Anne sütü/formül süt ısısının preterm bebeklerin yaşam bulguları üzerine etkisinin değerlendirilmesi

Yıl 2023, Cilt: 10 Sayı: 3, 485 - 496, 01.09.2023

Eda Aktaş , Ayşe Ferda Ocakçı , Güner Karatekin

https://doi.org/10.52880/sagakaderg.1345947

Öz

Amaç: Araştırma preterm bebeklere bir standart doğrultusunda hazırlanarak verilen farklı ısılardaki anne sütü/formül sütün bebeğin yaşam bulguları üzerine etkisini değerlendirmek amacı ile gerçekleştirilmiştir.
Yöntem: Araştırma İstanbul ilindeki bir eğitim araştırma hastanesinin YYBÜ’nde, ön test-son test kontrol gruplu deneysel tipte, 150 preterm bebek ile gerçekleştirilmiştir. Veriler, araştırmacı tarafından geliştirilen preterm bebeği tanıtıcı bilgi formu ve preterm bebek takip çizelgesi aracılığı ile toplanmıştır. Anne sütü/formül sütler Deney-1 grubu bebeklere 24 ºC’de, Deney-2 grubu bebeklere 37 ºC’de verilmiştir. Kontrol grubu bebeklere verilen süt ısısına herhangi bir müdahale yapılmamış, hemşirelerin hazırladığı ısıda verilmiştir. Farklı ısılardaki anne sütü/formül sütler preterm bebeklere verilmeden hemen önce, verildikten 5 dakika ve 30 dakika sonra bebeğin yaşam bulguları (vücut ısısı, KTA ve SpO2) ölçülmüş ve kayıt altına alınmıştır.
Bulgular: Araştırma kapsamındaki preterm bebeklerin %44’ü kız, %56’sı erkektir ve ortalama gestasyon haftası 31,31±3,02 olarak saptanmıştır. Gruplar tanımlayıcı özellikleri açısından benzerdir (p>0,05). Deney-2 grubu bebeklerin beslenme başladıktan sonra 5. ve 30. dakikalarda ölçülen yaşam bulgularının Kontrol ve Deney-1 grubuna göre fizyolojik stabilizasyonu daha etkili sağladığı saptanmıştır (p<0,05).
Sonuç: Preterm bebeklere 37 ºC’de verilen anne sütü/formül sütler bebeğin yaşam bulgularını olumlu yönde etkilemiştir. Bu sonuçlara göre enteral beslenen preterm bebeklere anne sütü/formül sütün 37 ºC’de verilmesi önerilebilir.
KAYNAKLAR
Aktaş, E. (2018). Developing a breast milk/formula preparation and heating standarts for preterm ınfants and evaluation of its effectiveness (Unpublished PhD Thesis). Marmara University Health Sciences Institute, Istanbul.
Anderson, C. A., & Berseth, C.L. (1996). Neither motor responses nor gastric emptying vary in response to formula temperature in preterm infants. Biology of the Neonate, 70(5), 265-270. https://doi.org/10.1159/000244375
Başkale, H., & Serçekuş, P. (2014). A Current knowledge and applications for breast milk storage. E-Journal of Dokuz Eylul University Nursing Faculyt, 7(4),311-314.
Belfort, M. B., & Ramel, S. E. (2019). NICU diet, physical growth and nutrient accretion, and preterm infant brain development. Neoreviews, 20(7), e385-e396. https://doi.org/10.1542/neo.20-7-e385
Blumenthal, I., Lealman, G. T., & Shoesmith, D. R. (1980). Effect of feed temperature and phototherapy on gastric emptying in the neonate. Archives os Disease Childhood, 55(7),562-564. https://doi.org/10.1136/adc.55.7.562
Çamur, Z., & Erdoğan, Ç. (2022). The effect of breast milk temperature on feeding intolerance in tube-fed preterm infants: A randomized controlled study. Journal of Neonatal Nursing, 29(4):675-680. https://doi.org/10.1016/j.jnn.2022.12.004
Çövener Özçelik, Ç., & Aktaş, E. (2019). The evaluation of the knowledge and practices of nurses regarding milk temperature delivered to infants during feeding: A descriptive study. Journal of Education and Research in Nursing, 16(3), 176-182. https://doi.org/10.5222/HEAD.2019.176
Dumm, M., Hamms, M., Sutton, J. A., & Ryan-Wenger, N. (2013). NICU breast milk warming practices and the physiological effects of breast milk feeding temperatures on preterm ınfants. Advances in Neonatal Care, 13(4), 279-287. https://doi.org/10.1097/ANC.0b013e31829d8c3a
Dvorak, B., Halpern, M. D., Holubec, H., Dvorakova, K., Dominguez, J. A., Williams, C. S., …McCuskey, R. S. (2003). Maternal milk reduces severity of necrotizing enterocolitis and increases intestinal IL-10 in a neonatal rat model. Pediatric Research, 53(3), 426-33. https://doi.org/10.1203/01.PDR.0000050657.56817.E0
Dvorak, B., Halpern, M. D., Holubec, H., Williams, C. S., McWilliam, D. L., Dominguez, J. A.,…McCuskey, R. S. (2002). Epidermal growth factor reduces the development of necrotizing enterocolitis in a neonatal rat model. American Journal of Physiology-Gastrointestinal and Liver Physiology, 282(1), G156-G164. https://doi.org/10.1152/ajpgi.00196.2001
Eckburg, J. J., Bell, E.F., Rios, G.R., & Wilmoth, P. K. (1987). Effects of formula temperature on postprandial thermogenesis and body temperature of premature infants. The Journal of Pediatrics, 111(4), 588-592. https://doi.org/10.1016/s0022-3476(87)80127-0
Filippa, M., Lordier, L., De Almeida, J. S., Monaci, M. G., Adam-Darque, A., Grandjean, D., Kuhn, P., & Hüppi, P. S. (2020). Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatric Research, 87(2), 249-264. https://doi.org/10.1038/s41390-019-0490-9
Gabrielski, L., & Lessen, R. (2015). Centralized Model of Human Milk Preparation and Storage in a State-of-the-Art Human Milk Lab. Infant, Child, & Adolescent Nutrition, 3(4), 225-32 https://doi.org/10.1177/1941406411416978
Gökçe, İ. K. (2017). Premature baby feeding. Turkiye Klinikleri Journals Pediatric Sciences, 13(3), 270-277.
Gonzales, I., Duryea, E. J., Vasquez, E., & Geraghty, N. (1995). Effect of enteral feeding temperature on feeding tolerance in preterm infants. Neonatal Network, 14(3), 39-43.
Halpern, M. D., Holubec, H., Dominguez, J. A., Williams, C. S., Meza, Y. G., McWilliam, D. L., Payne, C. M., McCuskey, R. S., Besselsen, D. G., & Dvorak, B. (2002). Up-regulation of IL-18 and IL-12 in the ileum of neonatal rats with necrotizing enterocolitis. Pediatric Research, 51(6), 733-739. https://doi.org/10.1203/00006450-200206000-00012
Holt, L. E., Davies, E. A., Hassel Meyer, E. G., & Adams, A. O. (1962). A study of premature infants fed cold formula. The Journal of Pediatrics, 61(4), 556–561. https://doi.org/10.1016/S0022-3476(62)80146-2
HTMM Aluminium Foil. (2016). Retrived from http://www.alufoil.org/files/alufoil/infoil/Infoil38Turkish.pdf, Accessed 15 April 2016
Kayhan Tetik, B. (2016). Current ınformation on consultancy of breast milk and breast-feeding. Ankara Medical Journal, 16, 115-118. https://doi.org/10.17098/amj.12772
Knobel, R. B. (2014). Thermal stability of the premature ınfant in neonatal ıntensive care. Newborn and Infants Nursing Reviews, 1(2), 72-76. https://doi.org/10.1053/j.nainr.2014.03.002
Kültürsay, N., Bilgen, H., & Türkyılmaz, C. (2018). Turkish Neonatal Society guideline on enteral feeding of the preterm infant. Turkish Archives of Pediatrics, 53(Supp: 1), 109-118. https://doi.org/10.5152/TurkPediatriArs.2018.01811
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-174. https://doi.org/10.2307/2529310
Lawlor-Klean, P., Lefaiver, C. A., & Wiesbrock, J. (2013). Nurses' perception of milk temperature at delivery compared to actual practice in the neonatal intensive care unite. Advances in Neonatal Care, 13(5), E1-E10. https://doi.org/10.1097/ANC.0b013e3182a14cbd
Lee, H., Park, J. H., & Cho, H. (2022). Analysis of research on developmentally supportive care for prematurity in neonatal intensive care unit: a scoping review. Child Health Nursing Research, 28(1), 9-22. https://doi.org/10.4094/chnr.2022.28.1.9
Malone, H. E, Nicholl, H., & Coyne, I. (2016). Fundamentals of estimating size. Nurse Researcher, 23(5), 21-25. https://doi.org/10.7748/nr.23.5.21.s5
Mohammed, R. E., Khamis, G. M., & Sabry, Y. Y. (2018). Effect of preterm neonates' developmental supportive care program on nurses' performance. IOSR Journal of Nursing and Health Science, 7(4), 33-45. https://doi.org/10.9790/1959-0704053345
Samancı, N. (2017). Thermal regulation in newborns. In Dağoğlu, T., & Ovalı, F. (Ed.), Neonatology (pp. 311-316) (3. ed). İstanbul: Nobel Tıp Kitapevi.
Sangild, P. T., Petersen, Y. M., Schmidt, M., Elnif, J., Petersen, T. K., Buddington, R. K., Greisen, G., Michaelsen, K. F., & Burrin, D. G. (2002). Preterm birth affects the intestinal response to parenteral and enteral nutrition in newborn pigs. The Journal of Nutrition,132(9), 2673-2681. https://doi.org/10.1093/jn/132.9.2673
Turkish Public Health Institution. (2015a). Frequently Asked Questions about Breastfeeding and Breast Milk (pp.20-21). Ankara: Kayıhan Ajans.
Turkish Public Health Institution. (2015b). Breastfeeding Consultant Training Guidebook (pp. 169-179). Ankara: Kayıhan Ajans.
Uygur, O., Yalaz, M., Can, N., Koroglu, O. A., & Kultursay, N. (2019). Preterm infants may better tolerate feeds at temperatures closer to freshly expressed breast milk: a randomized controlled trial. Breastfeeding Medicine, 14(3), 154-158. https://doi.org/10.1089/bfm.2018.0142
White, R. D., Smith, J. A., & Shepley, M. M. (2013). Recommended standards for newborn ICU design, eighth edition. Journal of Perinatology, 33, 2-16. https://doi.org/10.1038/jp.2013.10

Anahtar Kelimeler

Anne sütü, formül süt, süt ısısı, preterm bebek, yaşam bulguları

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

Araştırmaya katılan preterm bebeklere ve onların ebeveynlerine teşekkür ederiz.

Effect of breast milk/formula temperature on the vital signs of preterm infants

Öz

ABSTRACT
Purpose: The aim of this study was to evaluate the impact of breast milk/formula milk at different temperatures prepared and given to preterm infants in accordance with a standard on the vital signs of the infant.
Methods: This pretest-posttest controlled experimental study was conducted with 150 preterm infants in the NICU of a training and research hospital. Infants in experimental group 1 received breast milk/formula at 24 °C and those in experimental group 2 received breast milk/formula at 37 °C. Infants in the control group received breast milk/formula at the temperature prepared by the nurses as per routine practice with no specific instruction or intervention. The infants’ vital signs (body temperature, heart rate, and oxygen saturation) were measured and recorded immediately before feeding and at 5 minutes and 30 minutes after the start of feeding.
Results: The study sample comprised 44% female and 56% male infants with a mean gestational age of 31.3±3.0 weeks. The groups were similar in terms of descriptive characteristics (p>0.05). The vital signs of infants in experimental group 2 measured at 5 and 30 minutes after the start of feeding tended to be better and more stable than those of the infants in experimental group 1 and the control group.
Conclusion: Breast milk/formula given at 37 °C improved preterm infants’ vital signs. Based on these results, it can be recommended to administer breast milk/formula at 37 °C to preterm infants fed enterally.

Anahtar Kelimeler

Breast milk, formula, milk temperature, preterm infants, vital signs

Proje Numarası

-

Kaynakça

• Aktaş, E. (2018). Developing a breast milk/formula preparation and heating standarts for preterm ınfants and evaluation of its effectiveness (Unpublished PhD Thesis). Marmara University Health Sciences Institute, Istanbul.
• Anderson, C. A., & Berseth, C.L. (1996). Neither motor responses nor gastric emptying vary in response to formula temperature in preterm infants. Biology of the Neonate, 70(5), 265-270. https://doi.org/10.1159/000244375
• Başkale, H., & Serçekuş, P. (2014). A Current knowledge and applications for breast milk storage. E-Journal of Dokuz Eylul University Nursing Faculyt, 7(4),311-314.
• Belfort, M. B., & Ramel, S. E. (2019). NICU diet, physical growth and nutrient accretion, and preterm infant brain development. Neoreviews, 20(7), e385-e396. https://doi.org/10.1542/neo.20-7-e385
• Blumenthal, I., Lealman, G. T., & Shoesmith, D. R. (1980). Effect of feed temperature and phototherapy on gastric emptying in the neonate. Archives os Disease Childhood, 55(7),562-564. https://doi.org/10.1136/adc.55.7.562
• Çamur, Z., & Erdoğan, Ç. (2022). The effect of breast milk temperature on feeding intolerance in tube-fed preterm infants: A randomized controlled study. Journal of Neonatal Nursing, 29(4):675-680. https://doi.org/10.1016/j.jnn.2022.12.004
• Çövener Özçelik, Ç., & Aktaş, E. (2019). The evaluation of the knowledge and practices of nurses regarding milk temperature delivered to infants during feeding: A descriptive study. Journal of Education and Research in Nursing, 16(3), 176-182. https://doi.org/10.5222/HEAD.2019.176
• Dumm, M., Hamms, M., Sutton, J. A., & Ryan-Wenger, N. (2013). NICU breast milk warming practices and the physiological effects of breast milk feeding temperatures on preterm ınfants. Advances in Neonatal Care, 13(4), 279-287. https://doi.org/10.1097/ANC.0b013e31829d8c3a
• Dvorak, B., Halpern, M. D., Holubec, H., Dvorakova, K., Dominguez, J. A., Williams, C. S., …McCuskey, R. S. (2003). Maternal milk reduces severity of necrotizing enterocolitis and increases intestinal IL-10 in a neonatal rat model. Pediatric Research, 53(3), 426-33. https://doi.org/10.1203/01.PDR.0000050657.56817.E0
• Dvorak, B., Halpern, M. D., Holubec, H., Williams, C. S., McWilliam, D. L., Dominguez, J. A.,…McCuskey, R. S. (2002). Epidermal growth factor reduces the development of necrotizing enterocolitis in a neonatal rat model. American Journal of Physiology-Gastrointestinal and Liver Physiology, 282(1), G156-G164. https://doi.org/10.1152/ajpgi.00196.2001
• Eckburg, J. J., Bell, E.F., Rios, G.R., & Wilmoth, P. K. (1987). Effects of formula temperature on postprandial thermogenesis and body temperature of premature infants. The Journal of Pediatrics, 111(4), 588-592. https://doi.org/10.1016/s0022-3476(87)80127-0
• Filippa, M., Lordier, L., De Almeida, J. S., Monaci, M. G., Adam-Darque, A., Grandjean, D., Kuhn, P., & Hüppi, P. S. (2020). Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatric Research, 87(2), 249-264. https://doi.org/10.1038/s41390-019-0490-9
• Gabrielski, L., & Lessen, R. (2015). Centralized Model of Human Milk Preparation and Storage in a State-of-the-Art Human Milk Lab. Infant, Child, & Adolescent Nutrition, 3(4), 225-32 https://doi.org/10.1177/1941406411416978 Gökçe, İ. K. (2017). Premature baby feeding. Turkiye Klinikleri Journals Pediatric Sciences, 13(3), 270-277.
• Gonzales, I., Duryea, E. J., Vasquez, E., & Geraghty, N. (1995). Effect of enteral feeding temperature on feeding tolerance in preterm infants. Neonatal Network, 14(3), 39-43.
• Halpern, M. D., Holubec, H., Dominguez, J. A., Williams, C. S., Meza, Y. G., McWilliam, D. L., Payne, C. M., McCuskey, R. S., Besselsen, D. G., & Dvorak, B. (2002). Up-regulation of IL-18 and IL-12 in the ileum of neonatal rats with necrotizing enterocolitis. Pediatric Research, 51(6), 733-739. https://doi.org/10.1203/00006450-200206000-00012
• Holt, L. E., Davies, E. A., Hassel Meyer, E. G., & Adams, A. O. (1962). A study of premature infants fed cold formula. The Journal of Pediatrics, 61(4), 556–561. https://doi.org/10.1016/S0022-3476(62)80146-2 HTMM Aluminium Foil. (2016). Retrived from http://www.alufoil.org/files/alufoil/infoil/Infoil38Turkish.pdf, Accessed 15 April 2016
• Kayhan Tetik, B. (2016). Current ınformation on consultancy of breast milk and breast-feeding. Ankara Medical Journal, 16, 115-118. https://doi.org/10.17098/amj.12772
• Knobel, R. B. (2014). Thermal stability of the premature ınfant in neonatal ıntensive care. Newborn and Infants Nursing Reviews, 1(2), 72-76. https://doi.org/10.1053/j.nainr.2014.03.002
• Kültürsay, N., Bilgen, H., & Türkyılmaz, C. (2018). Turkish Neonatal Society guideline on enteral feeding of the preterm infant. Turkish Archives of Pediatrics, 53(Supp: 1), 109-118. https://doi.org/10.5152/TurkPediatriArs.2018.01811
• Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-174. https://doi.org/10.2307/2529310
• Lawlor-Klean, P., Lefaiver, C. A., & Wiesbrock, J. (2013). Nurses' perception of milk temperature at delivery compared to actual practice in the neonatal intensive care unite. Advances in Neonatal Care, 13(5), E1-E10. https://doi.org/10.1097/ANC.0b013e3182a14cbd
• Lee, H., Park, J. H., & Cho, H. (2022). Analysis of research on developmentally supportive care for prematurity in neonatal intensive care unit: a scoping review. Child Health Nursing Research, 28(1), 9-22. https://doi.org/10.4094/chnr.2022.28.1.9
• Malone, H. E, Nicholl, H., & Coyne, I. (2016). Fundamentals of estimating size. Nurse Researcher, 23(5), 21-25. https://doi.org/10.7748/nr.23.5.21.s5
• Mohammed, R. E., Khamis, G. M., & Sabry, Y. Y. (2018). Effect of preterm neonates' developmental supportive care program on nurses' performance. IOSR Journal of Nursing and Health Science, 7(4), 33-45. https://doi.org/10.9790/1959-0704053345
• Samancı, N. (2017). Thermal regulation in newborns. In Dağoğlu, T., & Ovalı, F. (Ed.), Neonatology (pp. 311-316) (3. ed). İstanbul: Nobel Tıp Kitapevi.
• Sangild, P. T., Petersen, Y. M., Schmidt, M., Elnif, J., Petersen, T. K., Buddington, R. K., Greisen, G., Michaelsen, K. F., & Burrin, D. G. (2002). Preterm birth affects the intestinal response to parenteral and enteral nutrition in newborn pigs. The Journal of Nutrition,132(9), 2673-2681. https://doi.org/10.1093/jn/132.9.2673
• Turkish Public Health Institution. (2015a). Frequently Asked Questions about Breastfeeding and Breast Milk (pp.20-21). Ankara: Kayıhan Ajans.
• Turkish Public Health Institution. (2015b). Breastfeeding Consultant Training Guidebook (pp. 169-179). Ankara: Kayıhan Ajans.
• Uygur, O., Yalaz, M., Can, N., Koroglu, O. A., & Kultursay, N. (2019). Preterm infants may better tolerate feeds at temperatures closer to freshly expressed breast milk: a randomized controlled trial. Breastfeeding Medicine, 14(3), 154-158. https://doi.org/10.1089/bfm.2018.0142
• White, R. D., Smith, J. A., & Shepley, M. M. (2013). Recommended standards for newborn ICU design, eighth edition. Journal of Perinatology, 33, 2-16. https://doi.org/10.1038/jp.2013.10