Cue-based feeding and short-term health outcomes of premature infants in newborn intensive care units: a non-randomized trial

Abstract

Background Feedings based on behavioral cues is a method relying on infants’ behavioral expressions of readiness to feed. The objective of this interventional study was to determine the effect of cue-based feeding on the short-term health outcomes of preterm infants. Methods This quasi-experimental study utilized a historical or phase lag design. It involved 60 preterm infants admitted to an Iranian referral hospital’s Level III-Newborn Intensive Care Unit (NICU) from April 2017 until January 2018. The experimental group (n = 30) received a three-step intervention of offering behavioral-cue-based oral (BCBO) feedings: Step 1 – One BCBO feeding every 12 hours for 3 days; Step 2 - Two BCBO feedings every 12 h for 3 days; and Step 3 – All feedings as BCBO feedings for 3 days. The control group received standard care feedings. Group difference data were analyzed with SPSS version 16 using descriptive and inferential statistics. Results The infants’ mean weight at time of discharge for the intervention and control groups were 1492.79 ± 21.65 g and 1395.71 ± 17.61 g (P = .003) respectively. The mean durations of achieving full oral feedings in the intervention and control groups were 17 ± 6 and 20 ± 11 days, respectively (P = .19). The mean frequencies of hypoxia were 1 ± 1.54 and 5 ± 9.31 respectively (P = .03) and of gavage feedings 725 ± 584 and 1846 ± 2097 respectively (P = .009). No apnea events were reported for the intervention group; the frequency of apnea in the control group was 1 ± 2.11 (P = .16). Conclusion The findings indicate that cue-based feeding is beneficial for preterm infants. Therefore, it is recommended that nurses employ cue-based feeding in the NICU. Trial registration IRCTID: IRCT20170828035962N2. Registered 27 may 2018 – Retrospectively registered, https://en.irct.ir/trial/27024.

Effectiveness of Cue-Based Feeding to Improve Time to Nipple Feed and Time to Discharge in Very Low Birth Weight Infants

“…[16,20] Cue-based feeding has shown to have positive effects on short-term health outcomes in infants, demonstrating greater weight gain, fewer oxygen desaturations, and decreased frequency of gavage feeding events. [21] Several quality improvement (QI) initiatives have been implemented in NICUs with emphasis on cue-based feeding, and a systematic review of the QI initiatives concluded that weight gain, time to full oral feedings, and hospital length of stay may be improved. [22] This approach also allows for early identi cation of infants at risk for a delay in the achievement of feeding independence in order to implement tailored and developmentally appropriate interventions to succeed in the PO feeding.…”

Métodos não farmacológicos no alívio da dor em neonatos prematuros

“…Um estudo 23 objetivou investigar o efeito da contenção facilitada sobre a dor neonatal durante a amostragem de sangue na punção do calcanhar. Este é um ensaio clínico cruzado que foi realizado em 40 recémnascidos prematuros.…”

“…Estudos 24,25 associaram a contenção facilitada determinando o seu efeito na redução da dor dos prematuros nos procedimentos invasivos. Pesquisas 23,25 identificaram que há necessidade de investigação e aprofundamento em relação a contenção facilitada.…”

“…Dos sete estudos 1,6,12,21,23,25,27 envolvendo esta categoria: dois usaram a glicose, um na comparação com o ruído branco e outro na escuta de canções de ninar. Um estudo avaliou o efeito da voz materna gravada, o odor do leite materno e a cobertura da incubadora.…”

“…Um estudo 21 comparou as variáveis neonatais e terapêuticas em recém-nascidos prematuros expostos a música e 25% de glicose oral . Um estudo usou a intervenção combinada de música e toque 23 . Um estudo observou os parâmetros fisiológicos e comportamentais nos bebês prematuros, ao ouvirem a mesma música que suas mães ouviam durante a gravidez 25 .…”