Promoting Human Milk and Breastfeeding for the Very Low Birth Weight Infant: Clinical Report

PEDIATRICS · 2026-01-12 · 5 citations

Mother's own milk (MOM), appropriately fortified, provides optimal nutrition for hospitalized very low birth weight (VLBW [≤1500 g]) infants in the neonatal intensive care unit (NICU) and confers a myriad of other short- and long-term health benefits. Every family of a VLBW infant should receive information about the critical importance of MOM to the health of their infants and receive intensive support throughout the full course of their infant's hospitalization to achieve their personal lactation goals. Provision of pasteurized donor human milk (PDHM) is recommended when MOM is not available, insufficient in volume, or is contraindicated. PDHM should optimally be continued until the infant's risk to develop necrotizing enterocolitis is low (approximately 34-36 weeks' postmenstrual age). Preterm infant formula is recommended when MOM is not available and PDHM is either not available or the family declines use. Promotion of human milk and breastfeeding for VLBW infants requires access to efficient, effective, and comfortable double electric breast pumps in the hospital and at home and multidisciplinary and system-wide adoption of lactation support practices, including early and frequent milk expression, skin-to-skin care (SSC), and direct breastfeeding. Addressing social inequities in provision of human milk at the local level requires access to PDHM, peer lactation support, maximizing use of interpreter services as appropriate, and implementation of standardized approaches to identify and address unmet basic needs.

Creating a Hospital-Based Nutrition Pathway for Adults: Evaluation of implementation in two United States hospital-systems

Research Square · 2026-03-18

Rapid Intervention to Support Eating Issues ( <scp>RISE</scp> ) Program: Using Quality Improvement to Reduce Medical Hospitalization in Malnourished Youth

International Journal of Eating Disorders · 2025-11-18

ABSTRACT Objective Program‐led and focused models may overcome structural barriers to accessing ED care, such as limited availability, for youth with EDs by prioritizing strategic, evidence‐based care delivered through a structured approach. The Rapid Intervention to Support Eating Issues (RISE) pilot aimed to promote weight restoration and prevent hospitalization among malnourished adolescents at risk for hospitalization. We used a “home hospital” approach, integrating medical oversight, family‐based treatment principles, and nutritional support via structured outpatient care. Methods Participants completed 4–5 visits with adolescent medicine and nutrition over 8 weeks. They received psychoeducation and support in implementing home hospital. Vital signs, anthropometrics, dietary intake, ED behaviors, and cognitions were assessed. Results A total of 27 patients participated. Patients experienced low hospitalization rates ( n = 1 throughout; 3.7%) and significant weight gain (M end of treatment = +2.7 kg from baseline, 95% CI: 2.6–4.7). There were statistically significant increases in calorie intake (M baseline = 43.3% of recommendation; M end of treatment = 76.0% of recommendation; dz = 0.98, 95% CI: 0.45–1.50) and decreases in the report of disordered weight control behaviors ( n reporting at baseline = 10 [37%], n reporting at end of treatment = 3 [11.1%]; paired RD = −1.00, 95% CI: −1.00–−0.33). Discussion This program‐led and focused intervention produced meaningful outcomes and circumvented hospitalization for youth at high risk in a short time frame. This approach offers promise for scalable, early ED care that leverages programmatic expertise, consistent with evolving models of mental health service delivery.

The buffet challenge: a behavioral assessment of eating behavior in adolescents with an eating disorder

Journal of Eating Disorders · 2024-01-18 · 1 citations

OBJECTIVE: Eating disorders are characterized by disturbances in nutritional intake and abnormal mealtime behaviors. Laboratory eating paradigms offer a unique opportunity to accurately measure dietary intake and eating behaviors, however, these studies have predominantly occurred in adults. This paper describes the development and preliminary psychometric examination of the Buffet Challenge, a laboratory-based meal task for youths with an eating disorder. METHOD: We recruited and assessed 56 participants as part of a randomized controlled trial of Family-Based Treatment for adolescents with anorexia nervosa. Adolescents completed the Buffet Challenge at baseline, midway through treatment (~ week 16 of a 6 months course), and end of treatment. Participants and their parents also reported eating disorder symptomatology and treatment related variables of interest were recorded. RESULTS: All adolescents were willing to complete the Buffet Challenge at all time points, although one refused to give up their cellphone, and there were no significant adverse events recorded. Preliminary results are presented. CONCLUSIONS: Our initial pilot of this task in adolescents with anorexia nervosa demonstrates its acceptability, although investigation of our hypotheses was hindered by significant missing data due to COVID-related research shutdowns. Future studies should replicate procedures in a larger sample to ensure analyses are adequately powered.

Clinical characterization of Co-morbid autoimmune disease and eating disorders: a retrospective chart review

Eating Disorders · 2024-01-25 · 2 citations

= 21) gastrointestinal inflammation] with matched ED-only cases. The sample was overwhelmingly female, with an average age of 15.40. Weight gain trajectories differed across groups, with similar rates of weight gain between controls and non GI-AI cases and with a lower rate of weight gain for individuals with comorbid GI-AI. Over half (56%) of patients reported an AI diagnosis prior to ED; 38% reported an AI diagnosis following ED, and 6% reported ED and AI simultaneous diagnosis. On presentation, ED-only controls had higher rates of comorbid anxiety than cases in either AI group, while those with non-GI AI were more likely to report depression. Mean total GI symptoms, % goal weight at presentation, vital sign instability, and markers of refeeding syndrome did not differ across groups. Health care professionals treating patients with either condition should have a low threshold for asking additional questions to identify the presence of the other condition.

Post-traumatic stress symptoms in parents of adolescents hospitalized with Anorexia nervosa

Eating Disorders · 2022-08-06 · 16 citations

The current study was a planned secondary analysis to examine post-traumatic stress symptoms (PTSS) in parents of youth hospitalized for medical stabilization due to anorexia nervosa (AN). Questionnaires were administered to 47 parents (34 mothers, 13 fathers; 10 parental dyads) after admission; follow-up occurred at discharge and 4 weeks, 3 months, and 6 months post-discharge. PTSS were present in the majority of mothers (55.9%) and fathers (61.5%). PTSS were not associated with illness severity, but were associated with parental report of mood symptoms, avoidance, inflexibility, and symptom accommodation. Parental PTSS may negatively impact the adolescent rate of weight gain post-discharge. As hospitalization of a child for medical management of AN can be a traumatizing experience for parents, astute attention should be paid by medical staff to their needs. More work needs to be done to understand the impact of PTSS on parents of adolescents with AN.

Cultural shifts in the symptoms of Anorexia Nervosa: The case of Orthorexia Nervosa

Appetite · 2021-12-12 · 38 citations

The shifting perspectives study protocol: Cognitive remediation therapy as an adjunctive treatment to family based treatment for adolescents with anorexia nervosa

Contemporary Clinical Trials · 2021-02-02 · 21 citations

To meat or not to meat: disordered eating and vegetarian status in university students

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · 2021-05-22 · 10 citations

Associations between ergogenic supplement use and eating behaviors among university students

Eating Disorders · 2020-03-04 · 30 citations

Ergogenic supplements to improve athletic performance are commonly used among college athletes, but little is known about their association with eating disorder symptoms. The objective of this study was to examine associations between ergogenic supplement use and disordered eating attitudes and behaviors among university students, and to compare differences by sex. Undergraduate students from 10 top-ranked National College Athletics Association (NCAA) Division I colleges completed an online survey on supplement use, athletic activities, and eating attitudes and behaviors. Among 1633 university students, males (38.9%) reported higher rates of current supplement use than females (15.2%) (p < .001). In linear regression models adjusting for athletic status and body mass index, current supplement use was associated with higher Eating Disorders Examination-Questionnaire (EDE-Q) Global, Shape Concern, and Restraint scores in both males and females. Supplement use was associated with driven/compelled exercise (OR 2.00, 95% CI 1.33–2.99) in males and diuretic (OR 6.39, 95% CI 2.02–20.22) and diet pill use (OR 3.07, 95% CI 1.79–5.27) in females. Results suggest ergogenic supplement use is common in undergraduates and associated with disordered eating attitudes and behaviors. Clinicians should screen for disordered eating behaviors particularly in young adults who use ergogenic supplements.