Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants

OBJECTIVE: To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants. METHODS: One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding). RESULTS: Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. CONCLUSION: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.

Length of stay in a neonatal intensive care unit and its association with low rates of exclusive breastfeeding in very low birth weight infants

OBJECTIVE: To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants. METHODS: One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding). RESULTS: Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. CONCLUSION: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.

Contando histórias de cuidado à infância em unidade de terapia intensiva pediátrica

The tales of children's literature, in their plots, mark existential dilemmas belonging in human‟s lives, such as death, situations of separation, loss, abandonment, fear, challenges, achievements and other elements that make them suitable material to assist children in their developmental process. Such elements, present in children‟s storybooks, are close to the experiences lived by the children in the context of hospitalization in a special manner. With that said this study focus on the understanding of the therapeutic possibilities of the tales of children's literature in the care of hospitalized children in Pediatric Intensive Care Units (UTIPED) based on the Heidegger's concept of Care and adopting the Phenomenology as the method. The UTIPED of a state public hospital located in the municipality of Natal/RN was elected as the study site and four hospitalized children aged between six and nine years, all males, presenting different clinical conditions were selected to participate in the study following age and clinical conditions as the selective criteria. The procedure of corpus construction included eight individual sessions of storytelling accompanied by the use of ludic resources. The phenomenological understanding about the therapeutic possibilities of tales was structured under three main elements: (1) the ludic axis; (2) the reflective axis; and (3) the affective axis. The appropriateness of the proposed therapy in the context of the UTIPED and the potential of the tales as a protection factor to the child was evident. The storytelling activity framed a scenario of care unusual in the context of intensive care units, establishing a symbolic space for children‟s expression. Therefore, this study indicates this therapeutic proposal for children‟s care in the UTIPED that considers their evolutionary stage, their clinical conditions at the time and especially their emotional needs during their immersion in a diverse and foreign environment which is filled with potentially harmful elements to their full development.