HOLDING PREMATURE INFANTS DURING GAVAGE FEEDING: EFFECT ON APNEA, BRADYCARDIA, OXYGENATION, GASTRIC RESIDUAL, GASTRIN, AND BEHAVIORAL STATE.
Contributors: Case Western Reserve University.
Published: 1995
Number of pages: 130
Subjects: Health Sciences, Nursing.; Psychology, Behavioral.; Psychology, Psychobiology.; Health Sciences, Human Development.
Description: The purpose of this research was to investigate the effects of holding premature infants upright chest-to-chest during gavage feeding on apnea, bradycardia, oxygenation, gastric residual, gastric gastrin, and behavioral state. Twenty-four premature infants were followed for three consecutive gavage feedings. Infants served as their own control. Feeding 1 was done in the routine prone position in bed. Infants were held for Feedings 2 and 3. Continuous data was collected on respiratory and heart rates, skin temperature, and oxygen saturation and recorded every one minute using a Mennen HorizonXL neonatal monitor with Nellcor software and hard copy print out. Infant behavioral state was observed every two minutes throughout the feedings using the Anderson Behavioral State Scoring System. Gastric gastrin samples were collected one hour after each feeding and were analyzed using a Becton-Dickson gastrin radioimmunoassay kit.

Analysis was done using ANOVA for repeated measures and Cochran's Q. Feeding times were divided into five equal periods, Times 1-5, with a 10 minute postfeed, Time 6. Significantly less apnea (apnea $\geq$15 seconds) occurred during Time 1 when infants were held (p $<$.05). In Feeding 3, heart rate means over Times 1-6 were significantly different (p $<$.05), however deemed clinically insignificant. Infants spent a significantly greater percentage of time in quiet irregular sleep during gavage feeding when they were held, and significantly less time in active sleep, active awake, and very active awake states (p $<$.05). Infants held for gavage feeding had significantly higher skin temperatures than when fed prone (p $<$.05). No significant differences were found in frequency of bradycardia or desaturation events, oxygen saturation means, gastric gastrin levels, or respiratory rate means when infants were held for gavage feeding. Only 3 instances of gastric residual occurred throughout the study, precluding any analysis. Holding premature infants during gavage feeding increases time spent in more desirable infant behavioral states, results in less apnea at the beginning of feedings, and does not compromise infant physiologic stability.
Notes: Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6037.

Thesis (PH.D.)--CASE WESTERN RESERVE UNIVERSITY, 1995.

School code: 0042.