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Oral Feeding Outcome after Analgesic and Sedative Exposure in VLBW Preterm Infant

Mark T Astoria1, Leroy Thacker2, Karen D Hendricks-Muñoz1

  • 1Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia.

American Journal of Perinatology
|June 9, 2018
PubMed

Insights

Analgesic and sedative use in very low birth weight (VLBW) infants is linked to difficulties with oral feeding. This study found that VLBW infants exposed to these medications were more likely to need feeding tubes at discharge.

Area of Science:

  • Neonatal medicine
  • Pediatric pharmacology

Background:

  • Very low birth weight (VLBW) infants (<1,500g) often face challenges with oral feeding.
  • Analgesics and sedatives are commonly used in neonatal intensive care units (NICUs).

Purpose of the Study:

  • To examine the association between analgesic and sedative exposure and oral feeding function in VLBW infants.
  • To determine if medication exposure impacts the need for feeding tubes at discharge.

Main Methods:

  • Retrospective review of 209 VLBW infants (<1,500g, <32 weeks gestation) discharged from the NICU.
  • Analysis of medication exposure, demographics, clinical course, and feeding tube use at discharge.
  • Logistic regression modeling to identify independent predictors of tube feeding.

Main Results:

  • Of 209 infants, 45 (21.5%) received analgesics/sedatives, and 23 (51.1% of those exposed) were discharged with tube feedings.
  • Infants on tube feedings had lower birth weight, younger gestation, higher illness scores, and more comorbidities.
  • Analgesic/sedative exposure (fentanyl, midazolam, morphine) independently predicted discharge on tube feedings.

Conclusions:

  • Exposure to analgesics and sedatives in VLBW infants is significantly associated with impaired oral feeding.
  • These medications are predictive of the need for tube feedings at the time of discharge in this vulnerable population.
Abstract

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