Dataset Information

Drug delivery from a solid formulation during breastfeeding-A feasibility study with mothers and infants.

ABSTRACT:

Background

Breastfeeding is critical to health outcomes, particularly in low-resource settings where there is little access to clean water. For infants in their first twelve months of life, the delivery of medications is challenging, and use of oral syringes to deliver liquid formulations can pose both practical and emotional challenges.

Objective

To explore the potential to deliver medicine to infants via a solid formulation during breastfeeding.

Methods

Single center feasibility study within a tertiary level neonatal unit in the UK, involving twenty-six breastfeeding mother-infant dyads. A solid formulation of Vitamin B12 was delivered to infants during breastfeeding. Outcomes included the quantitative change in serum vitamin B12 and assessment of maternal expectations and experiences.

Results

Delivery of Vitamin B12 through a solid formulation that dissolved in human milk did not impair breastfeeding, and Vitamin B12 levels rose in all infants from a mean baseline (range) 533 pg/mL (236-925 pg/mL) to 1871 pg/mL (610-4981 pg/mL) at 6-8 hours post-delivery. Mothers described the surprising ease of 'drug' delivery, with 85% reporting a preference over the use of syringes.

Conclusions

Solid drug formulations can be delivered during breastfeeding and were preferred by mothers over the delivery of liquid formulations via a syringe.

SUBMITTER: Maier T

PROVIDER: S-EPMC8896718 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Drug delivery from a solid formulation during breastfeeding-A feasibility study with mothers and infants.

Maier Theresa T Peirce Paula P Baird Laura L Whitehouse Sophie L SL Slater Nigel K H NKH Beardsall Kathryn K

PloS one 20220304 3

<h4>Background</h4>Breastfeeding is critical to health outcomes, particularly in low-resource settings where there is little access to clean water. For infants in their first twelve months of life, the delivery of medications is challenging, and use of oral syringes to deliver liquid formulations can pose both practical and emotional challenges.<h4>Objective</h4>To explore the potential to deliver medicine to infants via a solid formulation during breastfeeding.<h4>Methods</h4>Single center feas ...[more]

PMID: 35245341

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Project description:ImportanceThere is limited information on infant drug exposure via breastfeeding by mothers who are receiving antiepileptic drug therapy.ObjectiveTo provide direct, objective information on antiepileptic drug exposure through breast milk.Design, setting, and participantsThis prospective cohort study was conducted between December 2012 to October 2016, with follow-up in children until 6 years of age at 20 sites across the United States. Data were collected via an observational multicenter investigation (Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs [MONEAD]) of outcomes in pregnant mothers with epilepsy and their children. Pregnant women with epilepsy who were aged 14 to 45 years, had pregnancies that had progressed to less than 20 weeks' gestational age, and had measured IQ scores of more than 70 points were enrolled and followed up through pregnancy and 9 postpartum months. Their infants were enrolled at birth. Data were analyzed from May 2014 to August 2019.ExposuresAntiepileptic drug exposure in infants who were breastfed.Main outcomes and measuresThe percentage of infant-to-mother concentration of antiepileptic drugs. Antiepileptic drug concentrations were quantified from blood samples collected from infants and mothers at the same visit, 5 to 20 weeks after birth. Concentrations of antiepileptic drugs in infants at less than the lower limit of quantification were assessed as half of the lower limit. Additional measures collected were the total duration of all daily breastfeeding sessions and/or the volume of pumped breast milk ingested from a bottle.ResultsA total of 351 women (of 865 screened and 503 eligible individuals) were enrolled, along with their 345 infants (179 female children [51.9%]; median [range] age, 13 [5-20] weeks). Of the 345 infants, 222 (64.3%) were breastfed; the data collection yielded 164 matching infant-mother concentration pairs from 138 infants. Approximately 49% of all antiepileptic drug concentrations in nursing infants were less than the lower limit of quantification. The median percentage of infant-to-mother concentration for all 7 antiepileptic drugs and 1 metabolite (carbamazepine, carbamazepine-10,11-epoxide, levetiracetam, lamotrigine, oxcarbazepine, topiramate, valproate, and zonisamide) ranged from 0.3% (range, 0.2%-0.9%) to 44.2% (range, 35.2%-125.3%). In multiple linear regression models, maternal concentration was a significant factor associated with lamotrigine concentration in infants (Pearson correlation coefficient, 0.58; P < .001) but not levetiracetam concentration in infants.Conclusions and relevanceOverall, antiepileptic drug concentrations in blood samples of infants who were breastfed were substantially lower than maternal blood concentrations. Given the well-known benefits of breastfeeding and the prior studies demonstrating no ill effects when the mother was receiving antiepileptic drugs, these findings support the breastfeeding of infants by mothers with epilepsy who are taking antiepileptic drug therapy.

Project description:INTRODUCTION:Many women cease breastfeeding earlier than desired. This study examined the cessation of breastfeeding among mothers of preterm infants. Thus, the aim was to describe the cessation of breastfeeding in mothers of preterm infants up to 12 months after birth. METHOD:This mixed methods study used a convergent design with both qualitative data, consisting of written comments, and quantitative data, on breastfeeding status and breastfeeding satisfaction. The data were collected from questionnaires sent to the mothers at three points during the first year after birth. In total, 270 mothers of preterm infants who breastfed at the time of discharge from the neonatal unit provided data for the study. The quantitative and qualitative data were analysed separately with statistical tests and hermeneutical analysis, respectively and then together according to the convergent mixed methods design. RESULTS:Four themes of the meanings of the cessation of breastfeeding were identified in the qualitative analysis: "Desire to regain the mother's and the infant's well-being", "The mothers interpretation that the infants actively ceased breastfeeding", "The mother's body and/or the infants' signals showing the way" and "The mother's own will and perceived external obstacles". Mothers who did not breastfeed as long as they wanted were more likely to report less satisfaction with breastfeeding, a shorter breastfeeding period, and less activity when ceasing breastfeeding. In comparison, mothers who breastfed as long as they wanted were more satisfied with breastfeeding, breastfed for a longer period of time and were more active in decision making in breastfeeding cessation. CONCLUSION:Maternal passivity or activity influenced the cessation of breastfeeding in mothers of preterm infants who breastfed at the time of discharge from the neonatal unit. Passive behaviour related to breastfeeding may result in early cessation of breastfeeding, and low breastfeeding satisfaction while active behaviour may increase breastfeeding length and satisfaction.

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Project description:BackgroundBreast milk is the nutrient of choice for preterm infants. The World Health Organization has set a target of ensuring by 2030 that 70 % of infants younger than age 6 months are exclusively breastfed. The breastfeeding status of mothers of preterm infants is far below that target. Preterm infants are a special group, and there are many difficulties in and obstacles to adhering to breastfeeding. It is urgent to understand the current situation of breastfeeding among mothers of preterm infants, the change in their breastfeeding behaviors over time, and factors influencing breastfeeding in this population during different postpartum stages.ObjectiveWe aimed to explore potential breastfeeding behavior trajectories and analyze modifiable influencing factors to provide a reference for health care staff to identify risk groups of breastfeeding attrition at an early stage and develop targeted intervention measures.MethodsWe conducted a prospective, single-center, longitudinal study involving a cohort of mothers of preterm infants from July 2023 to May 2024. We administered the Breastfeeding Behavior Questionnaire, Breastfeeding Intention Questionnaire, Breastfeeding Prediction Scale, Breastfeeding Knowledge Questionnaire, and Edinburgh Postnatal Depression Scale. Data were collected at four timepoints: before discharge (T0) and at 6 weeks (T1), 4 months (T2), and 6 months postpartum (T3). A mixed model of latent variable growth was used to fit the trajectory of maternal breastfeeding behavior, and multiple logistic regression analysis was used to detect factors influencing the trajectory of breastfeeding behavior.ResultsThree types of heterogeneity tracks were found: a "high-level rising" group (36.5 %), "medium-level declining" group (26.0 %), and "low-level declining" group (37.5 %). Household income, spouse's educational background, smoking in the spouse, breastfeeding patterns before discharge (T0), perceived breastfeeding control and breastfeeding intention (T1), perceived breastfeeding control, breastfeeding intention, and breastfeeding knowledge (T2), and perceived breastfeeding control, breastfeeding positive attitude, and breastfeeding negative attitude (T3) were predictors of different profiles.ConclusionBreastfeeding is of great importance to promote the growth and development of preterm infants. However, the breastfeeding situation among mothers of preterm infants 6 months after delivery is not encouraging. The rate of exclusive breastfeeding is low and needs to be improved. Clarifying those variables related to the Theory of Planned Behavior, such as breastfeeding positive and negative attitudes, perceived breastfeeding control, breastfeeding knowledge, and postpartum depression score, can provide a theoretical basis for the early identification and screening of mothers at risk of exclusive breastfeeding attrition. Interventions should be delivered at scale to benefit all new mothers and infants.

Project description:BACKGROUND:Breastfeeding has a great effect on health promotion and disease prevention in premature infants. However, various factors affect the success of breastfeeding process in mothers. The present study aims to: a) explain breastfeeding experiences; b) assess the factors affecting breastfeeding self-efficacy; and c) present a guideline for promoting breastfeeding in mothers of premature infants. METHODS:This mixed-methods study with a sequential explanatory design consisted of three phases. The first phase is qualitative study to explore the breastfeeding experiences in mothers of premature infants. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used a cross-sectional approach to assess the association of the social determinants of health with breastfeeding self-efficacy in mothers of premature infants. In this phase, the multistage cluster sampling method will be used to select 360 subjects who will be visited healthcare centers in Tabriz, Iran. The third phase focused on developing strategies to increase the ability of mothers to breastfeed their premature infants, using the qualitative and quantitative results of previous phases, a review of the related literature, and the nominal group technique will be performed among experts. DISCUSSION:The present research is the first study that investigated the experiences of breastfeeding and factors influencing breastfeeding self-efficacy in mothers of premature infants. For the purposes of the study, the mixed methods approach will be used which aimed to develop strategies for the improvement of healthcare services in this regard. It is worth noting that there is no strategic guideline in Iran's healthcare system for the improvement of breastfeeding, especially regarding mothers of premature infants. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements in this regard. ETHICAL CODE:IR.TBZMED.REC.1398.100.

Dataset Information

Drug delivery from a solid formulation during breastfeeding-A feasibility study with mothers and infants.

Background

Objective

Methods

Results

Conclusions

Publications

Drug delivery from a solid formulation during breastfeeding-A feasibility study with mothers and infants.

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