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.

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/)

Direct swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial

2021 ◽  
pp. fetalneonatal-2021-321945
Author(s):  
Ju Sun Heo ◽  
Ee-Kyung Kim ◽  
Sae Yun Kim ◽  
In Gyu Song ◽  
Young Mi Yoon ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Tube Feeding ◽  
Tertiary Hospital ◽  
Oral Feeding ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Randomised Controlled

ObjectiveTo evaluate the effects of direct swallowing training (DST) alone and combined with oral sensorimotor stimulation (OSMS) on oral feeding ability in very preterm infants.DesignBlinded, parallel group, randomised controlled trial (1:1:1).SettingNeonatal intensive care unit of a South Korean tertiary hospital.ParticipantsPreterm infants born at <32 weeks of gestation who achieved full tube feeding.InterventionsTwo sessions per day were provided according to the randomly assigned groups (control: two times per day sham intervention; DST: DST and sham interventions, each once a day; DST+OSMS: DST and OSMS interventions, each once a day).Primary outcomeTime from start to independent oral feeding (IOF).ResultsAnalyses were conducted in 186 participants based on modified intention-to-treat (63 control; 63 DST; 60 DST+OSMS). The mean time from start to IOF differed significantly between the control, DST and DST+OSMS groups (21.1, 17.2 and 14.8 days, respectively, p=0.02). Compared with non-intervention, DST+OSMS significantly shortened the time from start to IOF (effect size: −0.49; 95% CI: −0.86 to –0.14; p=0.02), whereas DST did not. The proportion of feeding volume taken during the initial 5 min, an index of infants’ actual feeding ability when fatigue is minimal, increased earlier in the DST+OSMS than in the DST.ConclusionsIn very preterm infants, DST+OSMS led to the accelerated attainment of IOF compared with non-intervention, whereas DST alone did not. The effect of DST+OSMS on oral feeding ability appeared earlier than that of DST alone.Trial registration numberClinicalTrials.gov Registry (NCT02508571).

scholarly journals Cost-effectiveness of depression case management in small practices

2013 ◽  
Vol 202 (6) ◽  
pp. 441-446 ◽  
Author(s):  
Jochen Gensichen ◽  
Juliana J. Petersen ◽  
Michael Von Korff ◽  
Dirk Heider ◽  
Steffen Baron ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Case Management ◽  
Controlled Trial ◽  
Cost Effective ◽  
Control Group ◽  
Significant Difference ◽  
Small Primary ◽  
Care Practices ◽  
Primary Care Practices

BackgroundCase management undertaken by healthcare assistants in small primary care practices is effective in improving depression symptoms and adherence in patients with major depression.AimsTo evaluate the cost-effectiveness of depression case management by healthcare assistants in small primary care practices.MethodCost-effectiveness analysis on the basis of a pragmatic randomised controlled trial (2005-2008): practice-based healthcare assistants in 74 practices provided case management to 562 patients with major depression over 1 year. Our primary outcome was the incremental costeffectiveness ratio (ICER) calculated as the ratio of differences in mean costs and mean number of qualityadjusted life-years (QALYs). Our secondary outcome was the mean depression-free days (DFDs) between the intervention and control group at 24-month follow-up. The study was registered at the International Standard Randomised Controlled Trial Number Registry: ISRCTN66386086.ResultsIntervention v. control group: no significant difference in QALYs; significantly more DFDs (mean: 373 v. 311, P<0.01); no significant difference in mean direct healthcare costs (€4495 v. €3506, P = 0.16); considerably lower mean indirect costs (€5228 v. €7539, P = 0.06), resulting in lower total costs (€9723 v. €11 045, P = 0.41). The point estimate for the cost-utility ratio was €38 429 per QALY gained if only direct costs were considered, and ‘dominance’ of the intervention if total costs were considered. Yet, regardless of decision makers' willingness to pay per QALY, the probability of the intervention being cost-effective was never above 90%.ConclusionsIn small primary care practices, 1 year of case management did not increase the number of QALYs but it did increase the number of DFDs. The intervention was likely to be cost-effective.

scholarly journals Comparing the Effect of Breast Milk Odor and Incubator Cover on Nutritional Adequacy of Premature Infants: A Quasi-Experimental Study

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Zahra Saberi Louyeh ◽  
Mahin Naderifar ◽  
Hamed Faghihi ◽  
Brenda S. Lessen Knoll ◽  
Nasrin Mahmoodi
Keyword(s):  
Experimental Study ◽  
Breast Milk ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Nutritional Adequacy ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
And Control

Background: Premature babies face nutritional problems caused by underdevelopment and lack of coordination between sucking, swallowing, and breathing. Appropriate early interventions are needed to promote the nutritional adequacy of these infants. Objectives: This study was designed to compare the effect of breast milk odor and incubator cover on the nutritional adequacy of premature infants. Methods: A quasi-experimental study was conducted on 105 preterm infants aged 28 - 33 weeks who were admitted to the Neonatal Intensive Care Unit (NICU) of Ali Ibn Abi Taleb Hospital in Zahedan in 2018. The subjects were selected via convenience sampling and randomized into three groups: breast milk odor (BMO), incubator cover (IC), and control. Infants in the IC group were placed in an incubator for two hours before feeding. In the BMO group, a gauze soaked with breast milk was placed 1.5 cm away from the infant’s nose in the incubator, and a prescribed amount of milk was given by a syringe to the infant through the mouth. The amount of milk that the baby orally received in the first 10 min (nutritional adequacy) was recorded by a camera, and the results were compared in the three groups. Results: One-way analysis of variance showed a statistically significant difference between the control group and the two groups of incubator cover and breast milk odor (P < 0.001) such that nutritional adequacy was lower in the control group than in the two other groups. Conclusions: Both the smell of breast milk and incubator cover improved the nutritional adequacy of premature infants and enabled them to orally receive more breast milk.

Comparing the effectiveness of mother’s live lullaby and recorded lullaby on physiological responses and sleep of preterm infants: a clinical trial study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Razyeh Namjoo ◽  
Roghayeh Mehdipour-Rabori ◽  
Behnaz Bagherian ◽  
Monirsadat Nematollahi
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Sleep Duration ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Physiological Responses ◽  
Physiological Parameters ◽  
Control Group ◽  
Significant Difference ◽  
The Mean

Abstract Objectives Environmental stimuli in neonatal intensive care units can disrupt the physiological stability and sleep of infants. It is essential to perform nursing interventions to reduce the adverse effects of such stimuli. This study aimed to compare the effect of recorded lullabies and mothers’ live lullabies on physiological responses and sleep duration of preterm infants. Methods This study was a randomized clinical trial. The participants were 90 preterm infants selected using convenience sampling. In the intervention groups, music (recorded lullabies and mother’s live lullabies) was played for 14 days, 20 min a day, while the control group did not receive any intervention. The data were collected using physiological criteria and infant sleep checklists before, during, and after the intervention. The data were analyzed using SPSS software (Version 21.0). Results The mean scores of physiological parameters (O2 saturation and heart rate) were not significantly different in the three groups before, during, and after the intervention (p>0.05). However, there was an improvement in O2-saturation and a decrease in the heart rate in two intervention groups. The mean duration of the infants’ overnight sleep was not statistically significant between the groups before the intervention (p>0.05). However, there was a statistically significant difference in the intervention groups after the intervention, (p<0.05), and the infants’ overnight sleep was longer in the recorded-lullaby group than the other two groups. Conclusions Although performing interventions, including recorded lullaby and mother’s live lullaby did not differ significantly with that of the control group in physiological criteria, it can be clinically important. In addition, recorded-lullaby increased the infants’ overnight sleeping. Thus, it is suggested that further studies be conducted to confirm the effect of recorded lullaby and mother’s live lullaby interventions on physiological parameters and sleep duration of hospitalized infants.

scholarly journals Preterm Infant Neurodevelopmental Care Training Program and Mother-Infant Attachment

2019 ◽  
Vol 8 (2) ◽  
pp. 192-197
Author(s):  
Fatemeh Fallah Rostami ◽  
Farin Soleimani ◽  
Mehdi Norouzi ◽  
Nikta Hatamizadeh ◽  
Jamileh Mokhtarinouri ◽  
...  
Keyword(s):  
Preterm Infant ◽  
Training Program ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Infant Attachment ◽  
Significant Difference ◽  
Care Training

Objectives: Preterm birth and admission to the neonatal intensive care unit (NICU) would disrupt mother-infant attachment. Neurodevelopmental care training and support of family programs are essential for the family of such infants. The purpose of this study was to investigate the effect of neurodevelopmental care training program for mothers with preterm infants on mother-infant attachment at one month’s age. Materials and Methods: Study population included all the mothers of preterm infants born in the hospitals of Tehran in 2018. The research was designed as a multicenter cluster clinical trial and four hospitals were randomly selected and divided into intervention and control groups. Before the intervention, the mother-infant attachment was measured by the Maternal-Postnatal Attachment Scale (MPAS). The mothers in the intervention group received a 12-session preterm infant neurodevelopmental care training program while the control group only received the routine care in the unit. Finally, the mother-infant attachment was re-measured in both groups at the one month corrected age. Results: No significant difference was observed in the attachment score before and after the intervention in the control group but the mother-infant attachment score was significantly different in the intervention group (57.75±11.09 vs. 78.27±4.54). Conclusions: The neurodevelopmental care training program was effective and increased the mother-infant attachment rate.

scholarly journals A Randomized Controlled Trial Comparing Two Doses of Caffeine for Apnoea in Prematurity

2021 ◽  
Vol 18 (9) ◽  
pp. 4509
Author(s):  
Anis Munirah Mohd Kori ◽  
Hans Van Rostenberghe ◽  
Nor Rosidah Ibrahim ◽  
Najib Majdi Yaacob ◽  
Ariffin Nasir
Keyword(s):  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Duration Of Treatment ◽  
Significant Difference ◽  
To Receive ◽  
Higher Doses ◽  
Methyl Xanthine

Caffeine is the most commonly used methyl xanthine for the prevention of apnoea in prematurity, but the ideal dose was uncertain, until now. This study compared two doses of caffeine for the prevention of apnoea in prematurity. A clinical trial was conducted on 78 preterm infants ≤32 weeks in Neonatal Intensive Care Unit. They were randomly allocated to receive the intervention (loading 40 mg/kg/day and maintenance of 20 mg/kg/day) or the control (loading 20 mg/kg/day and maintenance of 10 mg/kg/day) dose of caffeine. The primary outcome of the study was the frequency and total days of apnoea per duration of treatment for both groups. The frequency of apnoea ranged from zero to fourteen in the intervention group and zero to twelve in the control group. There was no statistically significant difference between the groups, with a p-value of 0.839. The number of days of apnoea was also similar between both groups, with a p-value of 0.928. There was also no significant difference in adverse events between both regimens. This study did not support the use of higher doses of caffeine as a prevention for apnoea in prematurity.

Effects of Oral Stimulation and Supplemental Nursing System on the Transition Time to Full Breast of Mother and Sucking Success in Preterm Infants: A Randomized Controlled Trial

2021 ◽  
pp. 105477382110583
Author(s):  
Fikriye Çelik ◽  
Selma Sen ◽  
Gonca Karayagiz Muslu
Keyword(s):  
Preterm Infants ◽  
Transition Period ◽  
Controlled Trial ◽  
Vital Signs ◽  
Oral Feeding ◽  
Transition Time ◽  
Control Group ◽  
Oral Stimulation ◽  
Preterm Babies ◽  
Experimental Group

This study aimed to investigate the effect of oral stimulation and a supplemental nursing system on the time to full maternal breastfeeding and sucking success in preterm infants. The sample consisted of 70 preterm babies. Oral motor stimulation and a supplemental nursing system were applied to the preterm infants in the experimental group, while no intervention was applied to those in the control group. Significant differences were found between the two groups concerning transition time to oral feeding, transition weight, transition time to full maternal breast, discharge age, duration, and weight, LATCH mean scores, continuing to suck in the first month after discharge, and weight averages. Oral stimulation and a supplemental nursing system shortened the transition period to oral feeding and full breastfeeding, increased breastfeeding rates and the sustainability of breastfeeding, and did not affect the period of discharge and vital signs during feeding in preterm babies.

scholarly journals Structured Antenatal Milk Expression Education for Nulliparous Pregnant People: Results of a Pilot, Randomized Controlled Trial in The United States

2021 ◽  
Author(s):  
Jill Demirci ◽  
Melissa Glasser ◽  
Katherine P Himes ◽  
Susan M Sereika
Keyword(s):  
United States ◽  
Breast Milk ◽  
Self Efficacy ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
The United States ◽  
Control Group ◽  
Independent Practice ◽  
Convenience Sample ◽  
Lactation Consultant

Abstract Background Hand-expression, collection, and storage of breast milk during pregnancy (i.e., antenatal milk expression or AME) is a safe, potentially effective practice to reduce early, undesired formula supplementation among women with diabetes. The feasibility and potential benefits of AME in the United States (U.S.) and among non-diabetic birthing people is unknown. Methods The purpose of this study was to examine the feasibility of a structured AME intervention and its relationship to lactation outcomes among nulliparous birthing people in the United States. We recruited a convenience sample of 45 low-risk, nulliparous individuals at 34–366/7 weeks of gestation from a hospital-based midwife practice. Participants were randomized to AME or a control group receiving breastfeeding handouts. Interventions were delivered at weekly visits at 37–40 weeks of pregnancy. The AME intervention involved technique demonstration and feedback from a lactation consultant and daily independent practice. Lactation outcomes were assessed during the postpartum hospitalization, 1–2 weeks postpartum, and 3–4 months postpartum. Results Of 22 participants assigned to AME, 18 received an AME education study visit. Participants reported practicing AME on 60% or more of days prior to their infant’s birth. Most were able to express milk antenatally (15/18), more than half collected and froze antenatal milk (11/18), and 39% (7/18) supplemented their infants with antenatal milk after birth. No major problems were reported with AME. Perinatal and lactation outcomes, including infant gestational age at birth, neonatal intensive care unit admissions, and any or exclusive breastfeeding, appeared to be comparable between AME and control groups. There were trends toward higher breastfeeding self-efficacy and lower perceptions of insufficient milk postpartum among AME participants compared to control group participants, though AME participants exhibited higher breastfeeding self-efficacy and more favorable attitudes toward breastfeeding at baseline. Conclusions In a group of nulliparous birthing people in the U.S., AME education and independent practice beginning at 37 weeks of pregnancy was feasible and safe. In some cases, AME provided a back-up supply of breast milk when supplementation of direct breastfeeding was indicated or desired. The relationship between AME and lactation outcomes requires further study within a powered sample and other populations. Trial Registration: This trial was retrospectively registered at ClinicalTrials.gov on May 11, 2021 under the following registration ID: NCT04929301. https://clinicaltrials.gov/ct2/show/NCT04929301

scholarly journals Packed Cell Transfusion and Feeding Tolerance in Healthy Preterm Infants: A Randomized Clinical Tria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Minoo Fallahi ◽  
Mohammad Kazemian ◽  
Saeed Hojat Kashani ◽  
Saleheh Tajalli ◽  
Naeeme Taslimi
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Significant Difference ◽  
Packed Cell Transfusion ◽  
Feeding Tolerance

Background: Recently, the correlation between necrotizing enterocolitis (NEC) and packed cell transfusion (PCT) has been identified. Evidence shows that 25 - 35% of NEC cases are associated with PCT. Objectives: this study aimed to determine the association between PCT and feeding tolerance in healthy preterm newborns. Methods: Materials and Methods: This clinical trial was performed on preterm infants, admitted to the neonatal intensive care unit (NICU) of Mofid Children's Hospital, Tehran, Iran, from April 2017 to May 2018. A total of 70 healthy premature infants (birth weight < 1500 g and gestational age < 32 weeks) with enteral feeding, who required PCT, were included in this study. The eligible infants were divided into two groups by simple randomization. In the intervention group (n = 35), breastfeeding was withheld only during PCT and then continued as usual. On the other hand, in the control group (n = 35), feeding was performed as usual, regardless of PCT. Feeding tolerance within the first 72 hours post-transfusion was compared between the two groups. Sick newborns were excluded from the study. Data analysis was performed in SPSS version 20. Results: The mean gestational age, birth weight, and postnatal age of the neonates were 30.13 weeks, 1245.71 g, and 17 days in the intervention group and 29.97 weeks, 1169.43 g, and 15.46 days in the control group, respectively; there was no significant difference between the two groups. Except for pre-transfusion hemoglobin and hematocrit levels, other characteristics of the two groups were similar. Feeding tolerance was reported in 32 (91.2%), 33 (94.73%), and 34 (97.1%) newborns at 24, 48, and 72 hours post-transfusion in both groups, without any significant difference. There was no significant difference between neonates with and without feeding tolerance in either of the groups. Conclusions: According to the present results, withholding feeding during PCT is not necessary in healthy preterm neonates with a good general condition, and continued breastfeeding seems to be a safe option.

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