Abstract

Background. The purpose of this study of preterm infants was to test the effect of four approaches to the time of transition from gavage to full oral feedings, time to discharge, and weight gain during the transition. Methods. A randomized experimental design was used with four intervention groups: early start (32 weeks' postmenstrual age)/slow progressing experience (gradually increasing oral feedings offered per day); early start/maximum experience (oral feedings offered at every feeding opportunity); late start (34 weeks' postmenstrual age)/slow progressing experience; and late start/maximum experience. Results. The analysis included 86 preterm infants. Once oral feedings were initiated, infants in the late start/maximum experience group achieved full oral feeding and were discharged to home significantly sooner than infants in either early start group. Although not significantly different, these infants also achieved these outcomes sooner than infants in the late start/slow progressing experience group. There were no differences in weight gain across groups. Conclusions. Results suggest starting oral feedings later in preterm infants may result in more rapid transition to full oral feedings and discharge although not at early postnatal ages. Provision of a more consistent approach to oral feeding may support infant neurodevelopment and reduce length of hospitalization.

Highlights

  • The preterm birth rate has been declined over the last several years, it continues to hover around 11% [1]

  • This paper presents the analysis of our aim to determine the effect of the four feeding approaches on clinical outcomes in preterm infants

  • Based on the study results, we would recommend that nurses and others responsible for managing the oral feeding care of preterm infants consider delaying the start of oral feeding until infants are at least 34 weeks’ postmenstrual age (PMA); there does not appear to be an advantage to starting oral feedings early

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Summary

Introduction

The preterm birth rate has been declined over the last several years, it continues to hover around 11% [1]. Delay in achieving competence at oral feeding is one of the major reasons for delays in hospital discharge for otherwise physiologically stable preterm infants [4,5,6]. Achieving oral feeding competence takes time, with the transition from gavage to all oral feedings reportedly taking from 10 to 14 days [7]. The purpose of this study of preterm infants was to test the effect of four approaches to the time of transition from gavage to full oral feedings, time to discharge, and weight gain during the transition. Once oral feedings were initiated, infants in the late start/maximum experience group achieved full oral feeding and were discharged to home significantly sooner than infants in either early start group. Provision of a more consistent approach to oral feeding may support infant neurodevelopment and reduce length of hospitalization

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