| Learning Objective #1: Differentiate between a developmental feeding method and standard care method for transitioning preterm infants from gavage to nipple feeding | |||
| Learning Objective #2: Discuss heart rate variability and bradycardia outcomes for the study groups |
Objective: To compare heart rate variability (HRV) and bradycardia responses of preterm infants randomized to a developmental feeding method or a control method for the transition from gavage to nipple feeding. Design: Randomized clinical trial. Sample/Setting/Years: 81 healthy, preterm infants 32 – 34 weeks post-conceptional age (PCA) (41 controls, 40 experimental). Data were collected over 2 ½ years from 1998-2001, in two level III nurseries in mid-western U.S.A. Variables: Independent variable - feeding method. The developmental feeding method (experimental) used infant behavior and cardio-respiratory responses to regulate frequency of feedings. The standard care method (control) consisted of gradually increasing the number of scheduled nipple feedings. Dependent variables - HRV and bradycardia with nipple feeding. Bradycardia was defined as heart rate < 100 bpm for > 20 seconds. Methods: HRV and bradycardia were measured with a non-invasive signal monitoring system that captured the ECG and respiratory activity. A density spectral analysis generated the respiratory activity component (Rfa) and low frequency component (Lfa) of the HRV spectrum. Findings: Using analysis of variance procedures, control infants had significantly more bradycardia events with nipple feeding than experimental infants. There were no differences in Rfa or Lfa between infants with and without bradycardia, indicating a similar degree of vagal tone in the two groups. Conclusions: The feeding bradycardia for the control infants was likely due to immaturity in the coordination of sucking-swallowing-breathing. Because the experimental infants feedings were contingent on behavioral cues, they had more feeding opportunities and thus more opportunities to practice the coordination behavior. The control infants were given gradual increases in the frequency of scheduled feedings, and so had fewer opportunities to practice. As a result, their poor coordination persisted longer. Implications: The developmental feeding method reduces bradycardia over the standard care method for transitioning preterm infants from gavage to nipple feeding.
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Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003