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Effects of bottle feeding and two different methods of gavage feeding on oxygenation and breathing patterns in preterm infants
Author(s) -
Poets CF,
Langner MU,
Bohnhorst B
Publication year - 1997
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1997.tb09034.x
Subject(s) - medicine , bradycardia , bolus (digestion) , anesthesia , apnea , heart rate , oxygenation , bottle , blood pressure , mechanical engineering , engineering
Objective To determine the effect of bottle feeding, as compared to two methods of gavage feeding, on apnoea, bradycardia and oxygen desaturation frequency. Patients : Thirty preterm infants breathing room air; gestational age 28.6 ± 2.1 weeks at birth and 34 ± 1.4 weeks at study (mean ± SD). Methods : Nine‐hour recordings of pulse oximeter saturation (SpO 2 ), pulse waveforms, electrocardiogram, breathing movements and nasal airflow. Administration of 21 ± 1.5 ml/kg of milk/feed in 3‐h intervals using three different feeding techniques in random order: bottle feeding, bolus gavage feeding, and slow gavage feeding (1 h). Analysis of recordings for apnoeas (≥4 s, bradycardias (heart rate < 2/3 of baseline), and episodic desaturation (SpO 2 ≤ 80%). Results : There were three times more desaturations with bottle feeding than with bolus gavage feeding ( p < 0.001), but no further reduction with slow gavage feeding. With all three feeding techniques, there were significantly more desaturations in the hour when the feeds were given than during the following 2 h. The deleterious effects of bottle feeding were most evident during the hour of feeding, but desaturation frequency remained significantly higher than with gavage feeding during the following 2h. There was no significant effect of feeding technique on the frequency of apnoea or bradycardia. Conclusions : Preterm infants who are normally oxygenated in room air may have significant desaturation during bottle feeding. Such desaturation can be effectively reduced by gavage feeding. Slow gavage feeding offers no advantage over bolus gavage feeding with respect to the avoidance of hypoxaemia.