Kamitsuka Michael D, Nervik Patricia A, Nielsen Shana L, Clark Reese H
Division of Neonatology, Swedish Medical Center, Seattle, Washington.
Pediatrix Medical Group, Center for Research and Education, Sunrise, Florida.
Am J Perinatol. 2017 May;34(6):606-613. doi: 10.1055/s-0037-1601443. Epub 2017 Apr 4.
Reduce the number of infants requiring home tube feeds by initiating an oral feeding protocol (OFP). All infants < 30 weeks' gestation were eligible. The OFP involved four steps: encourage non-nutritive suck before 30 weeks, oral motor exercises starting as early as 30 weeks, swallowing exercises as early as 31 weeks, and an infant-driven oral feeding pathway as early as 32 weeks. The study included 129 infants before the protocol (January 2010 to December 2011) and 141 infants after the protocol (March 2013 to May 2015). Between the study periods, a multidisciplinary committee took 8 months to create the OFP, followed by a 3-month orientation of the protocol to the nursing and medical staff. The incidence of home tube feeds for 23 to 29 weeks was 26% before and 15% after the protocol ( = 0.03). Oral feeds were started sooner ( < 0.001), and full oral feedings were achieved earlier after the protocol was initiated ( < 0.001). After introducing an OFP, oral feedings were started earlier, full oral feedings were achieved sooner, and the incidence of home tube feeds at discharge was reduced.
通过启动口服喂养方案（OFP）来减少需要家庭管饲的婴儿数量。所有孕周小于30周的婴儿均符合条件。OFP包括四个步骤：在30周前鼓励非营养性吸吮，早在30周开始进行口腔运动练习，早在31周进行吞咽练习，早在32周采用婴儿主导的口服喂养途径。该研究包括方案实施前（2010年1月至2011年12月）的129名婴儿和方案实施后（2013年3月至2015年5月）的141名婴儿。在研究期间，一个多学科委员会花了8个月时间制定OFP，随后对护理和医务人员进行了为期3个月的方案培训。23至29周龄婴儿家庭管饲的发生率在方案实施前为26%，实施后为15%（P = 0.03）。口服喂养开始得更早（P < 0.001），在方案启动后更早实现完全口服喂养（P < 0.001）。引入OFP后，口服喂养开始得更早，更快实现完全口服喂养，出院时家庭管饲发生率降低。
