RESUMEN
Preterm neonates are at high risk of infectious and inflammatory diseases which require antibiotic treatment. Antibiotics influence neonatal gut microbiome development, and intestinal dysbiosis has been associated with delayed gastrointestinal transit. Neonates who take less time to pass meconium have a better tolerance to enteral feeding. We analyzed the effect of neonatal antibiotic treatment on the stool pattern and oral tolerance in 106 preterm infants < 33 weeks gestational age. Neonates were classified in 3 groups according to neonatal antibiotic (ABT) treatment days: no antibiotics, 3−7 d ABT, and ≥8 d ABT. Preterm infants from the ≥8 d ABT group took longer to pass meconium and to start green and yellow stools, took longer to reach 100 and 150 mL/kg/day, and reached reduced volumes in enteral feeds at day of life 14 and 28 than infants from no ABT and 3−7 d ABT groups. Multiple linear regression models showed that neonatal antibiotic treatment, birth weight, invasive mechanical ventilation, surfactant, enteral feeding start day, neonatal parenteral nutrition, and neonatal fasting days are associated with the stool pattern and oral tolerance in preterm infants.
RESUMEN
Objective To study the effect of Sandra Fucile oral stimulation on oral feeding readiness and ability of preterm infants.Methods Sixty-five premature infants were selected in the study.All of the premature infants were recruited randomly in convenience between Jul.and Dec.2012.For a randomized control principle,SPSS 13.0 was performed to achieve complete random design.Objects were divided into control group(receiving routine nursing) and intervention group(on the basis of routine nursing,receiving 15 minutes oral stimulation,1 time/day,for 10 days).Chinese version of Preterm Infant Oral Feeding Readiness Assessment scale(PIOFRA scale-CV) was used when intervention began,and 7 days,10 days,14 days after the start of the intervention.Results PIOFRA-CV scale score was statistically different at different time in both groups(F =169.062,P ＜0.001).The first day ratings were minimum in the 2 groups,after which with an upward trend over time.The control group and intervention group rated a statistically significant difference(F =5.538,P =0.022).Except for no difference on the first day and seventh day (t =1.650,P =0.204 ;t =0.817,P =0.369) between the 2 groups,the intervention group had a higher score than the control group (t =17.339,24.141,all P ＜0.001).Group and time had an interaction effect(F =1 1.561,P ＜0.001).The incidence of vomiting[42.4％ (14/33 cases) vs 34.4％ (11/32 cases)],infection [27.3％ (9/33 cases) vs 9.4％ (3/32 cases)],and gastro-oesophageal reflux[30.3％ (10/33 cases) vs 25.0％ (8/32 cases)] were not significantly different between the 2 groups(x2 =0.445,3.457,0.288,all P ＞ 0.05).Conclusions Saudra Fucile oral stimulation method can significantly promote the development of premature oral feeding ability on the 10 day after the intervention,and will not increase vomiting,gastroesophageal reflux,and infection.It is suitable for clinical application.