Effectiveness of supplementary suckling technique in underweight infants
DOI:
https://doi.org/10.18203/2349-3291.ijcp20171725Keywords:
Malnourished infants, Re-lactation, Supplementary suckling techniqueAbstract
Background: The period from birth to 6 months is part of a larger critical ‘window of opportunity’ within which the impact of undernutrition has both immediate and long term adverse consequences. Protocols for older children are often extended to this age group owing to the absence of evidence-based treatment protocols. The following study was carried out to assess the effectiveness of supplementary suckling technique and lactation counselling over counselling alone in management of malnourished infants in the age group of 1- 6 months.
Methods: After IRB clearance, all underweight infants with weight for age <-2SD by WHO charts were enrolled in the study. Once identified as lactation failure, the infants were randomly allocated into two groups using SAS 9.2 package. Both, cases and controls were counselled regarding breast feeding practices as per WHO module. Cases were additionally started on supplementary feeds by Supplementary Suckling Technique (SST) for the 1st week. Weight gain was monitored at enrolment, on day 7 and day 14. Weight gain >20gm/day in the 2nd week was considered successful re-lactation. Data was analysed using student unpaired t test and chi square test.
Results: Mean weight gain per day in 1st and 2nd week in the cases was significantly higher than that in the controls (p= <0.001). In 2nd week, maximum weight gain i.e. 20-30 g/day was found in 93.3% cases as against 13.3% controls (p=0.01) depicting successful re-lactation.
Conclusions: Lactation counselling along with supplementary suckling technique should be the standard of care in management of malnourished infants.Metrics
References
Vygen S, Roberfroid D, Captier V, Kolsteren P. Treatment of severe acute malnutrition in infants aged <6 months in Niger. J Pediatr. 2013; 162(3):515-21.
Ministry of Health and Family Welfare; Govt. of India. Operational Guidelines on Facility Based Management of Children with Severe Acute Malnutrition. 2011;1-66.
Kerac M, McGrath M, Grijalva-Eternod C, Bizouerne C, Saxton J, Bailey H, et al. Management of Acute Malnutrition in Infants (MAMI) Project Technical Review: Current evidence, policies, practices and programme outcomes; 2010.
WHO/UNICEF. Breastfeeding Counselling: A Training Course; 1993.
Operational guidelines on Facility Based Management of Children with Severe Acute Malnutrition. Ministry of Health and Family Welfare. Govt of India. 2012;75-6.
Kerac M, Mwangome M, Mcgrath M, Haider R, Berkley JA. Management of acute malnutrition in infants aged under 6 months (MAMI): Current issues and future directions in policy and research. Food Nutr Bull. 2015;36(1):30-4.
Wilkinson C, Isanaka S. Diluted F100 v infant formula in treatment of severely malnourished infants <6 months. F Exch. 2009;(37).
Singh DK, Rai R, Dubey S. Supplementary suckling technique for relactation in infants with severe acute malnutrition. Indian Pediatr. 2014;51(8):671.
Nobile C, Raffaele G, Altomare C, Pavia M. Influence of maternal and social factors as predictors of low birth weight in Italy. BMC Public Health. 2007;7(1):192.
Lee H, Gould J. Obstetric Survival Advantage Associated with Cesarean Delivery in Very Low Birth Weight Vertex Neonatess and Gynecology. Obstet Gynecol. 2006;107(1):97-105.
Silva AAM, Lamy-Filho F, Alves MTSSB, Coimbra LC, Bettiol H, Barbieri MA. Risk factors for low birthweight in north-east Brazil: the role of caesarean section. Paediatr Perinat Epidemiol 2001;15(3):257-64.
Subba G, Das G. Impact of feeding practices, socioeconomic, and demographic profiles of under five children with severe acute malnutrition. Int J ContempPediatr. 2014;1(3):152-5.
Kumar D, Goel N, Mittal P, Misra P. Influence of infant-feeding practices on nutritional status of under-five children. Indian J Pediatr. 2006;73(5):417-21.
Teferi E, Lera M, Sita S, Bogale Z, Datiko D, Yassin M. Treatment outcome of children with severe acute malnutrition admitted to therapeutic feeding centers in Southern Region of Ethiopia. Ethiop J Heal Dev. 2011;24(3):234-8.
Muresan M. Successful relactation--a case history. Breastfeed Med. 2011;6(4):233-9
Lelijveld N, Mahebere-Chirambo C, Kerac M. Carer and staff perspectives on supplementary suckling for treating infant malnutrition: qualitative findings from Malawi. Matern Child Nutr. 2014;10(4):593-603.