Effects of early intervention on feeding behavior in preterm infants: A randomized controlled trial

Abstract

Background: Although highly beneficial, human milk feeding is challenging in preterm infants due to adverse NICU factors for the infant and mother.

Aim: To investigate the effects of an early intervention in promoting infant's human milk feeding and acquisition of full oral feeding.

Methods: This study is part of a RCT. We included preterm infants born between 25⁺⁰ and 29⁺⁶ weeks of gestational age (GA) without severe morbidities, and their parents. Infants were randomized to either receive early intervention (EI) or standard care (SC). EI included PremieStart and parental training to promote infant massage and visual attention according to a detailed protocol. SC, in line with NICU protocols, included Kangaroo Mother Care. The time of acquisition of full oral feeding and human milk consumption at discharge were recorded.

Results: Seventy preterm (EI n = 34, SC n = 36) infants were enrolled. Thirteen were excluded according to the protocol. Fifty-seven (EI n = 29, SC n = 28) infants were evaluated at discharge. The two groups were comparable for parent and infant characteristics. A significantly higher rate of infants fed with any human milk was observed in the EI group (75.9%) compared with the SC group (32.1%) (p = 0.001), and EI infants were four times more likely to be fed exclusively with human milk. Full oral feeding was achieved almost one week earlier in EI infants (mean postmenstrual age 36.8 ± 1.6 vs 37.9 ± 2.4 weeks in EI vs SC, p = 0.04).

Conclusions: Early interventions promoting mother self-efficacy and involvement in multisensory stimulation have beneficial effects on human milk feeding in preterm infants.

Keywords: Early intervention; Feeding; Human milk; Preterm infant.