Behavioral stress is affected by the mode of tube feeding in very low birth weight infants

Clin J Pain. 2008 Jun;24(5):447-55. doi: 10.1097/AJP.0b013e3181633fd6.

Abstract

Objective: To compare the effect of continuous versus bolus feeding on behavioral responses of stress in very low birth weight infants during early postnatal life.

Methods: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with gestational age 24 to 29 weeks and birth weight <1200 g were randomly assigned to 1 of 3 feeding methods: continuous nasogastric feeding, bolus nasogastric feeding, and bolus orogastric feeding. Behavioral responses were video recorded during feeding at 7 and 15 days of postnatal age and at 32 weeks of postmenstrual age. The odds ratio (OR) of manifest behavioral stress was calculated by means of logistic regression.

Results: A significantly higher risk of a behavioral stress response in bolus-fed infants compared with continuous-fed infants at 15 days of age was observed, [adjusted OR=4.1 (95% confidence interval: 1.1-15.4)]. A similar difference was observed at 32 weeks of postmenstrual age [adjusted OR=4.2 (95% confidence interval: 1.0-17.8)]. In addition, bolus-fed infants showed statistically significant higher need of behavioral and physiologic stabilization during feeding.

Discussion: This trial suggests that continuous feeding is associated with lower behavioral stress response as compared with bolus feeding among very low birth weight infants, in early postnatal life.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Comorbidity
  • Enteral Nutrition / methods*
  • Enteral Nutrition / statistics & numerical data*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight*
  • Male
  • Mental Disorders / epidemiology*
  • Prevalence
  • Risk Assessment / methods*
  • Risk Factors
  • Stress, Physiological / epidemiology*
  • Sweden / epidemiology