Spilled volum, oxygen saturation, and heart rate during feeding of preterm newborns: comparison between two alternative feeding methods

Araújo, Viviane Castro de; Maciel, Ana Caroline Martinez; Paiva, Mariana de Almeida Ribeiro; Bezerra, Ana Cristina Barreto

doi:10.1590/2317-1782/20162015152

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Original Article • CoDAS 28 (3) • May-Jun 2016 • https://doi.org/10.1590/2317-1782/20162015152 copy

Spilled volum, oxygen saturation, and heart rate during feeding of preterm newborns: comparison between two alternative feeding methods

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To compare the use of syringe and finger feeding to feed preterm newborns considering amount of milk offered, amount of milk spilled, variation of oxygen saturation, and heart rate.

Methods

Quasi-experimental study with 30 preterm newborns. Thirteen infants were females and 17 were males. The mean gestational age at birth and during evaluation (corrected age) was 33 4/7 ± 4/7 and 36 ± 4/7, respectively. Newborns’ mean birthweight and mean weight when evaluated was 1,800 ± 140 and 1,972 ± 88 grams. We assessed one feeding session using a syringe and another feeding session using the finger feeding technique. Both techniques were used in the same infant, so that the preterm newborns were controls for themselves. A portable pulse oximeter was used to check the variation of oxygen saturation and heart rate. A gauze pad was placed under the infants’ chin to absorb the spilled milk. The statistical tests used were: ANOVA, paired Student’s t test, Tukey Multiple Comparison test, and Pearson Correlation Coefficient. The level of significance was set at 5%.

Results

We found a difference between the techniques in terms of both amount of milk offered and amount of milk spilled. These amounts were larger when the syringe was used. Heart rate was different at two specific times: before/during and before/after feeding for both techniques. However, the values were within normal limits. Oxygen saturation values were also different, showing higher values after syringe feeding.

Conclusions

Finger feeding proved to cause less spillage, whereas the variations of oxygen saturation and heart rate were within normal limits.

Keywords:
Newborn; Vital Signs; Premature Infant; Feeding Methods; Feeding Behavior

PTNB	PESOIG	GA	CGA	PN	PDA	DSOG	DORAL
1	SGA	36 2/7	38 2/7	1,870	1,945	12	2
2	SGA	34	36 3/7	1,605	1,855	11	10
3	AGA	30	37 5/7	1,225	1,865	52	2
4	SGA	34 2/7	40 5/7	1,430	1,986	26	18
5	SGA	35 2/7	37 2/7	2,020	1,950	5	8
6	AGA	31	37 2/7	1,125	1,920	42	2
7	SGA	34	39 5/7	1,175	1,810	38	2
8	AGA	32 3/7	37 2/7	1,615	2,160	31	3
9	AGA	30	34	1,300	1,615	21	4
10	AGA	32 6/7	37 2/7	1,670	2,270	26	2
11	AGA	33	35 3/7	1,655	1,815	15	2
12	AGA	33	35 1/7	2,100	1,960	6	10
13	AGA	33	34 4/7	2,065	1,920	6	6
14	AGA	34 2/7	35 2/7	2,085	1,920	3	5
15	AGA	33	36 2/7	1,690	1,735	37	5
16	AGA	35	36 3/7	2,905	2,825	6	5
17	AGA	31 4/7	35	2,030	2,320	22	2
18	AGA	31	35	1,510	2,040	26	2
19	AGA	33	35	1,940	1,945	12	2
20	SGA	36 1/7	37 1/7	1,885	1,725	6	2
21	AGA	33	34 5/7	2,320	2,400	7	5
22	SGA	36 6/7	41	2,130	2,010	24	3
23	AGA	32	36 6/7	1,420	1,860	32	3
24	SGA	35	37 6/7	1,530	1,605	16	3
25	AGA	35	35 4/7	2,200	2,000	2	3
26	SGA	35	38 6/7	1,980	2,100	14	2
27	AGA	34 2/7	36	2,185	2,100	9	3
28	SGA	34	38 3/7	1,530	1,875	22	10
29	SGA	35	36 3/7	1,995	1,890	8	2
30	SGA	32	34 3/7	1,817	1,735	14	4
		33 4/7^* * average; ±4/7^† † confidence interval; (1 5/7^‡ ‡ standard deviation )	36^* * average; ±5/7^† † confidence interval; (1 6/7^‡ ‡ standard deviation )	1,800^* * average; ±140^† † confidence interval; (390^‡ ‡ standard deviation )	1,972^* * average; ±88^† † confidence interval; (245^‡ ‡ standard deviation )	18.4^* * average; ±4.6^† † confidence interval; (12.9^‡ ‡ standard deviation )	4.4^* * average; ±1.3^† † confidence interval; (3.6^‡ ‡ standard deviation )

Variables	Finger feeding method		P-value	Result	Syringe		P-value	Result
Variables	AGA (n = 18)	AGS (n = 12)	P-value	Result	AGA (n = 18)	AGS (n = 12)	P-value	Result
Offered volume (%)	69.6^* * average; ±10.2^† (22.0^‡ ‡ standard deviation )	18.4^* * average; ±4.6^† † confidence interval; (12.9^‡ ‡ standard deviation )	0.003	AGA#AGS	87.0^* * average; ±6.7^† † confidence interval; (14.4^‡ ‡ standard deviation )	91.5^* * average; ±6.5^† † confidence interval; (11.5^‡ ‡ standard deviation )	0.383	AGA=AGS
Offered volume in 5 min (%)	35^* * average; ±4.9^† (10.5^‡ ‡ standard deviation )	41.5^* * average; ±6.5^† (11.4^‡ ‡ standard deviation )	0.122	AGA=AGS	38.6^* * average; ±4.0^† † confidence interval; (8.6^‡ ‡ standard deviation )	40.3^* * average; ±5.4^† † confidence interval; (9.5^‡ ‡ standard deviation )	0.608	AGA=AGS
Spilled volume (%)	2.3^* * average; ±1.9^† (4.1^‡ ‡ standard deviation )	2.4^* * average; ±3.3^† (5.8^‡ ‡ standard deviation )	0.965	AGA=AGS	16.6^* * average; ±3.5^† † confidence interval; (7.6^‡ ‡ standard deviation )	17.9^* * average; ±4.0^† † confidence interval; (7.1^‡ ‡ standard deviation )	0.634	AGA=AGS
Volume/time ratio (mL/min)	3.04^* * average; ±0.45^† † confidence interval; (0.97^‡ ‡ standard deviation )	3.42^* * average; ±0.57^† (1.01^‡ ‡ standard deviation )	0.316	AGA=AGS	3.34^* * average; ±0.31^† † confidence interval; (0.68^‡ ‡ standard deviation )	3.27^* * average; ±0.51^† † confidence interval; (0.90^‡ ‡ standard deviation )	0.827	AGA=AGS
Time (min)	9.90^* * average; ±1.45^† † confidence interval; (3.14^‡ ‡ standard deviation )	11.38^* * average; ±1.77^† (3.13^‡ ‡ standard deviation )	0.218	AGA=AGS	11.27^* * average; ±1.34^† (2.91^‡ ‡ standard deviation )	11.56^* * average; ±1.41^† † confidence interval; (2.49^‡ ‡ standard deviation )	0.781	AGA=AGS

Variables	Offer (n=30)		P-value	Result
Variables	Finger feeding method	Syringe	P-value	Result
Offered volume (%)	78.9^* * average; ±7.8^† † confidence interval; (21.9^‡ ‡ standard deviation )	88.8^* * average; ±4.8^† † confidence interval; (13.3^‡ ‡ standard deviation )	0.029	FF≠syringe
Offered volume in 5 min (%)	37.6^* * average; ±4^† † confidence interval; (11.2^‡ ‡ standard deviation )	39.3^* * average; ±3.2^† † confidence interval; (8.8^‡ ‡ standard deviation )	0.400	FF=syringe
Spilled volume (%)	2.3^* * average; ±1.7^† † confidence interval; (4.8^‡)	17.2^* * average; ±2.6^† † confidence interval; (7.3^‡ ‡ standard deviation )	<0.001	FF≠syringe
Volume/time ratio (mL/min)	3.20^* * average; ±0.35^† † confidence interval; (0.99^‡ ‡ standard deviation )	3.31^* * average; ±0.27^† † confidence interval; (0.76^‡ ‡ standard deviation )	0.515	FF=syringe
Time (min)	10.49^* * average; ±1.13^† † confidence interval; (3.17^‡ ‡ standard deviation )	11.38^* * average; ±0.97^† † confidence interval; (2.71^‡ ‡ standard deviation )	0.135	FF=syringe

Variables			GA	CGA	PN	PDA	DSOG	DORAL
Finger feeding method	Offered volume	r^*	20.4%	38.0%	11.1%	26.1%	7.9%	13.4%
	Offered volume	p-value	0.279	0.038^† † Current correlation, classified as bad in the test scale;	0.559	0.163	0.677	0.480
	Offered volume in 5 min	r^*	5.1%	36.9%	0.1%	23.6%	23.9%	8.6%
	Offered volume in 5 min	p-value	0.787	0.044^† † Current correlation, classified as bad in the test scale;	0.995	0.209	0.204	0.653
	Spilled volume	r^*	10.2%	8.4%	29.2%	31.7%	24.5%	21.3%
	Spilled volume	p-value	0.592	0.660	0.117	0.088	0.193	0.259
	Volume/time ratio	r^*	9.2%	40.4%	1.7%	22.4%	24.3%	24.5%
	Volume/time ratio	p-value	0.630	0.027^‡ ‡ Current correlation, classified as regular in the test scale	0.927	0.235	0.195	0.656
Syringe	Offered volume	r^*	-3.5%	32.4%	-4.4%	33.0%	17.7%	15.4%
	Offered volume	p-value	0.856	0.081	0.819	0.075	0.349	0.415
	Offered volume in 5 min	r^*	1.0%	19.9%	-6.2%	4.1%	5.8%	13.3%
	Offered volume in 5 min	p-value	0.958	0.292	0.743	0.830	0.761	0.483
	Spilled volume	r^*	21.0%	24.5%	15.8%	9.4%	-4.8%	19.1%
	Spilled volume	p-value	0.266	0.193	0.406	0.620	0.800	0.311
	Volume/time ratio	r^*	4.1%	27.1%	-5.6%	13.5%	12.9%	8.9%
	Volume/time ratio	p-value	0.830	0.147	0.768	0.478	0.498	0.641

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[1] Conflict of interests: nothing to declare.