Escolar Documentos
Profissional Documentos
Cultura Documentos
Patricia S. Coffey, PhD, MPH Johannesburg, South Africa April 16, 2013
Co-authors: Christy McKinney Michael Cunningham Peter Donkor Jered Singleton Robin Glass
15 million born globally each year. Coordinated suck, swallow, and breathe is undeveloped. Assistive feeding until exclusive breastfeeding.
Other infants
Policy Environment
Extra support for feeding small and preterm babies includes feeding cups as key commodity.
LBW infants who need to be fed by an alternative oral feeding method should be fed by cup, paladai (a cup with a beak), or spoon. Strong recommendation with moderate evidence.
4/16/2013
Page 3
Standard of Care
High-resource settings
Low-resource settings
Enteral feeding. Breast pump milk or stored breast milk. Fed with (specialized) bottles.
Enteral feeding (maybe) then Manual expression of breast milk as needed. Fed with conventional, locally available cup (or spoon).
Photo: WHO
Conventional Cups
Benefits
Inexpensive.
Limitations
Mothers and clinicians find it more effective. Too small to capture hand expressed breast milk.
Paladai
Used often in India. Pour into infants mouth, increased risk of aspiration/choking because infant not participating in pace of feeding. Less control (for mother and infant).
Paladai:
4oz volume.
Easy to hold.
Opening size for manual expression.
Too small for hand expression of breast milk. Too small for older infants. Not designed for optimal feeding efficiency. Metal increases risk of cutting infants mouth. Multiple parts increase risk of infection.
Foley cup:
Paladai:
Page 9
4/16/2013
Cost of Goods (includes packaging) $.90 max Top opening diameter = 60mm to 100ml Max volume = 2oz to 3oz (88ml to 118ml)
Material
Easy to hold for extended periods. Minimal, smooth grooves to lessen the risk of infection. Easy flow-rate control.
Decreased spillage.
Big enough for hand expression. Size: 2oz/60ml. Volume markers on cup. Pictorial instructions included.
Page 15
4/16/2013
Pictorial Instructions
Mothers/end-users and health care workers. Designed to assess demand and pricing.
Mother-infant pairs with cleft palate. NIFTY vs. standard of care cup Assess volume, feeding time, and mother preference.
Page 17
4/16/2013
Scale
Introduction Regulatory Validation Development - feasibility and acceptability by end-users (India, Ghana) - clinical trial to assess effectiveness - negotiate deal with interested partner (USA) that is CE and ISO certified manufacturer - market assessment in key target markets (Ghana, India)
Page 18
4/16/2013