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A key developmental step for preterm babies: achievement of full oral feeding
Marta Majoli1, Ilaria Artuso1, Simona Serveli1
1Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
Insights
Early oral feeding (OF) introduction in preterm infants accelerates full oral feeding (FOF) achievement and reduces hospitalization. Factors like birthweight and respiratory support influence feeding progression, suggesting a need for preventative interventions.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Developmental Pediatrics
Background:
- Preterm infants often require prolonged tube feeding due to immature feeding skills.
- Understanding factors influencing feeding progression is crucial for optimizing infant care and reducing hospital stays.
Purpose of the Study:
- To determine the optimal timing for introducing oral feeding (OF) and achieving full oral feeding (FOF) in preterm infants.
- To identify factors associated with the progression of feeding skills in this population.
Main Methods:
- Retrospective review of 100 medical records of preterm infants (≤32 weeks gestation) without major complications.
- Analysis of outcomes including timing of OF introduction, transition time from tube to FOF, and FOF achievement.
- Exploration of correlations between feeding progression and variables like gestational age, birthweight, and respiratory support duration.
Main Results:
- Oral feeding was introduced at a postmenstrual age (PMA) of 33.6 ± 1.1 weeks, with FOF achieved at 35.1 ± 1.5 weeks.
- PMA at OF introduction and FOF achievement correlated significantly with birthweight, duration of respiratory support, and gavage feeding introduction.
- Earlier OF introduction was strongly associated with earlier FOF achievement (r=0.61) and shorter hospitalization duration.
Conclusions:
- Anticipating oral feeding introduction can accelerate full oral feeding achievement and positively impact hospitalization length.
- Higher birthweight classes appear to favor earlier FOF achievement.
- The need for respiratory support and tube feeding may represent a nociceptive experience, potentially delaying feeding skill development, warranting further investigation into preventative strategies.
Abstract:
Aims: To investigate timing of oral feeding (OF) introduction and full oral feeding (FOF) achievement in preterm infants and to explore factors associated with feeding progression.Methods: Retrospective review of 100 medical records of preterms ≤32 weeks of gestation (GA) without major complications. Outcome measures were timing of OF introduction, transition time from nasogastric tube to FOF and FOF achievement. Variables such as sex, twins, GA, birthweight, respiratory supports used and duration of tube feeding, were also considered.Results: Post menstrual age (PMA) for OF introduction was 33.6 ± 1.1 weeks. FOF was achieved at 35.1 ± 1.5 weeks. PMA at OF introduction and PMA at FOF correlated with: birthweight (p = .0001, p = .001); duration of respiratory supports (p = 0.01, p = .0001); PMA at which respiratory supports were stopped (p = .0001, p = .0001); age of introduction of gavage (p = .0001, p = .003) and time of utilization of tube feeding (p = .02, p = .0001). Transition time was 1.5 ± 8.5 days. PMA at OF introduction significantly influenced PMA at FOF (p = .0001, r = .61). OF introduction, transition time and FOF were correlated with duration of hospitalization (p = .004, p = .0001, p = .008).Conclusions: The achievement of feeding skills is confirmed to affect length of hospitalization, but the earlier you introduce OF, the earlier you reach FOF, so introduction should be anticipated. There is a clear trend to favor higher birthweight classes in FOF achievement. Feeding tube placement and need for respiratory supports may represent a nociceptive experience delaying feeding skills' achievement. This highlights the importance of prospective studies investigating the role of preventative interventions.
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