The effect of oral milk during tube feeding on growth of very premature infants: a protocol.

What is it about?

Very premature babies have extremely high energy needs and if these are not met are at risk of general growth failure and neurodevelopmental delay. Very premature babies also poorly tolerate and absorb milk and cannot coordinate their suck and swallow. Tube feeding allows milk to be fed safely but does not address the tolerance and absorption problems. A feeding tube places milk directly into the baby’s stomach but does not allow the routine experience of smell and taste of milk, though smell and taste senses are well developed at this developmental stage. We know from Professor Pavlov’s famous experiments on his dogs, that anticipation of food starts digestion by increasing salivation, gut motility and the release of gastric hormones. Food anticipation can be triggered by the taste, smell, or sight of food, timing of a meal, or even a bell. Conversely, bread placed in the stomach of a dog through a tube, without the dog being aware, impairs digestion significantly. Accordingly, we have devised a randomized trial to find out if exposing very premature babies to smell and taste of milk along with tube feeding versus routine care with no smell and taste of milk would improve weight gain.

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