Weight at weaning of preterm infants from incubator to bassinet: a randomized clinical trial
Irit Berger1, Ronella Marom1, Francis Mimouni2
1Department of Neonatology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.
Insights
Weaning very low birth weight infants from incubators to warming bassinets at 1,500g is safe. This practice does not negatively impact infant weight gain or resting energy expenditure (REE).
Area of Science:
- Neonatal care
- Pediatric physiology
- Thermoregulation in infants
Background:
- Preterm infants require specialized thermal support.
- Weaning criteria from incubators to open warmers vary.
- Assessing the impact of earlier weaning on infant physiology is crucial.
Purpose of the Study:
- To evaluate thermal responses, weight gain, and resting energy expenditure (REE) in preterm infants.
- To compare outcomes when weaning from incubator to warming bassinet at 1,500g versus 1,600g.
Main Methods:
- Preterm infants weighing ≤1,500g were randomized to be weaned at 1,500g or 1,600g.
- Postweaning body temperature, REE (before and after weaning), and daily weight gain were monitored.
- Infants were transitioned to a warming bassinet at room temperature.
Main Results:
- Successful weaning to a warming bassinet was achieved for all infants.
- No significant differences in REE were observed between the 1,500g and 1,600g weaning groups.
- Weight gain and time to discharge were comparable between the two groups.
Conclusions:
- Weaning very low birth weight infants from incubators to warming bassinets at 1,500g is feasible.
- This earlier weaning approach shows no significant adverse effects on infant weight gain or REE.
- Earlier accessibility to premature infants in bassinets offers potential benefits.
Objective:
To evaluate thermal responses, weight gain, and resting energy expenditure (REE) in preterm infants weaned from an infant incubator to a warming bassinet after reaching a body weight of either 1,500 or 1,600 g, respectively.
Methods:
Preterm infants weighing ≤ 1,500 g were randomly allocated for weaning from a convective incubator after reaching 1,500 g body weight (study group) or 1,600 g (controls). Postweaning body temperature was recorded at short intervals. REE was measured before and after weaning, while the weight gain was calculated daily.
Results:
All 21 enrolled infants were weaned successfully to a bassinet (room temperature). REE inside the incubator and in the warming bassinette was similar between infants weaned at 1,500 g and at 1,600 g (2.9 ± 6.8 vs. 1.1 ± 4.8 kcal/kg/d, respectively (p = 0.7). REE increased slightly after weaning in both groups. Weight gain and days from randomization to discharge did not differ between groups.
Conclusion:
Weaning very low birth weight infants from an incubator to a warming bassinet at a body weight of 1,500 g is feasible and has no significant deleterious effects on weight gain and REE. The many benefits provided by such greater accessibility to premature infants are discussed.
