Attitudes of medical and nursing personnel to breast feeding practices.
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Biomedical subjects
Publications and source records attributed to I Narayanan.
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The problems of feeding preterm and low birth weight infants are discussed. Physiological requirements are considered, together with the ways in which these can be met in developed and developing countries. Although human milk may not always be considered best for preterm infants in developed countries it is concluded that in underprivileged areas of the Third World it is life saving.
Supplementary formula feeds inhibited the protective effect of expressed raw and pasteurised human milk in 226 high-risk neonates in a randomised controlled trial. The infection rate in the group given pasteurised human milk and formula (33%) was significantly higher than the rates in the groups given raw human milk (10.5%), pasteurised human milk (14.3%), and raw human milk and formula (16%). This accords with the impressions that some of the association of infection with artificial feeding is partly attributable to the lack of the protective effect of human milk. Heating expressed human milk to 62.5 degrees C for 30 min significantly reduces its protective effect.
A rise in the fat concentration of human milk within the syringe was noted towards the end of continuous infusion but not with intermittent bolus gastric feeding. The rise in the former was reduced most simply and effectively by using an eccentric nozzle syringe and tilting the pump up at an angle of between 25 degrees and 40 degrees.
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This paper comprises 261 low birth weight infants who were divided into four groups with different feeding schedules. Group I--expressed human milk for all the feeds; Group II--human milk for half the feeds and the nursery formula for the rest; Group III--colostrum, 20 ml three times a day along with the nursery formula; and Group IV--control--only the nursery formula. The groups were matched by means of a randomized block design for identifiable factors which could predispose to the occurrence of infection. Infections were found to be significantly less in the groups which received human milk (p less than 0.001).
A simple method of assessment of gestational age based on only four characteristics, namely, the anterior vascular capsule of the lens, plantar creases, breast nodule, and ear firmness, is presented. Critical evaluation by appropriate statistical analyses has shown this to be a useful method of practical value with 95% confidence limits of 11 days. It is applicable to newborn infants, including sick babies, at any time within the first 2 days of life.
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