How to make the transition from gavage to nipple feeding for preterm infants (weighing less than 2,000 grams at birth) varies from nursery to nursery based more on custom than on the use of existing knowledge of development of the preterm infant. The objective of this randomized clinical trial is to compare the effectiveness of a developmental protocol for transition of preterm infants from gavage to nipple feedings for an experimental group (n=42), to the hospital's standard practices of transition to nipple feeding for a control group (n=42). The experimental protocol is based on knowledge of neural and behavioral development from earlier studies and includes the following interventions: a behavioral assessment process that will identify behavioral readiness for feeding; the use of non-nutritive sucking to promote behavioral readiness for feeding; and systematic use of infant behavior to regulate frequency, length, and volume of feedings. The interventions to be tested are those which may be incorporated into routine, procedural care by staff nurses.
The specific aims are to examine infant outcomes including: behavioral organization, heart rate variability, and respiratory rate variability during feeding; weight gain; number of days to accomplish nipple feeding; and number of days hospitalized. Data analysis will include: Friedman's multiple chi square for modal behavioral state responses during feeding; spectral analysis of heart and respiratory variability during feeding; random effects analysis of variance (PROC MIXED) with covariables for heart and respiratory data during feeding, and for weight gain; and parametric survival regression (PROC LIFEREG) with covariables for days to attain full nipple feeding and days hospitalized. Cost savings will be determined on a per subject basis.
| McCain, Gail C; Del Moral, Teresa; Duncan, Robert C et al. (2012) Transition from gavage to nipple feeding for preterm infants with bronchopulmonary dysplasia. Nurs Res 61:380-7 |
| McCain, Gail C; Knupp, Amy M; Fontaine, Jessica Loucas et al. (2010) Heart rate variability responses to nipple feeding for preterm infants with bronchopulmonary dysplasia: three case studies. J Pediatr Nurs 25:215-20 |
| McCain, Gail C (2003) An evidence-based guideline for introducing oral feeding to healthy preterm infants. Neonatal Netw 22:45-50 |
| McCain, G C; Gartside, P S; Greenberg, J M et al. (2001) A feeding protocol for healthy preterm infants that shortens time to oral feeding. J Pediatr 139:374-9 |
