Abteilung Neuropädiatrie, Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Abteilung Neuropädiatrie, Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Physiol Behav. 2024 Feb 1;274:114417. doi: 10.1016/j.physbeh.2023.114417. Epub 2023 Nov 25.
Introducing early oral feeding in premature infants is important because it supports intestinal maturation and helps prevent infections. In addition, early oral feeding is likely to contribute to improved neurocognitive outcomes in preterm infants. Several holistic therapeutic strategies have been developed to improve feeding skills, food tolerance, and the ability to drink independently, including practices such as early breastfeeding, oral stimulation, and subsequent olfactory stimulation. Based on several studies using olfactory stimulation with food odors (vanilla, breast milk) to promote oral feeding in preterm infants this study was conducted to test the following hypothesis: Does olfactory stimulation with vanilla or milk odor (breast milk or formula) lead to a reduction in the time required for nasogastric tube weaning in premature infants older than 26 + 6 weeks of gestational age? In addition, does it influence secondary outcomes such as length of hospital stay, weight development, and attainment of greater amounts of independently consumed food?
Premature with complete or partial feeding by gastric tube and without ventilation were included. For this study, 207 infants over 26 + 6 gestational weeks were randomized into three different study groups. Before each feeding, an olfactory presentation was made with milk odor, a vanilla Sniffin' Stick, or a control stick. In the final analysis, 165 infants were included (87 males, 78 females). At the time of randomization, infants were on average 12 ± 9.5 days old.
While the influence of vanilla and milk odor did not provide a significant difference from the control for the primary outcome, a secondary analysis showed a significant group difference in the cumulative amount of independently drunk food consumed in the first ten days was the highest amount in the vanilla group. This time period was chosen due to the high dropout rate after the first ten days. In addition, there was a promising significance for earlier hospital discharge for prematurely below 32 weeks of gestation receiving vanilla odor stimulation in comparison to milk odor stimulation.
Although the primary outcome of this study (gastric tube removal) did not provide significant results, a significant benefit of vanilla olfactory stimulation for preterm infants was demonstrated in subgroup analysis above milk odor stimulation. Younger preterm infants seem to benefit from the stimulation.
尽早为早产儿提供口服喂养非常重要,因为这有助于促进肠道成熟并预防感染。此外,早期的口服喂养可能有助于改善早产儿的神经认知结果。已经开发了几种整体治疗策略来提高喂养技能、食物耐受性和独立饮水能力,包括早期母乳喂养、口腔刺激和随后的嗅觉刺激等措施。基于几项使用食物气味(香草、母乳)进行嗅觉刺激以促进早产儿口服喂养的研究,本研究旨在检验以下假设:使用香草或牛奶气味(母乳或配方奶)进行嗅觉刺激是否会缩短 26+6 周以上胎龄早产儿的鼻胃管拔管时间?此外,它是否会影响次要结果,如住院时间、体重增长和达到更多独立摄入的食物量?
纳入完全或部分经胃管喂养且无通气的早产儿。在这项研究中,207 名 26+6 周以上胎龄的早产儿被随机分为三个不同的研究组。在每次喂养前,使用牛奶气味、香草 Sniffin' 棒或对照棒进行嗅觉呈现。最终分析包括 165 名婴儿(男婴 87 名,女婴 78 名)。在随机分组时,婴儿的平均年龄为 12±9.5 天。
虽然香草和牛奶气味的影响与对照组相比对主要结果没有显著差异,但二次分析显示,在第一个十天内独立饮用的食物量的累积量方面,香草组的差异具有显著意义。选择这段时间是因为在十天后,高的脱落率。此外,对于妊娠 32 周以下的早产儿,接受香草气味刺激的组与接受牛奶气味刺激的组相比,提前出院的可能性更大。
尽管本研究的主要结果(胃管拔除)没有提供显著结果,但在亚组分析中,香草嗅觉刺激对早产儿的显著益处超过了牛奶气味刺激。年轻的早产儿似乎从刺激中受益。