Optimal Timing to Utilize Olfactory Stimulation with Maternal Breast Milk to Improve Oral Feeding Skills in the Premature Newborn.
Optimal Timing to Utilize Olfactory Stimulation with Maternal Breast Milk to Improve Oral Feeding Skills in the Premature Newborn.
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利用母亲母乳的嗅觉刺激来提高早产新生儿的口腔喂养技能的最佳时机。
DOI：
10.1089/bfm.2018.0180
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Maron,JillL
中科院分区：
文献类型：
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作者：
Davidson,Jessica;Ruthazer,Robin;Maron,JillL
背景：嗅觉成熟是成功口服喂养的必要条件。先前的研究表明，用母乳进行嗅觉刺激可能会加快早产儿的口腔喂养技能；然而，利用这种干预和对刺激的性别特异性反应的最佳发育窗口在很大程度上是未知的。目的：探讨母乳嗅觉刺激对早产儿喂养结果的影响。材料与方法：选取妊娠28 0/7 ~ 33 6/7周出生的婴儿（36例），在口腔喂养学习过程中随机接受MOM或水（假）刺激。记录临床和喂养结果。统计分析检验了MOM刺激对喂养结果的影响，并按年龄和性别分层。结果：总体而言，假手术婴儿与MOM婴儿在全口喂养的平均经后年龄方面无显著差异（sham: 35 5/7 vs MOM 36 0/7;p= 0.37）。然而，当按胎龄（GA）分层时，接受MOM刺激的出生<31周的婴儿比对照组更早学会喂养（p= 0.06），而出生≥31周的婴儿比对照组更晚学会喂养（p= 0.20），刺激（MOM vs sham）和二分类GA （<31 vs≥31周）之间存在显著的相互作用（p= 0.02）。对嗅觉刺激的反应无性别差异。结论：<31周出生的婴儿接受MOM刺激后比对照组婴儿更快地学会了喂养，并且在31周之前和31周之后出生的婴儿中，MOM的影响有显著差异。这些数据表明，在发育过程中可能存在利用母乳加速早产儿口服喂养成熟的最佳时间。
Background:Olfactory maturation is essential for successful oral feeding. Previous studies have suggested that olfactory stimulation with maternal breast milk may expedite oral feeding skills in the premature infant; however, the optimal developmental window to utilize this intervention and sex-specific responses to stimuli are largely unknown.Objectives:To determine individual responses to olfactory stimulation with mother's own milk (MOM) on feeding outcomes in premature newborns.Materials and Methods:Infants born between 28 0/7 and 33 6/7 weeks' gestation (n= 36) were randomized to receive either MOM or water (sham) stimulus during the learning process of oral feeding. Clinical and feeding outcomes were recorded. Statistical analyses examined the effect of stimulation with MOM on feeding outcomes stratified for age and sex.Results:Overall, there was no significant difference between sham infants compared with MOM infants in mean postmenstrual age of full oral feeds (sham: 35 5/7 versus MOM 36 0/7;p= 0.37). However, when stratified by gestational age (GA), infants born <31 weeks' gestation who received MOM stimulation learned to feed sooner than controls (p= 0.06), whereas infants born ≥31 weeks' gestation learned to feed later than controls (p= 0.20) with a significant interaction (p= 0.02) between the stimulus (MOM versus sham) and dichotomized GA (<31 versus ≥31 weeks). There were no sex differences in response to olfactory stimulus.Conclusions:Infants born <31 weeks' GA who received MOM stimulation learned to feed sooner than control infants and the impact of MOM is significantly different between infants born before or after 31 weeks GA. These data suggest there may be an optimal time in development to utilize maternal breast milk to expedite oral feeding maturation in the premature newborn.