Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia.
Neonatal Critical Care Unit, Mater Health, South Brisbane, Queensland, Australia.
JAMA Pediatr. 2021 Nov 1;175(11):1115-1123. doi: 10.1001/jamapediatrics.2021.2336.
Smell and taste of food increase food anticipation, activate gut motility, and stimulate digestion and metabolism. Despite poor growth of many preterm infants in neonatal intensive care units, the smell and taste of milk with tube feeding are not generally considered a regular component of care.
To determine the effect of smell and taste of milk with tube feeding on weight z scores at discharge from the hospital.
DESIGN, SETTING, AND PARTICIPANTS: A randomized, controlled, nonblinded, superiority trial was conducted at 2 perinatal centers between May 9, 2017, and February 1, 2020. Eligible infants (n = 659) were born at less than 29 weeks' postmenstrual age (PMA) and/or with a birth weight of less than 1250 g.
Infants were randomly assigned to receive either the smell and taste of milk with each tube feeding or routine care without the provision of smell and taste of milk.
The primary outcome was weight z score at discharge from any hospital. Secondary outcomes included anthropometric measures at predefined time points, time to full enteral feeds, and other health outcomes associated with prematurity.
Of the 658 infants, a total of 396 infants were randomized; some parents had not been approached for consent (n = 144) or declined participation (n = 117), and 1 infant with consent was not randomized. Of the 396 infants, 196 were assigned to the treatment group (51% male; mean [SD] PMA at birth, 27.5 [2.2] weeks) and 200 were assigned to the control group (52% male; mean [SD] PMA at birth, 27.6 (2.3) weeks). Mean weight z scores at discharge were -0.87 (95% CI, -1.02 to -0.72) for the treatment group and -0.97 (95% CI, -1.11 to -0.83) for the control group (P = .40). The mean difference in z scores between the treatment and control groups at 36 weeks' PMA was 0.21 (95% CI, 0.01 to 0.4; P = .04) for head circumference and 0.26 (95% CI, 0.05 to 0.51; P = .04) for length. There were no clinically notable differences between the study groups for any other anthropometric, feeding, or health outcomes.
In this randomized clinical trial, regular smell and taste of milk included with tube feeding did not improve weight at discharge in preterm infants. Secondary outcomes suggest exposure to smell and taste may improve head circumference and length at 36 weeks' PMA, but not at discharge. Regular exposure to the smell and taste of milk is a simple and inexpensive intervention with potential benefits and no apparent adverse effects.
anzctr.org.au Identifier: ACTRN12617000583347.
食物的气味和味道可以增加对食物的期待，促进肠道蠕动，并刺激消化和新陈代谢。尽管许多早产儿在新生儿重症监护病房中生长不良，但管饲牛奶的气味和味道通常不被认为是常规护理的一部分。
确定管饲牛奶的气味和味道对出院时体重 z 评分的影响。
设计、地点和参与者：这是一项在 2017 年 5 月 9 日至 2020 年 2 月 1 日在 2 个围产期中心进行的随机、对照、非盲、优效性试验。符合条件的婴儿（n = 659）出生时胎龄小于 29 周（PMA）和/或出生体重小于 1250 克。
婴儿被随机分配接受管饲牛奶的气味和味道或常规护理，不提供管饲牛奶的气味和味道。
主要结局是出院时的体重 z 评分。次要结局包括在预定义时间点的人体测量学指标、完全肠内喂养的时间以及与早产相关的其他健康结局。
在 658 名婴儿中，共有 396 名婴儿被随机分配；一些父母未被征求同意（n = 144）或拒绝参与（n = 117），1 名同意的婴儿未被随机分配。在 396 名婴儿中，196 名被分配到治疗组（51%为男性；出生时平均[SD] PMA，27.5[2.2]周），200 名被分配到对照组（52%为男性；出生时平均[SD] PMA，27.6[2.3]周）。治疗组出院时的平均体重 z 评分为-0.87（95% CI，-1.02 至-0.72），对照组为-0.97（95% CI，-1.11 至-0.83）（P = .40）。36 周 PMA 时治疗组和对照组 z 评分之间的平均差异为 0.21（95% CI，0.01 至 0.4；P = .04）为头围，0.26（95% CI，0.05 至 0.51；P = .04）为长度。两组在任何其他人体测量、喂养或健康结局方面均无临床显著差异。
在这项随机临床试验中，管饲牛奶中常规提供气味和味道并不能改善早产儿出院时的体重。次要结局表明，接触气味和味道可能会改善 36 周 PMA 的头围和长度，但不会改善出院时的头围和长度。常规接触牛奶的气味和味道是一种简单且廉价的干预措施，具有潜在的益处，且无明显的不良影响。
anzctr.org.au 标识符：ACTRN12617000583347。
