Almost 13.6% infants below the age of 6 months in Uttar Pradesh, India
are severely malnourished [1]. Almost 20% children with Severe acute
malnutrition (SAM) admitted to our Nutritional Rehabilitation Center
(NRC) were <6 mo of age [2]. The most important cause of SAM in infants
<6 months is lack of exclusive breast feeding because of cultural and
traditional practices, illiteracy, lack of antenatal counseling and
other factors [3].
We tried Supplementary suckling technique (SST) in
such mothers (with lactation failure) of infants aged <6 months with SAM
admitted in our NRC after counseling on positioning and attachment
failed to establish lactation. SST was not tried in mothers who had not
breastfed their infants at all in last 4 wks. In this technique, one end
of a 6 or 8F feeding tube is stuck to the mother’s breast close to the
nipple and the other end of the tube lies in a bowl of milk (expressed
breast milk or diluted F-100) kept lower than the mother’s breast while
the infant suckles at the mother’s breast [4]. The sucking stimulates
milk production in the mother and simultaneously the baby draws milk
from the bowl through the tube satisfying its needs. SST was considered
successful if the mother’s milk production increased and the baby
started gaining weight on exclusive breastfeeding. If relactation was
not successful in the mother and we were not able to shift the baby to
exclusive breastfeeding it was considered to be a failure of SST. The
duration for which SST was tried ranged from 7-14 d.
A total of 108 children <6 mo were admitted in the
NRC over the study period. We tried SST in 62 (57.4%) infants. The mean
(SD) age at admission was 2.5 (1.3) mo (46 infants
Contributors: DKS was involved in
collection of data, analysis and writing the manuscript. RR and SD were
involved in data analysis and manuscript revision.
Funding: None; Competing interests:
None stated.
References
1. National Family Health Survey-3, India 2005-06.
Ministry of Health and Family Welfare, Government of India.
Available from: www.measuredhs.com/pubs/pdf/FRIND3/FRIND3-Vol 1.pdf.
Accessed February 20, 2014.
2. Singh DK, Rai R, Mishra PC, Maurya M, Srivastava
A. Nutritional rehabilitation of children <6 m with SAM. Indian J
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3. Bansal CP. Breastfeeding - Why are we still
failing? Indian Pediatr. 2013;50:993-4.
4. Operational Guidelines on Facility Based
Management of Children with Severe Acute Malnutrition, Ministry of
Health and Family Welfare, Government of India, 2011. Available from:
www.nihfw.org/pdf/NCHRC/publications. Accessed February 20, 2014.
5. Lelijveld N, Mahebere-Chirambo C, Kerac M. Career
and staff perspectives on supplementary suckling for treating infant
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Treatment of severe acute malnutrition in infants aged <6 months in
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