Predictors of time to full enteral feeding in low birth weight neonates admitted to neonatal intensive care unit: a prospective follow up study.
Ethiopia
Full enteral feeding
Low birth weight
Predictors
Preterm
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
20 Jan 2024
20 Jan 2024
Historique:
received:
10
04
2023
accepted:
09
01
2024
medline:
21
1
2024
pubmed:
21
1
2024
entrez:
20
1
2024
Statut:
epublish
Résumé
Survival of LBW infants has increased in recent years because of novel perinatal interventions, but the introduction and advancement of enteral feeds for low birth weight infants is challenging. In Ethiopia the proportion of low birth weight infants is thought to be 17.3%. The purpose of this study was to determine the time to full enteral feeding (FEF) and its predictors in LBW neonates admitted to neonatal intensive care unit in selected hospitals of Addis Ababa, Ethiopia. An institutional based prospective follow up study was conducted from March 15 to June 15, 2022 among 282 LBW neonates admitted to six randomly selected hospitals. Both primary and secondary data was used by interviewing mothers and prospective medical chart review of neonates. The Cox regression model was used and variables having a p-value less than 0.05 with 95% CIs in a multivariable analysis were declared as statistically significant association with time to full enteral feeding. Out of 282 neonates involved in this study, 211 (74.8%) of them reached at FEF. The overall median time to full enteral feeding was 5 days. Predictors significantly associated with time to full enteral feeding were educational level, birth weight, cesarean delivery, hospital acquired infection, being on antibiotics, age at initiation of trophic feeding, routine gastric residual evaluation and NICU location (hospital). This study demonstrated the difficulty of understanding which low birth weight neonate will attain FEF in a timely manner and factors that affect time to FEF. There is a delay in full enteral feeding achievement among low birth weight neonates and there is a great deal of heterogeneity of practice among health care providers regarding feeding of infants as it was evidenced by a variation in feeding practice among hospitals. Nutrition should be considered as part of the management in neonatal intensive care units since low birth weight neonates are developing edematous malnutrition while they are in the NICU. There should be standard feeding protocol to avoid heterogeneity of practice and additional study should be conducted for each categories of GA and BW with long follow up time.
Sections du résumé
BACKGROUND
BACKGROUND
Survival of LBW infants has increased in recent years because of novel perinatal interventions, but the introduction and advancement of enteral feeds for low birth weight infants is challenging. In Ethiopia the proportion of low birth weight infants is thought to be 17.3%. The purpose of this study was to determine the time to full enteral feeding (FEF) and its predictors in LBW neonates admitted to neonatal intensive care unit in selected hospitals of Addis Ababa, Ethiopia.
METHOD
METHODS
An institutional based prospective follow up study was conducted from March 15 to June 15, 2022 among 282 LBW neonates admitted to six randomly selected hospitals. Both primary and secondary data was used by interviewing mothers and prospective medical chart review of neonates. The Cox regression model was used and variables having a p-value less than 0.05 with 95% CIs in a multivariable analysis were declared as statistically significant association with time to full enteral feeding.
RESULT
RESULTS
Out of 282 neonates involved in this study, 211 (74.8%) of them reached at FEF. The overall median time to full enteral feeding was 5 days. Predictors significantly associated with time to full enteral feeding were educational level, birth weight, cesarean delivery, hospital acquired infection, being on antibiotics, age at initiation of trophic feeding, routine gastric residual evaluation and NICU location (hospital).
CONCLUSIONS
CONCLUSIONS
This study demonstrated the difficulty of understanding which low birth weight neonate will attain FEF in a timely manner and factors that affect time to FEF. There is a delay in full enteral feeding achievement among low birth weight neonates and there is a great deal of heterogeneity of practice among health care providers regarding feeding of infants as it was evidenced by a variation in feeding practice among hospitals. Nutrition should be considered as part of the management in neonatal intensive care units since low birth weight neonates are developing edematous malnutrition while they are in the NICU. There should be standard feeding protocol to avoid heterogeneity of practice and additional study should be conducted for each categories of GA and BW with long follow up time.
Identifiants
pubmed: 38245699
doi: 10.1186/s12887-024-04545-0
pii: 10.1186/s12887-024-04545-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
64Informations de copyright
© 2024. The Author(s).
Références
Hansen K. Breastfeeding: a smart investment in people and in economies. The Lancet. 2016;387(10017):416.
doi: 10.1016/S0140-6736(16)00012-X
OHCHR | Home [Internet]. [cited 2021 Dec 18]. Available from: https://www.ohchr.org/EN/pages/home.aspx .
Roggero P, Liotto N, Menis C, Mosca F. New insights in Preterm Nutrition. Nutrients. 2020;12(6):1857.
doi: 10.3390/nu12061857
pubmed: 32580318
pmcid: 7353182
Gidi NW, Goldenberg RL, Nigussie AK, McClure E, Mekasha A, Worku B, et al. Incidence and associated factors of extrauterine growth restriction (EUGR) in preterm infants, a cross-sectional study in selected NICUs in Ethiopia. BMJ Paediatr Open. 2020;4(1):e000765.
doi: 10.1136/bmjpo-2020-000765
pubmed: 33094173
pmcid: 7552851
Nyqvist K. Early attainment of breastfeeding competence in very preterm infants. Acta Paediatr. 2008;97(6):776–81.
doi: 10.1111/j.1651-2227.2008.00810.x
pubmed: 18460108
Corpeleijn WE, Kouwenhoven SMP, Paap MC, van Vliet I, Scheerder I, Muizer Y, et al. Intake of own Mother’s milk during the First days of Life is Associated with decreased morbidity and mortality in very low Birth Weight infants during the first 60 days of life. Neonatology. 2012;102(4):276–81.
doi: 10.1159/000341335
pubmed: 22922675
Dutta S, Singh B, Chessell L, Wilson J, Janes M, McDonald K, et al. Guidelines for feeding very low Birth Weight infants. Nutrients. 2015;7(1):423–42.
doi: 10.3390/nu7010423
pubmed: 25580815
pmcid: 4303848
Aceti A, Maggio L, Beghetti I, Gori D, Barone G, Callegari M, et al. Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, very low Birth Weight Preterm infants: systematic review and Meta-analysis. Nutrients. 2017;9(8):904.
doi: 10.3390/nu9080904
pubmed: 28829405
pmcid: 5579697
Tonkin EL, Collins CT, Miller J. Protein intake and growth in Preterm infants. Glob Pediatr Health. 2014;1:2333794X14554698.
pubmed: 27335914
pmcid: 4804669
Enweronu-Laryea CC, Aryee INA, Adei EAP. Severe Acute Malnutrition in very low Birth Weight Preterm infants. J Parenter Enter Nutr. 2012;36(3):354–7.
doi: 10.1177/0148607111421789
Gidi NW, Mekasha A, Nigussie AK, Goldenberg RL, McClure EM, Worku B, et al. Preterm Nutrition and Clinical outcomes. Glob Pediatr Health. 2020;7:2333794X2093785.
doi: 10.1177/2333794X20937851
Jackson BN, Kelly BN, McCann CM, Purdy SC. Predictors of the time to attain full oral feeding in late preterm infants. Acta Paediatr. 2016;105(1):e1–6.
doi: 10.1111/apa.13227
pubmed: 26408819
Hughes MM, Black RE, Katz J. 2500-g low Birth Weight Cutoff: history and implications for Future Research and Policy. Matern Child Health J. 2017;21(2):283–9.
doi: 10.1007/s10995-016-2131-9
pubmed: 27449779
Clinical_Reference_Manual_for_Advanced_Neonatal_ Care. FINAL -.pdf.
Walsh V, Brown JVE, Copperthwaite BR, Oddie SJ, McGuire W. Early full enteral feeding for preterm or low birth weight infants. Cochrane Neonatal Group, editor. Cochrane Database Syst Rev [Internet]. 2020 Mar 12 [cited 2021 Dec 8]; https://doi.org/10.1002/14651858.CD013542 .
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. 2018;64(1):24–30.
doi: 10.1093/tropej/fmx023
pubmed: 28431170
A_Critical_Perspective_on_Trophic_Feeding.epub.
Mekonnen AG, Yehualashet SS, Bayleyegn AD. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies. Int Breastfeed J. 2019;14:12.
doi: 10.1186/s13006-019-0206-0
pubmed: 30820239
pmcid: 6379962
Patwardhan G, Soni A, Rachwani N, Kadam S, Patole S, Pandit A. Factors Associated with Time to full feeds in Preterm very low Birth Weight infants. J Trop Pediatr. 2018;64(6):495–500.
doi: 10.1093/tropej/fmx102
pubmed: 29300996
Bonet M, Blondel B, Agostino R, Combier E, Maier RF, Cuttini M, et al. Variations in breastfeeding rates for very preterm infants between regions and neonatal units in Europe: results from the MOSAIC cohort. Arch Dis Child - Fetal Neonatal Ed. 2011;96(6):F450–2.
doi: 10.1136/adc.2009.179564
pubmed: 20538713
Çelik K, Asena M, İpek MŞ. The trends in the usage of breast milk in neonatal intensive care setting. Pediatr Int. 2020;62(9):1064–72.
doi: 10.1111/ped.14263
pubmed: 32315473
Corvaglia L, Fantini MP, Aceti A, Gibertoni D, Rucci P, Baronciani D, et al. Predictors of full enteral feeding achievement in very low Birth Weight infants. PLoS ONE. 2014;9(3):e92235.
doi: 10.1371/journal.pone.0092235
pubmed: 24647523
pmcid: 3960219
Pickler R, Best A, Crosson D. The effect of feeding experience on clinical outcomes in preterm infants. J Perinatol off J Calif Perinat Assoc. 2009;29(2):124–9.
Mandich M, Ritchie SK, Mullett M. Transition Times to oral feeding in premature infants with and without Apnea. J Obstet Gynecol Neonatal Nurs. 1996;25(9):771–6.
doi: 10.1111/j.1552-6909.1996.tb01493.x
pubmed: 8951114
Sallakh-Niknezhad A, Bashar-Hashemi F, Satarzadeh N, Ghojazadeh M, Sahnazarli G. Early versus late trophic feeding in very low Birth Weight Preterm infants. Iran J Pediatr. 2012;22(2):171–6.
pubmed: 23056882
pmcid: 3446068
Salas AA, Kabani N, Travers CP, Phillips V, Ambalavanan N, Carlo WA. Short versus extended duration of Trophic Feeding to Reduce Time to achieve full enteral feeding in extremely Preterm infants: an observational study. Neonatology. 2017;112(3):211–6.
doi: 10.1159/000472247
pubmed: 28704816
Kamhawy H, Holditch-Davis D, Al-Sharkawy S, Alrafay S, Corazzini K. Non-nutritive sucking for Preterm infants in Egypt. J Obstet Gynecol Neonatal Nurs. 2014;43(3):330–40.
doi: 10.1111/1552-6909.12310
pubmed: 24754382
El-Farrash RA, Shinkar DM, Ragab DA, Salem RM, Saad WE, Farag AS, et al. Longer duration of kangaroo care improves neurobehavioral performance and feeding in preterm infants: a randomized controlled trial. Pediatr Res. 2020;87(4):683–8.
doi: 10.1038/s41390-019-0558-6
pubmed: 31493775
Hay WW. Aggressive Nutrition of the Preterm Infant. Curr Pediatr Rep. 2013;1(4). https://doi.org/10.1007/s40124-013-0026-4 .
Determinants of time to. full enteral feeding achievement among infants with birth weight 1000-2000 g admitted to the neonatal intensive care unit of public hospitals in Hawassa city, Sidama region Ethiopian, 2019: A retrospective cohort study - PMC [Internet]. [cited 2023 Dec 10]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9333277/ .
de Waard M, Li Y, Zhu Y, Ayede AI, Berrington J, Bloomfield FH, et al. Time to full enteral feeding for very low-birth-weight infants varies markedly among hospitals Worldwide but May not be Associated with incidence of necrotizing enterocolitis: the NEOMUNE-NeoNutriNet cohort study. JPEN J Parenter Enteral Nutr. 2019;43(5):658–67.
doi: 10.1002/jpen.1466
pubmed: 30465333
Tang K, Wang H, Tan SH, Xin T, Qu X, Tang T, et al. Association between maternal education and breast feeding practices in China: a population-based cross-sectional study. BMJ Open. 2019;9(8):e028485.
doi: 10.1136/bmjopen-2018-028485
pubmed: 31467048
pmcid: 6720234
Liu et al. - Optimal timing for introducing enteral nutrition i.pdf [Internet]. [cited 2022 Jun 8]. Available from: https://apjcn.nhri.org.tw/server/APJCN/24/2/219.pdf .
Kumar J, Meena J, Mittal P, Shankar J, Kumar P, Shenoi A. Routine prefeed gastric aspiration in preterm infants: a systematic review and meta-analysis. Eur J Pediatr. 2021;180(8):2367–77.
doi: 10.1007/s00431-021-04122-y
pubmed: 34018044