Negi Deepa, Swain Dharitri, Som Tapas Kumar
College of Nursing, AIIMS Bhubaneswar, Odisha, India.
Department of Neonatology, AIIMS Bhubaneswar, Odisha, India.
Eur J Obstet Gynecol Reprod Biol X. 2022 Jul 5;15:100159. doi: 10.1016/j.eurox.2022.100159. eCollection 2022 Aug.
Low- birth- weight neonates face oral feeding difficulties due to hemodynamic instability, immaturity of central nervous systems, and incomplete development of oral functions. Use of several interventions might help in improvement of the feeding ability of neonates. The objective of the study was to evaluate the effect of the multistimulation approach in low-birth-weight babies on the oral feeding performance, oral intake volume, weight gain and transition time from tube to total oral intake.
A Randomized, parallel-group, multiple arm trial study was conducted, and a total of 44 low birth weight babies were randomized into three parallel groups with a 2:1:1 ratio. Babies who are Hemodynamically stable were included in the trial. In two Intervention groups, one received an oral stimulation program, another intervention group received tactile stimulation, and the control group received routine newborn procedures for the same duration of time. Oral feeding performance was determined by Oral Feeding Skills (OFS) on a daily basis for five days after providing ten days of intervention. Neonates were monitored until hospital discharge.
Infants in the stimulation groups had significantly better oral feeding performance than infants in the control group in terms of mean proficiency, transfer rate and overall transfer of feeding volume. There was a substantial increase in mean feeding score, daily weight, oral intake volume, and early transition time in both intervention groups compared to control. There was no significant difference in feeding behaviours between the oromotor and multistimulation groups, but the multistimulation group gained more weight compared to the oromotor group.
Infants exposed to the stimulation programme had better feeding skills and a shorter transition period from tube feeding to oral feeding; however, the babies who received multistimulation gained greater weight than babies who received only oromotor stimulation. The study recommends multi stimulation in the form of oromotor, and tactile stimulation can be used as an effective NICU procedure for maintaining an infant's ability to take feeds orally before being discharged from the hospital.
低体重新生儿由于血流动力学不稳定、中枢神经系统不成熟以及口腔功能发育不完全,面临经口喂养困难。采用多种干预措施可能有助于提高新生儿的喂养能力。本研究的目的是评估多刺激方法对低体重儿经口喂养表现、经口摄入量、体重增加以及从管饲过渡到完全经口摄入的时间的影响。
进行了一项随机、平行组、多臂试验研究,共44名低体重儿按2:1:1的比例随机分为三个平行组。血流动力学稳定的婴儿被纳入试验。在两个干预组中,一组接受口腔刺激方案,另一干预组接受触觉刺激,对照组在相同时间段内接受常规新生儿护理程序。在进行十天干预后的五天里,每天通过经口喂养技能(OFS)来确定经口喂养表现。对新生儿进行监测直至出院。
在平均熟练程度、转移率和喂养量的总体转移方面,刺激组的婴儿经口喂养表现明显优于对照组的婴儿。与对照组相比,两个干预组的平均喂养评分、每日体重、经口摄入量和早期过渡时间均有显著增加。口运动组和多刺激组之间的喂养行为没有显著差异,但多刺激组比口运动组体重增加更多。
接受刺激方案的婴儿具有更好的喂养技能,从管饲过渡到经口喂养的时间更短;然而,接受多刺激的婴儿比仅接受口运动刺激的婴儿体重增加更多。该研究建议采用口运动和触觉刺激形式的多刺激方法,可作为一种有效的新生儿重症监护病房程序,用于在婴儿出院前维持其经口进食的能力。