NCT05815706 - The Effect of the SNS-Based Feeding on Transition to Exclusive Breastfeeding in Preterm Infants | Crick

Overview

This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants

Nutrition is a critical problem in preterm infants. They should initially be enterally fed because they have poor sucking-swallowing-breathing coordination. Once a preterm infant develops that coordination, enteral feeding should be discontinued immediately. Then, the preterm should switch to oral feeding (breastmilk). However, preterm infants are not good at sucking because they get tired too quickly, have poor sucking skills, and lack enough experience. Therefore, we must use alternative supplemental feeding methods (bottle, spoon, dropper, cup, breastfeeding support system, and finger feeding) until preterm infants mature enough to meet their daily nutritional needs by breastfeeding alone (exclusive breastfeeding). The Supplemental Nursing System (SNS) is an alternative supplemental feeding method that supports the development of sucking skills while providing the preterm infant's nutritional needs. This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

72

Conditions

Breastfeeding Preterm Infant Sucking Behavior

Interventions

MEDELA Supplemental nursing systemDEVICE

The experimental group participants were fed based on the MEDELA Supplemental Nursing System, which consists of a syringe/container and a feeding catheter. One end of the feeding probe is in the syringe/container, while the other is fixed to the mother's nipple through a plaster. MEDELA SNS is a sterile product with an adjustable breast milk flow system and neck strap. It is bisphenol A (BPA) free. All its parts are in direct contact with breast milk. This system allows the baby to both suck and feed (MEDELA Supplemental Nursing System, 2018).

Eligibility

Sex: ALLMin age: 30 WeeksMax age: 34 WeeksHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * being between the gestational ages of 30 to 34 weeks * having a birthweight of ≥1000 g * having an APGAR score of \>6 * having stabilized for 48 hours after receiving mechanical ventilator or continuous positive air pressure or both * being exclusively gavage-fed with breast and/or formula and ready to switch to oral feeding * being willing to breastfeed Exclusion Criteria: * having a congenital malformation that may cause asphyxia and affect breathing * having an intraventricular hemorrhage, intracranial hemorrhage, or periventricular leukomalacia * having intestinal anomalies or hyperbilirubinemia requiring exchange transfusion * having respiratory distress syndrome, bronchopulmonary dysplasia, or other chronic lung diseases.

Locations (1)

Istanbul Medeniyet University

Istanbul, Kadıköy, Turkey (Türkiye)

Outcomes

Primary Outcomes

The time to transition to oral feeding (hours)

It was measured when the preterm infant swiched from gavage feeding to oral feeding.

Time frame: up to three weeks

Time to discharge (hours)

It was measured at discharge

Time frame: up to 2 months

The sucking success (First measurement)

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.

Time frame: at the beginning of the study, up to three weeks

The sucking success (Second measurement)

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.

Time frame: 48 hours after the second measurement of sucking success

The sucking success (Last measurement)

The sucking success was assessed using the LATCH Breastfeeding Assessment Tool. The tool was developed by Jensen et al. (1994) and adapted to Turkish by Yenal and Okumus (2003). It consists of five evaluation criteria: L (Latch on breast), how well the infant latches onto the breast; A (Audible swallowing), the amount of audible swallowing noted; T (Type of nipple), the mother's nipple type; C (Comfort, breast/nipple), the mother's level of comfort in relation to the nipple; and H (Hold/Help), the amount of help the mother needs to hold her infant to the breast. Each item is rated on a scale of 0 to 2. The total score ranges from 0 to 10, with high scores indicating successful sucking.