{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:51:50Z","timestamp":1777852310570,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The benefits of human milk for preterm infants are well documented. Complex medical conditions can limit the extremely premature infant\u2019s ability to breastfeed and to receive human milk directly, yet these vulnerable infants may benefit most from receiving it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Issue:<\/jats:title>\n                    <jats:p>Extremely preterm infants are at risk for infections, digestive challenges, and chronic lung disease, and occasionally require a tracheostomy to facilitate weaning from mechanical ventilation. There is a risk of aspiration when orally feeding a child with a tracheostomy. This case study describes a tertiary neonatal team supporting a family\u2019s direct breastfeeding goal in an extremely premature infant with a diagnosis of bronchopulmonary dysplasia requiring a tracheostomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management:<\/jats:title>\n                    <jats:p>Initially, the infant participant (born at 24\u2009weeks and 3\u2009days of gestation, with a birthweight of 540\u2009g) was gavage fed with human milk. The interdisciplinary team collaborated with the family to guide the infant\u2019s feeding goals, providing positive oral stimulation with soothers, oral immune therapy, and frequent skin-to-skin contact to prepare for future oral feeding. Within a month of the tracheotomy procedure, oral feeding was initiated, and direct breastfeeding with the tracheostomy tubing in place was achieved at 50\u2009weeks and 1\u2009day of age as a primary source of nutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The open dialogue between the family and healthcare team was the foundation for trialing direct breastfeeding for an extremely premature infant with a tracheostomy. While direct breastfeeding of full-term infants with tracheostomies has been previously described in the literature, this is the first case study of an extremely premature infant with a tracheostomy transitioning to direct breastfeeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344241254342","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T06:51:25Z","timestamp":1717570285000},"page":"419-424","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Supporting Direct Breastfeeding for a Tracheostomy-Dependent Extremely Premature Infant: A Case Study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6631-1341","authenticated-orcid":false,"given":"Alanna","family":"Lakoff","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jadia","family":"Beckford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Charbonneau","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Lepine","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, ON, Canada"},{"name":"The Ottawa Hospital, ON, Canada"},{"name":"The Ontario Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"key":"bibr1-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1016\/j.gendis.2018.01.004"},{"key":"bibr2-08903344241254342","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1261316"},{"key":"bibr3-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06424-4"},{"key":"bibr4-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2018.09.008"},{"key":"bibr5-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-2843"},{"key":"bibr6-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-021-00340-y"},{"key":"bibr7-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1177\/00034894221140771"},{"key":"bibr8-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1177\/0890334421993467"},{"key":"bibr9-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2012.9975"},{"key":"bibr10-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01607-2"},{"key":"bibr11-08903344241254342","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12113864"},{"key":"bibr12-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110746"},{"key":"bibr13-08903344241254342","unstructured":"Public Health Agency of Canada. (2017). Perinatal health indicators for Canada. Canadian Perinatal Surveillance System. http:\/\/health-infobase.conada.ca\/PHI\/"},{"key":"bibr14-08903344241254342","unstructured":"Registered nurses\u2019 association of Ontario. (2018). Registered nurses\u2019 association of Ontario best practice guideline breastfeeding-promoting and supporting the initiation, exclusivity, and continuation of breastfeeding for newborns, infants, and young children. Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding in Newborns, Infants and Young Children | RNAO.ca. https:\/\/rnao.ca\/bpg\/guidelines\/breastfeeding-promoting-and-supporting-initiation-exclusivity-and-continuation"},{"key":"bibr15-08903344241254342","unstructured":"Sick Kids. (2020). Oral immune therapy for your hospitalized baby. About Kids Health. aboutkidshealth.ca. Oral immune therapy for your hospitalized baby (aboutkidshealth.ca). https:\/\/www.aboutkidshealth.ca\/oral-immune-therapy-for-your-hospitalized-baby#:~:text=Key%20points%201%20Oral%20immune%20therapy%20is%20a,four%20hours%20as%20part%20of%20routine%20mouth%20care"},{"key":"bibr16-08903344241254342","doi-asserted-by":"publisher","DOI":"10.3928\/19382359-20220504-05"},{"key":"bibr17-08903344241254342","doi-asserted-by":"publisher","DOI":"10.1177\/00034894211024060"},{"key":"bibr18-08903344241254342","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00224"}],"container-title":["Journal of Human Lactation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08903344241254342","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08903344241254342","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08903344241254342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:34:21Z","timestamp":1777502061000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08903344241254342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,5]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1177\/08903344241254342"],"URL":"https:\/\/doi.org\/10.1177\/08903344241254342","relation":{},"ISSN":["0890-3344","1552-5732"],"issn-type":[{"value":"0890-3344","type":"print"},{"value":"1552-5732","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,5]]}}}