Factors associated with the transition time to exclusive oral feeding in newborns under 32 weeks of gestational age
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Abstract
Background: The physiological and neurological immaturity of premature newborns makes their feeding challenging. Thus, nutritional needs are supplemented by nasogastric tube, until
they acquire aptitude for exclusive oral feeding. Objective: To verify the factors associated with the transition time from tube feeding to full oral feeding in newborns <32 weeks of gestational age. Methods: This is a cross-sectional, retrospective, study which analyzed 184 electronic medical records of newborns under 32 weeks of gestational age who were born between 2016 and 2021 in a reference maternity in the city of Florianópolis SC, Brazil. Associations between neonatal characteristics and interventions during hospitalization with the time of nutritional transition were evaluated, using the prevalence ratios and their respective confidence intervals, using the chi-square and Spearman tests. A significance level of p ≤ 0.05 was adopted in all analyses. Results: Average gestational age was 30 weeks
and 1 day. The average transition time was 30 days. There was a statistical association between medical interventions and feeding transition. The length of stay and age for tube removal were positively correlated, greater variables, longer was the time taken for transition. The longest average nutritional transition time was 37.7 days observed in year 2018. Conclusion: It was possible to identify that the longest time spent on feeding transition was associated, in addition to physiological limitations, with the interventions performed during hospitalization. Further studies should be carried out focusing on reduction of nutritional
transition time and hospitalization in the NICU.
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References
1. Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018;52:3-12.
2. UN IGME. Levels & trends in child mortality: report 2018. Estimates developed by the United Nations interagency group for child mortality estimation (UN IGME). New York: United Nations Children’s Fund; 2018.
3. Balbi B, Carvalhaes MABL, Parada CMGL. Tendência temporal do nascimento pré-termo e de seus determinantes em uma década. Cien Saude Colet. 2016;21(1):233-41.
4. World Health Organization (WHO). The optimal duration of exclusive breastfeeding: report of the expert consultation – Report of an Expert Consultation – Geneva, Suíça. 2001.
5. Programa Nacional das Nações Unidas para o Desenvolvimento (PNUD). Objetivos do Desenvolvimento Sustentável. Atlas Brasil [serial on the Internet]. 2016 [cited 2020 Aug 26]. Available from: http://www.br.undp.org/content/brazil/pt/home/sustainable development-goals.html
6. Tenório MC, Dutra TA, Lima AA. Prevalência e Fatores Associados ao Início Tardio do Aleitamento Materno em Recém-Nascidos Prematuros Nascidos em Maternidade de Referência de Alto Risco. Gep News, Maceió. 2018; 2(2):63-69.
7. Blesa M, Sullivan G, Anblagan D, Telford EJ, Quigley AJ, Sparrow SA, et al. Early breast milk exposure modifies brain connectivity in preterm infants. Neuroimage. 2019;184:431-39.
8. Andrews ET, Ashton JJ, Pearson F, Beattie RM, Johnson MJ. Early postnatal growth failure in preterm infants is not inevitable. Arch Dis Child Fetal and Neonatal Ed. 2019;104(3):235-41.
9. Rodrigues AP, Martins EL, Trojahn TC, Padoin SMM, Paula CC, Tronco CS. Manutenção do aleitamento materno de recém nascidos pré-termo: revisão integrativa da literatura. Rev Eletr Enf. [serial on the Internet]. 2013 [cited 2020 Aug 26];15(1):253-64. Available from: https://revistas.ufg.br/fen/article/view/17067.
10. Pickler RH, Best AM, Reyna BA, Wetzel PA, Gutcher GR. Prediction of Feeding Performance in Preterm Infants. Newborn Infant Nurs Rev [serial on the Internet]. 2005 Set [cited 2020 Aug 20];5(3):116–23. Available from: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC1350962/.
11. Jarjour J, Juarez AM, Kocak DK, Liu NJ, Tabata MM, Hawthorne KM, et al. A Novel Approach to Improving Fat Delivery in Neonatal Enteral Feeding. Nutrients [serial on the Internet]. 2015 Jun [cited 2020 Aug 20];7(6):5051–64. Available from: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC4488830/.
12. Petersen SM, Greisen G, Krogfelt KA. Nasogastric feeding tubes from a neonatal department yield high concentrations of potentially pathogenic bacteria — even 1 d after insertion. Pediatric Research. 2016 Abr; 80:395–400.
13. Grose, S. Gavage Feeding: Newborn - Transitioning to Oral Feeding. Nursing Practice Council. 2011, Ago; Vol. 20. ICD 996.3511.
14. Er I, Günlemez A. Transition Time to Full Oral Feedind Skill and its Determinants in Very Preterm Infants: A Single Center Experience. J Pediatr Res [serial on the Internet]. 2021; 8(2):216 224 [cited 2021 Sep 17]. Available from: http://jpedres.org/ archives/archive-detail/article-preview/transition-time-to-full oral-feeding-skill-and-ts-/47403
15. Brun G, Fumeaux CJF, Giannoni E, Graz MB. Factors associated with postmenstrual age at full oral feeding in very preterm infants. PLoS ONE [serial on the Internet]. 2020; 15(11): e0241769 [cited 2021 Sep 17]. Available from: https://journals.plos.org/ plosone/article?id=10.1371/journal.pone.0241769
16. Meier PP, Patel AL, Bigger HR, Rossman B, Engstrom JL. Supporting breastfeeding in the neonatal intensive care unit: Rush Mother’s Milk Club as a case study of evidence based care. Pediatr Clin North Am [serial on the Internet]. 2013;60(1):209-226. [cited 2021 Nov 10]. Available from: https://www.sciencedirect.com/science/article/abs/pii/ S0031395512001721?via%3Dihub
17. Lucas RF, Smith RL. When is it safe to initiate breastfeeding for preterm infants? Adv Neonatal Care [serial on the Internet]. 2015;15(2):134 141. [cited 2021 Nov 10]. Available from: https://journals.lww.com/ advancesinneonatalcare/Abstract/2015/04000/When_Is_It_Safe_ to_Initiate_Breastfeeding_for.11.aspx
18. Maastrup R, Hansen BM, Kronborg H, et al. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates. PLoS ONE [serial on the Internet]. 2014;9(9): e108208. [cited 2021 Nov 10]. Available from: https:// journals.plos.org/plosone/article?id=10.1371/journal.pone.0108208
19. Amoris EVN, Nascimento EN. Transição alimentar em prematuros: fatores interferentes. Rev. CEFAC [serial on the Internet]. 2020; 22(5):e14719. [cited 2021 Nov 10]. Available from: https://www.scielo.br/j/rcefac/a/p36WJyTtbmppzFwpm3RYGVp/?lang=pt
20. Nangia S, Vadivel V, Thukral A, Saili A. Early Total Enteral Feeding versus Conventional Enteral Feeding in Stable Very-Low-Birth Weight Infants: A Randomised Controlled Trial. Neonatology [serial on the Internet]. 2019;115(3):256-262. [cited 2021 Nov 10]. Available from: https://www.karger.com/Article/Abstract/496015
21. Nangia S, Bishnoi A, Goel A, Mandal P, Tiwari S, Saili A. Early Total Enteral Feeding in Stable Very Low Birth Weight Infants: A Before and After Study. J Trop Pediatr [serial on the Internet]. 2018;64(1):24-30. [cited 2021 Nov 10]. Available from: https:// academic.oup.com/tropej/article/64/1/24/3739807
22. Kreissl A, Sauerzapf E, Repa A, et al. Starting enteral nutrition with preterm single donor milk instead of formula affects time to full enteral feeding in very low birthweight infants. Acta Paediatr [serial on the Internet]. 2017;106(9):1460-1467. [cited 2021 Nov 10]. Available from: https://onlinelibrary.wiley.com/doi/10.1111/apa.13914
23. Boullata JI, Carrera AL, Harvey L, Hudson L, McGinnis C, Wessel JJ et al. ASPEN Safe Practices for Enteral Nutrition Therapy. J Parenter Enter Nutr [serial on the Internet]. 2017; 41(1):15-103. [cited 2021 Nov 10]. Available from: https://aspenjournals.onlinelibrary.wiley.com/doi/ pdf/10.1177/0148607116673053
24. Giannì ML, Roggero P, Piemontese P, Liotto N, Orsi A, Amato O, Taroni F, Morlacchi L, Consonni D, Mosca F. Is nutritional support needed in late preterm infants? BMC Pediatr [serial on the Internet]. 2015; 15:194. [cited 2021 Nov 10]. Available from: https://bmcpediatr. biomedcentral.com/articles/10.1186/s12887-015-0511-8
25. Yi YG, Oh BM, Shin SH, Shin JY, Kim EK, Shin HI. Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants. Front Pediatr [serial on the Internet]. 2018;6:54. [cited 2021 Nov 10]. Available from: https:// www.frontiersin.org/articles/10.3389/fped.2018.00054/full
26. Medeiros et al. Tempo de transição alimentar na técnica sonda-peito em recém-nascidos baixo peso do Método Canguru. CoDAS [serial on the Internet]. 2018; 30(2):e20170092. [cited 2021 Nov 10]. Available from: https://www.scielo.br/j/codas/a/yF89wtsXtWBJnzjcxQYFsyg/ abstract/?lang=pt