Weight Gain In Preterm Infants Research Articles

Motor sensory physiotherapy intervention in premature infants in neonatal intensive care unit (NICU)

Purpose: The purpose of this study is to explore the importance of implementing a customized motor sensory physiotherapy program by recording data about the total days spent and weight gain of preterm infants in Neonatal Intensive Care Unit. Methods: Randomized clinical trial of a sample of thirty (30) preterm infants split in two 15-member groups, one intervention group and one control group. An adapted program of motor sensory physiotherapy techniques, while in NICU, was implemented to the intervention group while nothing was implemented to the control group. Both groups met the same entry criteria. The same protocol of motor sensory physiotherapy was applied in the intervention group during the whole period of the study. Results: Data show that customized motor sensory physiotherapy while in NICU improves weight gain and reduces total days of stay. Discussion: Even though adapted motor sensory physiotherapy intervention has a positive impact on the development and outcome of preterm infants in NICU, more research is required on the physiotherapy techniques by studying a larger sample size in NICU.

Adverse effects of human milk fortifier on preterm neonates in a neonatal intensive care unit of a tertiary care hospital, Karachi.

Objective: To determine adverse effects of Human Milk Fortifier on Preterm neonates in a Neonatal Intensive Care Unit. Study Design: Descriptive study. Setting: Indus Hospital NICU in Karachi. Period: Mar 2022 to September 2023. Methods: Aimed to investigate the adverse effects of HMF on 139 preterm neonates. The study excluded infants with congenital anomalies. Adverse effects, including Necrotizing Enterocolitis (NEC), metabolic acidosis, feeding intolerance, and other complications, were monitored. Results: The findings revealed that feeding intolerance was the most common adverse effect of HMF. Mild metabolic acidosis and NEC were also observed. These results are consistent with previous studies and may be attributed to the high osmolality of feeds following fortification with HMF. Despite the well-established role of HMF in promoting weight gain in preterm infants, the study underscores the importance of closely monitoring its use. Conclusion: Careful consideration of the potential risks and benefits of HMF is essential before prescribing it to preterm neonates. Future research with larger sample sizes and controlled designs is needed to validate these findings and explore strategies to mitigate the adverse effects of HMF in NICU settings.

Effects of implementing non-nutritive sucking on oral feeding progression and outcomes in preterm infants: A systematic review and meta-analysis.

Preterm infants have imperfect neurological development, uncoordinated sucking-swallowing-breathing, which makes it difficult to realize effective oral feeding after birth. How to help preterm infants achieve complete oral feeding as soon as possible has become an important issue in the management of preterm infants. Non-nutritive sucking (NNS), as a useful oral stimulation, can improve the effect of oral feeding in preterm infants. This review aimed to explore the effect of NNS on oral feeding progression through a meta-analysis. We systematically searched PubMed, CINHAL, Web of Science, Embase, Cochrane databases, China's National Knowledge Infrastructure (CNKI), Wanfang and VIP database from inception to January 20, 2024. Search terms included 'non-nutritive sucking' 'oral feeding' and 'premature.' Eligibility criteria involved randomized controlled studies in English or Chinese. Studies were excluded if they were reviews, case reports, or observational studies from which valid data could not be extracted or outcome indicators were poorly defined. The meta-analysis will utilize Review Manager 5.3 software, employing either random-effects or fixed-effects models based on observed heterogeneity. We calculated the mean difference (MD) and 95% confidence interval (CI) for continuous data, and estimated pooled odds ratios (ORs) for dichotomous data. Sensitivity and publication bias analyses were conducted to ensure robust and reliable findings. We evaluated the methodological quality of randomized controlled trials (RCTs) utilizing the assessment tool provided by the Cochrane Collaboration. A total of 23 randomized controlled trials with 1461 preterm infants were included. The results of the meta-analysis showed that NNS significantly shortened time taken to achieve exclusive oral feeding (MD = -5.37,95%CI = -7.48 to-3.26, p<0.001), length of hospital stay(MD = -4.92, 95% CI = -6.76 to -3.09, p<0.001), time to start oral feeding(MD = -1.41, 95% CI = -2.36 to -0.45, p = 0.004), time to return to birth weight(MD = -1.72, 95% CI = -2.54 to -0.91, p<0.001). Compared to the NNS group, the control group had significant weight gain in preterm infants, including weight of discharge (MD = -61.10, 95% CI = -94.97 to -27.23, p = 0.0004), weight at full oral feeding (MD = -86.21, 95% CI = -134.37 to -38.05, p = 0.0005). In addition, NNS reduced the incidence of feeding intolerance (OR = 0.22, 95% CI = 0.14 to 0.35, p<0.001) in preterm infants. NNS improves oral feeding outcomes in preterm infants and reduces the time to reach full oral feeding and hospitalization length. However, this study was limited by the relatively small sample size of included studies and did not account for potential confounding factors. There was some heterogeneity and bias between studies. More studies are needed in the future to validate the effects on weight gain and growth in preterm infants. Nevertheless, our meta-analysis provides valuable insights, updating existing evidence on NNS for improving oral feeding in preterm infants and promoting evidence-based feeding practices in this population.

Nest positioning on motor development, sleep patterns, weight gain in preterm infants: systematic review.

The aimwas to evaluate the effects of Nest Positioning (NP) on motor development, sleep patterns, and weight gain in preterm newborns (PTNB) hospitalized in a neonatal intensive care unit (NICU). This study was constructed based on PRISMA guideline criteria. Systematic research was carried out in electronic databases: MEDLINE via PubMed, Web of Science, Scopus, and VHL-BIREME following the PICOS strategy. Studies with PTNB populations who were hospitalized in the NICU and received therapeutic NP as an intervention strategy in this population were included in this study. We sought outcomes related to sleep patterns, weight gain, and motor development. After selection, 12 studies were included in this systematic review, of which 5 (41.7%) evaluated motor development as their primary outcome, 6 (50%) sleep-wake cycle patterns, and 1 (8.3%), weight gain and, subsequently, hospital discharge. Qualitative results indicate that prolonged exposure to decubitus variations may favor PTNB hospitalized in NICUs acquiring flexor postures, stimulate their midline, and increase their total sleep time. Studies reported no adverse effects regarding the use of NP. Evidence suggests that NP benefits motor development and sleep pattern in PTNB hospitalized in NICUs. IMPACT: Nest positioning improves sleep quality in preterm newborns hospitalized in neonatal intensive care unit. Nest positioning improves motor development in preterm newborns hospitalized in neonatal intensive care unit. No evidence of nest positioning on weight gain was observed. Half of the included clinical studies showed good methodological quality. Nesting positioning is a secure and cost-effective method.

A Single-Subject Study to Consider the Premature Infant Oral Motor Intervention Combined with Kinesio-Tape in Premature Infants with Feeding Problems.

The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs. In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3). The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session. The combination therapy of PIOMI-KT improved feeding function in PIs.

Effects of white noise on preterm infants in the neonatal intensive care unit: A meta-analysis of randomised controlled trials.

To critically assess the effects of white noise on the pain level, weight gain and vital signs (heart rate, respiratory rate and oxygen saturation) of preterm infants in neonatal intensive care units (NICUs). A systematic review and meta-analysis of randomised controlled trials (RCTs). Ten databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP and Wanfang Data) were systematically reviewed from inception to July 2022. Two reviewers evaluated the risk of bias separately using the Cochrane Collaboration criteria and extracted data using a predesigned information form. The meta-analysis included eight eligible RCTs. According to statistical analysis, white noise significantly affected the pain level, weight gain, heart rate, respiratory rate and oxygen saturation in preterm infants. Regardless of the outcome measurement timing, gestational age and birth weight of preterm infants, subgroup analysis demonstrated that white noise reduced the pain level, heart rate and respiratory rate and promoted weight gain in preterm infants in NICUs. White noise is a practical and potentially useful therapy for premature neonates in NICUs. No Patient or Public Contribution.

Music therapy and weight gain in preterm infants: Secondary analysis of the randomized controlled LongSTEP trial.

This study assessed the association between MT and weight gain among preterm infants hospitalized in Neonatal Intensive Care Units. Data collected during the international, randomized, Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and their Caregivers (LongSTEP) study were compared between the MT group and the standard care (SC) group. Weights were recorded at birth, enrollment, and discharge. Weight percentiles, Z-scores, weight gain velocity, and extrauterine growth restriction (EUGR) were calculated. Among 201 preterm infants included, no significant differences in weight parameters (weight, weight percentiles, weight Z-scores; all p ≥ 0.23) were found between the MT group (n = 104) and the SC (n = 97) group at birth, enrollment, or discharge. No statistical differences in EUGR represented by change in Z-scores from birth to discharge were recorded between MT and SC (0.8 vs. 0.7). Among perinatal parameters, younger gestational age (p = 0.005) and male sex (p = 0.012) were associated with increased risk of EUGR at discharge. Antenatal steroid treatment, systemic infection, bronchopulmonary dysplasia, neurological morbidities, retinopathy of prematurity, necrotizing enterocolitis, parental factors (amount of skin-to-skin care, bonding, anxiety, and depression questionnaire scores), and type of enteral nutritiondid not significantly influence weight gain parameters (all p > 0.05). In the LongSTEP study, MT for preterm infants and families was not associated with better weight parameters compared to the SC group. The degree of prematurity remains the main risk factor for unfavorable weight parameters.

Fat Supplementation of Human Milk with MCT Oil for Promoting Weight Gain in Preterm Infants

Background: The addition of medium chain triglycerides is preferable as they are more easily digested and quickly absorb in bloodstream than long chain fat and provide ready supply of energy by increasing fatty acid bioavailability. Modular products like micro lipids and medium-chain triglyceride (MCT) oils are now focused as a fat supplementation. The rate of weight gain with MCT is not well known, and there is very less research done in Pakistan. Objective: To determine the effect of MCT oil supplemented human milk compared with un supplemented human milk fed to preterm infants on promoting weight gain. Study Design: Randomized controlled trial Study Setting: This study was conducted in Department of Neonatology, Children Hospital, PIMS, Islamabad, Pakistan from 20th August 2022 to 20th February 2023. Methodology: The study conducted after approval from institutional ethical committee. A total of 160 preterm infants fulfilling the inclusion criteria and enrolled in the study after informed consent from parents. The patients were receiving enteral feeding of human milk within neonatology department of hospital was included and they were randomly assigned to Group NF (receiving 20 ml of human milk without MCT oil), Group F (receiving 20ml of human milk with 1 ml of MCT oil fat). Primary outcomes were including growth in term of weight gain at measured at 1st ,5th and 10th day of MCT oil intake after hospital admission. Secondary outcome included feeding intolerance, diarrhoea, sepsis and necrotising enterocolitis. All the data was collected in the form of a questionnaire. The statistical analysis was done by using SPSS version 20. Results: One sixty very low birth weight infants were analyzed in this study. All infants were randomly divided into two groups: F and NF, the demographic details. The weight of infants was measured on first day, fifth day and tenth day and noted that the frequency of infants improved the weight gain after taking human milk without fat supplementation or human milk with fat supplementation. We found the gradually infants more increasing their weights in Group F as compared to Group NF. On tenth day 75% infants reaches between1400-1490 gm weight (p&lt;0.001). The average daily gain in weight of Group F infants (g/kg). 12.2 Group A, 13.6 in group B were calculated on day first. The average daily weight was shifted in Group B from 13.6 to 14.9 on day fifth then it was further increased as 15.6 in Group C, and 15.8 in Group D. Practical Implication: The fat in the milk of humans is a significant source of energy. In an underdeveloped State like Pakistan that is short on resources, (MCT) oil can be a useful substitute for MCT due to its high MCT content. Few research studies have been conducted into this area thus far. Previous studies have had a low number of participants and produced contradictory findings. Therefore, this study was carried out to compare the efficacy of feeding preterm infants human milk supplemented with MCT oil to that of feeding them human milk without the supplement. Conclusion: Our study shows the average weight gain in those infants fed fat supplementation of MCT oil added in breast milk. The study provides data regarding the selection and use of fat supplemented human milk over non-supplemented human milk and this reduces the morbidity and mortality rate due to insufficiency of nutrients. Keyword: Fat supplementation, MCT oil, breast milk, preterm infants, weight gain rate.

The Effects of Cup Feeding and Finger Feeding Techniques on Weight Gain in Preterm Infants Admitted to the Neonatal Intensive Care Unit

Background: Weight is one of the main indicators of physical growth and brain development in infants, especially preterm infants. Feeding preterm infants is an ongoing challenge for those in charge of feeding infants, especially those with very low birth weights. Feeding difficulties in premature infants lead to long hospital stays and increased costs. Objectives: This study aimed to compare the effects of cup feeding and finger feeding techniques on weight gain in premature infants. Methods: This randomized clinical trial study was conducted on 90 premature infants with an average weight of 1784.3 ± 497 g admitted to the neonatal intensive care unit (NICU) of Ali Bin Abi Talib (AS) Hospital located in Zahedan, the southeast of Iran, in 2021. The infants were randomly divided into 3 groups: Cup feeding, finger feeding, and control groups (each with 30 infants). The intervention was performed for 3 consecutive days without interruption, even on holidays for each infant. The amount and frequency of feeding each infant depended on the birth weight and the diagnosis of a specialist. The infant’s weight was recorded before and after the intervention. Data analysis was performed using SPSS version 22 using analysis of variance (ANOVA), paired-samples t-test, and chi-square test. Results: The average weight of infants significantly increased in the cup feeding (P &lt; 0.01) and finger feeding (P &lt; 0.01) groups compared with the control group. The highest weight gain was recorded in the finger feeding group (109.55 g), followed by the cup feeding group (65.8 g) and the control group (31.1 g; P = 0.001). The ANOVA results suggested that the finger feeding technique was most effective in gaining weight and achieving independent oral feeding in premature infants.

RELATION OF RETINOPATHY OF PREMATURITY WITH CHANGE IN BIRTH WEIGHT DURING THE POSTNATAL PERIOD IN PREMATURE INFANTS IN A TERTIARY CARE HOSPITAL IN LAHORE

This study assessed the relationship between Retinopathy of Prematurity (ROP) and post-natal weight gain in premature infants admitted to the Neonatal Intensive Care Unit (NICU). The observational study was conducted in the Department of Ophthalmology in collaboration with the Department of Pediatrics, the neonatal intensive care unit (NICU) at Sir Ganga Ram hospital in Lahore from September 2020 to August 2022. Data including gender, Birth Weight (BW), Gestational Age (GA), and post-natal complications(hypotension, packed red cell transfusion, intraventricular hemorrhage, necrotizing enterocolitis, and respiratory distress syndrome) of all the premature infants with gestational age less than 35 weeks, admitted in NICU was collected. All these premature infants underwent eye examination for the presence or absence of ROP, and weight was measured. In the second, fourth, and sixth weeks, their relative weight gain(RWG) was calculated. Infants with ROP had lower BW (P &lt;0.001) and GA (P&lt;0.001). More infants with severe ROP had body weight &lt;1000g and post-natal complications than those without ROP. Moreover, RWG at the 2nd and 4th weeks was lower in infants with ROP than with no ROP infants. Based on the result, it can be concluded that the ROP was associated with low postnatal weight gain, birth weight, and gestational age.

SCOPING REVIEW: APPLICATION OF TACTILE/KINESTHETIC STIMULATION IN PRETERM INFANTS

&lt;div class="WordSection1"&gt;&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Premature birth is the birth of a baby born less than 37 weeks gestational age with low birth weight are still a major concern in developing countries Low Birth Weight (LBW). That is puts babies at risk not only for neonatal complications, but also for other high-risk factors such as developmental disorders that can be indicated by the baby's physiological and behavioral responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective:&lt;/strong&gt; To assess the effect of tactile/kinesthetic stimulation on weight gain in preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: literature search was conducted from the Google Scholar database. Clinical trials studying tactile stimulation or massage therapy in Indonesia whether or not it is related to kinesthetic stimulation of premature infants; who assessed weight gain after the intervention; which has a control group and is compiled in Indonesian. Search results using these keywords yielded 31 articles. Then filtered articles with inclusion and exclusion criteria obtained 24 articles. Selection of the next article by eliminating duplication of articles with the results of 17 articles. Furthermore, the elimination of articles based on a complete arrangement of as many as 4 articles. Of these, meet the inclusion criteria.&lt;/p&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;Result:&lt;/strong&gt; There are many differences in the application of tactile/kinesthetic stimulation techniques to research. Also, many studies do not describe the side effects that occur during stimulation, the actions taken when the event occurs, and their effect on outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; These studies make a relevant contribution to the indications for tactile/kinesthetic stimulation. However, there is no standard for such applications. Future studies should describe the side effects of tactile/kinesthetic stimulation interventions.&lt;/p&gt;

Assessment of Mothers' Knowledge and Practice about Kangaroo Mother Care on Weight Gain of Premature Infants in Neonatal Intensive Care Units

Assessment of Mothers' Knowledge and Practice about Kangaroo Mother Care on Weight Gain of Premature Infants in Neonatal Intensive Care Units

Effect of a light-darkness cycle on the body weight gain of preterm infants admitted to the neonatal intensive care unit

The Continuous bright light conditions to which premature infants are subjected while hospitalized in Neonatal Intensive Care Units (NICU) can have deleterious effects in terms of growth and development. This study evaluates the benefits of a light/darkness cycle (LDC) in weight and early hospital discharge from the NICU. Subjects were recruited from three participating institutions in Mexico. Eligible patients (n = 294) were premature infants who were hospitalized in the low-risk and high-risk neonatal units classified as stable. The subjects randomized to the experimental group (n = 150) were allocated to LDC conditions are as follows: light from 07:00 to 19:00 and darkness (25 lx) from 19:00 to 07:00. The control group (n = 144) was kept under normal room light conditions (CBL) 24 h a day. Main outcome was weight gain and the effect of reducing the intensity of nocturnal light in development of premature infants. Infants to the LDC gained weight earlier, compared with those randomized to CBL, and had a significant reduction in length of hospital stay. These results highlight those premature infants subjected to a LDC exhibit improvements in physiological development, favoring earlier weight gain and consequently a decrease in hospital stays. ClinicalTrials.gov; 02/09/2020 ID: NCT05230706.

Effect of kangaroo care educational program for mother on weight gain of premature infants in neonatal intensive care units

Background: Kangaroo care is one of the nursing practices with medical provision that can meet the important physical and emotional needs of the preterm such as warmth, stimulation, parental attachment, breast-feeding and safety. This study aimed to: assess the mothers' knowledge and practices about kangaroo mother care on weight gain of premature neonates in neonatal intensive care units. Research design: A quasi-experimental design was utilized in the current study. Setting: This study was conducted at neonatal intensive care unit in Beni Suef University Hospital. Subjects: A purposive sample of 50 mothers accompanying their premature infants. Tools of data collection: Three tools were used: tool (1) interviewing questionnaire: (pre, post and follow-up), tool (2) checklist of reported practices: (pre, post and follow-up), tool (3) knowledge of the mother about kangaroo care technique: (pre, post and follow-up). Results: More than three quarters of the studied mothers had unsatisfied knowledge about Kangaroo Mother Care in the pre educational program implementation while nearly all of them had satisfactory level of knowledge in the post educational program implementation....

The Effect of Kangaroo Care Educational Program for Mother on Weight Gain of Premature Infants in Neonatal Intensive Care Units

Background: Kangaroo care is one of the nursing practices with medical provision that can meet the important physical and emotional needs of the preterm such as warmth, stimulation, parental attachment, breast-feeding and safety. Research design: A quasi-experimental design was utilized in the current study. Setting: This study was conducted at neonatal intensive care unit in Beni Suef University Hospital. Subjects: A purposive sample of 50 mothers accompanying their premature infants. Tools of data collection: Three tools were used: tool (1) interviewing questionnaire: (pre, post and follow-up), tool (2) checklist of reported practices: (pre, post and follow-up), tool (3) knowledge of the mother about kangaroo care technique: (pre, post and follow-up). Results: 88% of the studied mothers had unsatisfactory level of knowledge in the pre educational program implementation. While, 96% of them had satisfactory level of knowledge in the post educational program implementation. 64% of the studied mothers had incompetent practices in the pre educational program implementation, while 58% of the studied mother had competent practices in the post educational program implementation. Conclusion: The educational program had a significant positive effect on improving mothers' knowledge, practices regarding kangaroo care. Recommendation: Continuous educational programs to increase awareness of the mothers about Kangaroo Mother Care to ensure enough knowledge and practice about KMC.

The Gut Microbiome of Preterm Infants Treated With Aminophylline Is Closely Related to the Occurrence of Feeding Intolerance and the Weight Gain

BackgroundAminophylline is widely used in the treatment of preterm infants, but it can cause feeding intolerance events, in which gut microbial dysbiosis may have a role. This study aims to investigate the relationship between the gut microbiome of preterm infants treated with aminophylline and the occurrence of feeding intolerance and weight gain rate.MethodsThis study included a cohort of 118 preterm infants. Survival analysis and multivariate Cox regression were used to evaluate the relationship between aminophylline treatment and the occurrence of feeding intolerance. 16S rRNA V4 region gene sequencing was used to characterize the microbiome of fecal samples from the cohort. Linear discriminant analysis effect size was used to analyze the differential abundance of bacteria related to aminophylline treatment. Wilcoxon test, Kruskal–Wallis test, Spearman correlation coefficients and generalized linear mixed models were used to analyze the correlation between the differential bacteria and feeding intolerance events as well as the weight gain.ResultsThe results showed that the use of aminophylline could significantly increase the occurrence of feeding intolerance. The relative abundances of Streptococcus and Rothia in the gut microbiome of preterm infants were positively correlated with both the occurrence of feeding intolerance and the use of aminophylline, while the relative abundance of Staphylococcus was negatively correlated. In particular, preterm infants with a lower relative abundance of Rothia were more likely to develop feeding intolerance associated with aminophylline, and this difference existed before the onset of feeding intolerance. Moreover, it took longer for individuals with a lower relative abundance of Streptococcus to reach 2 kg weight. The contribution of Streptococcus to weight gain was greater than that of Bifidobacterium or Lactobacillus.ConclusionThe gut microbiome in preterm infants treated with aminophylline was characterized by a decrease in Streptococcus and Rothia and an increase in Staphylococcus. These microbes, especially Rothia, were positively correlated with the occurrence of feeding intolerance. Streptococcus but not Bifidobacter likely participated in the weight gain of preterm infants in early life.

Auditory Processing of the Brain Is Enhanced by Parental Singing for Preterm Infants.

As the human auditory system is highly malleable in infancy, perinatal risk factors, such as preterm birth, may affect auditory development. In comparison to healthy full-term infants, preterm infants show abnormal auditory brain responses at term age, which may have long-term detrimental outcomes. To achieve an optimal neonatal care environment for preterm-born infants, many early interventions have been developed. Musical interventions developed for neonatal intensive care units (NICUs) have shown beneficial effects on vital functions and weight gain of preterm infants and might also influence basic auditory processing and thereby enhance outcomes. In the present study, we tested the effect of parental singing during kangaroo care on auditory processing of standardized audio stimuli. Preterm infants (born between 24 and 32 weeks of gestation) were randomized to singing intervention (n = 13) or control (n = 8) groups. The auditory processing was tested using two audio paradigms assessed with magnetoencephalography (MEG) at term corresponding age. To verify that the paradigms elicit responses in MEG, we studied 12 healthy full-term infants. In the singing intervention group, parents were instructed by a music therapist twice a week for 4 weeks to sing or hum during kangaroo care in an infant-directed way. The control group received standard kangaroo care. The results show that the infants in the singing intervention group show larger neural responses than those in the control group when controlling for the total amount of singing during kangaroo care. Our findings suggest that incorporating singing into kangaroo care may be beneficial for preterm infants, but the effect may not be due to exposure to singing but instead positive parenting, improved parental self-esteem and improved caregiver sensitivity.

Effects of higher protein formula with improved fat blend on growth, feeding tolerance and nutritional biomarkers in preterm infants: A double-blind, randomized, controlled clinical trial

Preterm formulas containing greater protein:energy ratio are beneficial for non-breastfed infants, since protein is critical for promoting catch-up growth and synthesis of lean body mass. Additionally, formulas containing enriched sn-2 palmitate (sn-2) and reduced medium chain triglycerides (MCTs) may support better feeding tolerance and nutrient utilization. The objective of this randomized, controlled, double-blinded clinical trial is to evaluate growth, feeding tolerance and nutritional biomarkers of preterm infants with birth weight ≤2000g and gestational age ≤33wks from one neonatal unit in Vietnam receiving experimental formula (EF, n=80) containing higher protein level of 3.4g/100kcal and improved fat blend with enriched sn-2 and modified level of MCTs or isocaloric control formula (CF, n=80) containing protein level of 2.9g/100kcal and standard fat blend. The differences in weight gain (g/d; primary endpoint) from day 1 (D1) of full enteral feeding (FEF) until D21 between groups was evaluated for non-inferiority (margin=-2.5g/d) and superiority (margin=0g/d). Mean weight gain was 3.09g/d greater in EF than CF; the lower limit of 95% CI (0.31g/d) exceeded both non-inferiority and superiority margins. There was no significant difference in length-for-age and head circumference-for-age z-score. By D79, the mean change in weight-for-age z-scores from D1 in EF group (+0.76 SDs) surpassed the criteria for catch-up growth (+0.67 SDs). Infants in the EF group (vs. CF) tended to have softer stools (EF=3.2±0.59 vs. CF=3.4±0.58; P=0.07) based on 5-point scale (1=watery, 5=hard). Difference in blood urea nitrogen and biomarkers for bone mineral status (i.e., plasma phosphorus, alkaline phosphatase and urinary calcium/phosphorus ratio) between EF and CF on FEF Day 21 reached statistical significance (P<0.05) but all mean values stayed within normal clinical ranges for both groups. Preterm formula with greater protein:energy ratio and new fat blend is safe, nutritionally suitable, well-tolerated, and improves catch-up weight gain of preterm infants. Clinical trial registry identifier is NCT03055052 (ClinicalTrials.gov).

Effects of hydrotherapy and tactile-kinesthetic stimulation on weight gain of preterm infants admitted in the Neonatal Intensive Care Unit

ObjectiveThe present study aimed to evaluate the effects of hydrotherapy and tactile-kinesthetic stimulation on the birth weight of preterm infants admitted in the Neonatal Intensive Care Unit. MethodIt was a randomized controlled trial, without blinding, in which 44 preterm infants of both sexes with gestational age between 32 and 34 weeks were included into two groups: hydrotherapy group (n = = 22) and tactile-kinesthetic stimulation group (n = 22). Weight gain was the parameter assessed daily. ResultsIn the tactile-kinesthetic stimulation group there was a variation in weight gain, but without significant difference (p = 0,43). However, in the hydrotherapy group, it was observed that increased weight gain started from the 2nd day (p < 0,001). ConclusionsHydrotherapy group presented significantly increased weight after the interventions, indicating that this technique can interfere with weight gain in preterm infants.

Effects of family integrated care on weight gain in extremely preterm infants.

Family integrated care (FICare) is a model that integrates families as partners in the modern neonatal intensive care unit (NICU) care and which can improve the health outcomes of preterm infants. Our study aimed to explore the effect of FICare on extremely preterm infants. Overall, 182 preterm infants with complete data were collected from June 2017 to June 2018 in the Chongqing Health Center for Women and Children. Sixty-six of 182 infants were enrolled into the FICare group, and another 66 matched subjects were in the control group. SPSS v. 20.0 software (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. The correlation between each factor and weight gain was analyzed by linear regression. The rate of weight gain during hospitalization (t=4.32), oxygen exposure time (Z=1.967), hospitalization expenses (t=3.03) and the incidence of retinopathy of prematurity (ROP) (χ2=4.805) were higher in the FICare group (P<0.05). Elevated birth weight was associated with a decrease of the weight growth rate (P<0.001). The growth rate of small-for-gestational-age (SGA) infants was higher than normal gestational age infants, P=0.011. Every one year of increase in maternal age (P=0.016), each additional day for restoration days of birth weight (P=0.023), and each increment of δZ score (P<0.001) increased the weight growth rate. The irregular use of hormones reduced the weight growth rate (P=0.023). Compared with the control group, the weight growth rate of FICare group increased (P<0.001). FICare can significantly improve the weight gain in preterm infants ≤32 weeks during hospitalization.