Objective:To explore the current status of the time to full enteral feeding (FEFt) in very low birth weight infants (VLBWI) and its influencing factors, so as to provide a reference for shortening FEFt and improving infants' prognosis.Methods:This study was a prospective cohort study. Through the Sina-northern Neonatal Network (SNN) , convenience sampling was used to select the data of 158 premature infants with birth weight less than 1 500 g in the Neonatal Intensive Care Unit of a Class Ⅲ Grade A hospital in Shandong Province from January 1, 2019 to December 31, 2020. The current status of FEFt in premature infants was analyzed. According to the median time of FEFt, premature infants were divided into two groups (short FEFt group and long FEFt group) . Single factor χ 2 test or Fisher exact probability, rank sum test and multivariate Logistic regression model were used to analyze the influencing factors of FEFt of VLBWI. Results:This study finally included 145 cases of VLBWI. Multivariate Logistic regression analysis showed that long fasting time, feeding intolerance (FI) , and long positive pressure ventilation treatment time were independent factors of the long FEFt of VLBWI ( P<0.05) , while gestational diabetes was its protective factor ( P<0.05) . FI was related to the fasting time and positive pressure ventilation treatment time, and it was the main reason leading to the long FEFt ( P<0.01) . Hypertension during pregnancy was an independent influencing factor of FI ( P<0.05) . Conclusions:FEFt of VLBWI is still long enough, which is related to long fasting time, long positive pressure ventilation time and FI. FI is the main reason, and hypertension during pregnancy is the root cause of FI. Medical and nursing staff should pay attention to and strengthen the management of VLBWI FI, shorten fasting time and accelerate the rate of milk feeding during positive pressure ventilation treatment, and strengthen the management of hypertension during pregnancy, so as to shorten FEFt in VLBWI and improve the prognosis.

Objective:To analyze the clinical manifestations and duration of feeding intolerance (FI) in very low birth weight infants (VLBWI), explore the influencing factors of FI, so as to provide scientific basis for shortening the FI duration of VLBWI.Methods:From January 2018 to December 2020, 441 VLBWIs admitted to the Neonatal Intensive Care Unit of the Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected as the research object by the convenient samplingto describe the clinical characteristics and duration of FI in children. Multivariate Logistic regression was used to analyze the influencing factors of FI duration of VLBWI. Totally 354 VLBWIs were included, excluding 41 children transferred from other hospitals 24 hours after birth, 10 children died before full gastrointestinal feeding, 4 children with stageⅡ or above neonatal necrotizing enterocolitis, 1 child with congenital gastrointestinal malformation, and 31 cases with incomplete data.Results:The incidence of FI in 354 VLBWI was 71.5% (253/354), and the average duration was 9 days. Multivariate Logistic regression analysis showed that the long time of invasive positive pressure ventilation [ OR=1.081, 95% CI (1.034, 1.130) ], formula feeding [ OR=1.751, 95% CI (1.009, 3.040) ] and hypertension during pregnancy [ OR=1.876, 95% CI (1.073, 3.279) ] were the risk factors for FI duration ( P<0.05), andbirth weight [ OR=0.355, 95% CI (0.185, 0.683) ]was the influencing factor of FI duration ( P=0.002) . Conclusions:The incidence of FI in VLBWI is high and the duration is long. Small gestational age and low weight premature infants are the high-risk groups of FI. In order to shorten the FI duration of VLBWI, medical and nursing staff should manage the blood pressure of pregnant women during pregnancy, strengthen the nursing of children during mechanical ventilation, withdraw the machine as soon as possible, and promote breastfeeding.

Breastfeeding is the best natural food for infants. In infants with congenital heart disease(CHD), breast milk can reduce the incidence of necrotizing enterocolitis, feeding intolerance and growth failure, and improve the overall prognosis. However, there are many obstacles to breastfeeding in infants with CHD as well as lack of related domestic research. This study mainly focuses on breastfeeding status, influencing factors, assessment, implementation and solutions for the infants with CHD, and proposed the future research recommendations on clinical practices, in order to provide reference for the breastfeeding management of infants with CHD in China.