Transition times to oral feeding in premature infants with and without apnea

• Published in: Journal of obstetric, gynecologic, and neonatal nursing Vol. 25; no. 9; p. 771
• Main Authors: Mandich, M B, Ritchie, S K, Mullett, M
• Format: Journal Article
• Language: English
• Published: United States 01.11.1996
• Subjects: Aminophylline - therapeutic use; Analysis of Variance; Apgar Score; Apnea - drug therapy; Apnea - physiopathology; Case-Control Studies; Enteral Nutrition; Gestational Age; Humans; Infant Nutritional Physiological Phenomena; Infant, Low Birth Weight - physiology; Infant, Newborn; Infant, Premature - physiology; Linear Models; Neonatal Nursing; Sucking Behavior - physiology; Time Factors
• ISSN: 0884-2175
• DOI: 10.1111/j.1552-6909.1996.tb01493.x

To determine whether a significant relationship exists between the presence of apnea and the number of days it takes a premature infant to attain full oral feeding. A two-way analysis of variance factorial design (apnea x aminophylline) was used with infants grouped according to presence or absence of apnea and whether they were receiving aminophylline. Neonatal intensive-care and step-down nurseries of a level III teaching hospital. Eligibility criteria for this study included gestational age of 28-34 weeks, less than 48 hours of mechanical ventilation, and absence of congenital anomalies. Infants were classified into one of four groups: Group 1 (NN) consisted of infants who had no recorded apnea and were not receiving aminophylline (n = 27); group 2 (AA) consisted of infants receiving aminophylline who continued to experience apnea during the transition time to oral feeding, (n = 20); group 3 (NA) consisted of infants receiving aminophylline who did not experience apnea during the transition time to oral feeding (n = 12); and group 4 (AN) were infants who experienced some apnea but never received aminophylline (n = 6). All 65 enrolled subjects completed the study. Review of medical records and daily nursing notes to record apnea instances and oral feeding status for each 24-hour period. The number of days between the first attempted oral feeding and full oral feeding was recorded, as well as number of apnea instances occurring during the transition time. An analysis of variance procedure showed that groups who did not experience apnea had a significantly (F[1, 61] = 10.19, p < .01) shorter transition time (NN = 6.6 days, NA = 5.4 days) than groups who did (AA = 11.3 days, AN = 10.3 days). Apnea was found to be correlated strongly with transition time (R = .42, p < .001). A multiple linear regression forward selection procedure showed apnea to make the greatest contribution to variance in transition time in days with a partial R2 of .18 (p < .001). Apnea appears to be a factor that influences the length of time it takes a premature infant to begin receiving full oral feedings.