FEEDING STRATEGIES FOR LOW BIRTH WEIGHT INFANTS

随着低出生体重儿（LBW）存活率的提高， 婴儿迫切需要提高他们的教育质量 缩短住院时间。 改进战略， 肠内营养支持将优化发育结果， 通过早期独立口服喂养缩短住院时间。 需要关键数据来评价最适当的 开始肠内喂养的时间（早期与晚期喂养）， 喂养方案的类型（间歇推注vs连续输注）， 以及何时引入口服喂养。 喂养的有效性 策略取决于婴儿的适当成熟 生理功能。 本申请中提出的假设 1）具体的管饲策略不同地影响 生理指标的成熟和达到 独立的口服喂养; 2）之间存在的关系， 影响婴儿反应的生理指标 一种进食策略 本申请将评估以下2个具体目标：1） 确定4种管饲策略（早发性 间歇推注、早发型持续输注、晚发型 间歇推注和迟发性连续输注） 生理指标的成熟：营养/代谢（生长， 矿物质平衡，骨矿化，生化和激素 反应）、GI功能（吸收、运动、渗透性），以及 口腔运动动力学（喂养熟练度，压力相关影响）， 以及婴儿获得独立口腔的时间 （2）测试获得 独立经口喂养及上述生理指标。 八十 LBW婴儿，妊娠26 - 29周，按胎龄分层， 将被分配到四个治疗中的一个， 设计，其中两个因素是开始喂食的时间 （早发vs晚发）和喂养方法（间歇性 推注vs连续输注）。 从这个前景的结果， 婴儿喂养意愿的仔细控制的跨学科研究 为低出生体重婴儿的照顾者提供实用信息， 作为深入了解喂养策略影响 LBW婴儿的成熟。

With the improvements in the survival of low birth weight (LBW) infants there are compelling needs to enhance the quality of their life and shorten hospitalization time. Improved strategies for enteral nutritional support will optimize developmental outcome and shorten hospitalization through early independent oral feeding. Critical data are needed for the evaluation of the most appropriate time at which to begin enteral feedings (early vs late feeding), the type of feeding regimen (intermittent bolus vs continuous infusion), and when to introduce oral feeding. The effectiveness of feeding strategies depends upon the proper maturation of the infant's physiological functions. The hypotheses advanced in this application are: 1) that specific tube-feeding strategies differentially affect the maturation of physiological indices and the time of attainment of independent oral feeding; and 2) that relationships exist among physiological indices which influence the responses of the infant to a feeding strategy. This application will evaluate the following 2 specific aims: 1) To determine the effects of 4 tube-feeding strategies (early-onset intermittent bolus, early-onset continuous infusion, late-onset intermittent bolus, and late-onset continuous infusion) on the maturation of physiological indices: nutrition/metabolism (growth, mineral balance, bone mineralization, biochemical and hormonal responses), GI function (absorption, motility, permeability), and oral-motor kinetics (feeding proficiency, stress-related effects) as well as on the time at which the infant attains independent oral feeding; 2) To test the relationship between the attainment of independent oral feeding and the above physiological indices. Eighty LBW infants, 26 to 29 weeks gestation, stratified by gestational age, will be assigned to one of four treatments in a balanced two-way design where the two factors are time of initiation of feeding (early-onset vs late-onset) and the method of feeding (intermittent bolus vs continuous infusion). The results from this prospective, carefully controlled interdisciplinary study of infant feeding will provide practical information for caretakers of LBW infants as well as insight into the mechanisms by which feeding strategy affects the maturation of the LBW infant.