Intervention time until discharge for newborns on transition from gavage to exclusive oral feeding

Medeiros, Andréa Monteiro Correia; Ramos, Blenda Karen Batista; Bomfim, Déborah Letticia Santana Santos; Alvelos, Conceição Lima; Silva, Talita Cardoso da; Barreto, Ikaro Daniel de Carvalho; Santos, Felipe Batista; Gurgel, Ricardo Queiroz

doi:10.1590/2317-1782/20182017092

Brasil

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Article • CoDAS 30 (2) • 2018 • https://doi.org/10.1590/2317-1782/20182017092 linkcopy

Intervention time until discharge for newborns on transition from gavage to exclusive oral feeding

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose Measure the intervention time required for transition from gavage to exclusive oral feeding, comparing newborns exposed exclusively to the mother’s breast with those who, in addition to breastfeeding, received supplementation using a cup or baby bottle.

Methods Analytical, longitudinal, cohort study conducted with 165 newborns (NB) divided into groups according to severity of medical complications (G1-with no complications; G2-with significant complications), and into subgroups according to feeding mechanism (A and B). All NBs were low birth weight, on Kangaroo Mother Care, and breast stimulated according to medical prescription and hospital routine. Regarding feeding pattern, subgroup A comprised NBs exclusively breastfed at hospital discharge, whereas subgroup B was composed of NBs fed through cup/bottle at some time during hospitalization. The number of days spent in each stage of transition was recorded for each NB.

Results History of clinical complications significantly influenced total intervention time. Study participants in subgroups G1-A (10 days), G1-B (9 days), and G2-A (12 days) displayed greater chances of early discharge compared with those in subgroup G2-B (16 days).

Conclusion NBs with no important history of clinical complications displayed greater chances of early hospital discharge. NBs with significant history of clinical complications that underwent gavage to exclusive breastfeeding transition presented smaller intervention time than those that required supplementation using cup/bottle. Feeding transition using the gavage-to-exclusive oral feeding technique is recommended for Speech-language Pathology practice in Neonatology.

Keywords Breast Feeding; Enteral Nutrition; Bottle Feeding; Patient Discharge; Kangaroo Mother Care Method; Newborn

	Gestational Age at Birth				p-value
	<28w N (%)	28-31w6d N (%)	32-36w6d N (%)	37-42w N (%)	p-value
Subgroup
A	4 (3.9)	35 (34.3)	59 (57.8)	4 (3.9)	0.078
B	8 (12.7)	22 (34.9)	33 (52.4)	0 (0)
Group
G1	0 (0)	15 (21.7)	50 (72.5)	4 (5.8)	<0.001
G2	12 (12.5)	42 (43.8)	42 (43.8)	0 (0)

	Corrected Gestational Age in the beginning of Transition				p-value
	<28w N (%)	28-31w6d N (%)	32-36w6d N (%)	37-42w N (%)	p-value
Subgroup
A	0 (0)	6 (5.9)	80 (78.4)	16 (15.7)	0.061
B	1 (1.6)	0 (0)	46 (73)	16 (25.4)
Group
G1	1 (1.4)	0 (0)	55 (79.7)	13 (18.8)	0.094
G2	0 (0)	6 (6.3)	71 (74)	19 (19.8)

	GAB (weeks) Mean (SD) Median	BW (grams) Mean (SD) Median	CGA (weeks) Mean (SD) Median
Group
G1 (N=69)	33.74 (1.93)	1607.10 (258.82)	35.23 (2.17)
G1 (N=69)	33.71	1665.00	35.00
G2 (N=96)	31.52 (2.47)	1390.57 (293.81)	35.02 (2.27)
G2 (N=96)	32.00	1392.50	34.57
p-valor ^¢	<0.001 ^* * Significant at p<0.05	<0.001 ^* * Significant at p<0.05	0.349
Subgroup
A (N=102)	32.78 (2.41)	1506.00 (268.52)	35.00 (2.08)
A (N=102)	33.00	1517.50	34.71
B (N=63)	31.92 (2.59)	1440.84 (340.54)	35.29 (2.45)
B (N=63)	32.40	1470.00	35.14
p-valor ^¢	0.110	0.227	0.416
Group × Subgroup
G1-A (N=48)	33.80 (2.18)a	1592.46 (262.76)a	35.30 (1.77)
G1-A (N=48)	33.71	1637.50	34.92
G2-A (N=54)	31.86 (2.25)b	1429.15 (251.78)b	34.73 (2.30)
G2-A (N=54)	32.28	1455.00	34.49
G1-B (N=21)	33.61 (1.22)a	1640.57 (252.61)a	35.06 (2.93)
G1-B (N=21)	33.71	1685.00	35.14
G2-B (N=42)	31.07 (2.69)b	1340.98 (337.03)b	35.40 (2.21)
G2-B (N=42)	31.71	1305.00	34.92
p-valor ^£	<0.001 ^* * Significant at p<0.05	<0.001 ^* * Significant at p<0.05	0.531

	NNS GF+EB/OGT Median (IQR)	N	PFB+OGT Median (IQR)	N	Breast+OGT Median (IQR)	N	Breast to Discharge Median (IQR)	N
Group
G1 (N=69)	1.04 (0)	25	3 (4)	52	5 (5.35)	62	4 (4.5)	69
G2 (N=96)	1 (0)	9	3.5 (3)	76	6 (7)	85	3 (4)	96
p-valor ^¢	0.878		0.044 ^* * Significant at p<0.05		0.015 ^* * Significant at p<0.05		0.119
Subgroup
A (N=102)	1.06 (0)	16	3 (3)	82	5 (5)	98	3 (3)	102
B (N=63)	1 (0)	18	3 (4)	46	8 (6)	49	4 (4)	63
p-valor ^¢	0.772		0.214		0.002 ^* * Significant at p<0.05		0.430
Group × Subgroup
G1-A (N=48)	1.07 (0)	14	3 (3.5)	37	5 (5)a	45	3 (4.75)	48
G2-A (N=54)	1 (0)	2	4 (4)	45	6 (4)a	53	3 (3)	54
G1-B (N=21)	1 (0)	11	2 (2)	15	7 (7.5)a.b	17	5 (3.5)	21
G2-B (N=42)	1 (0)	7	3 (3)	31	9 (9.25)b	32	4 (4.5)	42
p-valor ^£	0.699		0.059		0.002 ^* * Significant at p<0.05		0.213

	MT (IQR)	Breslow (p-value)	Unadjusted HR (CI95%)	p-value
Group
G1 (N=69)	9 (7)	15.64 (<0.001)	1.89 (1.37-2.61)	<0.001
G2 (N=96)	13 (9)		1
Subgroup
A (N=102)	11 (6)	1.95 (0.162)	1.28 (0.93-1.75)	0.134
B (N=63)	13 (10)		1
Group × Subgroup
G1-A (N=48)	10 (6)	24.73 (<0.001)	2.07 (1.35-3.17)	0.001
G2-A (N=54)	12 (7)		1.43 (0.95-2.15)	0.086
G1-B (N=21)	9 (7)		3.02 (1.76-5.19)	<0.001
G2-B (N=42)	16 (9)		1

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Sociedade Brasileira de Fonoaudiologia Al. Jaú, 684, 7º andar, 01420-002 São Paulo - SP Brasil, Tel./Fax 55 11 - 3873-4211 - São Paulo - SP - Brazil
E-mail: revista@codas.org.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[1] Caption: N = number of observations; w = weeks; d = days; A = Exclusive Breast; B = Breast+Cup and/or Bottle; G1 = Group without complications; G2 = Group with complications. Chi-squared with Monte-Carlo correction (100.000 replicates)