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The Effect of the SNS-Based Feeding on Transition to Exclusive Breastfeeding in Preterm Infants

Not Applicable
Completed
Conditions
Breastfeeding
Preterm Infant
Sucking Behavior
Interventions
Device: MEDELA Supplemental nursing system
Registration Number
NCT05815706
Lead Sponsor
Istanbul Medeniyet University
Brief Summary

This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants

Detailed Description

Nutrition is a critical problem in preterm infants. They should initially be enterally fed because they have poor sucking-swallowing-breathing coordination. Once a preterm infant develops that coordination, enteral feeding should be discontinued immediately. Then, the preterm should switch to oral feeding (breastmilk). However, preterm infants are not good at sucking because they get tired too quickly, have poor sucking skills, and lack enough experience. Therefore, we must use alternative supplemental feeding methods (bottle, spoon, dropper, cup, breastfeeding support system, and finger feeding) until preterm infants mature enough to meet their daily nutritional needs by breastfeeding alone (exclusive breastfeeding).

The Supplemental Nursing System (SNS) is an alternative supplemental feeding method that supports the development of sucking skills while providing the preterm infant's nutritional needs. This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
72
Inclusion Criteria
  • being between the gestational ages of 30 to 34 weeks
  • having a birthweight of ≥1000 g
  • having an APGAR score of >6
  • having stabilized for 48 hours after receiving mechanical ventilator or continuous positive air pressure or both
  • being exclusively gavage-fed with breast and/or formula and ready to switch to oral feeding
  • being willing to breastfeed
Exclusion Criteria
  • having a congenital malformation that may cause asphyxia and affect breathing
  • having an intraventricular hemorrhage, intracranial hemorrhage, or periventricular leukomalacia
  • having intestinal anomalies or hyperbilirubinemia requiring exchange transfusion
  • having respiratory distress syndrome, bronchopulmonary dysplasia, or other chronic lung diseases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ExperimentalMEDELA Supplemental nursing systemThe experimental group participants were breastfed for ten minutes (five minutes for each breast) every day from the day they started oral feeding until they switched to exclusive breastfeeding. The nurse placed the warmed breast milk or formula in SNS. She then fixed it to the mother's nipples. Each experimental group participant sucked on the two breasts for 15 minutes. Breastfeeding (ten minutes), resting and SNS preparation (five minutes), and SNS feeding (15 minutes) were limited to a total of 30 minutes in light of earlier research.
Primary Outcome Measures
NameTimeMethod
The time to transition to oral feeding (hours)up to three weeks

It was measured when the preterm infant swiched from gavage feeding to oral feeding.

Time to discharge (hours)up to 2 months

It was measured at discharge

The sucking success (First measurement)at the beginning of the study, up to three weeks

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.

The time to transition to exclusive breastfeeding (hours)up to two weeks

It was measured when the preterm infant transitioned to exclusive breastfeeding

The sucking success (Last measurement)through study completion, an average of 2 months

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.

The sucking success (Second measurement)48 hours after the second measurement of sucking success

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Istanbul Medeniyet University

🇹🇷

Istanbul, Kadıköy, Turkey

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