Browsing by Author "Raban, Moegammad Shukri"
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- ItemOpen AccessFactors associated with provision of mothers' own breast milk for Very Low Birth Weight (VLBW) infants on a South African tertiary care neonatal unit(2017) Mutesu-Kapembwa, Kunda; Raban, Moegammad Shukri; Joolay, YaseenBackground: The maternal struggle to provide adequate breast milk for the infants' nutritional needs disadvantage preterm infants as the outcomes of those exclusively breast milk fed are superior to those fed infant formula. Objectives: To determine the proportion of Mothers' Own breast Milk (MOM) consumed by very low birth weight (VLBW) infants at Groote Schuur Hospital and explore potential maternal difficulties to provide MOM. Methods: In a prospective cross sectional study of 104 VLBW infant-mother dyads admitted between January and May 2015, an interviewer administered a structured questionnaire to the participating mothers before day 3 and on day 14. Infant folders were reviewed for gestational age, weight, and mode of delivery and the proportion of MOM received on days 1, 7 and 14 of life. Results: Ninety-one (88%) infants received <25% of enteral feeds as MOM on day 1. MOM made up >75% of enteral feeds in 60 infants (62%) on day 14 of life and 56(57.7%) received 100% as MOM. Infants with 2 or less siblings (22.2% vs 33.7% p=0.010) received a greater proportion MOM on day 14 as compared to those with larger families. 85.7% of the interviewed mothers would have preferred to stay in the hospital with their infants post discharge. Infant's weight, mode of delivery, maternal age, HIV status, hypertension, breastfeeding counselling, income, transport mode or distance from the hospital had no impact on MOM provision. Conclusion: Domestic responsibilities may affect mothers' breast milk provision to the newborn preterm. Breast-feeding counselling did not improve breast milk provision in this study. The effectiveness of current counselling methods may need to be examined and improved. Facilitating accommodation and rooming in of mother infant pairs from delivery to discharge may be useful in improving MOM provision to VLBW infants.
- ItemOpen AccessRapid versus slow rate advancement of feeds for enterally fed extremely low birth weight infants < 1000g: randomised controlled trial(2014) Raban, Moegammad Shukri; Harrison, Michael C; Horn, Alan R; Modi, NeenaBackground The timeous achievement of full enteral nutrition in a preterm infant is a critical prerequisite for optimal growth, neurodevelopment and long-term wellbeing. However, the optimal enteral feeding regimen for preterm infants has not been established, and wide variations occur in practice. The debate on the most appropriate feeding strategy is nuanced by studies suggesting that early introduction of enteral feeds and the rapid advancement of enteral feeds may increase the risk of feeding intolerance and may be involved in the pathogenesis of necrotising enterocolitis (NEC). Objective 1. To review randomised controlled trials (RCT); examining the effect that the rate of advancement of enteral feeds has on the incidence of; NEC, mortality, growth, health care utilisation and other morbidities in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. 2. To establish the safety and efficacy of commencing enteral breast milk feeds at 24 ml/kg/day on the day of birth and advancing enteral breast milk feeds at 36 ml/kg/day, in infants weighing ≤ 1000 g.