Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial.

Very preterm infants are usually supported by parenteral nutrition delivered through central lines (CLs) while progressing with enteral intake, although the optimal time point for their removal is unclear. This study evaluated the impact of the CL discontinuation time on the short-term growth outcomes of preterm infants. A non-inferiority, parallel-group, randomized controlled trial was conducted in four neonatal intensive care units in Poland. Preterm infants with very low birth weight (VLBW) without congenital abnormalities were eligible. Patients were allocated to discontinue central access at an enteral feeding volume of 100 mL/kg/day (intervention group) or 140 mL/kg/day (control group). The study's primary outcome was weight at 36 weeks' postmenstrual age, with a non-inferiority margin of -210 g. Overall, 211 patients were allocated to the intervention or control groups between January 2019 and February 2021, of which 101 and 100 were eligible for intention-to-treat analysis, respectively. The mean weight was 2232 g and 2200 g at 36 weeks' postmenstrual age in the intervention and control groups, respectively. The mean between-group difference was 32 g (95% confidence interval, -68 to 132; p = 0.531), which did not cross the specified margin of non-inferiority. No intervention-related adverse events were observed. Early CL removal was non-inferior to the standard type for short-term growth outcomes in VLBW infants.

The link between knowledge of the maternal diet and breastfeeding practices in mothers and health workers in Poland.

BACKGROUND: There are multiple misconceptions concerning the breastfeeding mother's diet and its adverse impact on breast milk composition and the breastfed child's health, which might lead to breastfeeding cessation. Although prophylactic maternal dietary restrictions are not recommended, mothers all over the world are often recommended to avoid certain foods, due to cultural beliefs, social pressure and even outdated or ambiguous medical recommendations. In Poland, there is no systematic approach to breastfeeding education in the form of nationwide educational programs for particular social groups. It was estimated that in 2017 only 3-4% of Polish infants were exclusively breastfed at 6 months of age. The aim of this study was to recognize the scale of common dietary misconceptions among lactating mothers in Poland and to compare knowledge and opinions between medical staff and mothers who have ever breastfed a child. In addition, the paper is an attempt to identify factors contributing to the still current practice of recommending prophylactic dietary restrictions to breastfeeding mothers by medical staff. METHODS: The study was conducted in Poland, in January - February 2019. The study used a diagnostic poll method and was conducted mainly in an electronic form. A total of 1159 completed questionnaires data were analyzed: 35.1% completed by medical staff and 64.9% by mothers in non-medical professions. Statistical calculations were conducted with Chi-square test, logistic regression and U Mann Whitney test (level of significance set at 0.05). RESULTS: The respondents presented a good level of knowledge and predominantly assessed the questioned statements correctly. Duration of breastfeeding was found to be the main factor determining respondents' knowledge (p <  0.05). Concerning medical staff, the parity (p <  0.001) and applying an elimination diet when themselves breastfeeding (p <  0.001) had a significant impact on recommendation of prophylactic dietetic restrictions to the lactating women. CONCLUSIONS: Regardless of a resonably good level of knowledge on maternal nutrition in the lactation period, both breastfeeding mothers and medical staff are still convinced of the beneficial effect of preventive dietary restrictions, which affects further lactational counselling and lactational performance.

Foods to Avoid While Breastfeeding? Experiences and Opinions of Polish Mothers and Healthcare Providers.

Popular beliefs regarding a mother's diet during lactation have a significant impact on breastfeeding practices among mothers, as well on breastfeeding counseling among healthcare providers worldwide. The objective of this study was to assess mothers' and medical professionals' knowledge and opinions on the "lactating mother's diet". An electronic survey, prepared in Polish, was administered to healthcare providers, as well as mothers who have breastfed a child. The chi-square test, logistic regression, and Mann Whitney U test were used for statistical calculations. Out of a total of 1180 responses received, 1159 were analyzed, and 21 were excluded because they did not meet the inclusion criteria. The survey was completed by 407 (35%) medical healthcare providers and 752 (65%) lactating mothers in non-medical professions. In total, the study included 1074 mothers who have breastfed a child, and 29.14% of them reported that they eliminated certain foods from their diet when breastfeeding. There was no statistically significant difference in the responses received from mothers and medical staff providing maternal care (for each of 17 products, e.g., steak tartare, sushi, legumes, dairy products, p > 0.05 by the Mann-Whitney test). However, a logistic regression revealed some significant correlations with other variables (e.g., duration of lactation). The respondents revealed an appropriate level of knowledge on nutrition during lactation and the majority of participants neither adhered to nor recommended a prophylactic elimination diet. Among other evaluated factors, the experience of following an elimination diet affected respondents' knowledge of nutrition during breastfeeding. Both mothers and healthcare providers require good nutritional education.

Donor human milk in Neonatal Intensive Care Unit - to whom, how much and how long?

OBJECTIVES: The aim of the study was to present the variability of patients who received donor human milk (DHM) duringNeonatal Intensive Care Unit (NICU) hospitalization, including time of its usage and volume of portions. MATERIAL AND METHODS: A retrospective analysis of data was conducted for all infants admitted to the NICU at the UniversityHospital during the first year of the Human Milk Bank operation. One-way analysis of variance in the intergroup scheme,Kruskal-Wallis variance analysis with the Jonckheere-Tepstra test, correlation analysis using Pearson's r and Spearmann'srho, frequency analysis using the Fisher's exact test were used to conduct analyses. RESULTS: 133 newborns received DHM. 3 groups of neonates were identified: < 32 0/7 weeks, 32 0/7-36 6/7 weeksand > 37 0/7 weeks of gestational age (GA). Time of DHM supplementation was similar in all groups and does not differdepending on the GA but preterm infants received the smallest total volume of DHM. However, infants > 37 weeks ofGA had almost a threefold greater chance of abandoning breastfeeding than the others (odds ratio (OR) = 2.89, 95% CI:0.69-12.20). There was a statistically significant, weak negative correlation between period of total parenteral nutrition andthe volume of milk from the bank: rho = -0.194; p = 0.026. CONCLUSIONS: The DHM supply did not have a negative impact on lactation and breastfeeding. Stimulation of lactation wasnecessary for 5-7 days. The time of DHM supply was the same regardless of GA. The majority of infants were breastfed orreceived only MOM on the day of discharge from the hospital.