Breastfeeding the 'healthy' near-term infants after laryngeal mask airway or traditional resuscitation methods.

BACKGROUND

The influence of delivery room resuscitation practice on neonatal breastfeeding pattern is largely not data driven, and clinical experience is insufficient to indicate the impact of available management methods.

AIM

This cohort observational study investigated weather laryngeal mask airway (LMA) rather conventional positive pressure resuscitation devices, face mask (FM), or endotracheal-tube (ETT) would influence breastfeeding pattern in the near-term infants triaged to regular newborn nursery.

METHODS

We identified through 18,641 birth records (from 2002 to 2006), 921 (4.9%) records of near-term infants of 34-36 6/7 weeks' gestation, 710 (77.1%) triaged to regular newborn nursery. Among those, 52/710 (7.3%) required positive pressure resuscitation at birth, inclusive of LMA (29, 55.7%), bag-face mask (FM, 19, 36.5%), and endo-tracheal tube (ETT, 4, 7.6%), respectively. Fifty non-resuscitated near-term infants were used as controls.

RESULTS

Anthropometrical and clinical characteristics of resuscitated near-term study groups were comparable to controls. LMA was more frequently employed at birth to resuscitate near-term infants triaged to regular newborn nursery (OR; 95% CI 17.16; 5.34-55.14), whereas ETT was less frequently utilized (OR; 95% CI 0.11; 0.02-0.55). Although LMA and ETT resuscitation methods did not influence breastfeeding rate at discharge with respect to controls, FM resuscitation was associated with both the lowest breastfeeding rate (OR; 95% CI 3.20; 1.07-9.57) and the more frequently formula-feeding (OR; 95% CI 7.23; 1.58-32.92), and bottle-feeding use (OR; 95% CI 4.20; 1.30-13.49) at discharge.

CONCLUSION

LMA is an effective and safe alternative to more conventional forms of airway management in near-term infants needing resuscitation at birth. Other studies are needed to clarify the potential advantages of the LMA on breastfeeding.