Cue-Based Feeding as Intervention to Achieve Full Oral Feeding in Preterm Infants Primarily Managed with Bubble CPAP

2021 ◽  
Author(s):  
Mohamed A. Mohamed ◽  
Kirsten K. Teumer ◽  
Mariana Leone ◽  
Nabi Akram ◽  
Mohamed H. Rahamn ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Comparison Group ◽  
Growth Parameters ◽  
Practice Change ◽  
Oral Feeding ◽  
Continuous Variables ◽  
Historical Comparison ◽  
Multilinear Regression Analysis ◽  
Feeding Group ◽  
Bubble Cpap

Objective Cue-based feeding aims at matching introduction of per oral (PO) feeding with physiological readiness of preterm infants to facilitate PO intake and avoid oral aversion. It was claimed that cue-based feeding may lead to delay in the initiation or achieving full PO feeding in clinical setting primarily using bubble nasal continuous positive airway pressure (CPAP). The study aimed to examine the association of cue-based feeding with time of introduction and completing oral feeding in infants primarily managed with bubble CPAP. Study Design A retrospective analysis where outcomes of preterm infants ≤32 weeks' gestational age (GA) and ≤2,000 g birth weight (BW) were compared after a practice change from volume-based feeding advancement to cue-based feeding. Continuous variables were compared by using t-test and multilinear regression analysis to control for confounding variables. Results Of the 311 preterm infants who met inclusion and exclusion criteria, 194 were in the cue-based feeding group and 117 were in the volume-based advancement historical comparison group. There were no differences between groups regarding demographic or clinical variables. Postmenstrual age (PMA) of initial feeding assessment was less in the cue-based feeding group. Age of first PO feeding and when some PO was achieved every feed was mildly delayed in the cue-based feeding compared with comparison group, 34 (±1.3) versus 33.7 (±1.2) weeks, and 36.2 (±2.3) versus 36.0 (±2.4) weeks, (p < 0.01) respectively. However, the age of achieving full PO did not differ between groups, 36.8 (±2.2) versus 36.4 (±2.4) weeks (p = 0.13). There was no difference between groups regarding growth parameters at 36 weeks' PMA or at discharge. Similar results were obtained when examining subcategories of infants ≤1,000 g and 1,001 to 2,000 g. Conclusion Cue-based feeding may not be associated with a delay in achieving full oral feeding or prolongation of the length of stay in preterm infants managed with CPAP. Key Points

scholarly journals Effectiveness of Cue-Based Feeding Versus Scheduled Feeding in Preterm Infants Using Comprehensive Feeding Assessment Scales: A Randomized Clinical Trial

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Farideh Kamran ◽  
Ahmad Reza Khatoonabadi ◽  
Mahshid Aghajanzadeh ◽  
Abbas Ebadi ◽  
Yaser Faryadras ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
P Value ◽  
Readiness Assessment ◽  
Feeding Group ◽  
Postmenstrual Age ◽  
Duration Of Hospitalization

Background: One of the most critical criteria in making ready an infant for discharge from the neonatal intensive care unit (NICU) is full oral feeding attainment. Objectives: The present study aimed at investigating the effectiveness of cue-based feeding in preterm infants. Methods: A randomized clinical trial study was designed to compare 37 preterm infants at a gestational age of ≤ 34 weeks in the cue-based feeding group (n = 18) and the scheduled feeding group (n = 19). All participants were evaluated by the Preterm Infant Oral Feeding Readiness Assessment Scale (PIOFRAS) and Early Feeding Skill (EFS) scale in four different stages. Outcome measures were weight (grams per day), duration of full oral feeding achievement, duration of hospitalization, postmenstrual age (PMA), and the score of PIOFRAS and EFS. A P-value of less than 0.05 has been considered statistically significant. Results: The duration of full oral feeding achievement was shorter in the cue-based feeding group (3.55 ± 1.24 vs 6.68 ± 2.00, P < 0.001). Infants were discharged earlier in the cue-based feeding group (15.55 ± 5.38 vs 27.10 ± 7.90, P < 0.001). The mean score of PIOFRAS only on the day of discharge in the cue-based feeding group was more than the scheduled feeding group (32.61 ± 1.14 vs 31.90 ± 0.87, P = 0.03). The score of EFS in each dimension was inconsistent in each stage, and differences were observed between two groups in the full oral feeding stage. Conclusions: Although PIOFRAS and EFS demonstrated no difference significantly in most of the stages of achievement in oral feeding between the cue-based feeding group and the scheduled feeding, the process of attainment of oral feeding and discharge from the hospital was more rapid in the cue-based feeding group.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

A feeding protocol for healthy preterm infants that shortens time to oral feeding

2001 ◽  
Vol 139 (3) ◽  
pp. 374-379 ◽  
Author(s):  
Gail C. McCain ◽  
Peter S. Gartside ◽  
James M. Greenberg ◽  
Judy Wright Lott
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Feeding Protocol

scholarly journals Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhisheng Jiang ◽  
Jing Luo ◽  
Mengqing Xu ◽  
Zhuangzhuang Cong ◽  
Saiguang Ji ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Type Ii Diabetes ◽  
Radical Resection ◽  
Oral Feeding ◽  
Life Questionnaire ◽  
Type Ii ◽  
Early Oral Feeding ◽  
Nutritional Index ◽  
Feeding Group

Abstract Objective To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma. Methods The clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups. Results There was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05). Conclusions Early oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Qiong Le ◽  
Sheng-hua Zheng ◽  
Lan Zhang ◽  
Li-fen Wu ◽  
Feng-juan Zhou ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Breast Milk ◽  
Premature Infant ◽  
Preterm Infants ◽  
Oral Feeding ◽  
Transition Time ◽  
Control Group ◽  
Oral Motor ◽  
Oral Stimulation ◽  
Nutritive Sucking

Abstract Objectives This study was performed to evaluate the effect of oral stimulation with breast milk for preterm infants. Methods A total of 68 subjects form neonatal intensive care unit were randomly assigned into control group (n=20), premature infant oral motor intervention (PIOMI) group (n=25) and premature infant oral motor intervention with breast milk (BM-PIOMI) group (n=23). Results BM-PIOMI group had significant shorter initiation of oral feeding (IOF) time compared to PIOMI group (2.95 days, 95% CI [0.42–5.48]) or control group (9.79 days, 95% CI [7.07–12.51]). BM-PIOMI group had significant sooner transition time from IOF to full oral feeding (FOF) compared to control group (6.68 days, 95% CI [2.2–11.16]), but not to PIOMI group (2.09 days, 95% CI [−2.07 to 6.25]). Length of hospital stay (LOS) did not show statistical different between three groups (control 38.85 ± 14.40 vs. PIOMI 38.48 ± 11.76 vs. BM-PIOMI 38.04 ± 12.2). Growth mixture model identified improvement in non-nutritive sucking (NNS) score in BM-PIOMI group compared to control and PIOMI group (0.8293, p<0.0001, and 0.8296, p<0.0001, respectively). Conclusions Oral stimulation with breast milk can better promotes the oral feeding process of premature infants than the simple oral stimulation, by shorten IOF time and improve early NNS score, but does not shorten transition time from IOF to FOF and LOS. Trial registration The trial identification number is ChiCTR1800019134 (Chinese Clinical Trial Registry http://www.who.int/ictrp/network/chictr2/en/)

Usefulness of the Infant Driven Scale in the early identification of preterm infants at risk for delayed oral feeding independency

2017 ◽  
Vol 115 ◽  
pp. 18-22 ◽  
Author(s):  
Maria Lorella Giannì ◽  
Patrizio Sannino ◽  
Elena Bezze ◽  
Laura Plevani ◽  
Chiara Esposito ◽  
...  
Keyword(s):  
At Risk ◽  
Preterm Infants ◽  
Early Identification ◽  
Oral Feeding

Early Introduction of Oral Feeding in Preterm Infants

PEDIATRICS ◽  
2002 ◽  
Vol 110 (3) ◽  
pp. 517-522 ◽  
Author(s):  
C. Simpson ◽  
R. J. Schanler ◽  
C. Lau
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Early Introduction

scholarly journals Therapeutic Efficacy of Nasoenteric Tube Feeding in Children Needing Enteral Nutrition

2021 ◽  
Vol 9 ◽  
Author(s):  
Mi-Chi Chen ◽  
Hsun-Chin Chao ◽  
Pai-Jui Yeh ◽  
Ming-Wei Lai ◽  
Chien-Chang Chen
Keyword(s):  
Enteral Nutrition ◽  
Pediatric Patients ◽  
Growth Parameters ◽  
Bowel Perforation ◽  
Tube Feeding ◽  
Oral Feeding ◽  
Tube Placement ◽  
Clinical Aspects ◽  
Limited Information ◽  
Therapeutic Benefits

Background: There is limited information on therapeutic benefits and tube-related complications of pediatric nasoenteric (NE) tube feeding. We viewed, from different clinical aspects, NE tube feeding in children who are under intolerable conditions.Methods: A 10-years retrospective study enrolled 77 pediatric patients who underwent an endoscopic-guided placement of the NE tube for enteral nutrition. The evaluated data, including growth parameters, feeding volume, parenteral nutrition (PN) dependence, and nutritional markers [serum hemoglobin (Hb) and albumin] before and after NE tube feeding were compared. Tube-related complications and major adverse events were also recorded.Results: A total of 77 patients (including 50 males) underwent 176 endoscopic-guided placements of the NE tube with an average duration of 133.7 (6.0–1,847.3) days. The gastroesophageal reflux disease-related symptoms (vomiting, desaturations, and aspiration pneumonia) improved in 71.4% of patients. Feeding volume increased significantly after intervention, especially in patients with delayed gastric emptying, from 144.8 ± 28.5 to 1,103.1 ± 524.7 ml/days (p &lt; 0.001). Weaning from PN was successfully achieved in 84.3% of patients with an average of 9.33 ± 7.30 days. About 16 patients (20.8%) were subsequently highly compatible with oral feeding after NE tube placement for an average of 24.7 ± 14.1 days. Patients either without neurologic dysfunction or with no ventilator-dependent status had a higher chance of shifting to oral feeding. Weight-for-age z-scores increased by 0.15 ± 1.33 after NE tube intervention. One NE tube-related adverse event, which caused bowel perforation at 6 days post-insertion, was recorded. No direct tube-related mortality was observed.Conclusions: Endoscopic-guided NE tube placement is a relatively safe, non-invasive procedure for pediatric patients who require enteral nutrition. Feeding via NE tube showed beneficial effects such as improvement in symptoms, PN weaning, and maintenance of body growth without major tube-related complications.

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