Systematic Review of Barriers and Facilitators to Complementary Feeding in Preterm Infants

Abstract Background: It has been reported that preterm infants may experience feeding difficulties in complementary food introduction. There is a lack of a comprehensive summary of the current evidence of the difficulties in complementary food introduction of preterm infants and how to intervene or solve these difficulties. So the purpose of this review is to systematically analyze the difficulties and solutions in the existing literature on it. Methods: A literature search was conducted in PubMed, Web of Science, Cochrane library and Scopus databases for the studies about complementary feeding in preterm infants. The time range of the search was from January 2012 to December 2021. Included studies were summarized and organized into two perspectives: (1) the difficulties of complementary feeding in preterm infants; (2) related factors influencing feeding difficulties and possible interventions. Results: A total of 6 articles were included in the systematic review ultimately. Three studies were cross-sectional study and the other three were longitudinal study. The current evidence demonstrated that feeding problems such as vomiting, gagging, food refusal, and chewing and swallowing difficulty might occur in complementary foods introduction in preterm infants. And preterm infants were more likely to experience these difficulties than full-term infants. Possible causes of these feeding difficulties include endotracheal intubation, gastric tube feeding, formula feeding, neonatal surgery, parenteral nutrition, etc. However, the available literatures do not provide specific intervention methods or guidelines to facilitate the complementary feeding in preterm infants. Conclusions: More experiments are needed to explore appropriate interventions to solve the problems and facilitate complementary feeding in preterm infants during infancy, and promote catch-up growth and develop good eating habits for preterm infants.