A clinical study of 24-hour pumping of continuous feeding in very low birth weight infants / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the effect of 24-hour continuous feeding by pump on gastrointestinal dysfunction and early growth of very low birth weight infants (VLBWI).Methods:Eighty VLBWI fed by tube in the Neonatal Intensive Care Unit (NICU) of Fuyang Women and Children′s Hospital, Anhui Province from January 2017 to June 2019, were retrospectively analyzed.They were randomly divided into the observation group and the control group according to the simple randomization method, 40 cases in each group.The observation group included 23 males and 17 females, with the gestational age of 28 + 2-33 + 5 weeks, and birth weight of 1.04-1.47 kg.The control group included 21 males and 19 females, with the gestational age of 28 + 1-33 + 5 weeks, and birth weight of 1.05 -1.47 kg.On the basis of giving both groups routine treatment, nursing, and non-nutritional sucking, the control group was treated with intermittent tube feeding and infusion of formula milk, while the observation group was microfed 24 h continuously by pump.The general situation, meconium discharge time, frequency of daily defecation, daily milk volume, gastrointestinal dysfunction, increase of body weight after birth, and neonatal behavioral neurological assessment (NBNA) at 40 weeks of gestational age were compared between the two groups.The increase of body mass after birth and the determination of neonatal behavioral neurological assessment (NBNA) in neonatal behavioral nerve at 40 weeks of gestational age were statistically analyzed by χ2 test and t test. Results:(1)There were no significant differences in sex, gestational age, birth weight, head circumference and body length between the 2 groups (all P>0.05). (2) Compared with the control group, the premature infants in the observation group had increased daily milk volume [(12.95±2.34) g/d vs.(10.08±2.08) g/d], shortened meconium discharge time [(3.90±0.84) d vs.(5.02±0.86) d], and higher frequency of daily defecation[(3.85±1.07) times/d vs.(3.00±0.81) times/d], shortened extubation time[(14.75±3.20) d vs.(16.80±3.08) d], shortened time of weight to loss to minimum[(3.38±0.86) d vs.(4.22±0.89) d], faster growth of the daily average body weight[(15.25±2.29) g/(kg·d) vs.(11.55±1.56) g/(kg·d)], shortened average hospitalization time [(35.58±8.29) d vs.(39.42±8.29) d], and faster increase of the head circumference[(35.23±2.40) cm vs.(33.74±1.63) cm]. The differences were statistically significant ( t=5.805, -5.907, 3.981, -2.918, -2.825, 3.890, -2.060, 3.233, all P<0.05). (3)The incidence of vomiting, abdominal distension, hypoglycemia and hyperbilirubinemia in the observation group was significantly lower than that in the control group ( χ2=5.000, 16.050, 5.165, 14.528, all P<0.05). (4) There was no significant difference in necrotizing enterocolitis (NEC) and dyspnea between the two groups ( χ2=1.438, 10.251, all P>0.05). The total scores of behavioral ability, passive muscle tension, active muscle tension, primitive reflex, general evaluation and NBNA in the observation group were higher than those in the control group, the difference was statistically significant ( t=5.026, 3.207, 3.000, 2.421, 3.150, 6.141, all P<0.05). Conclusions:Twenty-four-hour continuous feeding by pump combined with non-nutritious sucking can significantly reduce the occurrence of gastrointestinal dysfunction in VLBWI, promote the development and maturation of gastrointestinal function, improve the nutritional status, accelerate the physical growth, and thus facilitate the development of behavioral nerve.