Transition From Gavage to Nipple Feeding for Preterm Infants With Bronchopulmonary Dysplasia

Background: The transition from gavage to nipple feeding is difficult for preterm infants with bronchopulmonary dysplasia because of tachypnea and hypoxemia from chronic respiratory distress. Objective: The aim of this study was to test the hypothesis that preterm infants with bronchopulmonary dysplasia who transitioned from gavage to nipple feeding with the semidemand method would achieve nipple feeding sooner and be discharged from hospital sooner than control infants who received standard care. Methods: Forty- two infants were randomized to the control condition and 44 to the experimental protocol. Mean gestational ages and birth weights were 25 +/- 1.5 weeks and 784 g for controls and 25 +/- 1.4 weeks and 787 g for experimental infants. Control infants received standard care that included gradual increases in the number of nipple to gavage feedings per day. Experimental infants received the semidemand method that used infant behavioral and cardiorespiratory signs to regulate frequency, length, and volume of nipple feedings. General linear model procedures were used to compare study groups. Results: Experimental infants achieved nipple feeding at M = 5.9 +/- 0.7 days compared with control infants, M = 12.3 +/- 0.8 ( p < .0001). Length of hospitalization was not significantly different between groups. Discussion: The semidemand method significantly shortened the time for infants to attain nipple feeding in a manner taking their respiratory distress into consideration.