Impact of audio assisted relaxation technique on stress,anxiety and milk output among postpartum mothers of hospitalized neonates: A randomized controlled trial

Despite evidence suggesting use of relaxation technique beneficial for all human beings, it is one of the less commonly used approach for postpartum mothers.AimTo assess the impact of relaxation technique on stress, anxiety and milk output among the postpartum mothers of hospitalized neonates in NICU.Materials and methodsIn a non-blinded randomized controlled trial with total enumeration sampling technique, screening of NICU admission was done daily based on inclusion criteria. From total 160 admissions over a period of 6 month, 74 postpartum mothers meet the inclusion criteria whose neonates were born preterm (26–33 weeks gestation) and admitted consecutively to the level-III NICU at AIIMS Hospital in New Delhi, India. Total 57 mothers agree to participate, they were enrolled and randomly assigned to experimental (n₁ = 29) and control (n₂ = 28) groups using a computer generated random allocation sequence. There were total seven dropouts with the final sample size of 25 in each group. Baseline data including socio-demographic profile, maternal stress and anxiety were collected using subject data sheet, standardized Parental Stress Scale (PSS): NICU and Perinatal Anxiety Screening Scale (PASS) on 4 ± 2 postpartum day. An audio assisted relaxation technique of 30 min duration, was developed under the guidance of yoga therapist, which included deep breathing (5 min), Suksham Vyayam (8 min), Anulom-Vilom (5 min), Brahmari (5 min), Progressive Muscle Relaxation (PMR) (5 min), and deep breathing (2 min). The experimental group was administered audio assisted relaxation technique followed by every day practice for 10 days, while the control group continued to receive the routine care. The impact of the relaxation technique on stress, and anxiety of mothers along with milk output was assessed after 10 days of enrolment.ResultsBaseline characteristics and pre-intervention mean maternal stress (3.9 ± 0.5 vs. 3.8 ± 0.5, p = 0.34) and anxiety scores (31.12 ± 11.4 vs. 31.08 ± 12.0, p = 0.99) were comparable in both the groups. There was significant reduction observed in maternal stress (2.9 ± 0.5 vs. 3.6 ± 0.6) and anxiety scores (19.8 ± 6.7 vs. 28.18 ± 11.7, p ≤ 0.05) and improvement in milk output (69.2 ± 19.3 vs. 54.1 ± 22.5, p ≤ 0.05) in experimental group as compared to control group.ConclusionUse of relaxation technique may have significant role in reducing maternal stress and anxiety and improving the milk output.This trial is registered with Clinical Trials Registry India (CTRI/2018/06/014471).     

Comparison between videofluoroscopy and milk‐swallow endoscopy in the assessment of swallowing function

The investigation of swallowing function and the detection of aspiration has evolved over the past 10 years with the introduction of the fibreoptic endoscopic assessment. Practical reasons can limit the use of videofluoroscopy in some patients. A prospective study of 20 sets of videofluoroscopic and endoscopic assessments of swallowing function were compared. Endoscopic assessment was found to be a highly sensitive and specific method of determining swallowing safety. Reduced or absent laryngeal sensation at endoscopy correlates with silent aspiration and thus a high risk of aspiration pneumonia.     

Hypoglycin A in Cow’s Milk—A Pilot Study

Hypoglycin A (HGA) originating from soapberry fruits (litchi, and ackee) seeds or seedlings from the sycamore maple (SM) tree (related to Sapindaceae) may cause Jamaican vomiting sickness in humans and atypical myopathy in horses and ruminants. A possible transfer into dairy cow’s milk cannot be ruled out since the literature has revealed HGA in the milk of mares and in the offal of captured deer following HGA intoxication. From a study, carried out for another purpose, bulk raw milk samples from four randomly selected dairy farms were available. The cows were pastured in the daytime. A sycamore maple tree was found on the pasture of farm No. 1 only. Bulk milk from the individual tank or milk filling station was sampled in parallels and analyzed for HGA by LC-ESI-MS/MS. Measurable concentrations of HGA occurred only in milk from farm No. 1 and amounted to 120 and 489 nmol/L. Despite low and very variable HGA concentrations, the results indicate that the ingested toxin, once eaten, is transferred into the milk. However, it is unknown how much HGA the individual cow ingested during grazing and what amount was transferred into the bulk milk samples. As a prerequisite for a possible future safety assessment, carry-over studies are needed. Furthermore, the toxins’ stability during milk processing should also be investigated as well.     

Consumption of Breast Milk Is Associated with Decreased Prevalence of Autism in Fragile X Syndrome

Breastfeeding is associated with numerous health benefits, but early life nutrition has not been specifically studied in the neurodevelopmental disorder fragile X syndrome (FXS). Herein, I evaluate associations between the consumption of breast milk during infancy and the prevalence of autism, allergies, diabetes, gastrointestinal (GI) problems and seizures in FXS. The study design was a retrospective survey of families enrolled in the Fragile X Online Registry and Accessible Research Database (FORWARD). There was a 1.7-fold reduction in the prevalence of autism in FXS participants who were fed breast milk for 12 months or longer. There were strong negative correlations between increased time the infant was fed breast milk and the prevalence of autism and seizures and moderate negative correlations with the prevalence of GI problems and allergies. However, participants reporting GI problems or allergies commenced these comorbidities significantly earlier than those not fed breast milk. Parsing the data by sex indicated that males exclusively fed breast milk exhibited decreased prevalence of GI problems and allergies. These data suggest that long-term or exclusive use of breast milk is associated with reduced prevalence of key comorbidities in FXS, although breast milk is associated with the earlier development of GI problems and allergies.     

Maternal Distress and Social Support Are Linked to Human Milk Immune Properties

Possible alterations of maternal immune function due to psychological stress may reflect immunoactive factor levels in breast milk. This study aimed to assess the association between maternal distress and breast milk levels of secretory IgA (SIgA), IgM, IgG, and lactoferrin (LF). We hypothesized that this association is moderated by maternal social support achieved from others during lactation. The study group included 103 lactating mothers and their healthy five-month-old infants. Maternal distress was determined based on the State Anxiety Inventory and the level of salivary cortisol. Social support was assessed using the Berlin Social Support Scales. Breast milk samples were collected to test for SIgA, IgM, IgG, and LF using the ELISA method. Milk immunoactive factors were regressed against maternal anxiety, social support, salivary cortisol, and infant gestational age using the general regression model. Maternal anxiety was negatively associated with milk levels of LF (β = −0.23, p = 0.028) and SIgA (β = −0.30, p = 0.004), while social support was positively associated with milk IgG (β = 0.25, p = 0.017). Neither anxiety nor social support were related to milk IgM. No association was found between the level of maternal salivary cortisol and immunoactive factors in milk. Our results suggest that maternal psychological wellbeing and social support may affect milk immune properties.     

Infantile colic and small intestinal function: a nutritional problem?

Approximately 25% of infants with moderate or severe colic (crying > 3 h d⁻¹) have a cow's milk-dependent colic. The author recommends a strict cow's milk-free diet for the mother (with an extra supplement of calcium) in breastfed infants and a casein-hydrolysate formula for formula-fed infants. With this dietary regimen, there will be no nutritional problems. Later in infancy a relatively high proportion of the infants will continue to show an adverse reaction to cow's milk and will also develop allergies to other foods. Several signs (e.g. increased macromolecular absorption, increased motilin levels in serum, increased breath hydrogen excretion, decreased gallbladder contractility) indicate an abnormal intestinal function in colicky infants. The nature of this abnormality is still unknown.     

Effect of pulsed electric field on the rheological and colour properties of soy milk

The effects of pulsed electric field (PEF) treatments on rheological and colour properties of soy milk were evaluated. Flow behaviour, viscosity and rheological parameters of PEF-treated soy milk were monitored using a controlled stress rheometer. For PEF treatments, electric field intensity of 18, 20 and 22 kV cm^{? 1} and number of pulses of 25, 50, 75 and 100 were used. For the measurements of rheological properties of soy milk shear rates between 0 and 200 s^{? 1} was used. The rheological behaviour of control and the PEF-treated soy milk were described using a power law model. The PEF treatments affected the rheological properties of soy milk. Apparent viscosity of soy milk increased from 6.62 to 7.46 (10^{? 3} Pa s) with increase in electric field intensity from 18 to 22 kV cm^{? 1} and increase in the number of pulses from 0 to 100. The consistency index (K) of soy milk also changed with PEF treatments. Lightness (L*), red/greenness (a*) and yellowness/blueness (b*) of soy milk were affected by PEF treatments.     

牛奶蛋白诱导的过敏性直肠结肠炎患儿喂养干预研究

目的 评估牛奶蛋白过敏性直肠结肠炎患儿的营养风险;观察喂养干预方案的变化及疗效,探讨个体化喂养干预方案的选择时机.方法 回顾性分析2012年1月至2013年7月湖南省儿童医院确诊为牛奶蛋白过敏性直肠结肠炎的171例患儿临床资料,其中非母乳喂养组139例(81.3％).干预方案:母乳喂养组继续母乳喂养32例,非母乳喂养组中游离氨基酸配方干预36例(21.1％),深度水解配方干预103例(60.2％),观察喂养干预2周的疗效,随访8周、12周、24周时喂养干预配方变化及0、3、6个月营养风险评估情况.结果 171例患儿中,男∶女=1.5∶1.0;平均年龄(4.1±1.3)个月.疗效观察:干预2周共显效147例(86.0％),其中母乳喂养组显效率为79.2％,与游离氨基酸配方组及深度水解配方组比较差异无统计学意义(P＞0.05).随访0.5年内干预配方改变:8周:母乳喂养组30例继续母乳喂养,游离氨基酸配方粉喂养21例(12.3％),深度水解配方粉85例(49.7％),适度水解配方35例(20.5％);12周:母乳喂养23例(13.5％),游离氨基酸配方粉喂养16例(9.4％),深度水解配方粉喂养56例(32.7％),适度水解配方喂养76例(44.4％);24周:母乳喂养21例(12.3％),游离氨基酸配方粉喂养7例(4.1％),适度水解配方喂养13例(7.6％),普通配方喂养130例(76.0％).于0、3、6个月进行营养风险评估(STAMP营养风险评估表),3组在不同时期的风险评分均值比较差异均无统计学意义(P均＞0.05).结论 牛奶蛋白过敏性直肠结肠炎患儿营养风险较低,不同的喂养干预方式对患儿的营养状态无明显影响.继续母乳喂养可有效回避牛奶过敏,人工喂养患儿干预后2周左右症状可获缓解,50％左右在3个月以上可获得部分免疫耐受,故可根据其诱导免疫耐受情况进行个体化喂养干预,减轻经济负担.