Vanderbilt Kennedy Center, Nashville, Tennessee;
Pediatrics. 2014 Mar;133(3):462-8. doi: 10.1542/peds.2013-2547. Epub 2014 Feb 17.
We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants.
Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team.
Ninety-four infants (46 and 48 in the PAM intervention and control groups, respectively) completed the study. The intervention group had significantly increased oral feeding rate (2.0 vs. 0.9 mL/min, P < .001), oral volume intake (91.1 vs. 48.1 mL/kg/d, P = .001), oral feeds/day (6.5 vs. 4.0, P < .001), and faster time-to-full oral feedings (31 vs. 38 d, P = .04) compared with controls. Weight gain and cortisol levels during the 5-day protocol were not different between groups. Average hospital stays were 20% shorter in the PAM group, but the difference was not significant (P = .07).
A PAM using mother's voice improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth.
我们进行了一项随机试验,以检验这样一个假设,即在非营养吸吮过程中通过奶嘴激活的音乐播放器(PAM)播放母亲的声音是否会改善吸吮能力的发展,并促进早产儿更有效的口服喂养。
将胎龄在 34 0/7 至 35 6/7 周之间、包括有脑损伤的早产儿纳入研究,这些早产儿至少经口摄入一半的喂养量,且少于一半的喂养量通过口腔摄入,他们被随机分配接受 5 次每日 15 分钟的 PAM 干预(播放母亲录制的声音)或不接受 PAM 干预,同时两组均接受常规非营养性吸吮和母亲护理。分组对临床团队是盲态的。
94 名婴儿(PAM 干预组和对照组各 46 名和 48 名)完成了研究。干预组的口服喂养率(2.0 比 0.9 mL/min,P <.001)、口服摄入量(91.1 比 48.1 mL/kg/d,P =.001)、每日口服喂养次数(6.5 比 4.0,P <.001)以及达到完全口服喂养的时间(31 比 38 d,P =.04)均显著增加。在 5 天方案期间,两组的体重增加和皮质醇水平没有差异。PAM 组的平均住院时间缩短了 20%,但差异无统计学意义(P =.07)。
使用母亲声音的 PAM 可改善早产儿的口腔喂养技能,且对激素应激或生长无不良影响。