Department of Pediatric Nursing, Faculty of Health Sciences, Kocaeli University, Kocaeli 41001, Turkey.
Department of Pediatric Nursing, Faculty of Health Sciences, Kahramanmaraş İstiklal University, Kahramanmaraş 46100, Turkey.
J Trop Pediatr. 2023 Feb 6;69(2). doi: 10.1093/tropej/fmad015.
Feeding intolerance (FI) is a common condition in preterm infants because they have an immature gastrointestinal tract. There are studies on the effects of the position on gastric residual volume (GRV) in preterm infants. Kangaroo mother care (KMC) may be an instrument for reducing FI by providing an upright position to infants. Moreover, numerous studies conducted with this therapeutic position applied by putting an infant on the mother's chest have indicated its positive effects on the infant's weight gain, growth and development, and vital signs. Therefore, this study aimed to reveal the impact of KMC on FI in preterm infants.
The population of the study, designed as a randomized trial, consisted of 168 preterm infants [KMC: 84, Standart Care (SC): 84] hospitalized in the neonatal intensive care unit of a university hospital between June and November 2020. Infants were randomly selected and divided into two groups. After the vital signs of the infants in both groups became stable, the infants were fed in the same position. KMC was applied to the infants in the intervention group for 1 h by preparing a suitable environment after feeding. Infants in the SC group were placed in the prone position after feeding. The GRVs of the infants in both groups were recorded on the Infant Follow-up Form before the next feeding.
No statistically significant difference was detected between the groups upon comparing them in terms of demographic and clinical characteristics. The body temperatures and O2 saturations of the participants in the KMC group were statistically significantly higher, and their respiratory and heart rates were lower than the SC group. The transition time to full enteral feeding was statistically significantly shorter, and FI was experienced significantly less in the KMC group infants than in the SC group (p < 0.05). There was no statistically significant difference between the groups in terms of the infants' weight gain and length of hospital stay (p > 0.05).
The present study demonstrated that KMC had a positive impact on FI in preterm infants. KMC is not only a safe care model providing the earliest contact between parents and infants but also a practice whose positive effect on the functioning of the digestive system in preterm infants we can use.
喂养不耐受(FI)是早产儿常见的情况,因为他们的胃肠道不成熟。有研究表明,体位对早产儿胃残留量(GRV)有影响。袋鼠式护理(KMC)可以通过为婴儿提供直立位来减少 FI。此外,许多研究表明,将婴儿放在母亲的胸前应用这种治疗性体位,对婴儿的体重增加、生长发育和生命体征有积极影响。因此,本研究旨在揭示 KMC 对早产儿 FI 的影响。
该研究采用随机试验设计,研究人群为 2020 年 6 月至 11 月期间在大学医院新生儿重症监护病房住院的 168 名早产儿[KMC:84 名,标准护理(SC):84 名]。婴儿被随机选择并分为两组。两组婴儿生命体征稳定后,以相同的体位进行喂养。干预组婴儿在喂养后准备合适的环境,进行 1 小时的 KMC。SC 组婴儿在喂养后采取俯卧位。在下次喂养前,通过婴儿随访表记录两组婴儿的 GRV。
两组在人口统计学和临床特征方面无统计学差异。KMC 组婴儿的体温和 O2 饱和度显著升高,呼吸和心率显著降低,与 SC 组相比。KMC 组婴儿完全肠内喂养的过渡时间显著缩短,FI 发生率显著低于 SC 组(p<0.05)。两组婴儿的体重增加和住院时间无统计学差异(p>0.05)。
本研究表明,KMC 对早产儿 FI 有积极影响。KMC 不仅是一种安全的护理模式,为父母和婴儿提供最早的接触,而且是一种对早产儿消化系统功能有积极影响的实践。