极低出生体重儿住院期间经口喂养方案的构建

Developing an oral feeding protocol for very low birth weight infants during hospitalization

目的构建极低出生体重儿住院期间经口喂养方案,以规范经口喂养,推进其经口喂养进程、促进生长发育。方法以统合发展理论为指导,通过循证方法学总结极低出生体重儿经口喂养的最佳证据,经过研究小组讨论形成极低出生体重儿住院期间经口喂养方案初稿,进行2次专家论证会议讨论,根据专家意见结合临床实践,对方案初稿进行修订完善。结果形成包括入院后-经口喂养准备、微量经口喂养(母乳滴注喂养、个性化奶嘴内母乳滴喂)、每12小时尝试经口奶瓶喂养1次、每6小时尝试经口奶瓶喂养1次、每次喂养尝试经口奶瓶喂养、母乳亲喂6个环节的极低出生体重儿住院期间经口喂养方案。结论基于循证的极低出生体重儿住院期间经口喂养方案具有较好的科学性和临床适宜性,可为临床开展有效规范的经口喂养提供参考。

Objective To develop an oral feeding protocol for very low birth weight infants during their hospitalization,to provide a reference for standardized oral feeding practice for the infants,to smooth the process of oral feeding and promote infants′growth and development.Methods Guided by the Synactive Theory of Development,the best evidence for oral feeding in very low birth weight infants was summarized through evidence-based methodology.Following discussions in the research group,the first draft of the oral feeding protocol for very low birth weight infants during hospitalization was developed.This protocol underwent validation through organizing two meetings of expert and was subsequently revised and improved according to expert opinion combined with clinical practice considerations.Results A comprehensive oral feeding protocol for very low birth weight infants during hospitalization was finalized,which consisted of six stages:preparation for oral feeding upon admission,trophic feeding(breastmilk drip feeding,individualized breastmilk drip feeding through the pacifier),attempted oral bottle feeding every 12 hours,attempted oral bottle feeding every 6 hours,attempted oral bottle feeding at every feeding,and breastfeeding by mother.Conclusion The evidence-based oral feeding protocol for very low birth weight infants during hospitalization is scientific,and has good clinical appropriateness,offering a reference for effective and standardized oral feeding practices in clinical practice in the future.