Does the choice of bottle nipple affect the oral feeding performance of very-low-birthweight (VLBW) infants?
Does the choice of bottle nipple affect the oral feeding performance of very-low-birthweight (VLBW) infants?
复制标题
奶嘴的选择是否会影响极低出生体重（VLBW）婴儿的经口喂养表现？
DOI：
10.1111/j.1651-2227.2005.tb02087.x
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Lau,Chantal
中科院分区：
文献类型：
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作者：
Scheel,CE;Schanler,RichardJ;Lau,Chantal
背景：关于使用哪种奶瓶乳头来提高早产儿的奶瓶喂养性能一直存在争议。目的：验证使用具有增强婴儿吮吸技能的物理特性的奶瓶乳头是否可以改善喂养性能。方法：选择10名体重(941±273)g的健康极低出生体重儿。每天口服1-2次和6-8次，在两个时间段内监测喂养性能。在每个时间段和24小时内，以随机顺序提供三个不同的奶瓶乳头来监测喂养性能。乳汁转移率(ml/min)是主要的结局指标。被监测的吸奶技巧包括吸奶阶段、吸奶幅度和产生负口内吸压的持续时间。结果：在这两个时间段，婴儿在三个乳头之间表现出相似的乳汁转移率。然而，1-2个乳头的吸力阶段、吸力幅度和产生吸力的持续时间在1-2个乳头之间有显著差异，而在6-8个口服喂养/d时没有显著差异。结论：我们没有发现一个特定的奶瓶乳头可以促进健康的极低出生体重儿的奶瓶喂养。根据传入感觉反馈可能允许婴儿适应不断变化的条件的概念，我们推测婴儿可以修改他们的吸奶技能，以保持与特定时间实现的吸奶-吞咽-呼吸协调程度相适应的母乳转移率。因此，建议照顾者应更多地关注吸吮-吞咽-呼吸的协调，而不是奶瓶乳头的选择。
Background:There is a continuous debate regarding the best bottle nipple to be used to enhance the bottle‐feeding performance of a preterm infant.Aim:To verify that feeding performance can be improved by using the bottle nipple with the physical characteristics that enhance infants’ sucking skills.Methods:Ten “healthy” VLBW infants (941±273 g) were recruited. Feeding performance was monitored at two time periods, when taking 1–2 and 6–8 oral feedings/d. At each time and within 24 h, performance was monitored using three different bottle nipples offered in a randomized order. Rate of milk transfer (ml/min) was the primary outcome measure. The sucking skills monitored comprised stage of sucking, suction amplitude, and duration of the generated negative intraoral suction pressure.Results:At both times, infants demonstrated a similar rate of milk transfer among all three nipples. However, the stage of sucking, suction amplitude, and duration of the generated suction were significantly different between nipples at 1–2, but not 6–8 oral feedings/d.Conclusion:We did not identify a particular bottle nipple that enhanced bottle feeding in healthy VLBW infants. Based on the notion that afferent sensory feedback may allow infants to adapt to changing conditions, we speculate that infants can modify their sucking skills in order to maintain a rate of milk transfer that is appropriate with the level of suck‐swallow‐breathe coordination achieved at a particular time. Therefore, it is proposed that caretakers should be more concerned over monitoring the coordination of suck‐swallow‐breathe than over the selection of bottle nipples.