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Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania

Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low B...

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Autores principales: Semrau, Katherine E. A., Mokhtar, Rana R., Manji, Karim, Goudar, Shivaprasad S., Mvalo, Tisungane, Sudfeld, Christopher R., Young, Melissa F., Caruso, Bethany A., Duggan, Christopher P., Somji, Sarah S., Lee, Anne C. C., Bakari, Mohamed, Lugangira, Kristina, Kisenge, Rodrick, Adair, Linda S., Hoffman, Irving F., Saidi, Friday, Phiri, Melda, Msimuko, Kingsly, Nyirenda, Fadire, Michalak, Mallory, Dhaded, Sangappa M., Bellad, Roopa M., Misra, Sujata, Panda, Sanghamitra, Vernekar, Sunil S., Herekar, Veena, Sommannavar, Manjunath, Nayak, Rashmita B., Yogeshkumar, S., Welling, Saraswati, North, Krysten, Israel-Ballard, Kiersten, Mansen, Kimberly L., Martin, Stephanie L., Fleming, Katelyn, Miller, Katharine, Pote, Arthur, Spigel, Lauren, Tuller, Danielle E., Vesel, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115266/
https://www.ncbi.nlm.nih.gov/pubmed/37075019
http://dx.doi.org/10.1371/journal.pgph.0001789
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author Semrau, Katherine E. A.
Mokhtar, Rana R.
Manji, Karim
Goudar, Shivaprasad S.
Mvalo, Tisungane
Sudfeld, Christopher R.
Young, Melissa F.
Caruso, Bethany A.
Duggan, Christopher P.
Somji, Sarah S.
Lee, Anne C. C.
Bakari, Mohamed
Lugangira, Kristina
Kisenge, Rodrick
Adair, Linda S.
Hoffman, Irving F.
Saidi, Friday
Phiri, Melda
Msimuko, Kingsly
Nyirenda, Fadire
Michalak, Mallory
Dhaded, Sangappa M.
Bellad, Roopa M.
Misra, Sujata
Panda, Sanghamitra
Vernekar, Sunil S.
Herekar, Veena
Sommannavar, Manjunath
Nayak, Rashmita B.
Yogeshkumar, S.
Welling, Saraswati
North, Krysten
Israel-Ballard, Kiersten
Mansen, Kimberly L.
Martin, Stephanie L.
Fleming, Katelyn
Miller, Katharine
Pote, Arthur
Spigel, Lauren
Tuller, Danielle E.
Vesel, Linda
author_facet Semrau, Katherine E. A.
Mokhtar, Rana R.
Manji, Karim
Goudar, Shivaprasad S.
Mvalo, Tisungane
Sudfeld, Christopher R.
Young, Melissa F.
Caruso, Bethany A.
Duggan, Christopher P.
Somji, Sarah S.
Lee, Anne C. C.
Bakari, Mohamed
Lugangira, Kristina
Kisenge, Rodrick
Adair, Linda S.
Hoffman, Irving F.
Saidi, Friday
Phiri, Melda
Msimuko, Kingsly
Nyirenda, Fadire
Michalak, Mallory
Dhaded, Sangappa M.
Bellad, Roopa M.
Misra, Sujata
Panda, Sanghamitra
Vernekar, Sunil S.
Herekar, Veena
Sommannavar, Manjunath
Nayak, Rashmita B.
Yogeshkumar, S.
Welling, Saraswati
North, Krysten
Israel-Ballard, Kiersten
Mansen, Kimberly L.
Martin, Stephanie L.
Fleming, Katelyn
Miller, Katharine
Pote, Arthur
Spigel, Lauren
Tuller, Danielle E.
Vesel, Linda
author_sort Semrau, Katherine E. A.
collection PubMed
description Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge.
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spelling pubmed-101152662023-04-20 Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania Semrau, Katherine E. A. Mokhtar, Rana R. Manji, Karim Goudar, Shivaprasad S. Mvalo, Tisungane Sudfeld, Christopher R. Young, Melissa F. Caruso, Bethany A. Duggan, Christopher P. Somji, Sarah S. Lee, Anne C. C. Bakari, Mohamed Lugangira, Kristina Kisenge, Rodrick Adair, Linda S. Hoffman, Irving F. Saidi, Friday Phiri, Melda Msimuko, Kingsly Nyirenda, Fadire Michalak, Mallory Dhaded, Sangappa M. Bellad, Roopa M. Misra, Sujata Panda, Sanghamitra Vernekar, Sunil S. Herekar, Veena Sommannavar, Manjunath Nayak, Rashmita B. Yogeshkumar, S. Welling, Saraswati North, Krysten Israel-Ballard, Kiersten Mansen, Kimberly L. Martin, Stephanie L. Fleming, Katelyn Miller, Katharine Pote, Arthur Spigel, Lauren Tuller, Danielle E. Vesel, Linda PLOS Glob Public Health Research Article Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge. Public Library of Science 2023-04-19 /pmc/articles/PMC10115266/ /pubmed/37075019 http://dx.doi.org/10.1371/journal.pgph.0001789 Text en © 2023 Semrau et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Semrau, Katherine E. A.
Mokhtar, Rana R.
Manji, Karim
Goudar, Shivaprasad S.
Mvalo, Tisungane
Sudfeld, Christopher R.
Young, Melissa F.
Caruso, Bethany A.
Duggan, Christopher P.
Somji, Sarah S.
Lee, Anne C. C.
Bakari, Mohamed
Lugangira, Kristina
Kisenge, Rodrick
Adair, Linda S.
Hoffman, Irving F.
Saidi, Friday
Phiri, Melda
Msimuko, Kingsly
Nyirenda, Fadire
Michalak, Mallory
Dhaded, Sangappa M.
Bellad, Roopa M.
Misra, Sujata
Panda, Sanghamitra
Vernekar, Sunil S.
Herekar, Veena
Sommannavar, Manjunath
Nayak, Rashmita B.
Yogeshkumar, S.
Welling, Saraswati
North, Krysten
Israel-Ballard, Kiersten
Mansen, Kimberly L.
Martin, Stephanie L.
Fleming, Katelyn
Miller, Katharine
Pote, Arthur
Spigel, Lauren
Tuller, Danielle E.
Vesel, Linda
Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title_full Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title_fullStr Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title_full_unstemmed Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title_short Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania
title_sort facility-based care for moderately low birthweight infants in india, malawi, and tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115266/
https://www.ncbi.nlm.nih.gov/pubmed/37075019
http://dx.doi.org/10.1371/journal.pgph.0001789
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