Sucking Improvement Following Blood Transfusion for Anemia of Prematurity

OBJECTIVE: To determine whether correction of anemia of prematurity by packed red blood cell transfusion improves sucking. DESIGN: Nonexperimental intervention study. SETTING: Neonatal intensive care unit of Shaare Zedek Medical Center, Jerusalem, Israel, between July 23, 2006, and December 16, 2007. PATIENTS: Thirty-six neonates at a gestational age of 34 weeks or younger, feeding orally, who developed anemia of prematurity. INTERVENTION: Packed red blood cell transfusion, 15 mL/kg. MAIN OUTCOME MEASURES: Change in sucking parameters recorded with the Kron Nutritive Sucking Apparatus for 5 minutes and ingested volume, prior to and 1 to 2 days after intervention. RESULTS: The mean (SD) gestational age was 30.1 (2.1) weeks, and the mean (SD) birth weight was 1436 (45) g. At the time of the study, the mean (SD) postnatal age was 46 (26) days, the mean (SD) weight was 2311 (36) g, and the mean (SD) hematocrit was 26.7% (2.6%). Overall, there was no change in the number of sucks, number of bursts, or maximum negative pressure generated. Daily weight gain increased after transfusion (mean [SD] weight gain, 30.9 [10.0] g before transfusion vs 36.5 [13.0] g after transfusion; P=.02). The babies were then stratified into those below the median number of sucks (109 sucks) before transfusion (poor feeders) and those at or above the median (better feeders). In the former subgroup only, changes from before transfusion to after transfusion were found in the number of sucks (mean [SD] sucks, 73.4 [29.5] vs 108.9 [53.3], respectively; P=.006; mean [SD] sucks per burst, 3.4 [1.4] vs 4.9 [2.8], respectively; P=.01) and volume consumed (mean [SD] volume, 17.1 [9.8] mL vs 23.2 [12.8] mL, respectively; P=.004). CONCLUSIONS: Correction of anemia of prematurity with blood transfusion improved sucking and volume ingested in premature infants who were poor feeders prior to the transfusion. It also enhanced overall weight gain.