Skin-to-skin contact improves breastfeeding of healthy babies

Early skin-to-skin contact improves breastfeeding of healthy full-term babies. | National Institute for Health Research

Skin-to-skin contact is the direct contact between a naked baby and the mother’s bare chest. It can occur before or after the baby is cleaned following birth.

This review found that about a quarter more women who have this contact with their babies are still breastfeeding at one to four months after birth compared with those who don’t. The evidence that skin-to-skin contact may also help to stabilise the baby’s heart and breathing rates and blood sugar levels after birth was based on fewer trials and less strong.

These findings support UK good practice to promote immediate skin-to-skin contact after birth to improve breastfeeding rates. It remains one of the important steps recommended by NICE and UNICEF aimed at improving the low rates of breastfeeding in the UK. Other measures include providing a favourable environment, support and education.

Full reference: Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11:CD003519.

New resource to reduce barriers to breastfeeding

Public Health England (PHE) and NHS England have conducted a survey which found that of the three-quarters of the new mums who start breastfeeding, only 40% were still breastfeeding two months later.

To help dispel some of the concerns women have about breastfeeding, PHE’s Start4 life programme has launched a new interactive Breastfeeding Friend (BFF) ChatBot. The BFF can be accessed through Facebook messenger and provides personal support for mothers at any time of the day or night. The ChatBot works as a live chat tool which is able to respond to questions about breastfeeding posed by the user.

Read more on this at Public Health England

Parents’ and informal caregivers’ views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence

Ames HMR, Glenton C, Lewin S. Parents’ and informal caregivers’ views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD011787. DOI: 10.1002/14651858.CD011787.pub2.

This review of 38 studies, mainly from high-income countries, finds that parents want more information about childhood vaccinations, including for example balanced information on benefits and risks, given before the vaccination appointment and not during.

STAAR: a randomised controlled trial of electronic adherence monitoring with reminder alarms and feedback to improve clinical outcomes for children with asthma

Morton RW, Elphick HE, Rigby AS, et al. STAAR: a randomised controlled trial of electronic adherence monitoring with reminder alarms and feedback to improve clinical outcomes for children with asthma. Thorax 2017;72:347-354

Background Suboptimal adherence to inhaled steroids is common in children with asthma and is associated with poor disease control, reduced quality of life and even death. Previous studies using feedback of electronically monitored adherence data have demonstrated improved adherence, but have not demonstrated a significant impact on clinical outcomes. The aim of this study was to determine whether introduction of this approach into routine practice would result in improved clinical outcomes.

Methods Children with asthma aged 6–16 years were randomised to the active intervention consisting of electronic adherence monitoring with daily reminder alarms together with feedback in the clinic regarding their inhaled corticosteroid (ICS) use or to the usual care arm with adherence monitoring alone. All children had poorly controlled asthma at baseline, taking ICS and long-acting β-agonists. Subjects were seen in routine clinics every 3 months for 1 year. The primary outcome was the Asthma Control Questionnaire (ACQ) score. Secondary outcomes included adherence and markers of asthma morbidity.

Results 77 of 90 children completed the study (39 interventions, 38 controls). Adherence in the intervention group was 70% vs 49% in the control group (p≤0.001). There was no significant difference in the change in ACQ, but children in the intervention group required significantly fewer courses of oral steroids (p=0.008) and fewer hospital admissions (p≤0.001).

Conclusions The results indicate that electronic adherence monitoring with feedback is likely to be of significant benefit in the routine management of poorly controlled asthmatic subjects

Frequent interactions with grandparents lowers the age of autism diagnosis

Children who have older siblings or frequent interaction with grandparents are diagnosed with autism spectrum disorders (ASD) earlier than those who do not, according to new research | ScienceDaily

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Study results show that approximately 50 percent of friends and family members reported that they had suspected a child to have a serious condition before they were aware that either parent was concerned. Maternal grandmothers and teachers were the two most common relationship categories to first raise concerns

While interactions with grandparents and friends played an important role, family structure also impacted the age of diagnosis. Children with no siblings were diagnosed 6 to 8 months earlier than children with siblings. Among children with siblings, children with older siblings were diagnosed approximately 10 months earlier than those without older siblings, suggesting that older siblings may serve as a reference point, helping parents calibrate whether younger siblings are on target developmentally.

Read the commentary here

Read the original research article here

Self-management and social welfare of children with cystic fibrosis

Calvo-Lerma, J. et al. (2017) Innovative approach for self-management and social welfare of children with cystic fibrosis in Europe: development, validation and implementation of an mHealth tool (MyCyFAPP). BMJ Open. 7:e014931

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Introduction: For the optimal management of children with cystic fibrosis, there are currently no efficient tools for the precise adjustment of pancreatic enzyme replacement therapy, either for advice on appropriate dietary intake or for achieving an optimal nutrition status. Therefore, we aim to develop a mobile application that ensures a successful nutritional therapy in children with cystic fibrosis.

Methods and analysis: A multidisciplinary team of 12 partners coordinate their efforts in 9 work packages that cover the entire so-called ‘from laboratory to market’ approach by means of an original and innovative co-design process. A cohort of 200 patients with cystic fibrosis aged 1–17 years are enrolled. We will develop an innovative, clinically tested mobile health application for patients and health professionals involved in cystic fibrosis management. The mobile application integrates the research knowledge and innovative tools for maximising self-management with the aim of leading to a better nutritional status, quality of life and disease prognosis. Bringing together different and complementary areas of knowledge is fundamental for tackling complex challenges in disease treatment, such as optimal nutrition and pancreatic enzyme replacement therapy in cystic fibrosis. Patients are expected to benefit the most from the outcomes of this innovative project.

Read the full protocol here

Smoking cessation in secondary care: acute and maternity settings

Self-assessment framework for NHS acute trusts to develop local action to reduce smoking prevalence and the use of tobacco | Public health England

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The self-assessment tool breaks down the NICE guidance into 4 areas:

  • systems required to implement the guidance
  • communication required
  • training that will help staff to successfully implement the recommendations
  • treatments that should be available to support staff and service users

This self-assessment tool supports all of the recommendations applicable to acute services in the NICE guidelines on Smoking cessation in secondary care.

Please save the self-assessment file to your computer and click ‘enable editing’ before using it.

Public Health England has also developed a suite of resources including a self-assessment tool to support the implementation of NICE guidance in mental health settings.

View the full framework here