The 28:1 issue of The Journal of Perinatal & Neonatal Nursing covers nutrition, feeding, and obesity. These topics come together to focus on the growing epidemic of obesity in pregnancy and the importance of breast-feeding and nutrition to the neonate. The perinatal section opens with a special editorial on these topics. It is followed by 4 articles that cover the spectrum from nutrition and feeding to exercise in pregnancy to obesity during the perinatal period.
Kriebs addresses the topic of Obesity in Pregnancy: Addressing Risks to Improve Outcomes. The rapidly increasing rates of obesity among women of childbearing age across the world are contributing to increased risks during pregnancy and childbirth.
Spatz discusses how preventing obesity begins with breast-feeding. The nutrition that an infant receives at birth affects not just short-term health issues but also health issues as an adolescent and an adult. Breast-feeding appears to be protective regarding obesity and overweight and is one method by which to address the obesity epidemic in childhood.
Low-income women are at risk for excessive gestational weight gain. Inactivity and lack of moderate exercise may contribute to the risk of weight gain. Yeo and Logan conducted a study looking at low income pregnant women who exercised. They describe regularly and met national guidelines and recommendations for exercise. They describe how these women spent time with physical activities compared with those who did not exercise regularly.
The last article covers a topic not commonly seen in the nursing literature. Ferrecchia et al describe the topic of Glycogen Storage Disease in Pregnancy. This inborn error of metabolism, associated with the utilization of glycogen, if left untreated, can result in hypoglycemia. Metabolic control before conception and throughout pregnancy appears to be directly related to successful outcomes.
Feeding and nutrition are enormously important issues in the care of prematurely born and high-risk infants. This volume offers 2 clinical and 2 research articles, including review articles on feeding readiness in the preterm infant and nutritional and immunologic considerations for infants.
The article by Briere, McGrath, Cong, and Cusson is the CE article for this issue. It provides an updated narrative review on oral feeding readiness in preterm infants, specifically focused on research and practice guidelines published since 2004. Successful oral feeding is often a necessary milestone in determining readiness for transition to home and the functional status of a preterm infant. This article offers important information for nurse clinicians in providing appropriate interventions and researchers in continuing to add to new knowledge and apply prior knowledge in this important area of infant care.
The Supporting Oral Feeding in Fragile Infants (SOFFI) program was previously published in the Journal of Perinatal & Neonatal Nursing. Horner, Simonelli, Schmidt, Cichowski, Hancko, Zhang, and Ross present the results of their study in which they implemented the SOFFI program and measured outcomes on oral feeding, growth, and length of stay at discharge and feeding and growth outcomes after discharge. Their results are encouraging for reducing time to full oral feedings for infants born prior to 37 weeks' gestation and parents' reporting of feeding problems after discharge to home.
Park, Thoyre, Knafl, Hodges, and Nix report their findings from a pilot study on the use of a semielevated side-lying position as a feeding strategy to support breathing and help improve oral feeding in very preterm infants. In the pilot, they compared the side-lying position with the semielevated supine position. Very preterm infants fed in the side-lying position demonstrated better signs of physiological stability during the feedings, suggesting that more research might be indicated.
The article by Gregory, Dubois, and Steele provides a scientific review and update on infant nutrition, with specific focus on optimizing nutrition and establishing healthy immune system development. The dynamic macronutrient and immunologic properties of mothers' breast milk are reviewed so that clinicians can use such knowledge to optimize nutrition for infants.
I also want to recognize and thank Dr Jacqueline McGrath for her many contributions to the Journal. Dr McGrath has been a reviewer, a member of the neonatal editorial board, an author, and a column editor. She has been generous with her time and energy over the years and has also supported the development of authors. Jackie is becoming coeditor of the journal Advances in Neonatal Care, so her column in this issue of the Journal of Perinatal & Neonatal Nursing will be her last for the pink journal. Join me in congratulating her on her new role and thanking her for her commitment to nursing scholarship and, particularly, the care of preterm and high-risk newborns.
-Diane J. Angelini, EdD, CNM, NEA-BC, FACNM, FAAN
Perinatal Editor
-Susan Bakewell-Sachs, PhD, RN, PNP-BC, FAAN
Neonatal Editor