Food transition of premature infants admitted to the Kangaroo Unit: systematic review

Objective: To analyze the available evidence on the transition from orogastric tube feeding to breastfeeding directly from the breast with premature infants admitted to hospital units. Methods: Systematic literature review with search in the following databases: PubMed/MEDLINE, Web of Science, EMBASE, Scopus, Cochrane CENTRAL, CINAHL, with the inclusion criteria: experimental studies, without temporal restrictions and in Portuguese, Spanish and English. The methodological assessment was carried out using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) tools and consisted of two stages: methodological quality and the risk of bias of the studies. Results: 10 papers were identified, all randomized clinical trials. The techniques used in transitioning the premature babies' diet were: finger tube and syringe, cup and finger tube, cup and bottle, spoon and nonnutritive sucking, non-nutritive sucking, non-nutritive sucking and oral stimulation, behavior of premature babies, and smell of breast milk. Conclusion: The demonstrated techniques allowed the transition of the diet in a shorter period, reducing the length of hospital stay, increasing weight gain 1and proved to be safe, as long as the premature baby is mature enough to undergo the procedure. However, bottle feeding was not recommended due to the occurrence of episodes of desaturation, increased heart rate and nipple confusion.