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Published on: December 31, 2015
The effect of positioning on energy expenditure in preterm infants: a feasibility study
Shaul Dollberg1, Gala Yacov, Francis B Mimouni
1Department of Neonatology, Lis Maternity Hospital, Tel Aviv-Sourasky Medical Center, Tel Aviv University, Israel.
Insights
Investigating infant positioning effects on preterm infant energy expenditure, this study found minimal impact. Modifying infant positions is unlikely to significantly alter energy expenditure in clinical practice.
Area of Science:
- Neonatology
- Pediatric Metabolism
- Infant Physiology
Background:
- Preterm infants have unique metabolic needs.
- Understanding energy expenditure is crucial for preterm infant care.
- The impact of body positioning on preterm infant energy expenditure requires further investigation.
Purpose of the Study:
- To assess the feasibility of studying positioning effects on energy expenditure in preterm infants.
- To determine if body position significantly influences energy expenditure in preterm infants.
Main Methods:
- A prospective, randomized, cross-over pilot study involving eight clinically stable preterm infants (30 weeks postmenstrual age).
- Indirect calorimetry was used to measure energy expenditure in four different positions.
- Infants were studied asleep, 90 minutes post-feeding, after 20 minutes in each position.
Main Results:
- Energy expenditure showed no significant variation across the four studied body positions.
- The maximum difference in mean energy expenditure between positions was only 3.7%.
Conclusions:
- Infant positioning has a negligible practical impact on energy expenditure in preterm infants.
- Clinical strategies aimed at reducing energy expenditure through positioning are unlikely to be effective.
Abstract:
The aim of this study was to determine the feasibility of a study of the effect of positioning on energy expenditure in preterm infants. We performed a prospective, randomized, clinical cross-over pilot study of eight healthy, appropriate weight for gestational age, gavage-fed, clinically stable preterm infants at the postmenstrual age of 30 weeks. Prior to the study and in accord with our feeding protocol, infants uniformly received either their own mother's milk or a preterm formula. Each infant was studied in four different positions after randomization to eight different sequences. Infants were studied asleep, 90 minutes after feeding, after 20 minutes of being nursed in a given position. They were cared for in a servo-controlled convective incubator during the metabolic measurements, which were performed by indirect calorimetry. Energy expenditure was not significantly affected by the body position in which the infant was studied. The difference between the highest and the lowest mean energy expenditure was 3.7% of the highest one. We conclude that attempts to minimize energy expenditure by modifying infant positioning are likely to be insignificant, from a practical standpoint, because of the nonsignificant or minimal differences in energy expenditure.
