發展性照護於早產兒餵食之應用

Feeding Preterm Infants: Application of Developmental Care

發展性照護是早產兒照護之核心概念，具有互動性、個別性與逐步成長之特徵，醫護人員應在早產兒住院期間即將父母納入照護團隊，準備其照護能力，以協助早產兒返家照護與居家適應。而早產兒每天6-8次的進食需求，是頻率最高也最需要注重安全性的照護活動。母親在學習餵食時，早產兒所呈現的呼吸急促、發紺、疲倦等行為常令母親感到壓力，尤其母親為了增加早產兒的進食量可能出現過度刺激早產兒的行為，反而更容易造成生理危機。國外在80年代即逐漸發展早產兒餵食相關理論與照護準則，但國內卻鮮有相關報告。本文將介紹（1）早產兒之進食特性，（2）早產兒進食暗示行為的類型，（3）發展性照護概念在餵食之應用；最後提出發展性照護之餵食相關原則與建議流程，以做為醫護人員執行餵食及衛教早產兒父母之參考。

Developmental care is the core concept of the preterm infant caring model. It is characterized by interaction, individualization, and evolving process. In order to enhance family competency with regard to preterm infant care, health professionals should include parents as team members when preterm infants are hospitalized so that parents can provide care helpful to facilitate preterm infant adaptation to external environmental stimulation. The preterm infant's 6-8 feedings per day represent the most frequent daily activity and an activity in which safety is essential. Potential adverse feeding responses in preterm infants such as tachypnea, cyanosis, and fatigue may stress the mother. This is a particular risk when the mother tries to increase her infant's intake volume by over-stimulating oral-motor activity. Theories and guidelines for feeding preterm infants in western societies have been evolving since the 1980s. However, little has been done in this area in Taiwan. This article addresses preterm infant feeding characteristics and cues, the application of developmental care in feeding infants, and proposes guidelines for feeding preterm infants. Healthcare professionals may reference our suggestions in feeding preterm infants and educating parents.