Early Weaning From Incubator and Early Discharge of Preterm Infants: Randomized Clinical Trial

Abstract

In this study, weaning of moderately preterm infants from incubators to open cribs at 1600 g was safe and resulted in earlier discharge.

Transferring preterm infants from incubators to open cots at 1600 g: a multicentre randomised controlled trial

“…Bakewell-Sachs and colleagues19 report the feeding milestone is one of the last milestones to be achieved by preterm infants born less than 32 weeks. Zecca and colleagues9 recently reported a significantly shortened LOS for preterm infants transferred at 1600 g, with a mean GA of 32 weeks and mean individual amount of breastfeeding at discharge of 43–46%. The infants in our study were considerably younger than those in the study of Zecca et al 9 and a greater percentage were discharged exclusively breastfeeding, which may account for our result of no difference in LOS.…”

“…We identified one randomised9 and two quasi-randomised6 7 controlled trials and five observational studies3 8 12–14 assessing transferring preterm infants to standard open cots. Sutter and colleagues7 showed that preterm infants could be safely transferred to open cots at 1700 g but only for infants with birth weights >1000 g. However, they expressed caution in interpreting the results, due to the small number of infants with birth weights <1000 g (n=12).…”

“…There was evidence from two quasi-randomised studies suggesting that transfer to an open cot may safely occur at weights ≥16006 or ≥1700 g 7. More recent studies suggest potential transfer at 1500 g8 and at 1600 g 9…”

Role of effective thermoregulation in premature neonates

“…52 These researchers recommended transferring infants once they reach a weight of 1,500 g. Zecca et al found that transferring infants at weights less than 1,600 g resulted in a significant decrease in length of stay (23.5 versus 33 days, P=0.0002) compared with transferring infants at 1,600 g or more. 53 Lastly, New et al found that infants transferred at 1,800 g had more temperatures less than 36.4°C recorded than infants transferred at 1,600 g in the first 72 hours after transfer. Infants in the 1,600 g group had a larger average daily weight gain than those in the heavier group (17.07±4.5 g/kg/day versus 13.97±4.7 g/kg/day, P,0.001).…”

“…Three studies have been reviewed which support the criterion of weaning infants from an incubator to an open crib at 1,600 g. [52][53][54] A Cochrane review also confirms that infants can be safely transferred at 1,600 g. 55 Schneiderman et al concluded that for every incremental 100 g increase of weight in infants at the time of transfer to an open crib there was an associated increase in time of 0.8 days until the infant reached full enteral feeds and an increased length of stay of 0.9 days. 52 These researchers recommended transferring infants once they reach a weight of 1,500 g. Zecca et al found that transferring infants at weights less than 1,600 g resulted in a significant decrease in length of stay (23.5 versus 33 days, P=0.0002) compared with transferring infants at 1,600 g or more.…”