The Effect of Breast Milk Smell on Nutrition in Preterms

NCT ID: NCT04843293

Last Updated: 2021-04-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-15

Study Completion Date

2021-09-30

Brief Summary

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The study was planned to determine the effect of breast milk odor applied during gavage feeding on early feeding cues of preterm newborns, the transition time to oral feeding and abdominal perfusion.

Detailed Description

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It is known that nutrient odors stimulate the initiation of digestion. However, in preterm newborns who are fed by gavage or parenterally, exposure to the nutrient smell that initiates digestion disappears. For this reason, it is known that odor stimulation is applied to preterm newborns to improve nutrition. It is known that fragrances such as fragrant essential oils, the smell of breast milk, and amniotic fluid have positive effects such as shortening the transition time to oral feeding in preterm newborns, increasing nutritional tolerance and weight gain, increasing hunger symptoms, providing analgesic effect in painful procedures, and reducing hospital stay. However, no study was found to jointly evaluate the effect of odor stimulation with breast milk on early nutritional cues, transition time to oral nutrition and abdominal perfusion in preterm newborns.

Conditions

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Breast Milk Digestion Nutrition Smell Stimulation Preterm Birth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

In this study, stratified sampling was used according to postmenstrual week (PW) and type of nutrition. In order to ensure homogeneity in the intervention and control groups, according to PW \[28-(33+6)\] and \[34-35+6)\], according to the type of nutrition \[mixed nutrition (breast milk + formula milk)\] and \[breast milk\] 4 layers were formed. Firstly, 56 preterm newborns were divided as random into intervention (group A) and control (group B). Groups A and B were stratified first to the PW, then according to the type of feeding. Permutation was also used to strike a balance between the strata. Block sets were generated for each combination of the prognostic factors (PW and type of nutrition). The intervention and control groups were then randomized into the strata using a random numbers table.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Experimental Group: Olfactory stimulation group

Preterm newborns in the initiative group were sniffed the smell of breast milk before and during feeding, except for routine application

Group Type EXPERIMENTAL

Olfactory stimulation

Intervention Type BEHAVIORAL

Newborns in the experimental group will be given the smell of breast milk during 3 consecutive feedings and for 3 days in the morning. Smell stimulation will be started 1 minute before gavage feeding and the application of breast milk odor will continue until the feeding ends. A hand-cleaning researcher will drip 15 drops of breast milk on sterile gauze to apply the smell of breast milk. Sterile gauze dripped with breast milk will be placed as close to the newborn's nose as possible and not in contact with the newborn's skin. After the feeding of the newborn is completed, the application of the smell of breast milk will be terminated and the gauze will be removed from the incubator. A new sterile gauze will be used for each feeding, and these processes will be repeated with each smell stimulation for three days.

Control Group

Premature newborns in the control group feeds gavage according to the routine of the clinic, and no attempt will be made during feeding.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Olfactory stimulation

Newborns in the experimental group will be given the smell of breast milk during 3 consecutive feedings and for 3 days in the morning. Smell stimulation will be started 1 minute before gavage feeding and the application of breast milk odor will continue until the feeding ends. A hand-cleaning researcher will drip 15 drops of breast milk on sterile gauze to apply the smell of breast milk. Sterile gauze dripped with breast milk will be placed as close to the newborn's nose as possible and not in contact with the newborn's skin. After the feeding of the newborn is completed, the application of the smell of breast milk will be terminated and the gauze will be removed from the incubator. A new sterile gauze will be used for each feeding, and these processes will be repeated with each smell stimulation for three days.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Born at 28-36 weeks of PW
* Birth weight \>1000 gr
* 1\. and 5. Apgar score average per minute ≥ 6
* Gavage method used in nutrition
* Intermittent infusion method used in nutrition,
* Not receiving mechanical ventilation / CPAP support,
* No medication or treatment is administered by the nasal route,
* Without nasal obstruction,
* Have not received any established medical diagnosis

Exclusion Criteria

* Drugs that affect gastrointestinal function (drugs that facilitate gastric emptying and gastrointestinal passage of nutrients by increasing gastrointestinal tract motility, and drugs that reduce gastrointestinal tract motility)
* Newborns without breast milk
* Continuous infusion or parenteral feeding method is used in nutrition
Minimum Eligible Age

28 Weeks

Maximum Eligible Age

36 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Selcuk University

OTHER

Sponsor Role lead

Responsible Party

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Sibel Küçükoğlu

Assoch Prof

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sibel Kucukoglu, PhD

Role: PRINCIPAL_INVESTIGATOR

Selcuk University

Adalet Yucel, Master Student

Role: STUDY_CHAIR

Selcuk University

Hanifi Soylu, PhD

Role: STUDY_DIRECTOR

Selcuk University

Locations

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Sibel Kucukoglu

Konya, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Sibel Kucukoglu, PhD

Role: CONTACT

+903322230789 ext. 30789

Facility Contacts

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Sibel Kucukoglu, PhD

Role: primary

+903322410041

References

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Gay AN, Lazar DA, Stoll B, Naik-Mathuria B, Mushin OP, Rodriguez MA, Burrin DG, Olutoye OO. Near-infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets. J Pediatr Surg. 2011 Jun;46(6):1034-40. doi: 10.1016/j.jpedsurg.2011.03.025.

Reference Type RESULT
PMID: 21683194 (View on PubMed)

Gillam-Krakauer M, Cochran CM, Slaughter JC, Polavarapu S, McElroy SJ, Hernanz-Schulman M, Engelhardt B. Correlation of abdominal rSO2 with superior mesenteric artery velocities in preterm infants. J Perinatol. 2013 Aug;33(8):609-12. doi: 10.1038/jp.2013.3. Epub 2013 Feb 7.

Reference Type RESULT
PMID: 23392317 (View on PubMed)

Kirk AT, Alder SC, King JD. Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants. J Perinatol. 2007 Sep;27(9):572-8. doi: 10.1038/sj.jp.7211791. Epub 2007 Jul 12.

Reference Type RESULT
PMID: 17625573 (View on PubMed)

Neal-Kluever A, Fisher J, Grylack L, Kakiuchi-Kiyota S, Halpern W. Physiology of the Neonatal Gastrointestinal System Relevant to the Disposition of Orally Administered Medications. Drug Metab Dispos. 2019 Mar;47(3):296-313. doi: 10.1124/dmd.118.084418. Epub 2018 Dec 19.

Reference Type RESULT
PMID: 30567878 (View on PubMed)

Pillai A, Albersheim S, Matheson J, Lalari V, Wei S, Innis SM, Elango R. Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance. Nutrients. 2018 Oct 4;10(10):1433. doi: 10.3390/nu10101433.

Reference Type RESULT
PMID: 30287775 (View on PubMed)

Thomas S, Nesargi S, Roshan P, Raju R, Mathew S, P S, Rao S. Gastric Residual Volumes Versus Abdominal Girth Measurement in Assessment of Feed Tolerance in Preterm Neonates: A Randomized Controlled Trial. Adv Neonatal Care. 2018 Aug;18(4):E13-E19. doi: 10.1097/ANC.0000000000000532.

Reference Type RESULT
PMID: 30015674 (View on PubMed)

Yildiz A, Arikan D, Gozum S, Tastekin A, Budancamanak I. The effect of the odor of breast milk on the time needed for transition from gavage to total oral feeding in preterm infants. J Nurs Scholarsh. 2011 Sep;43(3):265-73. doi: 10.1111/j.1547-5069.2011.01410.x. Epub 2011 Jul 25.

Reference Type RESULT
PMID: 21884372 (View on PubMed)

Yucel A, Kucukoglu S, Soylu H. The Effect of Breast Milk Odor on Feeding Cues, Transition Time to Oral Feeding, and Abdominal Perfusion in Premature Newborns: A Randomised Controlled Trial. Biol Res Nurs. 2024 Jan;26(1):160-175. doi: 10.1177/10998004231200784. Epub 2023 Sep 8.

Reference Type DERIVED
PMID: 37682253 (View on PubMed)

Other Identifiers

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SelcukUAdlt42

Identifier Type: -

Identifier Source: org_study_id

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