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Cresi F, Maggiora E, Capitanio M, Bovio C, Borla F, Cosimi S, Enrietti D, Faggiano F, Loro S, Rovei SM, Runfola F, Scrufari M, Taglianti MV, Vignali F, Peila C, Coscia A. Effects of a valved infant-bottle with ergonomic teat on the coordination of sucking, swallowing, and respiration in late-preterm infants. The Safe Oral Feeding randomized Trial. Front Pediatr 2024; 12:1309923. [PMID: 38283629 PMCID: PMC10808751 DOI: 10.3389/fped.2024.1309923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Breastfeeding naturally enables the coordination of sucking, swallowing, and respiration patterns for safe feeding. When breastfeeding is not possible a feeding device that releases milk in response to intra-oral vacuum could potentially offer improved coordination of sucking, swallowing, and breathing patterns compared to conventional devices. The aim of the study is to evaluate the effect of a valved infant-bottle with an ergonomic teat compared to a standard infant-bottle. Methods This unblinded randomized controlled trial focused on late preterm infants fed by bottle for at least three meals over the day, admitted to the Neonatal Unit of Sant'Anna Hospital (Turin, Italy). Infants were randomized to be fed with a valved infant-bottle with an ergonomic teat (B-EXP arm) or with a standard infant-bottle (B-STD arm). Monitoring included a simultaneous synchronized recording of sucking, swallowing and respiration. The main outcome was the swallowing/breathing ratio. Results Forty infants (20 B-EXP arm; 20 B-STD arm) with a median gestational age of 35.0 weeks (IQR 35.0-36.0 weeks) completed the study. Four infants were censored for the presence of artifacts in the polygraphic traces. The median swallowing/breathing ratio was 1.11 (1.03-1.23) in the B-EXP arm and 1.75 (1.21-2.06) in the B-STD (p = .003). A lower frequency of swallowing events during the inspiratory phase of breathing was observed in B-EXP arm compared with B-STD arm (p = 0.013). Discussion The valved infant-bottle with an ergonomic teat improves the coordination of sucking-swallowing-respiration and limits the risk of inhalation reducing the frequency of swallowing during the inspiratory phase.
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Affiliation(s)
- Francesco Cresi
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Elena Maggiora
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Martina Capitanio
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Cecilia Bovio
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Federica Borla
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sara Cosimi
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Desirèe Enrietti
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Francesca Faggiano
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sara Loro
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Serena Maria Rovei
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Federica Runfola
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Mariangela Scrufari
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Michela Vigna Taglianti
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Federica Vignali
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Chiara Peila
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Alessandra Coscia
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
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McGrattan KE, Hammell AE, Turski ME, Klein KE, Delaware E, McCormick J, Weikle E, Broderick E, Ramel SE, Mohr AH. Feeding characteristics of healthy infants without reported feeding impairments throughout the first month of life. J Perinatol 2024; 44:71-77. [PMID: 37700008 PMCID: PMC10783545 DOI: 10.1038/s41372-023-01760-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 07/31/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVE Elucidate characteristics of feeding performance in healthy infants without reported feeding problems throughout the first month of life. STUDY DESIGN Feeding was monitored in 61 healthy infants by caregiver report for 48 h a week from birth to 4 weeks old. Outcomes included feeding modality, how much they consumed, how long the feed lasted, and how many coughing episodes the infant exhibited. Data were analyzed with descriptive and non-parametric statistics. RESULT The majority of infants (68%) exhibited at least one problematic feeding behavior. Infants consumed 68 ml/feed over 20 min, though the milk volumes and feed durations were highly variable. Coughing occurred an average of 2 feeds per day. No significant change in coughing was observed throughout the first month of life (p = 0.64). Infants coughed significantly less during breast feeds than bottle feeds (p = 0.02). CONCLUSION Healthy term infants exhibit what appear to be normal developmental imperfections in feeding performance throughout the first month of life.
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Affiliation(s)
- Katlyn Elizabeth McGrattan
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA.
- Department of Rehabilitation, Masonic Children's Hospital, Minneapolis, MN, USA.
| | - Abbey E Hammell
- Liberal Arts Technologies and Innovation Services (LATIS), University of Minnesota, Minneapolis, MN, USA
| | - Morgan Elaine Turski
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA
| | - Kristina E Klein
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA
| | - Elise Delaware
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA
| | - Jennie McCormick
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA
| | - Ellen Weikle
- Department of Speech Language and Hearing Science, University of Minnesota, Minneapolis, MN, USA
| | - Erin Broderick
- UC Health Department of Otolaryngology, University of Cincinnati, Cincinnati, OH, USA
| | - Sara E Ramel
- Department of Neonatology, University of Minnesota, Minneapolis, MN, USA
| | - Alicia Hofelich Mohr
- Liberal Arts Technologies and Innovation Services (LATIS), University of Minnesota, Minneapolis, MN, USA
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Ventura AK, Drewelow VM. Knowledge and Use of Paced Bottle-Feeding Among Mothers of Young Infants. J Nutr Educ Behav 2023; 55:796-802. [PMID: 37737815 DOI: 10.1016/j.jneb.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To describe mothers' awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices. METHODS Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n = 197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices. RESULTS Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio, 0.04; 95% confidence interval, 0.01-0.79). CONCLUSIONS AND IMPLICATIONS Paced bottle-feeding was associated with lower likelihood of one dimension of pressuring feeding practices, encouraging infant bottle-emptying. More research is needed to determine the effectiveness of PBF in promoting healthy feeding outcomes.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA.
| | - Vivian M Drewelow
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
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McGrattan KE, Jansen GP, Barrera JM, Beckstrand M. Exploring Alternative Methods to Reduce Milk Flow Rate From Infant Bottle Systems: Bottle Angle, Milk Volume, and Bottle Ventilation. Am J Speech Lang Pathol 2023; 32:2245-2253. [PMID: 37566887 DOI: 10.1044/2023_ajslp-23-00109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
PURPOSE Modifying milk flow rate is a common pediatric dysphagia treatment. Though past investigations have demonstrated how this can be achieved using bottle nipples, little is known about the impact of other bottle modifications. The objective of this investigation is to demonstrate how bottle vent, bottle position, and volume of milk alter bottle pressures and milk flow. METHOD A Dr. Brown's bottle filled with formula was secured to a retort stand and inverted to allow milk to free flow from a Level 1 nipple. Milk flow rate and bottle pressures were calculated under three conditions: (a) with and without a vent in place; (b) with varying volumes of milk (1-4 oz); and (c) in horizontal, semi-inverted, and completely inverted positions. Differences between flow rates under the conditions were tested using repeated-measures analysis of variance. RESULTS Upon inversion, milk dripped from both vented and unvented bottles. Dripping continued throughout the 20-min testing period in the vented bottle; however, as air pressure and hydrostatic pressure declined (p < .01) in the unvented bottle, milk flow slowed and eventually ceased (p < .001). As angle of bottle inversion increased, hydrostatic pressure and milk flow rate had corresponding increases as well (p < .001). Hydrostatic pressure increased an average of 1.4 ± 0.12 mm Hg per additional ounce of formula that was added to the bottle, with corresponding increases in milk flow rate observed (p < .001). CONCLUSIONS Milk flow rate can be altered by feeding conditions outside of bottle nipples alone. Future work examining the clinical significance of these modifications is warranted to determine optimal interventions.
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Affiliation(s)
- Katlyn Elizabeth McGrattan
- Department of Speech-Language and Hearing Science, University of Minnesota, Twin Cities, Minneapolis
- Department of Rehabilitation, Masonic Children's Hospital, Minneapolis, MN
| | - Gregory Paul Jansen
- Department of Speech-Language and Hearing Science, University of Minnesota, Twin Cities, Minneapolis
| | - Jennifer Meraz Barrera
- Department of Speech-Language and Hearing Science, University of Minnesota, Twin Cities, Minneapolis
| | - Michael Beckstrand
- College of Liberal Arts, University of Minnesota, Twin Cities, Minneapolis
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Lyu T, Tao Y, Hua W, Li L, Tang Y, Jin Y, Wang Y, Ma Y, Ji F, Dou Y, Cao Y, Hu XJ. Care practices and short-term clinical outcomes of very low birth weight infants in Yangtze River Delta in China. BMC Pediatr 2022; 22:676. [PMID: 36418987 PMCID: PMC9685934 DOI: 10.1186/s12887-022-03749-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Intensive care is of great significance for very low birth weight infants (VLBWI). The Yangtze River Delta is the most ecomonically developed area in China. However, there are few data on the care practices and survival of VLBWI in this region. OBJECTIVES To investigate the prevalence, care practices and motality of VLBWI in Yangtze River Delta in China. METHODS A multi-center retrospective investigation study was conducted at five tertiary hospitals within the Yangtze River Delta in China from January to December 2017. Clinical data included the general characteristics of the infants and the mothers, clinical prognosis, care practices in NICUs was collected by trained research members. RESULTS During the study period, 1059 VLBWIs were included. Infants with birth weight < 750 g, 750-1000 g, 1000-1250 g and 1250-1500 g accounted for 2.3, 14.9, 34.8 and 47.8%, respectively. Premature rupture of membranes (17.8%) was the main cause of premature delivery. The catheterization rates of umbilical vein catheterization (UVC) and peripherally inserted central catheter (PICC) were 25.0 and 64.4%, respectively. The duration of parenteral nutrition was 27.0 ± 19.5 d, the meantime of feeding tube indwelling was 36.2 ± 24.2 d. The corrected gestational age of the infants who reached full oral feeding was 35.8 ± 2.7 weeks. The breast feeding rate in the investigated infants was 61.9%. The mortality rate of preterm infants was 3.4%. The incidence of main complications BPD, PDA, ROP, NEC and sepsis were 24.9, 29.9, 21.7, 9.4 and 13.3% respectively. CONCLUSIONS Maternal and infant care practices need to be improved in the very preterm births. This study provides a baseline for the improvement in the further study.
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Affiliation(s)
- Tianchan Lyu
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Yibo Tao
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Wei Hua
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Liling Li
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Yunfei Tang
- Wuxi Children’s Hospital, Wuxi, Jiangsu China
| | - Yumei Jin
- Ningbo Women and Children’s Hospital, Ningbo, Zhejiang China
| | - Yan Wang
- grid.489986.20000 0004 6473 1769Anhui Provincial Children’s Hospital, Hefei, Anhui China
| | - Yuelan Ma
- grid.440227.70000 0004 1758 3572Suzhou Municipal Hospital, Suzhou, Jiangsu China
| | - Futing Ji
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Yalan Dou
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Yun Cao
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
| | - Xiao-jing Hu
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, Shanghai, China
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Mahoney AS, O'Donnell M, Coyle JL, Turner R, White KE, Skoretz SA. Non-Pharmacological and Non-Surgical Feeding Interventions for Hospitalized Infants with Pediatric Feeding Disorder: A Scoping Review. Dysphagia 2022. [PMID: 36044080 DOI: 10.1007/s00455-022-10504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
Infants born prematurely or with complex medical conditions often require treatment to facilitate safe and efficient feeding. Practice is based on evidence, so frontline clinicians look to the literature to make informed clinical decisions. The aim of this scoping review was to map and describe the literature base for infant feeding and swallowing interventions and to identify areas for further research. Four electronic databases were searched from the sources' inceptions through April 2020 using a search strategy designed by a health sciences research librarian. Thirteen grey literature sources were searched and forward and backward citation chasing was performed. Inclusion criteria were English-language studies reporting non-pharmacological and non-surgical interventions for hospitalized infants. Exclusion criteria included interventions exclusively for infants with cleft lip or palate or for infants being fed exclusively though enteral feeding. Data were extracted using a form created a priori and data were reported descriptively. We reviewed 6654 abstracts: 725 were chosen for full-text review and 136 met inclusion. Most studies explored interventions for infants born prematurely (n = 128). Studies were stratified by intervention domain: bridging (n = 91) and feeding/swallowing (n = 45); intervention approach: direct (n = 72), indirect (n = 31), or combination (n = 33); and outcome: feeding performance (n = 125), physiologic stability (n = 40), and swallowing physiology (n = 12). The body of research in infant feeding has grown; however, a need remains for research focused on populations of infants with various medical complexities and for frequently used interventions that lack supporting evidence.
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da Rosa Pereira K, Levy DS, Procianoy RS, Silveira RC. Impact of a pre-feeding oral stimulation program on first feed attempt in preterm infants: Double-blind controlled clinical trial. PLoS One 2020; 15:e0237915. [PMID: 32903261 DOI: 10.1371/journal.pone.0237915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 08/05/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the effect of an oral stimulation program in preterm on the performance in the first oral feeding, oral feeding skills and transition time from tube to total oral intake. Study designer Double-blind randomized clinical trial including very preterm newborns. Congenital malformations, intracranial hemorrhage grade III or IV, bronchopulmonary dysplasia, and necrotizing enterocolitis were excluded. Intervention group (GI) received an oral stimulation program of tactile extra-, peri-, and intraoral tactile manipulation once a day for 15 minutes, during a 10-day period. Control group (GII) received sham procedure with same duration of time. Feeding ability was assessed by a speech-language pathologist blinded to group assignment. The classification of infants’ oral performance was determined by Oral Feeding Skills (OFS). Neonates were monitored until hospital discharge. Results Seventy-four (37 in each group) were randomized. Mean gestational ages and birth weights were 30±1.4 and 30±1.5 weeks, and 1,452±330g and 1,457±353g for intervention and control groups, respectively. Infants in the intervention group had significantly better rates than infants in the control group on: mean proficiency (PRO) (41.5%±18.3 vs. 19.9%±11.6 (p<0.001)), transfer rate (RT) (2.3 mL/min and 1.1 mL/min (p<0.001)) and overall transfer (OT) (57.2%±19.7 and 35.0%±15.7 (p<0.001)). Median transition time from tube to oral feeding was 4 (3–11) and 8 (7–13) days in intervention and control groups, respectively (p = 0.003). Intake of breast milk was found to reduce transition time from tube feeds to exclusive oral feeding (p<0.001, HR 1.01, 95%CI 1.005–1.019), but the impact of the study intervention remained significant (p = 0.007, HR 1.97, 95%CI 1.2–3.2). Conclusion Infants who were breast-fed and an oral stimulation program proved beneficial in reducing transition time from tube feeding to oral feeding. Trial registration ClinicalTrials.gov number NCT03025815.
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Abstract
The increase in preterm infants' survival over the last 30 years has shed light over their inability to feed by mouth safely and efficiently. With adverse events such as increased risks for oxygen desaturation, bradycardia, penetration/aspiration, infants' hospitalization in neonatal intensive care units (NICUs) are understandably prolonged. Unfortunately, this leads to delayed mother-infant reunion, maternal stress, breastfeeding obstacles, and increased medical costs. Such impediments have stimulated clinicians and researchers to better understand the underlying causes and develop evidence-based solutions to assist these infants. However, it is notable that the research-to-practice translation of this knowledge has been limited as there are still no validated guidelines or protocols as how to best diagnose and care for these infants. This report revisits the immature physiologic functions at the root of these infants' oral feeding difficulties, the current practices, and the recent availability of evidence-based efficacious tools and interventions. Taking advantage of the latter, it presents a renewed perspective of how management strategies can be tailored to the specific needs of individual patients.
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Affiliation(s)
- Chantal Lau
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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Abstract
BACKGROUND The term "oral feeding success" (OFS) is frequently used in clinical practice and research. However, OFS is inconsistently defined, which impacts the ability to adequately evaluate OFS, identify risk factors, and implement interventions in clinical practice and research. PURPOSE To develop the defining attributes, antecedents, and consequences for the concept of OFS in preterm infants during their initial hospitalization. METHODS PubMed, CINAHL, and PsycINFO databases were searched for English articles containing the key words "oral feeding success" and "preterm infants." The Walker and Avant method for concept analysis was employed. RESULTS Sixteen articles revealed the defining attributes, antecedents, and consequences. Defining attributes included (1) physiologic stability; (2) full oral feeding; and (3) combined criteria of feeding proficiency (≥30% of the prescribed volume during the first 5 minutes), feeding efficiency (≥1.5 mL/min over the entire feeding), and intake quantity (≥80% of the prescribed volume). IMPLICATIONS FOR PRACTICE The 3 defining attributes may be used in clinical practice to consistently evaluate OFS. The antecedents of OFS provide clinicians with a frame of reference to assess oral feeding readiness, identify risk factors, and implement effective interventions. The consequences of OFS allow clinicians to anticipate challenges when OFS is not achieved and create a care plan to support the infants. IMPLICATIONS FOR RESEARCH The empirical referents of OFS provide consistent and clear operational definitions of OFS for use in research. The antecedents and consequences may guide researchers to select specific measures or covariates to evaluate valid measures of OFS.
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Griffith TT, Bell AF, White-Traut R, Medoff-Cooper B, Rankin K. Relationship Between Duration of Tube Feeding and Success of Oral Feeding in Preterm Infants. J Obstet Gynecol Neonatal Nurs 2018; 47:620-631. [DOI: 10.1016/j.jogn.2018.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 02/01/2023] Open
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Abstract
The hospital discharge of premature infants in neonatal intensive care units is often delayed due to their inability to feed by mouth safely and competently. With immature physiologic functions, infants born prematurely cannot be expected to readily feed by mouth at the equivalent age of a third trimester of gestation as the majority of their term counterparts do. Consequently, it is crucial that health care professionals gain an adequate knowledge of the development of preterm infants' oral feeding skills so as to optimize their safety and competency as they transition to oral feeding. With a greater sensitivity toward their immature skills, we can offer these infants a safer and smoother transition to independent oral feeding than is currently observed. This review article is an overview of the evidence-based research undertaken over the past 2 decades on the development of very-low-birth-weight infants' oral feeding skills. The description of the different functional levels where these infants can encounter hurdles may assist caregivers in identifying a potential cause or causes for their individual patients' oral feeding difficulties.
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Affiliation(s)
- Chantal Lau
- Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX
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Lau C, Bhat K, Potak D, Schanler RJ. Oral Feeding Assessment Predicts Length of Hospital Stay in Late Preterm Infants. J Pediatr Mother Care 2015; 1:102. [PMID: 27042698 PMCID: PMC4816462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND When compared with term infants, late preterm (LP) infants have greater morbidity and mortality, longer hospital stay, and greater rate of hospital readmission. Oral feeding difficulty is one of the prominent reasons for delayed discharge in LP infants. OBJECTIVE To identify the maturity levels of LP infants' oral feeding skills (OFS) at the time of their first oral feeding and to determine the relationship between OFS maturity levels and length of hospital stay. METHODS OFS was assessed in 48 LP infants born between 340/7 and 356/7 weeks gestational age at the time of their first oral feeding within 24 h of birth. The intake at 5 minutes, at completion of the feeding, and the duration of feeding a 15 mL prescribed volume of milk were tabulated. Proficiency expressed as percent mL consumed in the first 5 min/15 mL prescribed and rate of milk transfer over the entire feeding (mL/min) were recorded. OFS were assessed using a novel 4-level scale defined by the combined proficiency and rate of milk transfer. RESULTS When compared with their 35-week counterparts, infants born at 34 weeks gestation had poorer OFS profiles (p = 0.035) and longer hospital stay (p < 0.001). Additionally, further analyses demonstrated that, independently, LOS was associated negatively with both GA and OFS. CONCLUSION Assessment of OFS levels in LP infants at their first oral feeding can help identify infants at risk of oral feeding issues that may delay hospital discharge. For those infants, we speculate that provision of evidence-based efficacious interventions that improve OFS may shorten hospital stay and decrease hospital re-admissions.
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Affiliation(s)
- Chantal Lau
- Baylor College of Medicine, Department of Pediatrics, Houston TX
| | - Kiran Bhat
- Neonatal-Perinatal Medicine, Cohen Children’s Medical Center of New York, New Hyde Park NY
| | - Debra Potak
- Neonatal-Perinatal Medicine, Cohen Children’s Medical Center of New York, New Hyde Park NY
| | - Richard J. Schanler
- Neonatal-Perinatal Medicine, Cohen Children’s Medical Center of New York, New Hyde Park NY
- Hofstra North Shore-LIJ School of Medicine, Hempstead NY
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