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Relationship between feeding schedules and gastric distress during retinopathy of prematurity screening eye
Yi Ning J Strube1, Jeffrey A Bakal, Brian W Arthur
1Department of Ophthalmology, Queen's University, 166 Brock Street, Kingston, Ontario, Canada. yiningstrube@hotmail.com
Insights
Feeding premature infants one hour before retinopathy of prematurity (ROP) eye exams reduces crying and distress. This feeding schedule minimizes infant stress during ROP examinations without increasing vomiting or gastric issues.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Pediatric Gastroenterology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- ROP screening requires eye examinations in the neonatal intensive care unit (NICU).
- These examinations can cause distress and potential gastric side effects in vulnerable infants.
Purpose of the Study:
- To investigate the impact of feeding timing on infant distress during ROP eye examinations.
- To assess the relationship between pre-examination feeding and adverse gastric events.
Main Methods:
- A prospective, randomized, single-masked study involving NICU infants undergoing ROP examinations.
- Infants were assigned to either feeding 1 hour before or withholding feeding for 2 hours prior to the exam.
- Physiological data, crying time, vomiting, and gastric aspirates were meticulously recorded.
Main Results:
- Infants fed 1 hour before the exam exhibited 19% less crying (p=0.016).
- Vomiting occurred 3-fold less frequently in the earlier feeding group (4.2% vs 12.5%).
- While some physiological changes were noted, significant increases in vomiting or gastric aspirates were not observed.
Conclusions:
- Feeding infants 1 hour before ROP examinations may reduce examination-related stress and crying.
- This feeding strategy appears safe, with no increased incidence of vomiting or gastric aspirates.
- Optimizing feeding schedules can improve the infant experience during essential ROP screening.
Purpose:
To determine whether a relationship exists between the timing of feeding before retinopathy of prematurity (ROP) eye examinations and gastric side effects or distress associated with this examination.
Methods:
A prospective, randomized, single-masked study was conducted involving infants in the neonatal intensive care unit who required an ROP eye examination and who received normal or full enteral feeding over a 1 year period. Infants were randomly assigned to 1 of 2 study arms: feeding 1 hour before examination (arm 1) or feeding schedule adjusted to ensure no feeding within 2 hours before examination (arm 2). Physiological data, including blood pressure and pulse rate, before, during and after examination, crying time during the examination, presence of vomiting and gastric aspirates, and gastric aspirates volume 24 hours after the examination, were recorded.
Results:
A total of 34 infants were enrolled, with 57 separate eye examinations conducted. There was 19% less crying (p = 0.016) in arm 1 versus arm 2. Vomiting was 3-fold less in arm 1 versus arm 2 (4.2% vs 12.5%, p = 0.38). Gastric aspirates was less in arm 1 versus arm 2 (p = 0.18). Diastolic blood pressure was lower and respiratory rate greater during the examination in arm 1 (p < 0.05), whereas pulse rate was greater at the start of the examination in arm 1 (p < 0.05).
Conclusions:
Feeding neonatal intensive care unit infants 1 hour before compared with withholding feeding 2 or more hours before ROP examinations may reduce stress during the examination, as measured by percentage crying during the examination, with no increased incidence of vomiting or gastric aspirates.
