Full oral feeding is possible before discharge even in extremely preterm infants

Khan, Zahra; Sitter, Cornelia; Dunitz-Scheer, Marguerite; Posch, Katrin; Avian, Alexander; Bresesti, Ilia; Urlesberger, Berndt

doi:10.1111/apa.14478

Cited by 14 publications

(7 citation statements)

References 29 publications

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“…It is acknowledged that extremely preterm infants have immature motor skills and lack coordinated sucking ability. This result is in accordance with the results of Khan et al ( 12 ) and Jackson et al ( 15 ). Birth weight was associated with the postmenstrual age at the time of achievement of full enteral feeding, and Jackson's report was related to the full oral intake with the weight at birth.…”

Section: Discussionsupporting

confidence: 94%

“…In our results, full oral intake occurred at a median PMA of 36.6 (33.7–43.1) weeks. These results are similar to those reported by Khan et al ( 12 ) in which they found full oral feeding skills were reached at 37.1 (35.6–38.4) weeks in extremely preterm infants and at 34.7 (34.3–35.6) weeks in very preterm infants ( p < 0.001) Kangaroo mother care was promoted in our study, ( 13 ) but other interventions that could further improve oral capabilities were not applied, such as prefeeding oral stimulation and the use of a checklist, as described by da Rosa Pereira et al ( 14 ).…”

Section: Discussionsupporting

confidence: 93%

“…Birth weight was associated with the postmenstrual age at the time of achievement of full enteral feeding, and Jackson's report was related to the full oral intake with the weight at birth. Thus, we can confirm that premature infants born with a lower gestational age and lower birth weight take longer to reach full oral feeding ( 12 , 15 ).…”

Section: Discussionmentioning

confidence: 57%

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Influence of Full Oral Feeding Acquisition on Growth of Premature Infants

et al. 2022

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ObjectiveThe main objective was to describe the impact of full oral feeding achievement in very low birth weight infants on weight, length, and head circumference, measured as the change in z-score from 32 weeks to discharge, the time at which full oral feeding occurs.MethodsThis was a longitudinal retrospective observational study on infants younger than 30 weeks of gestational age, admitted to the Neonatology Unit of La Paz University Hospital, Madrid (Spain), from January 1, 2019 to December 31, 2019. The infant's anthropometric characteristics (weight, height, and head circumference) were compared at birth, at 32, 34, and 36 weeks of gestational age, at the time of full oral feeding, and at discharge from the unit.ResultsA total of 66 infants were included, gestational age at birth range from 24 to 30. Full oral intake occurred at 37.1 ± 2.1 weeks postmenstrual age (PMA). We found an inverse correlation between gestational age at birth and birth weight with PMA at which full oral feeding (FOF) is achieved. PMA at discharge was 38.6 ± 2.5 weeks. Age of full oral intake and discharge occurred later in infants who had patent ductus arteriosus, retinopathy of prematurity, and sepsis or received a blood transfusion. A positive correlation was found between days of oxygen and both parameters. However, we found no relationship between necrotizing enterocolitis or intraventricular hemorrhage with age at full oral feeding or age at discharge.ConclusionsThe transition from gastric tube to oral intake did not affect growth. We found a close relationship between preterm infants birth, earlier younger than 30 weeks of gestational age, and low birth weight, with a delay in full oral feeding achievement that correlated with age at discharge.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 57%

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Influence of Full Oral Feeding Acquisition on Growth of Premature Infants

et al. 2022

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“…An explanation for the lack of significant differences in terms of main clinical outcomes might partly be found in such use of donated human milk. First, no significant differences were found in the time to achieve FEF and in the parenteral nutrition duration, similar to findings of other authors [ 19 ]. Then, it is widely known that human milk contains bioactive components and microorganisms that shape the development of the intestinal microbiota contributing to improved clinical outcomes [ 1 , 20 ].…”

Section: Discussionsupporting

confidence: 90%

Breastfeeding and human milk bank in a neonatal intensive care unit: impact of the COVID-19 pandemic in an Italian cohort of very low birth weight infants

et al. 2022

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Background Parental stress in neonatal intensive care units (NICU) is well known, as is the stress induced by the COVID-19 pandemic. This combination might increase stress to the extent of affecting the availability of maternal expressed milk and the success of establishing breastfeeding. This is particularly relevant in very preterm infants. Methods We conducted a single-centre retrospective analysis in two cohorts of very low birth weight infants born in a hospital in Italy. Babies born before the pandemic (September 2017 – December 2019) (n = 101) and during the pandemic (March 2020 – December 2021) (n = 67) were included in the analysis. We compared the rate of babies fed with maternal milk (both expressed and / or donated) at the achievement of full enteral feeding and the rate of those exclusively breastfed at discharge in the two groups. Then, we analysed the impact of donated human milk availability on infant formula use. We also compared mother’s need for psychological support during NICU stay and the duration of psychological follow-up after discharge. Results In our NICU the availability of expressed maternal milk significantly decreased during the COVID-19 pandemic (86.1% before the pandemic vs 44.8% during the pandemic, p < 0.001) at the time of full enteral feeding achievement. Thanks to the availability of donated human milk, the rate of formula-fed babies remained almost unchanged (13.9% vs 14.9%). At discharge, the rate of breastfeeding was similar (73.3% vs 72.7%). The maternal need for psychological support was significantly higher during the pandemic (33% vs 64%, p < 0.001), as well as the duration of follow-up > 6 months (1% vs 15%, p < 0.001). No differences in the main clinical outcomes were found. Conclusion Pandemic-induced stress had a significant impact on the availability of expressed maternal milk in NICU. However, the presence of human donated milk was fundamental in preventing increased use of infant formula during NICU stays. This underlines how strategies to implement the widespread establishment of donor milk banks on a national level are warranted. Further research is desirable to optimise the use of donated human milk banks during emergency situations.

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“…In our cohort, infants of 27–31 + 6 weeks of gestation were discharged at 34.7 (34.3–36.0) weeks ( Table 3 ). In the literature some subgroups of VLBW infants achieved full enteral feeding on average at about 35 weeks ( 6 , 18 – 20 ). On average, these infants were discharged beyond 36 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

Safety and Parental Satisfaction With Early Discharge of Preterm Infants on Nasogastric Tube Feeding and Outpatient Clinic Follow-Up

2020

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Aim: To evaluate our early discharge program of preterm infants with nasogastric tube feeding (NTF) and close outpatient clinic follow-up with regard to safety, parent satisfaction and parental stress level. Methods: 119 preterm infants were discharged on NTF from our tertiary care neonatal unit (median gestational age 31.0 weeks, median birthweight 1,650 g). Parental satisfaction was evaluated by a standardized questionnaire. For safety assessment growth until term equivalent age and re-hospitalizations within 2 months after discharge were evaluated. Results: Infants were discharged home at a median gestational age of 35.4 weeks after a median hospital stay of 22 days. Follow up was attained in 95 of 104 parent-infant dyads. The majority of parents (94%) reported that they had made the right decision in taking their infant home on NTF. At the time of discharge 86% of parents felt very well-prepared to perform NTF. 70% Of parents rated their stress level at home as low (≤2 out of 5). There were no NTF associated readmissions and no growth faltering until term equivalent age. Conclusion: Early discharge of preterm infants with NTF together with outpatient clinic follow-up is very well-accepted by parents and appears to be safe.

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Full oral feeding is possible before discharge even in extremely preterm infants

Cited by 14 publications

References 29 publications

Influence of Full Oral Feeding Acquisition on Growth of Premature Infants

Influence of Full Oral Feeding Acquisition on Growth of Premature Infants

Breastfeeding and human milk bank in a neonatal intensive care unit: impact of the COVID-19 pandemic in an Italian cohort of very low birth weight infants

Safety and Parental Satisfaction With Early Discharge of Preterm Infants on Nasogastric Tube Feeding and Outpatient Clinic Follow-Up

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