Effectiveness Of Left Lateral Position on Feeding Tolerance Among Preterm Neonates: A Randomized Controlled Trial

Abstract

Preterm neonates often experience digestive issues due to underdeveloped anatomical and functional capabilities as well as immature nervous system function in the gut. Feeding tolerance significantly influences their nutritional status. A noninvasive post-feeding position could improve feed tolerance and promote growth.  A randomized controlled trial was conducted to evaluate the effectiveness of the left lateral position on feeding tolerance among preterm neonates and its association with weight gain, on 223 preterm neonates in the Special Newborn Care Unit (SNCU). The study group placed the preterm neonates in the post-feeding left lateral position, while the control group placed them in other recommended positions. Feeding tolerance was assessed based on the quantity of feed prescribed, the number of vomiting episodes, the number of days on an IV line, and abdominal distension measured by abdominal circumference before and after each feed over five consecutive days. Preterm demographics and selected variables were analyzed using descriptive and inferential statistics. A t-test was used to compare the differences in mean abdominal circumference, and the chi-square test was applied to determine the association between the left lateral position and weight gain. The effect size of the difference between groups was 0.352. The mean difference in abdominal circumference among preterm neonates in the post-feed left lateral position was statistically significant (p < 0.05). Additionally, a significant association (p < 0.05) was observed between the post-feed left lateral position and weight gain during the intervention, with similar trends noted at the 2nd and 4th-week follow-ups. Preterm neonates can be placed in the post-feed left lateral position, which improves feeding tolerance and significant weight gain.