Breastfeeding success after laryngeal mask airway resuscitation.
BACKGROUND
Positive pressure resuscitation by laryngeal mask airway (LMA) may expose the neonate to gas leak and gastric air insufflation, influencing postnatal gastrointestinal adaptation and breastfeeding success.


METHODS
Term neonates admitted to regular nursery of the Department of Pediatrics of Padua University (Italy), from January 2005 to December 2005, after positive pressure resuscitation by LMA (Group A, 50) were compared with neonates who required positive pressure resuscitation by endotracheal tube (ETT) (Group B, 13) and to non resuscitated control neonates, matched for gestational age, (Group C, 100).


RESULTS
Gestational age and birth weight were comparable among Group A, B, and C neonates. In addition, their ages at the first feeding and those of the first meconium emission were comparable. Diversely, LMA-, and ETT-resuscitated neonates presented a reduced exclusive breastfeeding rate at discharge and an increased hypoglycemia occurrence during postnatal adaptation. Moreover, ETT-resuscitated neonates presented a lower Apgar's score at 1 min, a significant increased regurgitation rate, and a delayed urine emission in comparison to LMA-resuscitated neonates.


CONCLUSIONS
LMA- and ETT-positive pressure resuscitation impair postnatal gastrointestinal adaptation and breastfeeding success at discharge with equal frequency and to similar degree in term neonates. Regurgitation reflex is instead, enhanced after ETT-resuscitation.
Zanardo
Vincenzo
V
Department of Pediatrics, University of Padua, Padua, Italy. zanardo@pediatria.unipd.it
Legarizzi
Sandra
S
Giustardi
Arturo
A
Micaglio
Massimo
M
Trevisanuto
Daniele
D
D000222:Adaptation, Physiological / Q000502:physiology; D001942:Breast Feeding / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D041943:Infant Formula / Q000706:statistics & numerical data; D007231:Infant, Newborn; D017214:Laryngeal Masks / Q000009:adverse effects / Q000706:statistics & numerical data*; D057045:Laryngopharyngeal Reflux / Q000453:epidemiology; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012151:Resuscitation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*