A simple step to improve fat and energy delivery of human milk delivered via bottle-feeding pump, an experimental study.

BACKGROUND: Enteral feeding pump systems deliver decreased amounts of macronutrients in human milk to neonates. This study determined the macronutrient loss associated with a bottle-feeding pump system and the effect of manually mixing the human milk during extended feeds. METHODS: Macronutrient content from samples of donor human milk was analyzed after simulated extended feeds with a bottle-feeding pump system, using a human milk analyzer. Simulations were repeated using manual mixing of the bottle every 30 min during feeding. The percentage of the baseline was calculated, and one-sample t tests and analysis of variance compared the effect of manual mixing and the duration of feeding on macronutrient delivery. RESULTS: The delivery of fat and energy was lower over time, but manual mixing considerably improved retention. The length of feeding impacted fat delivery, with less fat delivered over time (P < 0.001). Manually mixing significantly increased fat delivery (P < 0.001). Similar results were found for energy, with a significant reduction in energy delivery over time (P < 0.001) and significantly more energy delivered with mixing (P < 0.001). Mixing and the duration of feeding had minimal effect on protein or carbohydrate delivery. CONCLUSIONS: Bottle-feeding pump systems are associated with a significant reduction in the delivery of fat and energy of donor human milk. The manual mixing of donor human milk during prolonged feeds is a simple way to improve fat and energy delivery to the neonate.

Medics Sleep: Improving sleep education in medical training.

Sleep is essential for good health however, it is often neglected in medical education. As four students wanting to tackle this unique problem, we realised the necessity of establishing a platform dedicated to teaching about sleep.

Empirical Evaluations of Skinner's Analysis of Problem Solving.

We reviewed 12 studies in which the researcher taught problem-solving strategies, such as self-questioning and visual imagining, to children and adolescents with and without disabilities to facilitate the learning of math, spelling, play/social, and communication skills. We analyzed these studies in terms of types of problem-solving strategies, the multiple control involved in problem solving, the extent to which problem solving occurred at the overt or covert level. In addition to suggesting limitations of the literature, we recommend areas for future research and practice.