انواع الرضاعة والاستجابة للعلاج الضوئي كعلاج للاطفال حديثي الولادة المصابين بمرض اليرقان الغير مباشر في المستشفيات التعليمية في بغداد == Types of Infant Feeding and Response to Phototherapy as a Treatment for Fullterm Newborns with Neonatal Indirect Hyperbilirubinemia in Tertiary Teaching Hospitals in Baghdad
Author name:
شيماء خضير عباس
Supervisor name:
احمد سمير النعيمي
General topic:
Medicine
Specific topic:
Family Medicine
Degree:
Higher Diploma
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1326 - p.pdf
Abstract:
Background : Neonatal jaundice remains the most common and the most controversial problem in full - term newborns during the immediate postnatal period.Aim of the study : To assess the association between types of feeding and response to phototherapy in full - term infants with indirect hyperbilirubinemia.Method : In the period from the 25th of January to the 22th of July 2016, 120 full - term newborns admitted to the neonatal care unit in Tertiary Teaching Hospitals (Pediatric Teaching Hospital in medical city, AI - Imamein Al - Kadhimein medical city and Child Center Teaching Hospital) were studied by cohort study. The newborns diagnosed by pediatrician as cases of indirect hyperbilirubinemia and phototherapy started when TSB level>14.9 mg/dl. TSB was measured twice daily and phototherapy terminated when TSB level< 10.8 mg/dl. All infants were weighed at start and end of phototherapy. The duration of phototherapy had been recorded.Results : The infants divided into three groups according to type of feeding; group1, Breast - fed infants (n=37); group2, Formula - fed infants (n=51); group3, Mixed - fed infants (n=32).Phototherapy was highly effective in reducing serum bilirubin concentration in all of three groups but with a significant less efficacy for breast - fed neonates ( mean duration of phototherapy 32.2± 2.1 hrs) in comparison to mix - fed neonates (30.4 ± 2.5 hrs) and formula - fed neonates (29.9± 2.7 hrs).There was a weight loss during phototherapy. There was significant difference in the weight loss in the three groups, the more weight loss in breast - fed neonates than mixed - fed and formula - fed neonates. Conclusion and recommendations : Phototherapy had effectively reduced bilirubin levels in breast - fed newborns with hyperbilirubinemia, but these patients showed a significantly slower response to this modality of treatment than mixed and formula - fed newborns. Therefore; in breast - fed infants with severe jaundice that requires phototherapy, the addition of formula - feeding will enhance the response to phototherapy without any interruption of breastfeeding.
