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Transition times to oral feeding in premature infants with and without apnea
M B Mandich1, S K Ritchie, M Mullett
1Division of Physical Therapy, West Virginia University, Morgantown 26506-9226, USA.
Insights
Apnea significantly impacts the time premature infants need to achieve full oral feeding. Infants without apnea reached full oral feeding faster than those experiencing apnea.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
Background:
- Premature infants often experience apnea, a breathing disorder.
- The transition to full oral feeding is a critical developmental milestone for premature infants.
- Apnea may complicate and prolong this feeding transition.
Purpose of the Study:
- To investigate the relationship between apnea and the duration of time required for premature infants to achieve full oral feeding.
- To determine if the presence of apnea is a significant predictor of delayed oral feeding in preterm neonates.
Main Methods:
- A two-way analysis of variance (ANOVA) factorial design was employed, examining apnea and aminophylline treatment.
- Infants (gestational age 28-34 weeks, <48 hours mechanical ventilation, no congenital anomalies) were categorized into four groups based on apnea presence and aminophylline use.
- Data on apnea instances and oral feeding status were collected daily from medical records.
Main Results:
- Infants without apnea demonstrated a significantly shorter transition time to full oral feeding (6.6 days) compared to those with apnea (10.3-11.3 days).
- Apnea showed a strong correlation with the transition time to full oral feeding (R = .42, p < .001).
- Apnea was the most significant factor contributing to the variance in feeding transition duration.
Conclusions:
- Apnea is a significant factor influencing the time to achieve full oral feeding in premature infants.
- The findings highlight the importance of managing apnea to optimize feeding outcomes in preterm neonates.
Objective:
To determine whether a significant relationship exists between the presence of apnea and the number of days it takes a premature infant to attain full oral feeding.
Design:
A two-way analysis of variance factorial design (apnea x aminophylline) was used with infants grouped according to presence or absence of apnea and whether they were receiving aminophylline.
Setting:
Neonatal intensive-care and step-down nurseries of a level III teaching hospital.
Patients/Participants:
Eligibility criteria for this study included gestational age of 28-34 weeks, less than 48 hours of mechanical ventilation, and absence of congenital anomalies. Infants were classified into one of four groups: Group 1 (NN) consisted of infants who had no recorded apnea and were not receiving aminophylline (n = 27); group 2 (AA) consisted of infants receiving aminophylline who continued to experience apnea during the transition time to oral feeding, (n = 20); group 3 (NA) consisted of infants receiving aminophylline who did not experience apnea during the transition time to oral feeding (n = 12); and group 4 (AN) were infants who experienced some apnea but never received aminophylline (n = 6). All 65 enrolled subjects completed the study.
Procedures:
Review of medical records and daily nursing notes to record apnea instances and oral feeding status for each 24-hour period.
Main Outcome Measures:
The number of days between the first attempted oral feeding and full oral feeding was recorded, as well as number of apnea instances occurring during the transition time.
Results:
An analysis of variance procedure showed that groups who did not experience apnea had a significantly (F[1, 61] = 10.19, p < .01) shorter transition time (NN = 6.6 days, NA = 5.4 days) than groups who did (AA = 11.3 days, AN = 10.3 days). Apnea was found to be correlated strongly with transition time (R = .42, p < .001). A multiple linear regression forward selection procedure showed apnea to make the greatest contribution to variance in transition time in days with a partial R2 of .18 (p < .001).
Conclusion:
Apnea appears to be a factor that influences the length of time it takes a premature infant to begin receiving full oral feedings.