Evidence map›Paper›PMID 30229153›Full record

ArticlePediatric quality & safety

Reduced Necrotizing Enterocolitis after an Initiative to Promote Breastfeeding and Early Human Milk Administration.

Michelle Feinberg, Lynn Miller, Barbara Engers, Kathy Bigelow, Ann Lewis, Shannon Brinker, Fran Kurland, Elizabeth Potthoff, Melynda Wallin, Alfonso Pantoja and 1 more

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Short-term rate of milk synthesis and expression interval of preterm mothers.Archives of disease in childhood. Fetal and neonatal edition · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Michelle FeinbergNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Lynn MillerNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Barbara EngersNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Kathy BigelowNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Ann LewisNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Shannon BrinkerNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Fran KurlandNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Elizabeth PotthoffNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Melynda WallinNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Alfonso PantojaNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
John R BrittonNewborn Intensive Care Unit, Saint Joseph Hospital, Denver, Colo.; and Department of Neonatology, Colorado Permanente Medical Group, Denver, Colo.
Colorado Permanente Medical Group · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe sought to reduce the incidence of necrotizing enterocolitis (NEC) in premature infants (PI) by fostering the postnatal establishment of protective intestinal bacteria through early administration of human milk (HM) and probiotics.

methodsA multidisciplinary team implemented an initiative to support breastfeeding (BF) and provide early postnatal supplemental donor human milk (DHM) and probiotics to PI. Interventions included process improvements in milk preparation, storage, and fortification. PI admitted to our NICU between 2006 and 2015 were monitored for feeding of HM, DHM, and preterm formula (PF), frequency of early feedings, and incidence of NEC.

resultsRetrospective review of 2557 cases revealed post-initiative increases in the percentage of PI receiving HM (91.5% to 96.1%), HM within 48 hours of birth (75% to 90.6%), and DHM (17.7% to 71.9%). The percentage of infants receiving feedings on day one increased from 23.9% to 44.6% while the percentage receiving PF within the first 72 hours declined (31.2% to 10.3%). The NEC rate declined from 4.1% to 0.4%. Reduction in NEC occurred despite a simultaneous increase in perinatal antibiotic exposure and the universal but late administration of bovine HM fortifier. The improvement associated with the decrease in NEC included initiation of probiotic administration, a reduction in PF feeding, and improvements in milk preparation, storage, and fortification processes.

conclusionsEarly exclusive feedings of HM and avoidance of PF together with probiotics and milkhygiene may decrease NEC in PI. Neither brief perinatal antibiotic exposure nor late introduction of bovine fortifiers appears detrimental in this context.

Identifiers

PMID30229153
PMCPMC6132913
OpenAlexW2950537117

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.