Contingent Mother's Voice Intervention Targeting Feeding in Hospitalized Infants with Critical Congenital Heart Defects.
Contingent Mother's Voice Intervention Targeting Feeding in Hospitalized Infants with Critical Congenital Heart Defects.
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DOI：
10.3390/children10101642
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发表时间：
2023-09-30
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危重先天性心脏病（CCHD）婴儿的喂养挑战和神经发育迟缓的风险很高;然而，很少有干预措施促进喂养的神经发育进展已经研究了这一人群。在对早产儿的研究中，母亲的声音已经成功地被用作非营养性吸吮（NNS）的正强化，导致体重增加改善和更快地停止管饲;然而，这种类型的干预尚未在CCHD婴儿中进行研究。本研究旨在确定使用母亲的声音作为正强化并在早产儿中验证的NNS训练方案是否可以改善接受心脏外科手术的CCHD住院婴儿的口服喂养结果。婴儿在心脏手术前后随机接受母亲的声音干预，对照组在手术后被动暴露于母亲的声音。有没有显着差异，出院体重，PO摄入量，住院时间，时间到充分喂养，或喂养状态在出院后1个月的婴儿谁收到应急母亲的声音相比，那些谁没有。根据婴儿入组前PO状态和疾病严重程度，术后PO摄入量和至完全进食的时间存在显著差异。在出院后1个月，与对照组婴儿的父母相比，干预组婴儿的父母表达了更高的积极情绪，对婴儿喂养的担忧更少。虽然目前的5个疗程的方案与改善CCHD婴儿的喂养结果无关，但它使父母能够为婴儿的护理做出贡献，并证明了使用母亲的声音作为CCHD婴儿的积极强化的可行性。需要进一步研究利用这一人群中母亲声音的干预措施的时机、强度和持续时间。ClinicalTrials.gov标识符：NCT 03035552。
Infants with critical congenital heart defects (CCHD) are at high risk for feeding challenges and neurodevelopmental delays; however, few interventions promoting the neurodevelopmental progression of feeding have been studied with this population. Contingent mother’s voice has been successfully used as positive reinforcement for non-nutritive suck (NNS) in studies with preterm infants, leading to improved weight gain and more rapid cessation of tube feedings; however, this type of intervention has not been studied in infants with CCHD. This study aimed to determine whether an NNS-training protocol using the mother’s voice as positive reinforcement and validated in preterm infants could improve oral feeding outcomes in hospitalized infants with CCHD undergoing cardiac surgical procedures. Infants were randomized to receive the contingent mother’s voice intervention before or after cardiac surgery, with a control comparison group receiving passive exposure to the mother’s voice after surgery. There were no significant differences in discharge weight, PO intake, length of stay, time to full feeds, or feeding status at 1-month post-discharge between infants who received contingent mother’s voice compared to those who did not. There were significant differences in PO intake and time to full feeds following surgery based on infants’ pre-enrollment PO status and severity of illness. At 1-month post-discharge, parents of infants in the intervention group expressed a higher rate of positive feelings and fewer concerns regarding their infant’s feeding compared to parents of infants in the control group. While the current protocol of 5 sessions was not associated with improved feeding outcomes in infants with CCHD, it empowered parents to contribute to their infant’s care and demonstrated the feasibility of using the mother’s voice as positive reinforcement for infants with CCHD. Further study of timing, intensity, and duration of interventions leveraging the mother’s voice in this population is needed. ClinicalTrials.gov Identifier: NCT03035552.
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