Breastfeeding performance of late preterm newborns with hyperbilirubinemia undergoing phototherapy: Controlled Cross-Sectional Study

Abstract

Abstract Background: Prematurity is a risk factor for eating disorders. However, late preterm newborns are generally cared for in a rooming-in unit, with no different management from term newborns. Hyperbilirubinemia is considered physiological, but can be potentially neurotoxic at high levels. Phototherapy is the most widely used treatment, but it can lead to adverse events, such as circadian rhythm changes. Preterm infants are at greater risk of neurotoxicity due to hyperbilirubinemia and feeding difficulties are a risk factor for increased serum bilirubin levels. In view of this, it is necessary to evaluate the breastfeeding performance of late preterm infants in order to provide data that will enable appropriate management in the face of possible difficulties and guarantee that preterm infants undergoing phototherapy will have an effective feed and adequate intake. Methods: Controlled cross-sectional study. Conducted in a public maternity hospital, the sample was based on convenience and consisted of 60 mother/late preterm newborn dyads, assisted in the Joint Lodging, divided into two groups. One group comprised of 30 mother/newborn dyads in which the newborns had hyperbilirubinemia that required phototherapy (case group) and another group with 30 dyads in which the newborns did not require phototherapy (control group). Data characterizing the sample was obtained through anamnesis and medical/hospital records. Breastfeeding performance was assessed using the Breastfeeding Observation Form proposed by UNICEF. The analyses were carried out using Jamovi (version 2.4.1). The significance level of 5% was adopted for all analyses. The study was approved by the Research Ethics Committee. All participants/guardians signed the Free and Informed Registration Form. Results: Newborns in the case group had a higher occurrence of "fair" and "poor" scores in all the protocol categories. Conclusion: The study concluded that late preterm newborns undergoing phototherapy have more difficulties in breastfeeding compared to late preterm newborns who do not require the treatment, and therefore need careful and individualized attention in the management of breastfeeding.