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Instrumental delivery is associated with increased risk of Neonatal Hospital readmission due to feeding difficulties
  1. R Balfour,
  2. A Torres,
  3. K Jeyasinghe,
  4. S Banerjee
  1. Division of Women and Child Health, ABM University Health Board, Swansea, UK

Abstract

Background Hospital readmission is high in the first 2 weeks of life.

Aim To determine factors affecting hospital readmission in neonates in the first 15 days.

Methods Information on all births was collected in our institution between June and August 2009 for gestation, birth weight, parity, mode of delivery and feeding at discharge. Reason for referral and readmission to the Paediatric Admissions Unit (PAU) in the first fortnight was recorded. All babies were seen by PAU staff before admission to hospital. Statistical analysis was performed using z test for proportions.

Results There were 870 births within the study period. 57 (6.6%) babies were referred to the PAU of which 23 (2.64%) were admitted to the paediatric ward. 13 (56.5%) admissions were related to a combination of poor feeding, weight loss and jaundice. 39% of babies admitted with feeding difficulties were born by instrumental delivery when compared to 8% in all births (p<0.001). There was no statistical difference in the admitted group and the general population when analysed for other modes of delivery, parity, birth weight, gestation and mode of feeding at discharge.

Conclusion Feeding difficulties constituted the majority of hospital readmissions. Instrumental delivery was associated with increased risk of hospital readmissions related to feeding difficulties. The effect on infant feeding of less tissue trauma, pain and recovery time of the mother-infant pair with normal delivery and greater length of postnatal hospital stay with Caesarean section may explain the results. Increased feeding support is warranted for babies born by instrumental delivery.

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