Frontiers Journal of Pediatrics and Neonatology (FJPN)

Early Discharge Of Premature Infants < 37 Weeks Gestational Age With Nasogastric Tube Feeding. The New Standard Of Care?

Abstract

Background: Most premature infants are hospitalized until they no longer need monitoring of vital parameters and are independent of nasogastric tube feeding (NTF). Hospital admission-time may reach multiple months in extremely preterm infants, but also in late preterms, in whom drinking may be the only problem, hospital admission-time can reach weeks. This is stressful for both parents and child. Parents in the Albert Schweitzer Hospital (ASH) are taught to give NTF. When monitoring is no longer necessary, the child is discharged with NTF, with home care by pediatric nurses.

Objective: In this study duration of NTF at home, the safety of the procedure and parental satisfaction were evaluated. Duration of NTF at home was compared to admission time from cessation of monitoring till discharge independent of NTF in infants born in 2 comparable hospitals where discharge with NTF is not standard care.

Methods: Premature infants  < 37 weeks gestational age were included in a prospective study between February 2014-2016 in the ASH. Exclusion-criteria: syndromal anomalies, asphyxia with neurological sequelae or social problems. Control-group: premature infants from the Northwest Hospital Group Alkmaar and the Maasstad Hospital Rotterdam.

Parental satisfaction in the study group was evaluated by questionnaire.

 

Results:

Of 416 eligible ASH-infants, 133 (32%) were discharged home with NTF, 123 participated in the study. 75% of infants born at 24-29 weeks GA was discharged with NTF, decreasing to 6% at 36 weeks GA. Median duration of NTF at home was 9 days.

82 (67%) questionnaires were completed. 96% of the parents regarded the procedure as safe, 93% would repeat it again in the future if necessary.

No readmissions because of NTF at home were noted of 192 eligible infants in the control hospitals, 103 (54%) stayed in hospital only for NTF after cessation of monitoring. Median admission time after cessation of monitoring was 9 days.

Conclusion: NTF at home in premature infants shortens hospital admission-time, is safe and results in high parental satisfaction rates.

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