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Simple actions to support breastfeeding can avoid unwanted weaning in infants younger than 6 months hospitalized for bronchiolitis: A before/after study (Bronchilact II) - 09/01/21

Doi : 10.1016/j.arcped.2020.10.004 
K. Ben Gueriba a, C. Heilbronner b, M. Grimaud b, E. Roy c, A. Hadchouel c, T. Hachem a, C. de Barbeyrac a, M. Murmu d, S. Renolleau b, V. Rigourd a, d,
a Neonatology Necker Enfants Malades, 75015 Paris, France 
b Pediatrics Intensive care, Necker Enfants Malades, 75015 Paris, France 
c Paediatrics Necker Enfants Malades, 75015 Paris, France 
d Milk Bank Necker Enfants Malades, 75015 Paris, France 

Corresponding author at: Hôpital Necker enfants malades, Lactarium, 149, rue de sèvres, 75015 Paris, France.Hôpital Necker enfants malades, Lactarium149, rue de sèvresParis75015France

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Abstract

Background

Admission to hospital with bronchiolitis may adversely affect breastfeeding. Correct advice and support have been pointed out as a determining factor.

Objectives

We conducted a telephone survey to evaluate a set of actions to promote breastfeeding during hospitalization for acute bronchiolitis.

Methods

Population: All patients 6 months of age or younger hospitalized with acute bronchiolitis and receiving at least partial breastfeeding were eligible for the study. Patients discharged home whose parents accepted to be contacted by phone were also included.

Intervention

We established a set of actions to promote breastfeeding (posters, flyers, staff training, and equipment) in all pediatric wards attending to these patients.

Comparison

This was a cross-sectional study conducted during two epidemic seasons of bronchiolitis in a tertiary care hospital. Data on continued breastfeeding at 3 months (0.5–6; median, range) postdischarge were collected by telephone and compared with the same set of data collected from patients with bronchiolitis in the same setting the year before the intervention.

Outcome

We conducted a telephone survey to evaluate whether some actions regarding breastfeeding might diminish the risk of unwanted weaning during hospitalization for bronchiolitis. The primary outcome was the proportion of stopped or reduced breastfeeding at discharge. Secondary objectives were to evaluate whether there were factors associated with breastfeeding modification.

Results

The results of the evaluation before intervention (phase 1) are published by Heilbronner et al. In Phase 1 of our study, 84 patients were included and 43 mothers (51%) reported that breastfeeding was modified by hospitalization of their child: 20.4% stopped, 14% switched to partial breastfeeding, and 16.6% reduced breastfeeding. These mothers stated that causes of breastfeeding disturbances were lack of support and advice (63%), followed by severity of the child's respiratory disease (32%), logistical hospital difficulties (30%), and personal organizational issues (9.3%). The intervention took place in September. After the intervention, 50 patients could be included in the study between October 1and December 31, 2016. Among them, 40 (80%) mothers kept breastfeeding as before, four (8%) stopped, four (8%) switched to partial breastfeeding, and two (4%) reduced breastfeeding without stopping. Bronchiolitis was more severe among patients with altered breastfeeding in terms of ventilatory support.

Conclusion

Bronchiolitis is a high-risk event for breastfeeding disruption but interventions to promote breastfeeding might help to prevent the risk of unwanted weaning. More severe bronchiolitis probably poses the highest risk of weaning and the need for supplementary nutrition.

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Keywords : Breastfeeding, Bronchiolitis, Health promotion, Training


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