Oropharyngeal colostrum immunotherapy and risk reduction of mortality in very low birth weight premature newborns: a clinical trial.

OBJECTIVE: To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). METHOD: Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. RESULTS: The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p = 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. CONCLUSION: The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.

Oropharyngeal colostrum immunotherapy and risk reduction of mortality in very low birth weight premature newborns: a clinical trial

Abstract Objective To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). Method Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. Results The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p= 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. Conclusion The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.

Fatores preditivos da interrupção do aleitamento materno exclusivo no primeiro mês de lactação / Factors predicting early discontinuation of exclusive breastfeeding in the first month of life

OBJETIVO: Averiguar os fatores associados à interrupção do aleitamento materno exclusivo no primeiro mês de lactação na cidade de Feira de Santana, BA. MÉTODOS: Estudo de coorte com 1.309 duplas mães-bebês selecionadas em todas as maternidades do município. Os dados foram coletados no hospital e domicílio ao final do primeiro mês. A associação entre desfecho e variáveis de interesse foi avaliada por meio de regressão logística. RESULTADOS: Falta de experiência prévia com amamentação (razão de prevalência 1,24; IC95 por cento 1,75-1,43), presença de fissura mamilar (razão de prevalência 1,25; IC95 por cento 1,09-1,43), horários pré-determinados para amamentar (razão de prevalência 1,42; IC95 por cento 1,09-1,84) e uso de chupeta (razão de prevalência 1,53; IC95 por cento 1,34-1,76) foram identificados como fatores preditivos da interrupção do aleitamento exclusivo. CONCLUSÕES: Medidas de prevenção da interrupção do aleitamento exclusivo devem priorizar mulheres sem experiência com amamentação e contemplar prevenção de traumas mamilares, incentivo à prática do aleitamento em livre demanda e desestímulo ao uso de chupeta.

OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil. METHODS: Cohort study with follow-up of 1,309 mother-child pairs selected from all maternities in the municipality. Data were collected in hospital and in home visits during the first month of life. Logistic regression analysis was used to examine the relationship between outcome and variables of interest. RESULTS: Lack of prior breastfeeding experience (PR 1.24; 95 percentCI 1.75-1.43), cracked nipples (PR 1.25; 95 percentCI 1.09-1.43), use of fixed breastfeeding schedules (PR 1.42; 95 percentCI 1.09-1.84) and pacifier use (PR 1.53; 95 percentCI 1.34-1.76) were identified as factors predicting discontinuation of exclusive breastfeeding. CONCLUSIONS: Measures to prevent early discontinuation of exclusive breastfeeding must focus on women without breastfeeding experience and include prevention of nipple trauma, encourage breastfeeding on demand, and discourage the use of pacifiers.