The aim of this study was to determine the feasibility of a study of the effect of
positioning on energy expenditure in preterm infants. We performed a prospective,
randomized, clinical cross-over pilot study of eight healthy, appropriate weight for
gestational age, gavage-fed, clinically stable preterm infants at the postmenstrual
age of 30 weeks. Prior to the study and in accord with our feeding protocol, infants
uniformly received either their own mother’s milk or a preterm formula. Each infant
was studied in four different positions after randomization to eight different sequences.
Infants were studied asleep, 90 minutes after feeding, after 20 minutes of being nursed
in a given position. They were cared for in a servo-controlled convective incubator
during the metabolic measurements, which were performed by indirect calorimetry. Energy
expenditure was not significantly affected by the body position in which the infant
was studied. The difference between the highest and the lowest mean energy expenditure
was 3.7% of the highest one. We conclude that attempts to minimize energy expenditure
by modifying infant positioning are likely to be insignificant, from a practical standpoint,
because of the nonsignificant or minimal differences in energy expenditure.
KEYWORDS
Metabolic rate - body position - growing preterm infants - convective incubator
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