Hamid Iqbal, Qamar Ali, Sardar Khan, Noman.
Frequency and Association of Late Neonatal Sepsis in Breast Fed and Bottle Fed Full Term Infants.
Pak Paed J Jan ;41(1):20-4.

Introduction: Infections are a frequent and important cause of morbidity and mortality in the neonatal period. Late-onset infections, occurring after one week of life, are acquired in the normal newborn nursery, neonatal intensive care unit (NICU), or the community. The associated factor of late-onset sepsis causing deaths includes lack of breastfeeding among others. Feeding colostrum and breast feeding, especially exclusive breast feeding, protects against such deaths. Aim and Objectives: The objective of our study was to compare the frequency of late neonatal sepsis LNS in breastfed and bottle fed infants. Materials & Methods: This cross sectional study was conducted in a period of six months after the approval of synopsis. The study was carried out in the Neonatology unit of Pediatric department, Khyber Teaching Hospital, Peshawar receiving patients from both outpatient department and emergency from April 8, 2016 to Oct 7, 2016. A sample of 246 cases of full term infants were selected according to the inclusion/exclusion criteria, by convenience method. Cultures from blood, urine, CSF and umbilicus in all cases and pleural fluid in selective cases were taken. Feeding pattern of the infant was determined besides maternal demographic characteristics and comparison was made with LNS. All this information was recorded on a pre prepared proforma. Means and standard deviation were given for quantitative variables and frequencies and percentages were given for qualitative variables while associations were tested by applying chi square tests. Results: Out of 246 infants studied as per inclusion criteria, 145 (56%) were found to have late onset neonatal sepsis, 57% were males and 43% females with a mean age of 16.75 days (SD ±5.93); 67% were bottle fed, while 33% were breastfed; most common presenting feature was reluctance to feed (93%) while the least common feature being sclerema (5%); other features included hypothermia and vomiting (76% each); lethargy (64%), fever (24%), apnea (22%) and bulging fontanelle (12%). Infants studied had 13% positive blood cultures while other positive cultures included those of CSF (8.9%), urine (7.3%) and umbilical stump swab (2.8%). About 68% infants had negative culture reports. There was significant association of LOS with bottle feeding. P-value 0.003. Conclusions: This study has shown that bottle feeding may be associated with increased risk of developing late onset neonatal sepsis.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com