Sleep Positioning in Low Birth Weight Infants to Reduce Enteral Feeding Intolerance

Dyah Dwi Astuti, Yeni Rustina, Fajar Tri Waluyanti


Introduction: Enteral feeding intolerance is a common problem in low birth weight infants. This study aimed to analyze the effects of sleep positioning on low birth weight infants on the occurrence of enteral feeding intolerance. Methodology: This quasi experiment was applied on 20 low birth weight infants with a purposive sampling technique. The infants were grouped into control and intervention. Infants in the control group were given intervention with routine procedures; while those in the intervention group were performed prone sleep positioning after enteral feeding with the head of the bed elevated 30 degrees during the enteral feeding. Results: Independent t-test and Fisher’s Exact Test analysis showed that sleep positioning could decrease desaturation event (p value = 0.011), abdominal distension (p value = 0.017), and frequency of vomiting (p value = 0.035). Discussion: Nurses can make sleep positioning as standard operating procedures in low birth weight infants who have enteral feeding intolerance


low birth weight, enteral feeding intolerance, sleep positioning

Full Text:



Bredemeyer, S.L., & Foster, J.P. (2012). Body positioning for spontaneusly breathing preterm infants with apnoea (review). The Cochrane Collaboration, 6, 1-40.

Carter, B.M. (2012). Feeding intolerance in preterm infants and standard of care guidelines for nursing assessments. Newborn & Infant Nursing Reviews, 12 (4), 187-201.

Carvaglia, L., Martini, S., Aceti, A., Arcuri, S., Rossini, R., & Faldella, G. (2013). Nonpharmacological management of gastroesophageal reflux preterm infants. BioMed Research International, 7, 1-7.

Chen, S-S., Tzeng, Y-L., Gau, B-S., Kuo, P-C., & Chen, J-Y. (2013). Effects of prone and supine positioning on gastric residuals in preterm infants: A time series with cross-over study. International Journal of Nursing Studies, 50, 1459–1467.

Dutta, S., Sigh, B., Chessell, L., Wilson, J., Janes, M., McDonald, K., ..., Fusch, C. (2015). Guidelines for feeding very low birth weight infants. Nutrients, 7, 423-442.

Elser, H.E. (2012). Positioning after feedings: What is the evidence to reduce feeding intolerances? Advances in Neonatal Care, 12 (3), 172-175.

Fanaro, S. (2013). Feeding intolerance in the preterm infant. Early Human Development, 89, 513-520.

Gomella, T.L., Cunningham, M.D., & Eyal, F. (2013). Neonatology: Management, procedures, on-call problems, diseases, and drugs. New York: Mc Graw Hill Education.

Kaur, A., Kler, N., Saluja, S., Modi, M., Soni, A., Thakur, A., & Garg, P. (2015). Abdominal circumference or gastric residual volume as measure of feed intolerance in VLBW infants. J Pediatr Gastroenterol Nutr, 60 (2), 259-63.

Moore, T.A., & Pickler, R.H. (2013). Evaluating the precision of clinical assessments for feeding intolerance. Newborn & Infant Nursing Review, 13, 184-188.

Pickler, R.H., Wetzel, P.A., Meinzen-Derr, J., Tubbs-Cooley, H.L., & Moore, M. (2015). Patterned feeding experience for preterm infants: Study protocol for a randomized controlled trial. Bio Med Central, 16 (255), 1-9.

Prodo, L.E., & Dewey, K. (2014). Nutrition and brain development in early life. Nutrition Reviews, 72 (4), 267-284.

Rafati, M.R., Nakhshab, M., Ghaffari, V., Mahdavi, M.R., & Pharm, M.S. (2014). Evaluation of nutritional status in a neonatal intensive care unit at a teaching hospital. Iranian Journal of Neonatology, 5 (4), 24-29.

Sangers, H., Jong, P.M.D., Mulder, S.E., Stigter, G.D., Berg, C.M.V.D., Pas, A.B.T., & Walther, F.J. (2013). Outcomes of gastric residuals whilst feeding preterm infants invarious body positions. Journal of Neonatal Nursing, 19, 337-341.

Sharma, P., Nangia, S., Tiwari, S., Goel, A., Singla, B., & Saili, A. (2013). Gastric lavage for preventing of feeding problems in neonates with meconium-stained amniotic fluid: A randomised controlled trial. Paediatrics and International Child Health, 0 (0), 1-6.

Underwood, M.A. (2013). Human milk for the premature infant. Pediatr Clin North Am, 60 (1), 189-207.

Unger, S., Stintzi, A., Shah, P., Mack, D., & O’Connor, D.I. (2015). Gut microbiota of the very low birth weight infant. Pediatric Resiarch, 7 (1), 205-213.

Visscher, M.O., Lacina, L., Casper, T., Dixon, M., Harmeyer, J., Haberman, B., ..., & Simakajomboon, N. (2015). Conformational positioning improves sleep in premature infants with feeding difficulties. The Journal of Pediatrics, 166 (1), 44-48.

Zecca, E., Costa, S., Barone, G., Giordano, L., Zecca, C., &Maggio, L. (2014). Proactive enteral nutrition in moderately preterm small for gestational age infants: A randomized clinical trial. The Journal of Pediatrics, 165 (6), 1135-1139.

Zubaidah, Rustina, Y., & Syahreni, E. (2013). Penerapan model konservasi Levine pada bayi prematur dengan intoleransi minum. Jurnal Keperawatan Anak, 1 (2), 65-72.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

View My Stats