| Objective To explore the effects of oral application of colostrum,donated human milk and normal saline on improving the oral feeding ability and clinical outcomes of very low birth weight premature infants,and to analyze and compare the effects of colostrum,donated human milk and normal saline on the growth and development of very low birth weight premature infants within 6 months of corrected age.Methods Very low birth weight premature infants,born from June 2018-March 2019 in Ningxia Yinchuan Maternal and Child Health Hospital in Neonatal intensive care unit(NICU)were selected as the research object.The subjects were randomly divided into the own mother's colostrum group,the donated human milk group and the normal saline group,with 32 cases in each group.During the period of hospitalization,Three groups of very low birth weight preterm infants were given normal saline,donated human milk and colostrum oral smear on the basis of developmental support for preterm infants,and used the Preterm Infant Oral Feeding Readiness Acessment Scale to evaluate the oral feeding ability of three groups of very low birth weight preterm infants every day,observed and recorded the time of oral feeding and the time of complete oral feeding in three groups of very low birth weight premature infants,and calculated the feeding process.measured body weight once a day,body length and head circumference were weekly,and recorded feeding intolerance,necrotizing enterocolitis,hyperbilirubinemia and hospital stay in three groups of very low birth weight premature infants.Before discharge,establish a discharge follow-up registration form forpremature babies and follow-up monitoring instructions for discharge.After discharge,three groups of very low birth weight preterm infants were fed,promoted,followed up and monitored until the corrected age of 6 months.Follow-up monitoring records the development of physical and neurological intelligence in very low birth weight preterm infants on day 42 after birth,corrected at 3 and 6 months of age.Results1.Results of general clinical dataA total of 96 very low birth weight premature infants were included in this study.During follow-up monitoring up to 6 months of corrected age,a total of 9 cases were lost to follow-up,and 87 cases were finally followed up,including 29 cases in the saline group,30 cases in the donated human milk group,and 28 cases in the own mother's colostrum group.87 cases of very low birth weight premature infants were born for an average gestational age of(32.04±1.69)weeks;The average birth weight was(1.35±0.13)Kg,the average birth length was(39.16±3.00)cm and the average head circumference was(27.92±1.88)cm,Apgar score 1minute mean(8.53±1.25)points,5 minute mean(9.49±0.73)points;Gender:49 males(56.3%)and 38 females(43.7%);.the average age of the mothers of 87 cases of very low birth weight premature infants was(29.95±4.98)years old.2.Intervention results2.1 Before the interventionThere was no significant difference in general clinical data of very low birth weight premature infants and their mothers with three different oral smears(P>0.05).There was no significant difference in the total average score of oral feeding ability,score of each dimension,head circumference,body length and head circumference among the three groups(P>0.05).2.2 After intervention(1)The Comparison of feeding of very low birth weight premature infants:on the first day of admission,there was no significant difference in oral feeding ability among the threegroups of very low birth weight premature infants with different oral smear(P>0.05).On the7 th day of admission,The score of oral reflex dimension of very low birth weight preterm infants with oral own mother's colostrum application and oral application of donated human milk was higher than that of those with oral application of normal saline(P<0.05).On the14 th day of admission,The total score of oral feeding ability,oral reflex,and non-nutritive sucking dimensions of own mother's colostrum oral smear and donated human milk oral smear for very low birth weight premature infants were higher than those of normal saline oral smear(P<0.05).The duration of oral feeding for very low birth weight infants in the own mother's colostrum group was less than that of the donated human milk group and the normal saline group(P<0.05),while total oral feeding time and Feeding process of very low birth weight premature infants with own mother's colostrum application was all shorter than those with oral milk donation and which were also shorter than those with oral saline application(P<0.05).(2)The Comparison of complications associated with very low birth weight premature infants showed that:there were statistical differences in feeding intolerance and HB incidence among the three groups of very low birth weight premature infants(P<0.05),while there was no statistical difference in NEC incidence(P>0.05).(3)The Comparison of hospitalization time and recovery time of very low birth weight premature infants showed that:The average hospital stay of very low birth weight premature infants with own mother's colostrum oral application is shorter than those with donated human milk oral applicator and shorter than those with normal saline oral application,There was a statistically significant difference between the own mother's colostrum oral application and the very low birth weight premature infants who donated human milk's oral application compared with the physiological salt oral application(P=0.012,P=0.048;P<0.05),There was no statistical difference between very low birth weight premature infants with own mother's colostrum oral smears and those who donated human milk oral smears(P=0.550,P>0.05);Therecovery time of extremely low birth weight preterm infants with oral application of own mother's colostrum was shorter than that of those with oral application of human milk and normal saline.The ratio of oral application of own mother's colostrum to oral application of extremely low birth weight preterm infants was statistically different from that of those with oral application of human milk and physiological salt(P=0.028,P=0.022).P<0.05),there was no statistically significant difference between oral oral smear of very low birth weight premature infants donated human milk and oral oral smear of normal saline(P=0.898,P> 0.05).(4)The Comparison of growth and development of very low birth weight premature infants showed:(1)Weight:there was no significant difference in the weight of the three groups of very low birth weight premature infants on the 4th and 7th days after birth(P>0.05);The weight of very low birth weight premature infants who received own mother's colostrum and oral milk donation were higher than who received oral saline on the 14 th day after birth(P <0.05);The weight of very low birth weight preterm infants with oral colostrum application at the 42 nd day after birth and at the correction age of 3 and 6 months were all higher than those with oral milk donation and which were all higher than those with oral saline application(P<0.05);(P<0.05);(2)Body length:there was no significant difference in body length between the three groups of very low birth weight premature infants on the 7th and 14 th days after birth(P>0.05);The body length of very low birth weight preterm infants with oral own mother's colostrum application at the 42 nd day after birth and at the correction age of 3 and 6 months were higher than those with oral milk donation and which were all higher than those with oral saline application(P<0.05);(3)Head circumference: there was no significant difference in the head circumference of the three groups of very low birth weight premature infants on the 7th and 14 th day after birth(P > 0.05).The head circumference of very low birth weight preterm infants with oral own mother's colostrum application at the 42 nd day after birth and at the correction age of 3and 6 months were higher than those with oral milk donation and which were all higher than those with oral saline application(P<0.05).(5)Comparison of growth and development index Z score of very low birth weight premature infants at 6 months of age:(1)weight:There is no statistically significant difference in the weight Z score of the three groups of very low birth weight premature infants with different oral applicators at birth(P>0.05),and There was a significant difference in the Z-score of very low birth weight preterm infants treated with colostrum at the age of 3 months compared with the normal saline group(P<0.05),At the age of 6 months,the weight Z of VLBW preterm infants in three groups was significantly different(P<0.05).(2)body length:three groups of different Oral applicator of very low birth weight premature infants body length Z score differences at birth without statistical significance(P>0.05),and which is also true of correcting the infants at the age of 3 and 6 months(P<0.05).head circumference:three groups of different Oral applicator of very low birth weight premature infants head circumference Z score differences at birth without statistical significance(P>0.05),and which is also true of correcting the infants at the age of 3 and 6 months(P<0.05).(6)The comparison of neural intelligence indexes at different time points within the corrected 6-month-old for very low birth weight premature infants showed that:there was no significant difference in the number of normal,suspicious,abnormal+unexplained Neural intelligence development the 42 days after birth,3 months after correction and 6 months after correction(P>0.05).Conclusion1.The own mother's colostrum oral application and the donated human milk application premature infant development support nursing all can improve the oral feeding ability andshorten the feeding process of very low birth weight premature infants,but in colostrum oral application premature development support effect is superior to the donated human milk group,better than normal saline.also can shorten the time of the completely through the mouth to feed and recovery time of birth weight.2.The colostrum oral application and the donor human milk oral application of the very low birth weight premature infants can reduce the incidence of hyperbilirubinemia and feeding intolerance,no increase the incidence of necrotizing enterocolitis,and both can shorten the hospital stay.3.Feeding,development promotion guidance and follow-up monitoring of the very low birth weight premature infants with colostrum oral application and donor human milk oral application can effectively promote the growth and development of the very low birth weight premature infants,and make their body weight,body length and head circumference catch-up growth and development reach above the medium level at the corrected age of 6 months. |
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