Does Kangaroo Care Have an Effect on Transition Time from Gavage Feeding to Full Oral Feeding in Premature Babies?

Abstract

Objectives Kangaroo care is a safe and effective alternative method to conventional neonatal care for newborn babies. The aim of this study was to evaluate the effect of kangaroo care on the transition time to full oral feeding in preterm infants fed by gavage.

Methods This is a randomized controlled trial. This study was conducted in a level III neonatal intensive care unit of a university hospital in eastern Turkey 50 premature babies with a birth weight of≥1000 g and a gestational age of 27–36 weeks, and their mothers were included in the study. The cases were randomly divided into two groups: kangaroo care, which would be applied up to five days a week, and standard care. Records of cases were kept regularly from their hospitalization until they reached full oral feeding.

Results Premature babies in the kangaroo care group reached full oral feeding at 29.20±8.06 days after birth, while babies in the standard care group reached full oral feeding at 44.60±21.90 days. The transition period from gavage feeding to reaching full oral feeding was 13.60±6.83 days in the kangaroo care group, and 22.10±7.38 days in the standard care group. The difference was statistically significant (p=0.007).

Conclusion Kangaroo care is an effective method to reduce the transition time from gavage feeding to full oral feeding for premature babies.

Zusammenfassung

Fragestellung und Hintergrund Känguru Pflege ist eine sichere und effektive Alternative zur traditionellen Neugeborenenpflege für Neugeborene. Das Ziel dieser Studie war es, die Wirkung der Känguru-Pflege auf die Übergangszeit zur vollständigen oralen Ernährung bei Frühgeborenen, die mit einer Schlundsonde ernährt wurden, zu bewerten.

Patienten und Methodik Dies ist eine randomisierte kontrollierte Studie. In diese Studie wurden 50 Frühgeborene mit einem Geburtsgewicht≥1000 g und einem Gestationsalter von 27–36 Wochen und deren Mütter auf der neonatologischen Intensivstation der 3. Ebene eines Universitätskrankenhauses in der Osttürkei in die Studie eingeschlossen. Die Fälle wurden zufällig in zwei Gruppen eingeteilt: Känguru-Pflege und Standard-Pflege für bis zu fünf Tage in der Woche. Die Aufzeichnungen der Fälle wurden regelmäßig von ihrem Krankenhausaufenthalt bis zum Erreichen der vollständigen oralen Ernährung aufbewahrt.

Ergebnisse Frühgeborene in der Känguru-Pflegegruppe erreichten nach 29,20±8,06 Tagen nach der Geburt eine vollständige orale Nahrungsaufnahme, während Babys in der Standard- Pflegegruppe nach 44,60±21,90 Tagen eine vollständige orale Nahrungsaufnahme erreichten. Die Übergangszeit von der Sondenernährung zur vollständigen oralen Ernährung betrug 13,60±6,83 Tage in der Känguru-Pflegegruppe und 22,10±7,38 Tage in der Standard-Pflegegruppe. Der Unterschied war statistisch signifikant (p=0,007).

Schlussfolgerung Die Känguru-Pflege ist eine wirksame Methode, um die Übergangszeit von der Sondenernährung zur vollständigen oralen Ernährung von Frühgeborenen zu verkürzen.

Key words

gavage feeding - kangaroo care - oral feeding - preterm babies

Schlüsselwörter

sondenernährung - känguru-pflege - orale ernährung - frühgeborene

• References

• 1 Bidzan M, Bieleninik Ł. Psychomotor development of preterm babies in the context of biomedical predictors in a Polish sample. Health Psychology Report 2013; 1: 18-33
• 2 Czajkowska M, Kaptur E. Vojta therapy in the diagnosis and the suck–swallow–breathe triad treatment of a prematurely born child. Logopedia 2016; 45: 143-156
• 3 Tume L, Latten L, Darbyshire A. An evaluation of enteral feeding practices in critically ill children. Nurs Crit Care 2010; 15: 291-299
• 4 Gargasz A. Neonatal and pediatric parenteral nutrition. AACN Adv Crit Care 2012; 23: 451-464 quiz 465-6
• 5 Wickramatilake CM, Withanaarachchi K, Dharmadasa R, Amaraweera MTJ, Dissanayake SR. Parenteral nutrition therapy for neonates: Experience in a tertiary care centre in Sri Lanka. Sri Lanka J Child Health 2018; 47: 16-20
• 6 Vineeth V. A study to determine effectiveness of planned teaching programme on knowledge of total parenteral nutrition in children among the third year B.Sc nursing students in a selected institute at Mangalore. Int J Nurs Care 2013; 1: 35-38
• 7 Platt MJ. Outcomes in preterm infants. Public Health 2014; 128: 399-403
• 8 Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2014; 4: CD002771
• 9 Davy K, Bergh AM, Van Rooyen E. Mother and child health: The neonatal nurse’s role in kangaroo mother care. Prof Nurs Today 2011; 15: 32-37
• 10 Flynn A, Leahy-Warren P. Neonatal nurses’ knowledge and beliefs regarding kangaroo care with preterm infants in an Irish neonatal unit. J Neonatal Nurs 2010; 16: 221-228
• 11 Solomons N, Rosant C. Knowledge and attitudes of nursing staff and mothers towards kangaroo mother care in the eastern sub-district of Cape Town. South Afr J Clin Nutr 2012; 25: 33-39
• 12 Moore ER. Early skin-to-skin contact for mothers and their healthy newborn infants. J Obstetric, Gynecologic & Neonatal Nurs 2013; 42: S86
• 13 Moore H. Improving kangaroo care policy and implementation in the neonatal intensive care. J Neonatal Nurs 2015; 21: 157-160
• 14 Sweeney SR, Rothstein R, Visintainer P, Rothstein R, Singh R. Impact of kangaroo care on parental anxiety level and parenting skills for preterm infants in the neonatal intensive care unit. J Neonatal Nurs. 2017; 23: 151-158
• 15 Mizuno K, Mizuno N, Shinohara T, Noda M. Mother-infant skin-to-skin contact after delivery results in early recognition of own mother’s milk odour. Acta Paediatr 2004; 93: 1640-1645
• 16 Gouchon S, Gregori D, Picotto A, Patrucco G, Nangeroni M, Di Giulio P. Skin-to-skin contact after cesarean delivery: an experimental study. Nurs Res 2010; 59: 78-84
• 17 Bigelow A, Power M, MacLellan-Peters J, Alex M, McDonald C. Effect of mother/infant skin-to-skin contact on postpartum depressive symptoms and maternal physiological stress. J Obstet Gynecol Neonatal Nurs 2012; 41: 369-382
• 18 Yildiz A, Arikan D, Gözüm S, Taştekın A, Budancamanak I. The effect of the odor of breast milk on the time needed for transition from gavage to total oral feeding in preterm infants. J Nurs Scholarsh 2011; 43: 265-273
• 19 World Health Organization Department of reproductive health and research: Kangaroo Mother Care. A practical guide. Geneva, Switzerland: World Health Organization; 2003
• 20 Montirosso R, Del Prete A, Bellù R, Tronick E, Borgatti R. Neonatal Adequate Care for Quality of Life (NEO-ACQUA) Study Group. Level of NICU quality of developmental care and neurobehavioral performance in very preterm infants. Pediatrics 2012; 129: e1129-e1137
• 21 Abd-Elgawad M, Eldegla H, Khashaba M, Nasef N. Oropharyngeal administration of mother’s milk prior to gavage feeding in preterm infants: A pilot randomized control trial. JPEN J Parenter Enteral Nutr 2020; 44: 92-104
• 22 Coşkun D, Günay U. The effects of kangaroo care applied by Turkish mothers who have premature babies and cannot breastfeed on their stress levels and amount of milk production. J Pediatr Nurs 2020; 50: e26-e32
• 23 De Almeida H, Venancio SI, Sanches MT, Onuki D. The impact of kangaroo care on exclusive breastfeeding in low birth weight newborns. J Pediatr (Rio J) 2010; 86: 250-253
• 24 Ludington-Hoe SM, Morgan K, Abouelfettoh A. A clinical guideline for implementation of kangaroo care with premature infants of 30 or more weeks’ postmenstrual age. Adv Neonatal Care 2008; 8: S3-S23
• 25 Jayaraman D, Mukhopadhyay K, Bhalla AK, Dhaliwal LK. Randomized Controlled Trial on Effect of Intermittent Early Versus Late Kangaroo Mother Care on Human Milk Feeding in Low-Birth-Weight Neonates. J Hum Lact 2017; 33: 533-539
• 26 Mahmood I, Jamal M, Khan N. Effect of mother-infant early skin-to-skin contact on breastfeeding status: a randomized controlled trial. J Coll Physicians Surg Pak 2011; 21: 601-605
• 27 Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2016; 11: CD003519
• 28 Mekonnen AG, Yehualashet SS, Bayleyegn AD. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies. Int Breastfeed J 2019; 14: 12
• 29 Kwok MK, Leung GM, Schooling CM. Breast feeding and early adolescent behaviour, self-esteem and depression: Hong Kong’s ‘Children of 1997’ birth cohort. Arch Dis Child 2013; 98: 887-894
• 30 Leventakou V, Roumeliotaki T, Koutra K, Vassilaki M, Mantzouranis E, Bitsios P, Kogevinas M, Chatzi L. Breastfeeding duration and cognitive, language and motor development at 18 months of age: Rhea mother-child cohort in Crete, Greece. J Epidemiol Community Health 2015; 69: 232-239
• 31 Suman RP, Udani R, Nanavati R. Kangaroo mother care for low birth weight infants: a randomized controlled trial. Indian Pediatr 2008; 45: 17-23
• 32 Christensson K, Siles C, Moreno L, Belaustequi A, De La Fuente P, Lagercrantz H, Puyol P, Winberg J. Temperature, metabolic adaptation and crying in healthy full-term newborns cared for skin-to-skin or in a cot. Acta Paediatr 1992; 81: 488-493
• 33 Akbari E, Binnoon-Erez N, Rodrigues M, Ricci A, Schneider J, Madigan S, Jenkins J. Kangaroo mother care and infant biopsychosocial outcomes in the first year: A meta-analysis. Early Hum Dev 2018; 122: 22-31
• 34 Shrivastava SR, Shrivastava PS, Ramasamy J. Utility of kangaroo mother care in preterm and low birthweight infants. South African Family Practice 2013; 55: 340-344
• 35 Venancio SI, de Almeida H. Método Mãe Canguru: aplicação no Brasil, evidências científicas e impacto sobre o aleitamento materno [Kangaroo-Mother Care: scientific evidence and impact on breastfeeding]. J Pediatr (Rio J) 2004; 80: S173-S180 Portuguese