Impact of Oro-Pharyngeal Administration of Mother's Milk Prior to Gavage Feeding on GIT Motility in Preterm Infants
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 试验地点
- 2
- 主要终点
- Cholecystokinin
研究概览
简要总结
Mother's milk does not come in contact with the oropharyngeal pouch of preterm infants during gavage feeding. We hypothesized that stimulation of the oropharyngeal pouch using small amount of the mother's milk 5 minutes before initiation of regular gavage feeding will increase the level of GIT hormones.
详细描述
Feeding preterm infants continues to challenge health care providers because of difficulty to provide adequate volume of milk that maintains optimum nutrition without increasing the risk of feeding intolerance. Preterm, VLBW, infants are at increased risk of feeding intolerance as they have shorter GIT with lower digestive, absorptive, and motility capabilities than those of full-term infants. Intolerance to enteral feeding has been associated with abdominal distention, initiation of inflammatory cascade, edema of the bowel, and subsequent development of necrotizing enterocolitis.
Oral feeding is the best physiologic method for enteral nutrition of preterm infants. However, because of immaturity of suckling reflex and poor coordination between suckling and swallowing, gavage feeding (oro-gastric or naso-gastric tube feeding) has been used an alternative method of enteral nutrition in preterm infants.
During breastfeeding, mother's milk comes in contact with mouth and oro-pharyngeal pouch which, theoretically, stimulates both oro-pharyngeal receptors that improves the motility, secretory, and absorptive ability of the GIT. Furthermore, anti-inflammatory and pro-inflammatory cytokines, which are present abundantly in mother's colostrum and milk, may exert an immuno-protective effect when they come in contact with oro-pharyngeal as well as GIT mucosa.
Preterm, VLBW, infant in the NICU receives enteral feedings by a naso-gastric or oro-gastric gavage tube. Thus, mother's milk does not typically come into contact with oro-pharyngeal pouch which delays the maturation of oral suckling and swallowing skills in preterm infants.
Oral stimulation has been shown to improve oral feeding performance, attain early oral feeding, improve weight gain and shorten the length of hospital stay. Investigators aimed to study the effect of Oro-pharyngeal administration of mother's milk before regular gavage feeding on gastrointestinal movement in preterm infants.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
盲法说明
Laboratory assessment of GIT hormonal level will be masked
入排标准
- 年龄范围
- 1 Day 至 60 Days（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Preterm infants delivered at less than 32 weeks gestation and less than 1500 grams birth weight will be included in the study
排除标准
- •Preterm infants > 32 weeks gestation unable to be fed on own mother's colostrum or milk.
- •Preterm infants with major congenital anomalies or chromosomal abnormalities.
- •Preterm infants delivered to mothers with confirmed chorioamnionitis.
- •Preterm infants with confirmed early onset sepsis.
结局指标
主要结局
Cholecystokinin
时间窗: 24 hours
Plasma Cholecystokinin hormone level
Motilin hormone
时间窗: 24 hours
Plasma Motilin hormone level
Secretin hormone
时间窗: 24 hours
Plasma Secretin hormone level
Gastrin hormone
时间窗: 24 hours
Plasma Gastrin hormone level
次要结局
- Holding feeds(24 hours)
- Feeding residual(24 hours)
研究者
Nehad Nasef
Professor of Pediatrics
Mansoura University Children Hospital