Clinical research on feeding effect of semi-demand feeding and abdominal massage in preterm infants

Abstract

Objective To evaluate the feeding effect of semi-demand feeding and abdominal massage on the feeding process, feeding performances and clinical safety (including the time of returning to birth weight, feeding tolerance, apnea). Methods A total of 120 preterm infants that met inclusion criteria of the study were randomly assigned to three groups, and each group had 40 cases. Control group: received standard feeding care. Semi-demand feeding group: received 5-10 minutes of oral motor intervention every time before feeding(including oral stimulation and non nutritional sucking), then decided feeding methods according to its consciousness behavior state. Semi-demand feeding combined abdominal massage group: received both semi-demand feeding and abdominal massage before feeding. Observed and recorded the three groups' transition time, whether there were statistically significant differences in feeding performance and clinical safety. Results The feeding transition time was (11.55±4.69), (10.98±3.85), (8.50±3.87)d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=6.088, P=0.003). In terms of feeding performance, the feeding efficiency were (7.27±2.65), (9.74±2.63), (9.52±2.13) ml/min, the feeding proficiency were (66.31±14.51)%, (76.64±12.46)%, (82.26±10.65)%, the volume transfer were (63.99±11.02)%, (80.16±14.41)%, (84.97±11.16)% in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=12.189, 16.383, 31.959, all P < 0.01).Among the clinical safety, the time of restoration of birth weight were (10.55±1.99), (9.28±1.77), (10.05±2.46) d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences(F=3.759, P=0.026). The incidence of feeding intolerance were 50.0%(20/40), 40.0%(16/40), 22.5%(9/40), and there were significant differences(χ2=6.613, P=0.037). The incidence of apnea were 37.5%(15/40), 20.0%(8/40), 15.0%(6/40), and there were significant differences(χ2=6.093, P=0.048). Conclusions The combined intervention methods could accelerate the feeding process, improve feeding performance as well as reduce the incidence of feeding intolerance and apnea. Hence, semi-demand feeding combined abdominal massage is a recommended choice for clinical use. Key words: Semi-demand feeding; Abdominal massage; Preterm infants; Feeding effect