Increase in Breastfeeding Rates in Baby-Friendly Hospitals in Greece: Comparison with the National Study of 2017.

BACKGROUND/OBJECTIVES: The primary purpose of this study was to correlate the factors influencing the onset and duration of exclusive breastfeeding (EBF) and breastfeeding (BF) rates at different time points in baby-friendly hospitals (BFHs) in Greece. METHODS: This study was conducted from October 2020 to January 2022. The sample consisted of 1201 mothers with corresponding newborn births out of the total 7201 that took place during the same period. We used a questionnaire that the mothers answered during the first hour after birth, before being discharged from the maternity hospital, and at the 2nd, 4th, and 6th month of the infant's life. The results were compared with the data of the national study from 2017 (concerning births from general maternity hospitals and not only from BFHs). RESULTS: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. Between the two studies, differences were recorded in BF and EBF rates at the 6th and 4th month of the infants' life, respectively, especially in mothers who are less likely to breastfeed (e.g., those without breastfeeding experience, those over 40 years old, etc.). CONCLUSION: This study showed that EBF and BF rates are higher in infants born in BFHs compared to non-BFHs both during their hospitalization in the first days of life and during the first 6 months of life. BFHs also play a decisive role in mothers who, due to their socio-economic profile, have lower chances of starting to breastfeed.

Changes in Empathy and Mental Resilience in Health Professionals After Completing the Certified "Generic Instructor Course" Seminar.

INTRODUCTION: Factors that may affect the performance of healthcare professionals performing resuscitation include stress, social profile, fatigue, empathy, and resilience. Interpersonal skills are required for better performance. This study aimed at evaluating the change in empathy and mental resilience in health professionals who have the status of instructor potential achieved after successfully completing a certified training/intervention course and want to develop/certify as course instructors. METHODS: Healthcare professionals attended the Generic Instructor Course (GIC), a two-day course training instructor candidates from different training courses. Empathy and the cultivation of mental resilience of adult healthcare professional trainers were measured in order to investigate whether participation in a simulated training process can influence these characteristics of the trainer and how these characteristics interact with the training process. Four measurements were recorded: (i) baseline (before the GIC course), (ii) after the course, (iii) follow-up after one month, and (iv) follow-up after three months. RESULTS: Ninety participants in the GIC course were the study sample. Participants showed statistically higher empathy after participation in the GIC vs. baseline, one-month, and three-month follow-up (p = 0.023). Resilience did not reveal any statistical difference, after the participation in the GIC and follow-up measurements (p = 0.084). For both variables (empathy and resilience), demographics did not have any association with the variables. CONCLUSIONS: Besides its primary aim of training and certifying future instructors in resuscitation courses, the GIC also had a positive impact on the participants' empathy.

Gut Microbiome and Neurodevelopmental Disorders: A Link Yet to Be Disclosed.

Τhe importance of the gut microbiome and its functions has only recently been recognized and researched in greater depth. The establishment of the human gut microbiome begins in utero, forming its adult-like phenotype in the first 2-3 years of life. Several factors affect and alter the gut microbiome composition and its metabolic functions, such as early onset of breastfeeding, mode of delivery, antibiotic administration, or exposure to chemical substances, among others. Existing data support the important connection between health status and gut microbiome homeostasis. In cases when this balance is disturbed, several disorders may arise, such as inflammatory reactions that lead to atopy, eczema, or allergic asthma. The so-called gut-brain axis refers to the complex biochemical pathways between the central nervous system and the gastrointestinal system. One of the most fascinating areas of ongoing research is the broad spectrum of neurodevelopmental disorders (NDDs) and how gut health may be associated with such disorders. The prevalence of NDDs, such as autism spectrum disorder or attention deficit hyperactivity disorder, has increased over recent years. Whether gut microbiota homeostasis plays a role in these disorders is not yet fully understood. The aim of this narrative review is to provide an account of current knowledge on how gut health is linked with these disorders. We performed a literature review in order to identify and synthesize available data that highlights the potential association between NDDs and a balanced gut microbiome in terms of composition and proper function. The connection between the gut microbiome and NDDs offers promising new opportunities for future research.

The Rates of Breastfeeding in Baby-Friendly Hospitals in Greece: A Nationwide Survey.

BACKGROUND: Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. METHODS: The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant's nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the "Infant and Young Child Feeding" indicators, were used. RESULTS: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers' advanced education level constitute independent positive prognostic factors for increased EBF rates. CONCLUSION: The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO's targets by 2025.

Human Breast Milk: The Key Role in the Maturation of Immune, Gastrointestinal and Central Nervous Systems: A Narrative Review.

Premature birth is a major cause of mortality and morbidity in the pediatric population. Because their immune, gastrointestinal and nervous systems are not fully developed, preterm infants (<37 weeks of gestation) and especially very preterm infants (VPIs, <32 weeks of gestation) are more prone to infectious diseases, tissue damage and future neurodevelopmental impairment. The aim of this narrative review is to report the immaturity of VPI systems and examine the role of Human Breast Milk (HBM) in their development and protection against infectious diseases, inflammation and tissue damage. For this purpose, we searched and synthesized the data from the existing literature published in the English language. Studies revealed the significance of HBM and indicate HBM as the best dietary choice for VPIs.

Theoretical knowledge and skill retention 3 and 6 months after a European Newborn Life Support provider course.

INTRODUCTION: The European Resuscitation Council Newborn Life Support Course (ERC- NLS) aims at training healthcare professionals, involved in perinatal care, in order to intervene efficiently and promptly to assist transition or resuscitate neonates who require help at birth. However, limited data exists for the retention of the theoretical knowledge and practical skills provided by the course. This study aims to evaluate the degree of knowledge and skill retention 3 and 6 months after the ERC-NLS provider course. METHODS: This is a prospective study. Theoretical knowledge was evaluated using the ERC-approved NLS written test (50 True/False questions). Evaluation of technical skills included performance, on an Advanced Life Support neonatal maniquin (LAERDAL), of airway management, ventilation and support of circulation (21 detailed skills). The effect of certain factors on theoretical skill retention was also evaluated. RESULTS: One hundred and sixteen (n = 116) participants were initially recruited in the study (12 males and 104 females). Theoretical knowledge was evaluated in 113 participants (3 participants missed follow-up appointments) and technical skills in 80 participants. The mean score for theoretical knowledge was 86.24% ± 5.3, 80.88% ± 7.43 and 80.04% ± 7.04 at baseline, at 3 and 6 months, respectively. This difference was significant among the three time points (baseline vs 3 months: p < 0.001; baseline vs 6 months: p < 0.001; 3 month's vs 6 months: p = 0.034). Although gender did not have an effect, doctors and participants of higher education yielded higher score of success. Regarding technical skills, 9 skills showed a continuous decline of performance from baseline to 6 months, while no difference existed for 12 skills. CONCLUSIONS: Healthcare professionals after the NLS provider course retain satisfactory levels of theoretical knowledge and technical skills even at 6 months post-training, although, there is a decline compared to baseline. Further research is needed in order to establish the proper time and type of refreshment course in order to improve outcomes.

Mothers in Need of Lactation Support May Benefit from Early Postnatal Galactagogue Administration: Experience from a Single Center.

BACKGROUND: Galactagogues are substances that promote lactation, although data on their effects on humans remain limited. We investigated the efficacy of Silitidil to increase milk supply and duration of breastfeeding of a specific subgroup of mothers in need of lactation support. METHODS: 161 mothers from November 2018 until January 2021 were the study subjects in this retrospective study; during their hospitalization, due to neonatal or maternal factors that inhibited lactation, they were prescribed galactagogues. Mothers were surveyed by telephone interview via a 13-item questionnaire. RESULTS: 73.91%, were primigravidas, 78.26% gave birth by cesarean section (CS) and 72.05% continued to take galactagogues after hospital discharge. Of the neonates, 24.22% were preterm ≤37 weeks of gestation, and 55.9% had birth weight (BW) between 2500 and 3500 g. With respect to breastfeeding rates, 100% were breastfed during their first week, 98.8% breastfed during the first month, 87% during the first 4 months, dropping to 56.5% at 6 months, 41% at 1 year and 19.3% over 1 year of age. CONCLUSIONS: This study demonstrates that administration of a galactagogue containing Silitidil (Piulatte-Humana) improves breastfeeding rates at from 1 until 12 months of life in mothers with low milk supply during their hospital stay. Further studies are needed to generate evidence-based strategies to improve breastfeeding outcomes.

Factors affecting human colostrum fatty acid profile: A case study.

The role of maternal colostrum to infant development has been extensively studied and presented. Among the main factors which contribute to breast milk composition are maternal diet, age and body mass index, parity, duration of pregnancy and stage of lactation. This study aims to investigate the potential impact of several factors including demographic (i.e. maternal age and nationality) on the colostrum fatty acid profile. Colostrum was collected the third day postpartum in a Greek maternity hospital. Certain lipid quality indices and fatty acid ratios were estimated and results were statistically processed. The main identified fatty acids were palmitic (C16:0), oleic (C18:1ω-9), and linoleic (C18:2ω-6) acids. Among fatty acids, saturated fatty acids predominated (47.61%), followed by monounsaturated fatty acids (39.26%), while polyunsaturated fatty acids had the lowest proportion (13.13%). Values of lipid quality indices were within the reported in the literature ranges. Maternal body mass index, nationality, age, mode of delivery, gender and fetal weight percentile were studied in respect to their potential influence on the fatty acid profile of colostrum fat. Results suggest that colostrum fatty acid profile was mainly dependent on maternal nationality and age rather than mode of delivery and maternal BMI. Regarding the effect of maternal nationality, significant differences were found for saturated and monounsaturated fatty acids. Of the most interesting findings is that colostrum fat from older (≥35 years) mothers had less saturated fat and more appropriate LQIs values. Finally, a reversed correlation was observed between the customized centile of the infants and the colostrum fat content.