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A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants
Gayoung Lee1, Juyoung Lee1,2, Ga Won Jeon1
1Department of Pediatrics, Inha University Hospital, Incheon, Korea.
Insights
Thickened formula (TF) feeding significantly reduced desaturation and bradycardia events in preterm infants during oral feeding. This intervention may help stabilize oxygen saturation and heart rate in vulnerable infants.
Area of Science:
- Neonatal Nutrition and Feeding
- Pediatric Gastroenterology
- Infant Respiratory and Cardiac Physiology
Background:
- Preterm infants frequently experience desaturation and bradycardia during oral feeding.
- Lack of specific management guidelines for these feeding-related events in preterm infants.
Purpose of the Study:
- To evaluate the impact of a commercial thickened formula (TF) on oxygen saturation and heart rate stabilization.
- To assess the efficacy of TF in managing feeding-associated desaturation and bradycardia in preterm infants.
Main Methods:
- Retrospective study of 122 preterm infants fed cornstarch-containing TF for feeding-associated desaturation or bradycardia.
- Comparison of desaturation and bradycardia event frequencies before and after TF initiation.
- Defined desaturation as SpO2 <85% and bradycardia as heart rate <100 bpm.
Main Results:
- Significant reduction in desaturation events (2.3 to 0.3 events/day) and bradycardia events (0.3 to 0 events/day) post-TF feeding (P<0.001 and P=0.006, respectively).
- No adverse effects like diarrhea or electrolyte abnormalities were observed.
- Subgroup analysis in infants with bronchopulmonary dysplasia showed reduced desaturation and improved weight gain.
Conclusions:
- Thickened formula feeding effectively reduces oral feeding-associated desaturation and bradycardia in preterm infants.
- TF is a potentially beneficial intervention for stabilizing cardiorespiratory parameters during oral feeding in preterm infants with feeding difficulties.
Background:
Although preterm infants often experience desaturation or bradycardia during oral feeding, specific guidelines for its management are lacking.
Purpose:
This study aimed to investigate the effects of a commercial thickened formula (TF) on oxygen saturation and heart rate stabilization during oral feeding in preterm infants.
Methods:
This retrospective study included 122 infants born at a median (interquartile range [IQR]) 31+6 weeks (29+4 -34+6 weeks) of gestation weighing 1,725 g (1,353-2,620 g) and fed commercial cornstarch-containing TF due to feeding-associated desaturation or bradycardia. We excluded infants fed TF to treat symptomatic regurgitation. Desaturation and bradycardia events were compared between 3 days prior to the change and 3 days after the change to TF. Desaturation and bradycardia were defined as SpO2 <85% and heart rate <100 beats/min during or immediately after oral bottle feeding, respectively.
Results:
The median (IQR) postmenstrual age and weight were 36+1 weeks (34+6-38+0 weeks) and 2,395 g (2,160-2,780 g), respectively, at the time of change to TF. The frequency of desaturation significantly decreased after TF feeding (median [IQR]: 2.3 [1.3-3.3] events/day vs. 0.3 [0-1.7] events/day, P< 0.001). Bradycardia also decreased after TF feeding (0.3 [0-1] events/day vs. 0 [0-0.7] events/day, P=0.006). There were no cases of diarrhea or electrolyte abnormalities after TF feeding. Defecation frequency decreased (P=0.037), and polyethylene glycol was prescribed to 27% of the TF-fed infants. In a subgroup analysis of 16 infants with bronchopulmonary dysplasia, the frequency of desaturation was reduced (2.3 [1.8-3.8] events/day vs. 0.5 [0-1.5] events/day, P=0.042), and weight gain improved (22.5 [3.1-36.3] g/day vs. 41.3 [28.1-55.1] g/day, P=0.019), after TF feeding.
Conclusion:
TF feeding significantly reduces oral feeding-associated oxygen desaturation and bradycardia in preterm infants. TF may be useful for stabilizing oxygen saturation and heart rate among preterm infants with difficulties in oral feeding.
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