Role of early feeds, breast milk and KMC in infection prevention
- Introduction...
- 1. Benefits of ear...
- 2. Learning object...
- 3. Dangers of dela...
- 4. Common myths...
- 5. How breast milk...
- 6. How KMC prevent...
- 7. Summary...
Introduction
DR. SHIV SAJAN SAINI
MD, DM (Neonatology)
Assistant Professor
Department of Pediatrics
PGIMER, Chandigarh
1. Benefits of early feeding
► Failure to give early feeds
♦ Require IV fluids, increases risk of infection
► Early and exclusive breast milk feeding
♦ Prevents mortality, infections
► KMC in LBW neonates
♦ Decreases mortality and morbidity
► Early enteral feeding + breast milk feeding + KMC
♦ Important role in resource constraint setting
2. Learning objectives
► Dangers of not initiating early enteral feeds
► Common myths regarding early enteral feeding
► Role of breast milk in prevention infection
► Role of KMC in prevention of infections
3. Dangers of delayed feeds
* Khan J et al, Matern Child Health J. 2015
4. Common myths
► CPAP/oxygen support
► Maternal HIV
► Isolated regurgitation
► Occasional blood tinged aspirate
► Isolated apnea
5. How breast milk prevents infection?
► Breast milk - rich in bioactive factors
► Augments immunity, prevent infections
► Secretory immunoglobulin A
♦ Prevents bacteria entry in gut cells
♦ Develop against local pathogens
► White blood cells
► Lysozyme and lactoferrin - antibacterial anti-viral
and antifungal
► Oligosaccharides - prevent bacterial attachment to mucosa
6. How KMC prevents infection?
► Decreases mortality - 40% (especially LBW neonates)
► Decreases nosocomial infection - 55%
► Prevents hypothermia - 66%
♦ Less interventions - less infections
► Improved breastfeeding rates
♦ Decreases infection
► Decreases hospital stay
♦ Decreases exposure to pathogens
7. Summary
► Delay in feeds - increases the risk of death, acquired infections
► Enteral feeds - initiated within first hour of life unless
contraindicated
► Minor problems & normal abdominal examination - continue
feeds
► Numerous biofactors in breast milk - prevent infection
► KMC prevents mortality and morbidity especially in LBW
neonates