Effects of pre-feeding oral stimulation on oral feeding in preterm infants: A randomized clinical trial

Bache, Manon; Pizon, Emmanuelle; Jacobs, Julien; Vaillant, Michel; Lecomte, Aline

doi:10.1016/j.earlhumdev.2013.12.011

Cited by 69 publications

(45 citation statements)

References 18 publications

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“…This resulted in decreased time to achieve full oral feeds (Lessen, 2011), higher milk transfer rates, and greater volume taken during oral feeds (Zhang et al, 2014). Data for reduction in length of stay has been mixed (Bache, Pizon, Jacobs, Vaillant, & Lecomte, 2014; Zhang et al, 2014), though a recent metaanalysis including these studies concluded that length of stay was reduced by a mean of 3.64 days (95% CI, −5.57 to −1.71) (Tian et al, 2015). Our study was one of the first to employ oral motor intervention exercises in infants with complex CHD born at or beyond 37 weeks gestation.…”

Section: Discussionmentioning

confidence: 99%

Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding

Indramohan

Pedigo

Rostoker³

et al. 2017

Journal of Pediatric Nursing

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Many infants with complex congenital heart disease (CHD) do not develop the skills to feed orally and are discharged home on gastrostomy tube or nasogastric feeds. We aimed to identify risk factors for failure to achieve full oral feeding and evaluate the efficacy of oral motor intervention for increasing the rate of discharge on full oral feeds by performing a prospective study in the neonatal and cardiac intensive care units of a tertiary children’s hospital. 23 neonates born at ≥ 37 weeks gestation and diagnosed with single-ventricle physiology requiring a surgical shunt were prospectively enrolled and received oral motor intervention therapy. 40 historical controls were identified. Mean length of stay was 53.7 days for the control group and 40.9 days for the study group (p=0.668). 13/23 patients who received oral motor intervention therapy (56.5%) and 18/40 (45.0%) controls were on full oral feeds at discharge, a difference of 11.5% (95% CI −13.9% to 37.0%, p=0.378). Diagnosis of hypoplastic left heart syndrome, longer intubation and duration of withholding enteral feeds, and presence of gastroesophageal reflux disease were predictors of poor oral feeding on univariate analysis. Although we did not detect a statistically significant impact of oral motor intervention, we found clinically meaningful differences in hospital length of stay and feeding tube requirement. Further research should be undertaken to evaluate methods for improving oral feeding in these at-risk infants.

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Section: Discussionmentioning

confidence: 99%

Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding

Indramohan

Pedigo

Rostoker³

et al. 2017

Journal of Pediatric Nursing

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“…Nonnutritive sucking (NNS) is used during gavage feeding and in the transition from gavage to oral feeding in preterm infants. The rationale for this intervention is that nonnutritive sucking facilitates the development and maturation of sucking behaviour and improves digestion of enteral feedings . Nonnutritive sucking on the expressed breast (mother pumps first and then places the baby to the breast) can be attempted as soon as the baby is extubated and stable with success noted as early as at 28 weeks corrected gestational age …”

Section: Methodsmentioning

confidence: 99%

“…Nonnutritive sucking increases absorption of feeds due to an increase gastrin secretion, decreased somatostatin secretion, and enhanced functioning of the gastro‐intestinal track. Nonnutritive sucking during gavage feedings contributes to the faster transition from tube to oral feeds and better bottle feeding outcomes, due to an acceleration in maturation and greater weight gain result in earlier discharge from hospital Nonnutritive sucking is beneficial for pain relief, soothing, and self‐consolation, since it increases self‐regulatory state modulation with increased levels of alertness and increased duration of sleeping and finally improving muscle tone and coordination. According to a study by Bingham et al, higher nonnutritive sucking organization scores predicted a shorter transition to full oral feeds ( P <.05) or 3 days earlier than infants with more chaotic patterns of suck bursts.…”

Section: Methodsmentioning

confidence: 99%

Clinicians guide for cue‐based transition to oral feeding in preterm infants: An easy‐to‐use clinical guide

Lubbe

2017

Evaluation Clinical Practice

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Rationale, aims and objectivesThis article aims to provide evidence to guide multidisciplinary clinical practitioners towards successful initiation and long‐term maintenance of oral feeding in preterm infants, directed by the individual infant maturity.MethodA comprehensive review of primary research, explorative work, existing guidelines, and evidence‐based opinions regarding the transition to oral feeding in preterm infants was studied to compile this document.ResultsCurrent clinical hospital practices are described and challenged and the principles of cue‐based feeding are explored. “Traditional” feeding regimes use criteria, such as the infant's weight, gestational age and being free of illness, and even caregiver intuition to initiate or delay oral feeding. However, these criteria could compromise the infant and increase anxiety levels and frustration for parents and caregivers. Cue‐based feeding, opposed to volume‐driven feeding, lead to improved feeding success, including increased weight gain, shorter hospital stay, fewer adverse events, without increasing staff workload while simultaneously improving parents' skills regarding infant feeding. Although research is available on cue‐based feeding, an easy‐to‐use clinical guide for practitioners could not be found. A cue‐based infant feeding regime, for clinical decision making on providing opportunities to support feeding success in preterm infants, is provided in this article as a framework for clinical reasoning.ConclusionsCue‐based feeding of preterm infants requires care providers who are trained in and sensitive to infant cues, to ensure optimal feeding success. An easy‐to‐use clinical guideline is presented for implementation by multidisciplinary team members. This evidence‐based guideline aims to improve feeding outcomes for the newborn infant and to facilitate the tasks of nurses and caregivers.

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“…Often this weight gain is not achievable in preterm infants because extrauterine life requires higher energy expenditure than intrauterine life 2. Breast milk feeding remains the best way to provide nutrition to the newborn infant, but it is not always possible to start breast feeding immediately after the delivery of a preterm infant2 because coordination of sucking/swallowing and swallowing/breathing does not occur before 32 and 33–34 gestational weeks, respectively 3…”

Section: Introductionmentioning

confidence: 99%

Experience of compounding total parenteral nutrition admixtures for preterm infants in a hospital pharmacy: evidence of calcium and phosphate compatibility problem

Zenoni

Loiacono

2017

Eur J Hosp Pharm

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ObjectiveParenterally fed preterm newborn infants require large amounts of calcium and phosphate in a low volume of solution. The lower the volume of solution, the higher is the possibility of precipitation of calcium hydrogen phosphate (CaHPO4). Precipitation could cause respiratory distress and pulmonary embolism, and the use of organic salts of calcium and phosphorus may reduce the likelihood of this problem. To date, no previous work on the stability of solutions with organic salts has been published in the literature. This study aims to evaluate the visible precipitation of calcium and phosphorus in total parenteral nutrition solutions.Methods20 parenteral nutrition solutions were aseptically prepared in a laminar airflow hood in a clean room. The solutions are intended to facilitate precipitation, with the amino acid ratio below the standard concentration and other parameters also modulated to promote the precipitation of CaHPO4. The solutions contained dextrose, amino acids, calcium gluconate and fructose 1,6-bisphosphate. We did not use lipid emulsion so that we could see all precipitations.ResultsNo visible precipitation was observed during 4 weeks of observation at 25°C. The only observed event was the change in colour of the solution, which became yellow, maybe because of a Maillard reaction.ConclusionsThis study evaluated the compatibility of organic calcium and phosphorus in order to prevent the precipitation of CaHPO4 when preparing total parenteral nutrition solutions. The fact that no precipitation was observed is very significant as it indicates the compatibility of the ions, even though no instrumental analysis was performed.

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Effects of pre-feeding oral stimulation on oral feeding in preterm infants: A randomized clinical trial

Cited by 69 publications

References 18 publications

Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding

Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding

Clinicians guide for cue‐based transition to oral feeding in preterm infants: An easy‐to‐use clinical guide

Experience of compounding total parenteral nutrition admixtures for preterm infants in a hospital pharmacy: evidence of calcium and phosphate compatibility problem

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