Effect of Body Positioning on Gastrointestinal Tolerance in Very-Low-Birth- Weight Preterm Infants Fed Enriched Breast Milk in a NICU in Yazd, Iran

Marzieh  Pourakrami; Mohamad Hosein  Lookzadeh; Zahra  Pourmovahed

doi:10.18502/wjpn.v8i1.21582

Marzieh Pourakrami School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mohamad Hosein Lookzadeh Mother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Zahra Pourmovahed Department of Nursing Education, Research Center for Nursing and Midwifery Care, Non-communicable Diseases Research Institute, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/wjpn.v8i1.21582

Keywords: Premature Infant, Body Position, Gastrointestinal Tolerance, Fortified Breast Milk

Abstract

Background: Feeding preterm infants with unfortified breast milk can lead to growth delays and nutritional deficiencies. To address this while promoting breastfeeding, commercial human milk fortifiers are commonly used. However, gastrointestinal intolerance, including gastric residue, remains a significant concern in these infants. This study investigates the impact of body positioning on gastrointestinal tolerance in very low birth weight (VLBW) preterm infants fed enriched breast milk.

Methods: A crossover clinical trial was conducted on 60 VLBW preterm infants admitted to the NICUs of Shahid Sadoughi Hospital in Yazd, Iran, in 2023. Infants were divided into two groups (n=30 each) via convenience sampling. In Group 1, infants were first placed in the prone position after feeding, followed by the right lateral position, with gastrointestinal tolerance assessed 3 hours post-feeding using a standardized checklist. Group 2 followed the reverse order.

Results: The majority (86.7%) of infants exhibited effective tolerance, with minimal gastric residuals (<20%) before and after feeding. No statistically significant differences in gastrointestinal outcomes were detected between the prone and right lateral positions (p > 0.05). These findings do not establish equivalence between the two positions, but they suggest that both may be considered as options in NICU feeding management.

Conclusion: The present study detected no significant difference in gastrointestinal tolerance between prone and right lateral positioning in VLBW infants, with no observed increase in adverse effects such as vomiting or abdominal distension. The results indicate that both positions may be acceptable for clinical use; however, formal equivalence has not been demonstrated. Further studies with larger samples and equivalence designs are needed before the two positions can be considered fully interchangeable