Ilana Levene

University of Oxford | OX · National Perinatal Epidemiology Unit (NPEU)

Importance Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health. Objective To appraise all available evidence on whether the provision of relaxation interventions to la...

Objective Assess the relationship of time to first expression after very preterm birth and mothers’ own milk quantity. Design A cohort study (nested within a randomised trial). Setting Four neonatal units in the UK. Patients 132 mothers of single or twin infants born at 23+0 to 31+6 weeks postmenstrual age. Exposures Time to the first attempt t...

Background: Mothers of very preterm infants (born under 32 weeks' gestation) have specific lactation challenges. There is little literature related to the influences on exclusive maternal milk provision. Method: An observational cohort using prospectively entered clinical data in a single tertiary neonatal unit in the United Kingdom over a 2-year p...

Background Few studies have compared breastfeeding rates before and during the pandemic using comparable data across time. We used data from two national maternity surveys (NMS) to compare breastfeeding rates in England before and during the pandemic. Methods Analysis was conducted using the NMS from 2018 (pre-pandemic; n = 4,509) and 2020 (during...

Aim: To characterise parathyroid hormone (PTH) concentrations in infants at high risk for metabolic bone disease, in order to assist clinical decisions around the use of PTH for screening. Methods: Infants born under 28 weeks' postmenstrual age or with birthweight under 1.5 kg in a tertiary neonatal unit in the UK were included. Clinical guidanc...

Background Patient and Public Involvement (PPI) is a rich and valuable part of the process of planning, designing, carrying out and disseminating research. It is important to communicate PPI findings in detail so that the contributions of those involved are fully utilised and disseminated. The extended and iterative PPI process used within a neonat...

Aims The average maximal early weight loss in exclusively breastfed babies is 5.5-8.6%¹ which is predominantly due to excretion of excess fluid as urine. Babies who experience difficulty establishing effective breastfeeding risk having higher levels of weight loss and hypernatraemic dehydration which can have significant morbidity and mortality.² R...

Background Premature birth is the leading cause of neonatal death and can cause major morbidity. Maximising the amount of maternal breastmilk given to very premature infants is important to improve outcomes, but this can be challenging for parents. Parents of infants receiving neonatal care also have high rates of anxiety and distress. There is gro...

Aim Measure weight gain in preterm infants after introduction of a nutritional care bundle. Methods 509 infants less than 32 weeks gestation were studied until discharge home from the tertiary unit or their local neonatal unit. Growth and feeding data were prospectively collected for 18 months before and after the intervention. The intervention co...

Aim: To measure growth outcomes in preterm infants after introduction of a nutritional care bundle. Methods: A total of 509 infants of less than 32 weeks' gestation in a level III neonatal intensive care unit in the UK were studied until they were discharged home. Growth and feeding data were extracted from a prospective data registry for 18 mon...

Report of improved growth parameters of extremely and very preterm babies after change in routine nutritional practice

Small scale retrospective study looking at breast milk expression volumes and long term beastfeeding outcomes. Part of preparatory work for a larger study

Small retrospective study looking at time of first expression of breast milk and longer term breastfeeding outcomes. Part of preparatory work for larger study

The beneficial health and economic impacts of breastfeeding are considerable. However the majority of babies in the UK are not exclusively breastfeeding by 6 weeks of age. The first few weeks of life are therefore a critical period to facilitate breastfeeding. Health professionals must have a thorough knowledge of normal breastfeeding patterns in o...

Feeding a child is an emotive experience. Selective eating (often referred to as fussy eating) is a typical part of early childhood but can cause significant anxiety to parents. This article covers the factors that influence the development of selective eating, the key points to elicit in history and examination, and evidence-based advice for paren...

Aims To compare time to antibiotics in febrile neutropenia cases, with and without use of a patient group direction (PGD). The PGD empowers nurses to administer tazocin, within strict criteria, without a doctor’s prescription. Methods In a district general hospital, a PGD was created allowing specifically trained nurses to administer tazocin to ch...

You are about to give a 2-month-old baby her first vaccinations. You wonder if there is a role for topical local anaesthetics in reducing pain from intramuscular injection of vaccinations.

A 3-year-old girl with diabetes insipidus has had previous hyponatraemic seizures when generally unwell. She is on the ward with an intercurrent illness for monitoring of her sodium status. It is extremely difficult to get venous blood samples from her and she is generally traumatised by these prolonged attempts. Your team has been tracking her sod...

A 3-week-old baby presents with cough and episodes of apnoea. Nasopharyngeal aspirate is negative for common respiratory viruses. You consider the diagnosis of pertussis and take a full blood count to assess the lymphocyte count. You wonder what the sensitivity and specificity of the lymphocyte count is for pertussis in infants. In an infant with...

There is an established link between depression and interest in hastened death in patients who are seriously ill. Concern exists over the extent of depression in patients who actively request euthanasia/physician-assisted suicide (PAS) and those who have their requests granted. To estimate the prevalence of depression in refused and granted request...