Weekly Updates #8

Oei JL, Kingsbury A, Dhawan A, Burns L, Feller JM, Clews S, Falconer J, Abdel-Latif ME: Amphetamines, the pregnant woman and her children: a review. J Perinatol 2012, 32(10):737-747.  This review article notes the limited evidence about the perinatal effects of amphetamines, showing for example that there is probably an increase in placental abruption; but this finding may be due to the drug, or may be associated with poorer prenatal care. Similarly for the increased incidence of low birth weight, and we know almost nothing about long term outcomes. With the dramatic increases in amphetamine abuse in many countries, better studies are very much needed.

Morton J, Wong RJ, Hall JY, Pang WW, Lai CT, Lui J, Hartmann PE, Rhine WD: Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants. J Perinatol 2012, 32(10):791-796. This observational study examined the milk composition of mothers who were combining pump expression of their milk with hand expression. Mothers who hand expressed more than 5 times a day in addition to pumping 8 times a day had more volume of milk, but also a higher calorie concentration. This is not necessarily how things normally happen, as a general rule mothers who produce more volume of milk for their term babies tend to produce milk with a higher water content, and thus lower calorie and protein concentration. In the very abnormal situation of expressing milk for preterm babies this may not always be true, and this study suggests that those women who are capable of following this demanding regime produced milk with more calories (and similar protein). I often tell my residents and fellows that we are fortunate that in nature it is the mothers who provide milk for their babies, if men had to pump their breasts 8 times a day, and then had express themselves in between, there would be a lot more formula fed preterm babies!!! The website of the Lucille Packard Children’s hospital at Stanford, which is the source of this study, have a number of resources for supporting breast feeding of mothers of preterm babies.

Porat S, Amsalem H, Shah PS, Murphy KE: Transabdominal amnioinfusion for preterm premature rupture of membranes: a systematic review and metaanalysis of randomized and observational studies. Am J Obstet Gynecol 2012(0). This systematic review of both RCTs and observational studies suggests that there is quite possibly a major benefit of routine regular amnioinfusion after preterm premature rupture of membranes, and that we should do a definitive large RCT to show for sure whether or not this is true.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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