Transition de l'alimentation passive à l'alimentation active chez le bébé prématuré

Abstract

The research presented was conducted in three phases. A first retrospective study describes the reference population composed of 18 premature neonates receiving usual neonatal care and focuses on the duration and the shape of the transition from completely passive (probe feeding) to fully active feeding (bottle or breast-feeding). Nasal CPAP influences this transition. The second group of premature infants (N = 24) received a standardized transition program based on body positioning in a flexed state, and a recommendation regulating the volumes of active and passive feeding offered to the neonate. The effect of nasal CPAP on this transition is evaluated. The third group (N = 25) received the same body support as above when feeding as well as the standardized transition program, but in addition, a predetermined peri-oral and oral stimulation was applied. Again, the effect of nasal CPAP on transition is analyzed. The same analyses conducted in the three groups demonstrate a significant reduction of transition time and variability. Nasal CPAP, when present for more than seven days, has a significant negative effect on acquisition of active feeding, an effect that may be offset by behavioural interventions such as body positioning and peri-oral stimulation. Independent of gestational age, 90 % of the food the premature infant is able to actively ingest, is done so during the first ten minutes. This fact allows adaptation of feeding practices : the duration of active breast- or bottle-feeding and passive tube feeding.