Feeding Readiness in Preterm Infants

描述（由申请人提供）：项目概述：每年出生的50万早产儿面临的一个主要挑战是从灌胃到口服喂养的过渡。大多数早产儿在医院时都是用奶瓶喂养配方奶或挤出的母乳。因此，早产儿的奶瓶喂养管理是医院护理的一个关键方面。由于几乎没有循证协议来指导临床医生实现经口喂养的能力，已经脆弱的婴儿受到这种复杂和关键的生命维持活动的试错方法的影响。这项研究建立在国家护理研究所（NINR）资助的研究，其中发病率，成熟度和喂养经验预测喂养结果。这项研究将前瞻性地测试四种不同的方法过渡到完全口服喂养。拟议的研究将提供有关如何帮助早产儿从灌胃过渡到完全口服喂养以及过渡如何影响长期发育的重要信息。本申请的具体目的是：1）测试经口喂养引入和进展的四种方法; 2）测试发病率、成熟度、经验和行为状态对早产儿喂养结局的影响; 3）估计喂养方法对临床结局的影响;以及4）估计喂养方法对出院后喂养过渡结局的影响。这项研究的目的是与NINR的努力，建立一个科学的基础，照顾个人的整个生命周期。具体而言，该研究将改善早产儿的临床护理，并将促进这些儿童更好的临床和健康相关结果。一个前瞻性的，随机的，实验设计将被用来测试四种不同的方法过渡到完全口服喂养。将在14天方法期间、出院时和出院后2周收集婴儿的数据。将使用混合模型方法分析数据。相关性：每年有超过50万名早产儿出生，喂养这些婴儿是他们住院期间的主要临床挑战。婴儿在住院期间的喂养方式对健康和发育有长期影响。这项研究将帮助新生儿重症监护室的护士和家庭提供喂养护理，这可能会缩短住院时间并改善发育结果。

DESCRIPTION (provided by applicant): Project Summary: A major challenge-facing the 500,000 preterm infants born each year is the transition from gavage to oral feedings. Most preterm infants are bottle fed either formula or expressed breast milk while in the hospital. Thus, management of bottle feedings in preterm infants is a key aspect of hospital care. As there are few evidence-based protocols to guide clinicians in achieving competence at oral feeding, already vulnerable infants are subject to a trial-and-error approach to this complex and critical life-sustaining activity. This study builds on a National Institute of Nursing Research (NINR) funded study in which morbidity, maturity, and feeding experience predicted feeding outcomes. This study will prospectively test four different approaches to the transition to full oral feedings. The proposed study will provide important information about ways to assist preterm infants to make the transition from gavage to full oral feeding and how the transition may affect longer term development. The specific aims of this application are to: 1)Test four approaches to oral feeding introduction and progression; 2) Test the effect morbidity, maturity, experience and behavior state on feeding outcomes in preterm infants; 3) Estimate the effect of feeding approaches on clinical outcomes; and 4) Estimate the effect of feeding approaches on feeding transition outcomes after discharge. The study aims are consistent with the NINR's efforts to establish a scientific basis for care of individuals across the life span. Specifically, the study will improve clinical care of preterm infants and will promote better clinical and health related outcomes of these children. A prospective, randomized, experimental design will be used to test four different approaches to the transition to full oral feedings. Data will be collected from infants during the 14 day approaches, at discharge, and 2-weeks post-discharge. Data will be analyzed using a mixed-models approach. Relevance: Over 500,000 preterm infants are born each year and feeding these infants is a major clinical challenge while they are in the hospital. How infants are fed during their hospitalization has long term consequences on health and development. This study will help nurses and families in neonatal intensive care units provide feeding care that may result in shorter hospital stays and improved developmental outcomes.