Last update Dec. 2, 2020

Infant Hospitalization

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

SUMMARY: Assess according to pathology. In general, few infant diseases contraindicate or hinder breastfeeding. Children admitted to hospitals have the right to remain with their mothers and, if they can be fed by mouth, breastmilk, directly or expressed, is the best option.
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Infant hospitalization is a risk factor for partial or total cessation of exclusive breastfeeding (Bochner 2020, Heilbronner 2017, Lapillonne 2013, Courtois 2010, Souza 2008, Quattrone 1995).
The causes of this risk are the emotional impact and fatigue it causes on the mother and baby, the seriousness of the infant’s clinical situation, maternal and family misinformation and, above all, hospital practices that are not very favourable to breastfeeding (routine administration of bottles, difficulty for the adequate and comfortable stay of the mother, absence of a specific protocol) and the lack of knowledge about breastfeeding of the health personnel (Heilbronner 2017, Courtois 2010, Souza 2008, Quattrone 1995).

The company of the mother and breastfeeding reduce the anxiety that the hospital environment causes in the baby. Breastfeeding produces analgesia in invasive practices such as venous access, tests, catheters, etc. (AEP 2018, CW 2019, ABA 2017, Costa 2016). In many cases, sick children can only tolerate the mother's breast, rejecting all other food. Breastmilk provides them with defensive immune factors that help them fight infection and protective factors of the intestine, shortening the duration of hospitalization (CW 2019, ABA 2017, Costa 2016, Courtois 2010). In these cases especially, breastmilk serves as both food and medicine (CW 2019).

"Hospitalized children have the right to be accompanied by their parents or the person who substitutes for them as long as possible during their stay in the hospital, not as passive spectators but as active elements of hospital life" (European Charter for Hospitalized Children , European Parliament 1986).

There is a great deal of inconsistency between hospitals in practices regarding admissions of breastfed infants and some are not the most appropriate (Bochner 2020, Heilbronner 2017, Courtois 2010).
It should be facilitated for the mother to stay in the same room or, if the clinical situation does not allow it, provide her with a nearby room and facilities so that she is in a position to breastfeed or be able to express milk for her baby (Lawrence 2016 p517).
Breastfeeding training should be on the curriculum of all health personnel working in pediatric units (Meek 2017).
It is desirable that the hospital has personnel trained in breastfeeding and in manual or mechanical expression of breastmilk and offers the mother the appropriate resources.
Otherwise, the mother must have her own knowledge and means for expressing breastmilk (ABA 2017). Expressed breastmilk must be labelled with the date before freezing and storing (CW 2019).
All staff (doctors, nurses) should know that the mother is breastfeeding the admitted child and the type of breastfeeding, exclusive or partial-mixed (ABA 2017).

As long as the illness of the admitted infant allows for oral feeding, direct breastfeeding or using expressed and administered breastmilk is the best option (Lawrence 2016, Costa 2016).

If the mother cannot breastfeed, either because the hospital does not permit joint admission, or because of the baby's clinical situation, it is advisable to express milk frequently to avoid breast problems (retention, mastitis), maintain production and have milk available for the baby, freezing it if necessary (CHP 2018).

In general, few diseases suffered by a hospitalized infant prevent breastfeeding or only temporarily until the clinical situation improves. An individual assessment is necessary according to the disease and, day by day, according to its evolution.
Respiratory diseases (bronchiolitis, pneumonia), except for extreme respiratory distress, will allow breastfeeding with short feeds and frequent pauses or the administration of breastmilk through a nasogastric tube (Costa 2016).

If the infant is to undergo surgical intervention, the child can breastfeed up to 3 to 4 hours before anesthesia. Longer fasting times are not necessary since breastmilk is digested in that time, not interfering with anesthesia and calming the infant (ABA 2017, Costa 2016).
Most surgical procedures allow breastfeeding as soon as the baby is awake; an individual assessment according to the type of operation and disease is required (CW 2019, ABA 2017).

During hospitalization, the mother may notice a decrease in milk production. Normally, once they have returned home and the baby has recovered, they can return to breastfeeding as before hospitalization (ABA 2017).

It is instructive to read brochures and guides from various hospitals and pediatric associations (CW 2019, AEP 2018, CHP 2018, ABA 2017, Costa 2016).


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Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

Infant Hospitalization belongs to this group or family:

References

  1. Bochner RE, Kuroki R, Lui K, Russell CJ, Rackovsky E, Piper L, Ban K, Yang K, Mandal P, Mackintosh L, Mirzaian CB, Gross E. Variations in Care for Breastfed Infants Admitted to US Children's Hospitals: A Multicenter Survey of Inpatient Providers. Hosp Pediatr. 2020 Jan;10(1):70-75. Abstract
  2. CW - Children´ Wisconsin. Breastfeeding your hospitalized child. Breastfeeding support. 2019 Full text (link to original source) Full text (in our servers)
  3. CHP - Children Hospital of Philadelphia. Maintaining Your Milk Supply While Baby Is Hospitalized. Fact sheet. 2018 Full text (link to original source) Full text (in our servers)
  4. AEP. Lactancia materna en niños hospitalizados. En Familia. Noticias. 2018 Full text (link to original source) Full text (in our servers)
  5. Heilbronner C, Roy E, Hadchouel A, Jebali S, Smii S, Masson A, Renolleau S, Rigourd V. Breastfeeding disruption during hospitalisation for bronchiolitis in children: a telephone survey. BMJ Paediatr Open. 2017 Sep 28;1(1):e000158. Abstract Full text (link to original source)
  6. ABA - Australian Breastfeeding Association. Breastfeeding and hospitalization. 2017 Full text (link to original source) Full text (in our servers)
  7. Meek JY. Pediatrician Competency in Breastfeeding Support Has Room for Improvement. Pediatrics. 2017 Oct;140(4). pii: e20172509. Abstract Full text (link to original source)
  8. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  9. Costa Romero Marta, Gómez-Fernandez Vegué Marta. Comité de lactancia materna de la AEP. Lactancia materna en niños hospitalizados. Tríptico informativo. 2016 Full text (link to original source) Full text (in our servers)
  10. Lapillonne A, Regnault A, Gournay V, Gouyon JB, Benmedjahed K, Anghelescu D, Arnould B, Moriette G. Development of a questionnaire to assess the impact on parents of their infant's bronchiolitis hospitalization. BMC Health Serv Res. 2013 Jul 12;13:272. Abstract Full text (link to original source)
  11. Courtois E, Thibault P. Impact de l'hospitalisation d'un nourrisson sur la poursuite de l'allaitement maternel : enquête mères/soignants. [Impact of hospitalization of an infant during breast-feeding: mother-child investigation]. Rech Soins Infirm. 2010 Sep;(102):50-8. French. Abstract Full text (link to original source) Full text (in our servers)
  12. Souza EL, Silva LR, Sá AC, Bastos CM, Diniz AB, Mendes CM. [Impact of hospitalization on breastfeeding practices in a pediatric hospital in Salvador, Bahia State, Brazil]. Cad Saude Publica. 2008 May;24(5):1062-70. Portuguese. Abstract Full text (link to original source) Full text (in our servers)
  13. Quattrone F, Dell Oso MA, Sanchis MC, Du Mortier A. Abandono de la lactancia como consecuencia de la internación pediátrica. Med Infant 1995; 2:97-9.
  14. Parlamento europeo. Carta europea de los niños hospitalizados (doc. A 2-25/86) Diario Oficial de las Comunidades Europeas. 13.05.1986. 1986 Full text (link to original source) Full text (in our servers)

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