Background: Functional immaturity of the gastrointestinal tract in premature infants can cause several problems, leading to feeding intolerance.Objectives: This study aimed to investigate the effect of abdominal massage on the feeding tolerance of neonates with very low birth weight. Methods: This randomized single-blind clinical open-label trial was conducted on low-birth-weight neonates, who were hospitalized in the neonatal intensive care units (NICUs) of two tertiary university hospitals from March 2016 to March 2017. The neonates were randomly assigned to two groups. In the massage group, massage was applied three times a day, while in the control group, the patients received routine care. The gastric residual volume (GRV), vomiting, defecation frequency, and abdominal circumference were measured before and after massage in the massage group, as well as the control group. Results: There was no significant difference between the massage and control groups regarding gender, birth weight, age, feeding mode, and gestational age (P = 0.711, 0.076, 0.082, 0.612, and 0.629, respectively). None of these variables changed significantly in the controls (P = 0.06, 0.264, 0.421, and 0.07, respectively). Conclusions: We found that premature infants who received massage therapy experienced a significant decline in GRV, vomiting frequency, and abdominal circumference and a significant increment in the defecation frequency. Therefore, abdominal massage, which results in less abdominal distension and GRV, is recommended prior to enteral feeding for infants with very low birth weight.

Background:Mothers of neonates admitted to the intensive care unit are prone to sleep disorders due to stress and anxiety. Some herbs have anti-anxiety and sedative properties.The aim of this study was to investigate the effect of bitter orange blossom distillate on anxiety and sleep disorder in mothers with infants admitted to neonatal intensive care unit. Methods:This randomized controlled clinical trial was conducted in 2021on 60 mothers with NICU-admitted infants in one of the medical teaching centers affiliated to Babol University of Medical Sciences,Iran. Permuted block randomization was used to assign the mothers to the experimental (bitter orange blossom distillate syrup)and control groups(syrup prepared from water and sugar).Given the impossibility of blinding the participants, allocation concealment was used to prevent the researcher from predicting the future allocation of the samples to the groups. In addition, the statistical consultant received coded data pertaining to the type of intervention in each group.A demographic questionnaire,the Spielberger State and Trait Anxiety Inventory (STAI) and the General Sleep Disorder Scale were employed to collect data.We assessed the level of anxiety and sleep disorder (in both groups before the intervention and again after the last day of the intervention). Data were analyzed using SPSS V22 software. P value less than 0.05was considered significant. Reasults: The mean and standard deviation of the sleep disorder score in the intervention group from (50.26±5.81) to (44.70±6.94) and in the control group from (50.46±6.95) to(48.53±8.62)changed. The covariance test showed that bitter orange blossom distillate syrup has a significant effect on the improvement of sleep disorders (P=0.01, Effect size=0.09), but there was no significant difference in the anxiety level of mothers(P> 0.05, Effect size < 0.06). Conclusions:Due to the positive effect of bitter orange blossom distillate syrup on sleep disorders of mothers with hospitalized babies, this low-cost and low-risk intervention is recommended. Trial registration: IRCTID: IRCT20201209049666N1. Registered 15-04-2021. Retrospectively registered. https://www.cochranelibrary.com/es/central/doi/10.1002/central/CN-02280085/full https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20201209049666N1, 2021