FEEDING STRATEGIES FOR LOW BIRTH WEIGHT INFANTS

随着低出生体重(LBW)存活率的提高 婴儿有迫切的需求来提高他们的质量 延长生命，缩短住院时间。改进的战略 肠内营养支持将优化发育结局和 通过早期独立口服喂养缩短住院时间。 需要关键数据来评估最合适的 开始肠内喂养的时间(早期喂养与后期喂养)， 喂养方案的类型(间歇推注与持续输液)， 以及何时引入口服喂养。喂食的有效性 策略取决于婴儿的适当成熟 生理功能。在本申请中提出的假设 它们是：1)具体的管饲策略对 生理指标的成熟度与达到目标的时间 独立的口服喂养；以及2)存在以下关系 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)的效果 间歇给药，早发持续输液，晚发 间歇性给药和迟发型持续输液) 生理指标的成熟度：营养/代谢(生长、 矿物质平衡、骨矿化、生化和激素 反应)、胃肠道功能(吸收、动力、通透性)，以及 口腔运动动力学(进食熟练程度、应激相关效应) 以及婴儿获得独立口腔能力的时间 饲喂；2)检验不同年龄段的 独立的口服喂养和上述生理指标。八十 LBW婴儿，怀孕26至29周，按胎龄分层， 将被分配到四个治疗中的一个，以平衡的双向 这两个因素是开始喂食的时间的设计 (早发与晚发)和喂养方法(间歇性 团注VS持续输液)。这一展望的结果是， 婴儿喂养意愿的严格控制的跨学科研究 也为LBW婴儿的照顾者提供实用信息 作为对喂食策略影响的机制的洞察 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.