.

Why do we fear bottles and pacifiers?

Why do we fear bottles and pacifiers?

Cleft lip and palate : One of the most frequent congenital malformations

With afrequency of1 per 500 live births, a cleft lip and palate is one of the most frequent congenital malformations. Untreated, it leads to disturbances in feeding, speech, hearing, tooth position and esthetics. Amultifactorial genesis is assumed. The fusion of the different facial processes takes place in the first 3 months of pregnancy and acleft can develop during this time. Surgical treatment includes the early anatomical and functional restoration of the affected structures within the first year of life in order to enable normal intake of food, articulation, nasal breathing and middle ear ventilation. Breastfeeding is possible in children with acleft formation but alternative feeding methods, such as finger feeding, often have to be used. In addition to the surgery for primary closure of the cleft, otorhinolaryngological (ENT) interventions, speech therapy, orthodontic treatment as well as other surgical interventions are part of the interdisciplinary treatment concept.

Risk factors independently associated with the maintenance of severe restriction of oral intake and alternative feeding method indication at hospital outcome in patients after acute ischemic stroke

Background and aimsFrom a clinical point of view, post-stroke patients present difficulties in swallowing management. The purpose of this research was to identify risk factors that were independently related to the maintenance of a severe restriction of oral intake in patients affected by acute ischemic stroke. MethodsThe authors conducted a prospective observational cohort study of patients with dysphagia post-acute ischemic stroke who were admitted to an Emergency Room (ER). Demographic and clinical data were collected at ER admission. Swallowing data was based on The Functional Oral Intake Scale (FOIS) and was collected at two distinct moments: initial swallowing assessment and at the patient outcome. Patients were divided into two groups according to their FOIS level assigned on the last swallowing assessment (at hospital outcome): G1 with severe restriction of oral intake and indication of feeding tube – patients with FOIS levels 1 to 4; G2 without restriction of food consistencies in oral intake – patients with FOIS levels 5 to 7. ResultsOne hundred and six patients were included in our study. Results of the multivariate logistic regression model for the prediction of maintenance of a severe restriction of oral intake at hospital outcome in patients post-acute ischemic stroke indicated that increasing age (p = 0.006), and dysarthria (p = 0.003) were associated with higher chances of presenting severe restriction of oral intake at hospital outcome. ConclusionsPatients with acute ischemic stroke in an Emergency Room may experience non-resolved severe dysphagia, indicating the need to prepare for the care/rehabilitation of these patients.

Factors associated with breastfeeding duration among women in Sarajevo Canton, Bosnia and Herzegovina

Breastfeeding is the optimal method of infant feeding bringing short-and long-term benefits for infants, mothers, environment, economy and the entire society. A variety of factors influence and determine breastfeeding duration, including characteristics of the mother, the child and the family, aspects of the health care system, public health and social policies, advertising and promotion of alternative feeding methods. This study aimed to investigate the factors which are associated with breastfeeding duration in a sample of mothers living in Sarajevo Canton, Bosnia and Herzegovina. This cross-sectional study was carried out at the Pediatric Outpatient Department of the Public Institution Primary Health Care Centre of Canton Sarajevo. The study evaluated 150 mothers in three groups according to breastfeeding duration of 50 each (i.e. less than 3 months, 3–5 months and 6 months and more). As an instrument for data collection a questionnaire was used to provide sociodemographic data, information about mother’s health during pregnancy, delivery in baby-friendly hospital and breastfeeding duration. The results of logistic regression analysis showed that delivery in baby-friendly hospital had a significant association with breastfeeding duration of 6 months and more (p=0.023). Maternal age (p=0.873), marital status (p=0.628), maternal education level (p=0.228), maternal employment (p=0.949), self-perceived financial status (p=0.189), maternal health during pregnancy (p=0.874) were not significantly associated with breastfeeding duration of 6 months and more. These results support the importance of the hospital environment and health provider practices in breastfeeding promotion.

The Finger Feeding Method and Relactation.

Background: Breastfeeding is one of the most important factors ensuring the healthy growth and development of babies. Preterm babies, babies with metabolic, neurological, or developmental delays, babies separated from their mothers for any reason, and adopted babies need alternative feeding methods. This study was carried out to investigate the effect of the finger feeding (FF) method on relactation.Method: In this retrospective study, infants who were admitted to the Istanbul Medipol University breastfeeding counseling clinic between January 2020 and June 2021 and were recommended to be fed with finger feeding were evaluated. Gender, gestation, mode of delivery, birth weight, age, cause for admission, feeding type, breastfeeding starting time, finger feeding time, and breastfeeding duration of the cases were recorded from the counseling forms.Results: Of 41 babies, 29.3% were girls and 70.7% were boys, and 82.9% were term. Seventeen (41.5%) were born with spontaneous vaginal delivery and 24 (58.5%) with a cesarean section. The most common reason for admission was found to be the inability to latch. While 30 (73.2%) of the babies fed with finger feeding were able to suck, nine babies continued to be fed with a bottle, one baby with a spoon, and one baby with a supplemental nursing system (SNS). The breastfeeding starting time was 23.1 ± 27.5 (1-100) days.Conclusion: The finger feeding method is an effective alternative feeding method for successful breastfeeding. There is a need for studies to be conducted with more babies, both preterm and term, in this regard.

The Effects of Oral Feeding Methods in Preterm Infants on Transition to Direct-Breastfeeding and Discharge Time: A Retrospective Cohort Design

BackgroundThe most common alternatives in feeding preterm infants are bottle feeding and cup feeding. However, there is no clear and precise clinical evidence to show the superiority of a single method. New studies are needed to eliminate confusion on this subject.AimThe effects of oral feeding methods on the transition to direct-breastfeeding and length of stay in preterm infants.MethodsThis retrospective study was carried out in a single NICU. Data was collected from the digital records and explored the effects of bottle feeding and cup feeding. One hundred fifty-eight preterm infants (30–34 weeks) met the inclusion criteria. Seventy-eight of them were bottle-fed, and eighty of them were cup-fed.ResultsStatistical analysis (Mann-Whitney U test and t-test) has shown that there was no statistically significant difference between the two groups (bottle & cup) in terms of transition to direct-breastfeeding and length of hospital stay (p > .05).ConclusionsAs a result of the current study, both feeding methods are equally effective and can be used as alternative oral feeding methods.

Breastfeeding challenges in infants with nasal breathing difficulties: alternative supplemental feeding methods

This review article highlights the features of breastfeeding in case of obstructed nasal breathing in infants, special attention is paid to non-sucking or alternative methods of bottle feeding with expressed breast milk for the period when breastfeeding is not possible or formula supplementation is necessary as an addition to breastfeeding.Breathing through the mouth is considered a pathological adaptation due to difficulty in nasal breathing and is associated with the development of many pathological conditions. There is an evidence base that prolonged breastfeeding is associated with nasal breathing at an older age, as well as the correct formation of the bite. The anatomical and physiological features of the structure of the upper respiratory tract in infants predispose to a more frequent occurrence of difficult nasal breathing compared to adults, which causes difficulties in breastfeeding, up to the refusal of the child’s breast. Therefore, knowledge of modern methods of supplementary feeding with expressed breast milk for this period, as well as ways to effectively and safely deal with nasal congestion in infants, will help doctors and parents to overcome the difficult period of the disease, accompanied by nasal congestion without loss and maintain breastfeeding for as long as possible, in the light of modern data on influence of breast milk on the subsequent life of mother and child.The main method of treatment for nasal congestion of various etiologies is irrigation-elimination therapy. According to the literature, good tolerability and no side effects were found when using a nasal aspirator used in conjunction with isotonic saline.

Poremećaji hranjenja i gutanja kod dece sa rascepima usne i/ili nepca

Introduction. Cleft lip and palate are complex congenital anomalies of the orofacial system of children. Feeding and swallowing problems occur with varying degrees in children with cleft lip and/or palate. Aim. The aim of this paper was to review the literature and available evidence regarding the types of eating and swallowing disorders that can be identified in children with cleft lip and/or palate, as well as a description and types of compensatory strategies and interventions to alleviate difficulties. Methods. Insight into the relevant literature was performed by specialized search engines on the internet and insight into the electronic database. Results. The extent of the cleft is related to the severity of eating and swallowing disorders, so the most common problems are decreased oral sensitivity, cough, choking, nasal regurgitation, difficulty in sucking, laryngotracheal aspiration due to inadequate airway protection during swallowing, which may result in pneumonia and lung damage. Feeding and swallowing difficulty is also a source of stress for parents. Conclusion. Choking, coughing, nasal regurgitation, laryngotracheal aspiration, excessive air intake can lead to dehydration, malnutrition, but also the need for alternative feeding methods Therefore, it is of great importance to identify the problems of feeding and swallowing in a timely manner, along with modifications of the feeding method.

Characterization of the transition to oral feeding in premature newborns.

To characterize the transition from alternative feeding methods to oral feeding, to investigate techniques to favor feeding used during the transition, and the prevalence of breastfeeding at hospital discharge of premature newborns. The following variables were considered: gender, gestational age and birth weight, classification of prematurity, time of transition to oral use, corrected gestational age and newborn weight at the beginning and end of the food transition, transition technique used, length of hospitalization and type of breastfeeding at discharge. For data analysis, the software SPSS version 25.0 was used considering the significance level of 5%. Significant results were observed between the premature groups for corrected gestational age at the beginning of the food transition, transition time, and hospital days. The study concludes that the breast-probe technique was the most used. The length of hospital stay was shorter for the group of late and moderate preterm newborns. The transition time to the oral route was longer in the group of very preterm infants. Moreover, the proportion of exclusive breastfeeding at hospital discharge was similar between the prematurity classification groups.

The baby‐led weaning method: A focus on mealtime behaviours, food acceptance and fine motor skills

AbstractBaby‐led weaning (BLW) is an alternative complementary feeding method by which children feed themselves starting at 6 months with suitable solid finger foods. Despite its increasing popularity worldwide, research is limited on its effects on diet‐related behaviours and no study has yet addressed its association with fine motor skills. This cross‐sectional study aimed to compare 10‐ to 14‐month‐old children's mealtime behaviours, food acceptance and fine motor skills between the BLW and traditional spoon‐feeding (TSF) methods (n = 82; 41 per group). Parents completed three online questionnaires regarding feeding practices, eating behaviours and food consumption acceptance, and the Peabody developmental motor scale test was performed in person with each child. Compared to the TSF method, BLW was associated with a higher satiety responsiveness score (mean ± SEM: BLW 13.6 ± 0.5 vs. TSF 11.6 ± 0.5, p = 0.005), a slower eating pace (BLW 10.0 ± 0.5 vs. TSF 11.4 ± 0.5, p = 0.04), and a marginally higher grasping skill score and fine motor quotient (p = 0.05 for both). There was no difference in food acceptance between the two feeding methods. Parental pressure was negatively associated with some food acceptance and mealtime behaviours. BLW is associated with beneficial mealtime behaviours and possibly with fine motor skills development. This study reiterates the importance of avoiding pressuring infants while eating.

An alternative supplemental feeding method for preterm infants: the supplemental feeding tube device

Background/aimThe purpose of this study was to determine the effects of the supplemental feeding tube device (SFTD) and bottle methods on weight gain, transition to full breastfeeding, breastfeeding success, and duration of discharge in preterm infants.Materials and methodsThis randomized controlled trial was conducted with a total of 46 preterm infants including 23 infants in study (SFTD) and control (bottle) groups. An information form, an infant follow-up form for feeding, and LATCH breastfeeding assessment instrument were used to collect the data.ResultsThe gestation week of the infants in the study group was 31.22 ± 2.76, and in the control group it was 30.52 ± 2.47. The birth weight of the infants in the study group was 1586.3 ± 525.35 g and 1506.09 ± 454.77 g in the control group. The daily weight gain of the infants was 24.09 ± 15.21 g in the study group and 27.17 ± 17.63 g in the control group. The infants in the study group (4.70 ± 2.44 days) transitioned to full breastfeeding earlier than those in the control group (6.00 ± 4.10 days). LATCH 2nd measurement scores were significantly higher in both groups than LATCH 1st measurement scores (p < 0.01). Although it was not statistically significant (p > 0.05), the infants in the study group (10.22 ± 5.20 days) were discharged earlier than those in the control group (13.48 ± 8.78 days).ConclusionThe SFTD and bottle methods were determined to be similar in terms of daily weight gain, transition to full breastfeeding, breastfeeding success, and duration of hospitalization.

Perbedaan Frekuensi Pemberian Enteral Feeding terhadap Toleransi Feeding dan Kadar Glukosa Darah

Medical nutrition therapy is one of the interventions to provide sufficiently nutrition and to optimize glycemic controls in meeting the body metabolic needs. An Enteral Feeding is an alternative feeding method when there are obstacles to fulfill patients nutrition orally. This study aims to determine feeding tolerances and blood glucose controls in Type2 Diabetes Mellitus patients with different Enteral Feeding frequencies-three and six times preserving. This research is a quasi-experimental design study involving 26 patients admitted in a hospital. The results of the study on respondents with enteral feeding of a frequency 3x/24 hours found that 2respondents (15.4%) were tolerant with enteral feeding given and as many as 3respondents (23.1%) had normal blood glucose, while the results of the study for respondents with enteral feeding of a frequency 6x / 24 hours, 12 respondents (92.3%) were tolerant with enteral feeding given and as many as 12 respondents (92.3%) had normal blood glucose.&#x0D; The results showed that there was a statistically difference between the three times and six times Enteral Feeding with feeding tolerance (p = 0.005). There was a difference between the frequency of enteral feeding six times and three times in the blood glucose level (p = 0.005). Results of this study will assist in controlling blood glucose by regulating the timing of feeding in patients with type 2 diabetes mellitus.&#x0D; &#x0D;

Good Questions 14: Is feeding with infant formula much worse than breastfeeding?

Is infant feeding with formula much worse than breastfeeding? It’s complicated, so this essay explores the evidence and ways to think about it.&#x0D; There is a clear global consensus that in any population, feeding with infant formula is not as good as breastfeeding for infants’ health and also for their mothers’ health. Infant formula manufacturers agree. Nevertheless, there is an ongoing debate about when feeding with infant formula might be acceptable.&#x0D; Undoubtedly, compliance with the global recommendations for optimum breastfeeding is low partly because many new parents and policymakers believe there is little difference between the health impacts of breastfeeding and feeding with formula. It is important to consider not only the ranking of alternative methods of infant feeding but also the degree of difference between them. Is the difference small and unimportant or substantial and important to consider when choosing among the options? There should be an orderly way to take account of not only the relevant scientific knowledge, but also parents’ views and circumstances related to infant feeding.

Posicionamento BRASPEN sobre o uso de micronutrientes via parenteral em adultos

Introduction: micronutrients (vitamins and oligoelements) are essential components in human nutrition. Usually, they are obtained through a varied and balanced diet. However, when patients are stricken with some diseases, it is often necessary to utilize alternative feeding methods, which can interfere in micronutrient availability and acquisition. The objective of this work is to promote the rational use of micronutrients in parenteral nutrition to doctors and other staff in the multidisciplinary nutritional therapy team (MNTT). Methods: the text reflects a compilation of the current guidelines and literature by experienced healthcare workers in adult parenteral nutrition therapy (PNT). Results: in cases of severe illness, the micronutrient concentration deficiency must be corrected in order to improve clinical results. The correction is necessary due to the negative effects micronutrient deficiency have on antioxidant defense mechanisms, metabolic and general immunologic pathways. Final considerations: the present document has the intention of contributing the rational use of micronutrients as a daily integrant of the safe and responsible supply of nutrients in parenteral nutrition.