The Effect Of Intermittent Nasogastric Feeding With Nonnutritive Sucking On Nutrient And Gastrointestinal Tract In Premature Infants

To evaluate the effects of NNS on premature infants,38 preterm infants with INGF were studied. The changes of nutrient intake, physical growth, feeding - related complications, gastrointestinal transit time ( WGTT) and gastrointestinal hormones insulin (INS) , soma-tostatin (SS) levels in those infants were observed.Material and Methods38 premature infants in NICU in the 2nd Clinical College of China Medical University from Apr. 2001 to Dec. 2001 were studied and satisfied with the following criteria: ( 1) Apropriate for gestational age (AGA) , birth - weight less than 2500g, gestation less than 37 weeks; ( 2 ) No any diseases; ( 3 ) Accepting intermittent nasogastric feeding. All the preterms, including 25 males and 13 females, gestation from 28 to 35 weeks ( mean 32 weeks) , brith - weight from 1050g to 1790g ( mean 1555g ) , were randomizedly assigned into NNS group (n = 18) or N -NNS group (n =20) according to INGF with and without NNS and fed with the same milk formula. There were nosignificant difference between the two groups in the components of gender, gestation, birth - weight and Apgar scores at 5 min. Monitoring indices as below: (1) Physical growth parameters: recorded the body weight (daily) , length, head circumference (weekly) ; (2)recorded the level of intake of liquid, milk input, caloric and stool frequency and characters; ( 3 ) feeding - related complications; ( 4 ) WGTT; 125mg carmine red (made in UK) was mixed with the initial feeding and designated the time from this first feeding up to the marker first appeared in the stool as the transit time ( weekly) ; (5 ) gastrointestinal hormones parameters: plasma INS and SS were detected by Radioimmunoassay ( RIA) at the time before initial feeding and one and two week after feeding. All the data except the morbilities of feeding - related complications were subjected to statistical analysis with SPSS 10.0 for Windows and described as means standard devariation. The significance of difference between the two groups was detennined by two - tailed t test and x2determintion.Results1. The time of birth - weight regain in NNS were significantly shorter than that in N - NNS (8.81 ±3.69days vs 11.08 ±3.04 days ,P <0.05). The differences were not significant in increases of birth -weight,length and head circumference between NNS and N - NNSgroups by the first and second week (P >0. 05).2. The time of reaching the level 100kcal/kg ?d (12. 25 ± 5. 07days vs 15. 70 ± 5. 16 days, P < 0. 05 ). There was a decreasing tendency of the time of putting nasogastric tube in NNS, but difference was not significant ( P > 0.05 ).3. The morbidity of gastric residue in NNS was significantly lessthan in N - NNS ( P < 0. 05 ) , there was no significant difference in the mobidity of other complications in the two groups.4. WGTT of the second week in NNS group was significantly shorter than that in N - NNS(33.41 ± 12. 80hr vs 44.92 ±20.43hr, P < 0. 05 ). Stool frequencies of the second week in NNS group was significantly more than that in N - NNS group (2. 26 ±0. 17times/d vs 1. 79 ±0. 58times/d ,P <0.05) . There were no significantly differences in WGTT and stool frequencies of the frist week between NNS and N -NNS groups (P>0.05).5. After a week and two weeks of initial feeding, the plasma levels of INS in NNS group were both significantly higher than that in N-NNS group(37. 06 ± 11. 34uu/ml vs 29. 63 ± 8. 78uu/ml; 50. 32 ± 18. 38uu/ml vs 39.99 ±9. 94uu/ml, P <0.05) ; the plasma levels of SS in NNS group were both significantly less than that in N - NNS group (454.56 ±.136.44pg/ml vs 595.30 ±260.14pg/ml ;595.61 ± 172.07pg/ml vs 727. 15 220. 84pg/ml, P < 0. 05 ). INS and SS levels before initial feeding were not significant difference in NNS and N -NNS groups (P>0.05).DiscussionSeveral days after birth, neonate boms suffered from physiologic weight loss, regained weight after the lowest weight loss reflected nutrient supply and physical growth except the excess of liquid intake. The increases in weig...