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Effects of human milk odor stimulation on feeding in premature infants: a systematic review and meta-analysis
Yangyang Qin1, Shu Liu2, Yanming Yang1
1Nursing Department, The First Affiliated Hospital of Henan University of Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou, 450099, He Nan, China.
Insights
Human milk odor stimulation significantly reduces the time premature infants need to transition to oral feeding and shortens parenteral nutrition duration. However, it does not appear to affect hospital stay length.
Area of Science:
- Neonatal Nutrition and Feeding
- Developmental Pediatrics
- Evidence-Based Medicine
Background:
- Premature infants often face challenges with oral feeding initiation and require prolonged nutritional support.
- Odor stimulation, particularly with human milk, has been hypothesized to positively influence feeding behaviors in neonates.
- A systematic review and meta-analysis is needed to consolidate existing evidence on this intervention.
Approach:
- Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) adhering to PRISMA guidelines.
- Searched multiple major biomedical databases (PubMed, Cochrane, Embase, Web of Science, Chinese databases) up to July 2022.
- Evaluated the quality of six included RCTs (763 participants) using the Cochrane Handbook, with all studies rated as Grade B.
Key Points:
- Human milk odor stimulation significantly reduced the transition time to oral feeding in premature infants (SMD = -0.48, P < 0.00001).
- The intervention also shortened the duration of parenteral nutrition (MD = -1.01, P = 0.004).
- No significant effect was observed on the length of hospitalization for premature infants (MD = -0.03, P = 0.86).
Conclusions:
- Human milk odor stimulation is an effective intervention for accelerating oral feeding transition and reducing parenteral nutrition dependence in premature infants.
- Further high-quality, large-sample research is required to ascertain its impact on hospital stay duration and other developmental outcomes.
- This finding supports the integration of sensory-based interventions in neonatal care protocols for premature infants.
Abstract:
Previous studies suggested odor stimulation may influence feeding of premature neonates. Therefore, this systematic review and meta-analysis of randomized controlled trials was conducted to assess the effect of human milk odor stimulation on feeding of premature infants. All randomized controlled trials related to human milk odor stimulation on feeding in premature infants published in PubMed, Cochrane, Library, Medline, Embase, Web of science databases and Chinese biomedical literature databases, China National Knowledge Infrastructure, China Science and Technology Journal Database (VIP) and Wanfang Chinese databases were searched, and The Cochrane Handbook 5.1.0 was used to evaluate the quality and authenticity of the literature. Relevant information of the included studies was extracted and summarized, and the evaluation indexes were analyzed using ReviewManager5.3. The retrieval time was from the establishment of the database to July 28, 2022.12 articles were assessed for eligibility, and six randomized controlled studies were eventually included in the meta-analysis (PRISMA). A total of 6 randomized controlled studies with 763 patients were finally included in the study, and the quality evaluation of literatures were all grade B. Human milk odor stimulation reduced the transition time to oral feeding in premature infants [SMD = - 0.48, 95% CI (- 0.69, - 0.27), Z = 4.54, P < 0.00001] and shortened the duration of parenteral nutrition [MD = - 1.01, 95% CI (- 1.70, - 0.32), Z = 2.88, P = 0.004]. However, it did not change the length of hospitalization for premature infants [MD = - 0.03, 95% CI (- 0.41, 0.35), Z = 0.17, P = 0.86]. The implementation of human milk odor stimulation can reduce the transition time to oral feeding and the duration of parenteral nutrition in premature infants, but further studies are needed to determine whether it can reduce the length of hospital stay in premature infants. More high-quality, large-sample studies are needed to investigate the effect of human milk odor stimulation on the feeding process and other outcomes in premature infants.
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