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Phillips R, VanNatta D, Chu J, Best A, Ruiz P, Oswalt T, Wooldridge D, Fayard E. Breastfeeding Practice Before Bottle-Feeding: An Initiative to Increase the Rate of Breastfeeding for Preterm Infants at the Time of Neonatal Intensive Care Unit Discharge. Crit Care Nurs Clin North Am 2024; 36:251-260. [PMID: 38705692 DOI: 10.1016/j.cnc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Preterm babies who received 72 hours of breastfeeding practice before introducing a bottle had significantly higher rates of breastfeeding at the time of neonatal intensive care unit (NICU) discharge than did babies who were introduced to bottle-feeding with or before breastfeeding during the first 72 hours of oral feeding or babies who were primarily bottle-fed. There were no statistical differences in corrected gestational age (CGA) at birth, first oral feeding, or full oral feeds, in days from first to full oral feeds, or in CGA or days of life at NICU discharge.
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Affiliation(s)
- Raylene Phillips
- Loma Linda University Children's Hospital, Neonatology Division, 11175 Campus Street, CP 11121, Loma Linda, CA 92350, USA; Loma Linda University School of Medicine, Department of Pediatrics, Division of Neonatology, 11175 Campus Street, Loma Linda, CA 92350, USA; Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
| | - Dawn VanNatta
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Jenny Chu
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Allison Best
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Pamela Ruiz
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Tonya Oswalt
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Dianne Wooldridge
- Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
| | - Elba Fayard
- Loma Linda University Children's Hospital, Neonatology Division, 11175 Campus Street, CP 11121, Loma Linda, CA 92350, USA; Loma Linda University School of Medicine, Department of Pediatrics, Division of Neonatology, 11175 Campus Street, Loma Linda, CA 92350, USA; Loma Linda University Children's Hospital, Unit 3700, 11234 Anderson Street, Loma Linda, CA, 92354, USA
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ElSeed Peterson EE, Roeckner JT, Deall TW, Karn M, Duncan JR, Flores-Torres J, Kumar A, Randis TM. Need for Gastrostomy Tube in Periviable Infants. Am J Perinatol 2024. [PMID: 38513690 DOI: 10.1055/s-0044-1781461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
OBJECTIVE We sought to identify clinical and demographic factors associated with gastrostomy tube (g-tube) placement in periviable infants. STUDY DESIGN We conducted a single-center retrospective cohort study of live-born infants between 22 and 25 weeks' gestation. Infants not actively resuscitated and those with congenital anomalies were excluded from analysis. RESULTS Of the 243 infants included, 158 survived until discharge. Of those that survived to discharge, 35 required g-tube prior to discharge. Maternal race/ethnicity (p = 0.006), intraventricular hemorrhage (p = 0.013), periventricular leukomalacia (p = 0.003), bronchopulmonary dysplasia (BPD; p ≤ 0.001), and singleton gestation (p = 0.009) were associated with need for gastrostomy. In a multivariable logistic regression, maternal Black race (Odds Ratio [OR] 2.88; 95% confidence interval [CI] 1.11-7.47; p = 0.029), singleton gestation (OR 3.99; 95% CI 1.28-12.4; p = 0.017) and BPD (zero g-tube placement in the no BPD arm; p ≤ 0.001) were associated with need for g-tube. CONCLUSION A high percentage of periviable infants surviving until discharge require g-tube at our institution. In this single-center retrospective study, we noted that maternal Black race, singleton gestation, and BPD were associated with increased risk for g-tube placement in infants born between 22 and 25 weeks' gestation. The finding of increased risk with maternal Black race is consistent with previous reports of racial/ethnic disparities in preterm morbidities. Additional studies examining factors associated with successful achievement of oral feedings in preterm infants are necessary and will inform future efforts to advance equity in newborn health. KEY POINTS · BPD, singleton birth, and Black race are associated with need for g-tube in periviable infants.. · Severe intraventricular hemorrhage is associated with increased mortality or g-tube placement in periviable infants.. · Further investigation into the relationship between maternal race and g-tube placement is warranted..
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Affiliation(s)
- Erica E ElSeed Peterson
- Division of Neonatology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Jared T Roeckner
- Division of Maternal-Fetal Medicine, Florida Perinatal Associates, Pediatrix, Tampa, Florida
| | - Taylor W Deall
- Division of Neonatology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Michele Karn
- Department of Pediatrics, Johns Hopkins All Children Hospital, St. Petersburg, Florida
| | - Jose R Duncan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Jaime Flores-Torres
- Division of Neonatology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Ambuj Kumar
- Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Tara M Randis
- Division of Neonatology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, Florida
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Ciochetto CR, Bolzan GDP, Gonçalves DDS, da Silveira FPH, Weinmann ARM. Effects of Kangaroo Care on the development of oral skills and achievement of exclusive oral feeding in preterm infants. Codas 2023; 35:e20220070. [PMID: 37556686 PMCID: PMC10449087 DOI: 10.1590/2317-1782/20232022070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/22/2022] [Indexed: 08/11/2023] Open
Abstract
PURPOSE analyze the effects of hospitalization in the Kangaroo Neonatal Intermediate Care Unit (UCINCa), the second stage of the Kangaroo Care (KC), on the development of oral feeding skills in preterm neonates. METHODS an analytical observational study of the prospective longitudinal type, carried out in a public hospital in Southern Brazil, where infants were accompanied until hospital discharge. The sample consisted of 20 preterm neonates hospitalized at the UCINCa and 26 preterm neonates at the Conventional Neonatal Intermediate Care Unit (UCINCo), that were periodically evaluated through the levels of oral skill, in a bottle, according to the criteria of proficiency and milk transfer rate. The outcomes considered were a progression of the oral skill level, days of transition to obtain the full oral route, and days of hospital stay. RESULTS the duration of transition to exclusive oral feeding was shorter for preterm neonates at the UCINCa (4.5 vs. 10 days) relative to those at the UCINCo (p = 0.041). By the third assessment, all preterm neonates at the UCINCa had reached level 4, while participants at the UCINCo only achieved this level of performance on the fifth assessment. The average number of days of hospitalization was four days shorter in UCINCa participants (p=0.098). CONCLUSION the admission to the UCINCa had been a further acceleration in the maturation of oral skills, which allowed for a faster transition to exclusive oral feeding as compared to neonates admitted in UCINCo.
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Affiliation(s)
- Carla Ribeiro Ciochetto
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Faculdade de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | - Geovana de Paula Bolzan
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | - Daniela da Silva Gonçalves
- Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | | | - Angela Regina Maciel Weinmann
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Faculdade de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
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Non-Pharmacological and Non-Surgical Feeding Interventions for Hospitalized Infants with Pediatric Feeding Disorder: A Scoping Review. Dysphagia 2022; 38:818-836. [PMID: 36044080 DOI: 10.1007/s00455-022-10504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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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Liang X, Miao A, Zhang W, Li M, Xing Y. Effect of family integrated care on physical growth and language development of premature infants: a retrospective study. Transl Pediatr 2022; 11:965-977. [PMID: 35800279 PMCID: PMC9253945 DOI: 10.21037/tp-22-210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Premature birth (PTB) increases the long-term risk of diseases such as hypertension, heart disease, and diabetes in adulthood. It is an independent disease with the largest global burden in terms of high mortality and lifelong negative health impacts. The purpose of this study was to analyze the physical growth and language development of premature infants (PIs) at the age of 18 months, and to explore the impact of family integrated care (FIcare) on PI. METHODS This study retrospectively included mothers and their PIs born in the Neonatal Pediatrics Department, Affiliated Hospital of Nantong University from January 2018 to September 2020 and hospitalized in the neonatal intensive care unit (NICU) within 24 hours after birth. The weight, head circumference, body length, and language development of each child were followed up at the age of 1, 3, 6, 12, and 18 months and recorded, and the relationship between FIcare and physical growth and language development of PIs was evaluated. RESULTS The development quotient (DQ) score and language development score of the FIcare group were always higher than those of the control group from 6 to 18 months, and the difference was statistically significant (P<0.05). Multiple regression analysis showed that the body length of the FIcare group participants was longer than that of control group participants. The head circumference of infants was positively correlated with gestational age, birth head circumference, and family average monthly income. The head circumference of FIcare group participants was longer than that of control group participants. The DQ score was positively correlated with gestational age, and the FIcare group participants scored higher than control group participants. Logistic regression analysis showed that early language milestone (ELM) scale score and gestational age were positively correlated with mother's education, and the score of FIcare group participants was higher than that of control group participants (P<0.05). CONCLUSIONS Compared with the traditional nursing model, the implementation of FIcare for the hospitalized PIs in the NICU can actively promote the physical growth and language development of infants.
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Affiliation(s)
- Xiangyan Liang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Aimei Miao
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Wei Zhang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Min Li
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Yan Xing
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
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Muir H, Kidanemariam M, Fucile S. The Impact of Infant and Maternal Factors on Oral Feeding Performance in Premature Infants. Phys Occup Ther Pediatr 2022; 42:130-136. [PMID: 34519261 DOI: 10.1080/01942638.2021.1975863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Aims: To identify infant and maternal factors associated with attainment of full oral feeding (FOF) in premature infants.Method: A retrospective study was performed on 89 premature infants (<34 weeks gestational age) from a tertiary care neonatal intensive care unit (NICU). Infant and maternal factors were concurrently assessed. Infant factors included gestational age, birthweight, continuous positive airway pressure assistance, mechanical ventilation support, and presence of neonatal morbidities including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and intraventricular hemorrhages (IVH). Maternal factors included maternal age, first born, twin birth, and presence of mental health conditions including anxiety, stress, or depression.Results: A total of 89 premature infants were included in the sample. A stepwise linear regression model revealed that infants who received mechanical ventilator support and presence of maternal mental health conditions were significantly associated with time to attain FOF.Conclusions: Results suggest that oral feeding performance is influenced not only by infant's medical severity denoted by need for ventilator assistance, but also by presence of maternal anxiety, stress, and/or depression.
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Affiliation(s)
- Hailey Muir
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
| | - Miriam Kidanemariam
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
| | - Sandra Fucile
- School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada.,Department of Pediatrics, Queens University, Kingston, Ontario, Canada
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McFadden A, Fitzpatrick B, Shinwell S, Tosh K, Donnan P, Wallace LM, Johnson E, MacGillivray S, Gavine A, Farre A, Mactier H. Cue-based versus scheduled feeding for preterm infants transitioning from tube to oral feeding: the Cubs mixed-methods feasibility study. Health Technol Assess 2021; 25:1-146. [PMID: 34878383 DOI: 10.3310/hta25740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is a lack of evidence of the effect of cue-based feeding compared with scheduled feeding on important outcomes for preterm infants. OBJECTIVES The objectives were as follows: (1) to describe the characteristics, components, theoretical basis and outcomes of approaches to feeding preterm infants transitioning from tube to oral feeding; (2) to identify operational policies, barriers and facilitators, and staff and parents' educational needs in neonatal units implementing cue-based feeding; (3) to co-produce an intervention for feeding preterm infants in response to feeding cues; (4) to appraise the willingness of parents and staff to implement and sustain the intervention; (5) to assess associated costs of implementing cue-based feeding; (6) to determine the feasibility and acceptability of a future trial; (7) to scope existing data-recording systems and potential outcome measures; and (8) to determine stakeholders' views of whether or not a randomised controlled trial of this approach is feasible. DESIGN This was a mixed-methods intervention development and feasibility study comprising (1) a systematic review, case studies, qualitative research and stakeholder consensus; (2) the co-production of the intervention; (3) a mixed-methods feasibility study; and (4) an assessment of stakeholder preferences for a future evaluation. SETTING Three neonatal units in the UK (two level 3 units and one level 2 unit). PARTICIPANTS Developmentally normal, clinically stable preterm infants receiving enteral feeds (n = 50), parents (n = 15 pre intervention development; n = 14 in the feasibility study) and health-care practitioners (n = 54 pre intervention development; n = 16 in the feasibility study). INTERVENTION An evidence-informed multicomponent intervention comprising training, a feeding protocol, feeding assessment tools, supplementary training materials [including posters, a film and a narrated PowerPoint (Microsoft Corporation, Redmond, WA, USA) presentation] and the 'Our Feeding Journey' document. MAIN OUTCOME MEASURES The main outcome measures were recruitment and screening rates, infant weight gain, duration of the intervention, feeding outcomes, implementation outcomes (contextual facilitators and barriers, acceptability, adoption, appropriateness and fidelity) and stakeholder preferences for a future evaluation. RESULTS The systematic review of 25 studies concluded that evidence in favour of cue-based feeding should be treated cautiously. The case studies and qualitative research highlighted contextual barriers to and facilitators of the implementation of cue-based feeding. The telephone survey found that many neonatal units are considering implementing cue-based feeding. We recruited 37% of eligible infants, and there was good retention in the study until discharge but a high loss to follow-up at 2 weeks post discharge. The mean number of days from intervention to transition to full oral feeding was 10.8, and the mean daily change in weight gain was 25 g. The intervention was acceptable to parents and staff, although there was dissatisfaction with the study documentation. Intervention training did not reach all staff. A cluster-randomised design with a composite outcome was suggested by stakeholders for a future study. LIMITATIONS The intervention was available only in English. Intervention training did not reach all staff. There was low recruitment to qualitative interviews and observations. Only a small number of medical staff engaged in either the training or the interviews. CONCLUSIONS It is feasible to implement a cue-based feeding intervention with improved training and documentation. Further work is needed to assess the feasibility of a future trial, noting evidence of existing lack of equipoise. FUTURE WORK The next steps are to digitalise the intervention and conduct a survey of all neonatal units in the UK. STUDY REGISTRATION This study is registered as PROSPERO CRD42018097317 and ISRCTN13414304. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 74. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | | | - Shona Shinwell
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Karen Tosh
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Peter Donnan
- Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
| | - Louise M Wallace
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
| | | | | | - Anna Gavine
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Helen Mactier
- Princess Royal Maternity, NHS Greater Glasgow and Clyde, Glasgow, UK
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Ringham C, Rankin J, Marcellus L. The Social Organization of Neonatal Nurses' Feeding Work. Neonatal Netw 2021; 39:283-292. [PMID: 32879044 DOI: 10.1891/0730-0832.39.5.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE We report findings from an institutional ethnography (IE) of nurses' work of feeding infants within an increasingly technical organization of NICUs. SAMPLE Five primary informants; 18 secondary informants. DESIGN The institutional ethnographic approach included field observations, interviews, and phone and e-mail conversations. Our analysis followed accounts of what actually happened within the textual organization of nurses' work. MAIN OUTCOME Nurses' feeding practices are directed by protocols that arise within multiple documentation systems and clinical technologies. These systems produce barriers to nurses' efforts to skillfully feed infants. RESULTS Prioritization of quality and safety perspectives can obscure and constrain the ordinary yet critical clinical reasoning neonatal nurses employ during feeding work. Clinical technologies that have been developed to improve safety can paradoxically disrupt the ability of nurses to respond in the moment to neonatal feeding cues. This finding provides nurses, leaders, and policymakers with insight into why policies and procedures may not be followed as expected.
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Majoli M, De Angelis LC, Panella M, Calevo MG, Serveli S, Knoll BL, Ramenghi LA. Parent-Administered Oral Stimulation in Preterm Infants: A Randomized, Controlled, Open-Label Pilot Study. Am J Perinatol 2021; 40:845-850. [PMID: 34182577 DOI: 10.1055/s-0041-1731452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The study aimed to assess whether there was any difference in the transition time to full oral feedings between parent-administered and professional-administered premature infant oral motor intervention (PIOMI). The study also evaluated parental satisfaction with performing the intervention through an open-ended questionnaire. STUDY DESIGN A single-center, randomized, controlled, open-label pilot study was carried on between March 2017 and May 2019. A total of 39 infants born ≤32 weeks' gestation were randomly assigned to either parent-performed or professionally performed oral stimulation. The oral stimulation was performed once a day for seven consecutive days between 31 and 32 weeks' postmenstrual age. RESULTS There was no statistically significant difference in transition time, weight gain, or length of hospital stay between the two groups. No adverse events were observed. Parents' satisfaction was high, and their active involvement enhanced their perception of adequacy to care for their infant. CONCLUSION Following adequate training, a parent-administered PIOMI may be considered in preterm infants to reduce the transition time to full oral feeding and enhance the direct involvement of parents in neonatal care. KEY POINTS · No difference in transition time between parent-performed and professional-performed PIOMI.. · PIOMI may be delivered by parents following appropriate training.. · Active involvement of parents may improve the parent-infant bonding..
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Affiliation(s)
- Marta Majoli
- Department Mother and Child, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Laura Costanza De Angelis
- Department Mother and Child, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Monica Panella
- Rehabilitation Department, ASL Bi Biella Hospital, Biella, Italy
| | - Maria Grazia Calevo
- Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Simona Serveli
- Department Mother and Child, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Luca Antonio Ramenghi
- Department Mother and Child, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
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Brantes ALG, Curado MADS. NURSES' PERCEPTIONS ABOUT THE FEEDING OF PRETERM NEWBORNS. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze nurses' perceptions about the feeding of preterm newborns and their motivations in using feeding methods during hospitalization in the neonatology unit. Method: descriptive study with a qualitative approach. Data collection was carried out between July 2019 and January 2020, using semi-structured interviews with 30 nurses from a neonatology unit. The analysis of interview data was carried out using lexicographical textual analysis, the descending hierarchical classification, and similarity analysis through IRaMuTeQ - R Interface software. Results: 876 text segments were analyzed in the descending hierarchical classification, retaining 86.3% of the total for the creation of five classes that resulted from content participation. The similarity analysis of the words representing the nurses' perception about oral feeding and the choice of feeding method led to three central cores, represented by the words: think, give, bottle. Conclusion: Nurses recognize the importance of continuing education and training in the assessment of oral skills. The reason for choosing the feeding method is often based on criteria such as preference, speed, and ease.
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Factors associated with postmenstrual age at full oral feeding in very preterm infants. PLoS One 2020; 15:e0241769. [PMID: 33175897 PMCID: PMC7657555 DOI: 10.1371/journal.pone.0241769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 10/21/2020] [Indexed: 02/02/2023] Open
Abstract
Aim We aimed to identify variables associated with gestational age at full oral feeding in a cohort of very preterm infants. Methods In this retrospective study, all infants born below 32 weeks of gestation and admitted to a level III neonatal unit in 2015 were included. We dichotomized our population of 122 infants through the median age at full oral feeding, and explored which variables were statistically different between the two groups. We then used linear regression analysis to study the association between variables known from the literature and variables we had identified and age at full oral feeding. Results The median postnatal age at full oral feeding was 36 6/7weeks post menstrual age (Q1-Q3 35 6/7-392/7), and was associated with the duration of hospital of stay. In the univariable linear regression, the variables significantly associated with full oral feeding were gestational age, socioeconomic status, sepsis, patent ductus arteriosus, duration of supplementary oxygen, of non-invasive and invasive ventilation, and bronchopulmonary dysplasia. In the multivariable regression analysis, duration of non-invasive ventilation and oxygen therapy, bronchopulmonary dysplasia, and patent ductus arteriosus were associated with an older age at full oral feeding, with bronchopulmonary dysplasia the single most potent predictor. Discussion Lung disease severity is a major determinant of age at full oral feeding and thus length of stay in this population. Other factors associated with FOF include socioeconomic status and patent ductus arteriosus, There is a need for research addressing evidence-based bundles of care for these infants at risk of long-lasting feeding and neurodevelopmental impairments.
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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 PMCID: PMC7480839 DOI: 10.1371/journal.pone.0237915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [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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Underwood MA, Umberger E, Patel RM. Safety and efficacy of probiotic administration to preterm infants: ten common questions. Pediatr Res 2020; 88:48-55. [PMID: 32855513 PMCID: PMC8210852 DOI: 10.1038/s41390-020-1080-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In spite of a large number of randomized placebo-controlled clinical trials and observational cohort studies including >50,000 preterm infants from 29 countries that have demonstrated a decrease in the risk of necrotizing enterocolitis, death, and sepsis, routine prophylactic probiotic administration to preterm infants remains uncommon in much of the world. This manuscript reflects talks given at NEC Society Symposium in 2019 and is not intended to be a state-of-the-art review or systematic review, but a summary of the probiotic-specific aspects of the symposium with limited additions including a recent strain-specific network analysis and position statement from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). We address ten common questions related to the intestinal microbiome and probiotic administration to the preterm infant.
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Affiliation(s)
- Mark A Underwood
- Division of Neonatology, Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA, USA.
| | - Erin Umberger
- Necrotizing Enterocolitis (NEC) Society, Davis, CA, USA
| | - Ravi M Patel
- Division of Neonatology, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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14
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Salas AA, Meads C, Ganus S, Bhatia A, Taylor C, Chandler-Laney P, Imtiaz MH, Sazonov E. Quantitative assessment of nutritive sucking patterns in preterm infants. Early Hum Dev 2020; 146:105044. [PMID: 32361560 PMCID: PMC8506900 DOI: 10.1016/j.earlhumdev.2020.105044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess patterns of nutritive sucking in very preterm infants ≤32 weeks of gestation. STUDY DESIGN Very preterm infants who attained independent oral feeding were prospectively assessed with an instrumented feeding bottle that measures nutritive sucking. The primary outcome measure was nutritive sucking performance at independent oral feeding. RESULT We assessed nutritive sucking patterns in 33 very preterm infants. We recorded 63 feeding sessions. The median number of sucks was 784 (IQR: 550-1053), the median sucking rate was 36/min (IQR: 27-55), and the median number of sucking bursts during the first 5 min of oral feeding was 14 (IQR: 12-16). Maximum sucking strength correlated with the number of sucks (r = 0.62; p < 0.01). No safety concerns were identified during the study. CONCLUSION The quantitative analysis of nutritive sucking patterns with a newly developed instrumented bottle in stable, very preterm infants is safe and feasible. More research is needed to develop and refine the instrument further.
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Affiliation(s)
- Ariel A Salas
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
| | - Claire Meads
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Shae Ganus
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Anisha Bhatia
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Caitlin Taylor
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Paula Chandler-Laney
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Masudul H Imtiaz
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL 35487, USA
| | - Edward Sazonov
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL 35487, USA
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Uhm JY, Choi MY. Mothers' needs regarding partnerships with nurses during care of infants with congenital heart defects in a paediatric cardiac intensive care unit. Intensive Crit Care Nurs 2019; 54:79-87. [PMID: 31353190 DOI: 10.1016/j.iccn.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 06/28/2019] [Accepted: 07/04/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We investigated mothers' needs in forming partnerships with nurses based on children's postoperative recovery in a paediatric cardiac intensive care unit. DESIGN This was a descriptive study using prospective data. SETTING Data were collected from 36 mothers enrolled in a mother-nurse partnership program. MAIN OUTCOME MEASURES We investigated mothers' need for information and participation activities using a self-made survey tool, as well as the duration of mothers' care participation and physical engagement and psychological connectedness. RESULTS The mothers desired information on their infants' postoperative stability in the early recovery phases and information on infants' transfer and care in the later phases. Mothers' mean duration of care participation increased as infants' recovery progressed (15.82 ± 8.76 minutes in the second phase of recovery to 29.46 ± 4.53 minutes in the fifth phase; F = 19.54, p < .001). Mothers' physical engagement and psychological connectedness also increased with infants' recovery (F = 200.95, p < .001; F = 93.27, p < .001, respectively). Mothers generally passively participated at first and gradually developed more positive and enthusiastic participation as infants recovered. CONCLUSION Infants' condition heavily influenced mothers' needs regarding partnerships. Thus, nurses must individually provide mothers with information and encourage them to participate in care.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Daegu Haany University, 1 Haanydaero, Gyeongsan-si, Gyeongsangbuk-Do 712-715, Republic of Korea.
| | - Mi-Young Choi
- Department of Nursing Science, Chungbuk National University, Chungdae-ro 1, Seowon-Gu, Cheongju, Chungbuk 28644, Republic of Korea.
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16
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Harrison TM. Improving neurodevelopment in infants with complex congenital heart disease. Birth Defects Res 2019; 111:1128-1140. [PMID: 31099484 DOI: 10.1002/bdr2.1517] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Worldwide, more than 400,000 infants are born each year with complex congenital heart disease (CCHD) requiring surgical intervention within the first months of life. Although improvements in perioperative care have resulted in increased rates of survival, more than half of infants with CCHD have neurodevelopmental impairments affecting subsequent educational achievements, job opportunities, and mental health. Brain maturity and impaired outcomes in infants with CCHD are similar to those of prematurely born infants. Developmentally supportive care, including foundational application of kangaroo care (KC), improves neurodevelopment in premature infants. Provision of developmentally supportive care with KC during the early hospitalization of infants with CCHD has the potential to similarly improve neurodevelopment. The purposes of the article are to describe common congenital heart defects, describe developmentally supportive care with an emphasis on KC, and to offer specific recommendations for KC and research in infants with CCHD.
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Abstract
PURPOSE OF REVIEW Probiotic administration to premature infants for the purpose of prevention of necrotizing enterocolitis is common in many parts of the world but uncommon in the United States. The present review will emphasize recent findings in support of routine administration of probiotics to this highly vulnerable population. RECENT FINDINGS Additional evidence from animal models describing mechanisms of protection of probiotics in the immature gut and updated meta-analyses of randomized placebo-controlled trials and observational cohorts are presented (now including more than 40 000 premature infants from countries across the globe). SUMMARY The preponderance of evidence suggests that probiotic administration to premature infants is well tolerated and decreases the risk of death, necrotizing enterocolitis, and sepsis. Further comparisons of probiotic administration to placebo are not likely to alter these conclusions. Rather, future work should focus on assurance of high-quality products with demonstrated purity and viability of probiotic microbes, and future clinical trials should focus on comparisons between high-quality products and doses.
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Khan Z, Sitter C, Dunitz‐Scheer M, Posch K, Avian A, Bresesti I, Urlesberger B. Full oral feeding is possible before discharge even in extremely preterm infants. Acta Paediatr 2019; 108:239-244. [PMID: 29953661 PMCID: PMC6585780 DOI: 10.1111/apa.14478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/17/2018] [Accepted: 06/26/2018] [Indexed: 12/01/2022]
Abstract
AIM This study described the steps needed to achieve full oral feeding before discharge in a group of very and extremely preterm (EPT) infants. We analysed the effects of oral feeding skills on discharge timing and on weight gain during their neonatal intensive care unit (NICU) stay. METHODS A prospective cross-sectional observational study of 100 infants who were <32 weeks of gestation (GA) was conducted at the Division of Neonatology, Graz, Austria, from March 2014 to February 2015. Patients were stratified into two groups: those who were <28 weeks at birth and those who were 28 weeks and over. Velocity of oral feeding skills attainment and weight gain were analysed. RESULTS All infants successfully acquired oral feeding skills during hospitalisation. The median GA at which full oral feeding skills were reached was 37 + 1 weeks in EPT and 34 + 5 weeks in very preterm infants. More immature neonates showed worse feeding performances and lower weight increments during oral feeding steps. CONCLUSION Our study confirmed the role of GA in the development of oral feeding skills in the most premature babies. It also raises the question of whether expected daily weight gain should be targeted according to GA.
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Affiliation(s)
- Zahra Khan
- Division of NeonatologyMedical University of GrazGrazAustria
- Department of Food Science and Human NutritionUniversity of Veterinary and Animal SciencesLahorePakistan
| | - Cornelia Sitter
- Division of NeonatologyMedical University of GrazGrazAustria
| | | | - Katrin Posch
- Division of NeonatologyMedical University of GrazGrazAustria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and DocumentationMedical University of GrazGrazAustria
| | - Ilia Bresesti
- Division of NeonatologyMedical University of GrazGrazAustria
- Division of NeonatologyV. Buzzi Children's HospitalASST‐FBF‐SaccoMilanItaly
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Ding W, Zhao L, Sheng N, Ma J, Zhang Y. Impact of Neonatal Intensive Care Unit oral feeding on neuropsychomotor outcomes at 9 months of corrected age in Chinese low-birthweight preterm infants: A retrospective study. J Clin Nurs 2018; 28:420-429. [PMID: 29777555 DOI: 10.1111/jocn.14537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 04/12/2018] [Accepted: 05/07/2018] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES To examine the changes in neuropsychomotor development and investigate the effect of feeding progression in Neonatal Intensive Care Unit (NICU) on neuropsychomotor outcomes in low-birthweight preterm infants within 9 months of corrected age. BACKGROUND Low-birthweight (LBW) preterm infants (<37 weeks of gestation and birthweight <2,500 g) are at a high risk for neuropsychomotor development delay. Therefore, exploring NICU practices related to neuropsychomotor development is important. DESIGN This is a retrospective hospital-based cohort study. METHODS This study included 196 LBW preterm infants who were admitted to the NICU between January 2014-March 2016 and attended the follow-up growth evaluation in the clinic after discharge. The neuropsychomotor development of preterm infants was assessed every 3 months to a corrected age of 9 months using the paediatric neuropsychomotor diagnostic scale (PNDS). Generalised linear mixed models (GLMM) were performed. RESULTS The total PNDS scores had a downward trend, but the difference on pairwise comparison was not statistically significant. In total, 18.1%, 15.2% and 9.7% of preterm infants were examined for neuropsychomotor disorders at 3, 6 and 9 months of corrected age, respectively. The result of GLMM showed that the early initiation of oral feeding with breast milk was associated with optimal neuropsychomotor development. The first 3 months of corrected age is the critical period for neurodevelopmental disorders. CONCLUSIONS This study showed the importance of the early initiation of oral feeding with breast milk as early as possible within the NICU setting and highlighted the importance of close developmental follow-up. RELEVANCE TO CLINICAL PRACTICE The early initiation of oral feeding with breast milk may be recommended to promote neuropsychomotor development of LBW preterm infants within the NICU setting. Early identification of neuropsychomotor developmental delays within the first 3 months may guide early interventions.
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Affiliation(s)
- Wenwen Ding
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lijin Zhao
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Sheng
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jiali Ma
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Yi YG, Oh BM, Shin SH, Shin JY, Kim EK, Shin HI. Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants. Front Pediatr 2018; 6:54. [PMID: 29594085 PMCID: PMC5857543 DOI: 10.3389/fped.2018.00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/26/2018] [Indexed: 11/13/2022] Open
Abstract
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included. Video recordings of at least 2 min of oral feeding were further analyzed retrospectively by two assessors and the premature infants who exhibited disorganized sucking patterns (n = 109) were divided into three clusters (clusters 2-4). The observational items compatible with disorganization in the original NOMAS were divided into three groups: cluster 2 (disorganized: arrhythmical), cluster 3 (disorganized: arrhythmical + unable to sustain), and cluster 4 (disorganized: arrhythmical + incoordination ± unable to sustain) and further divided into incoordination-positive (cluster 4) and incoordination-negative groups (clusters 2 and 3). Premature infants in the incoordination-positive group (cluster 4, which means stress signals) showed a median transition time of 22 days (range: 4-121 days) which was longer than that in the incoordination-negative group (median 6 days; range: 1-25 days). Univariate linear regression analysis revealed that the presence of incoordination among disorganized sucking patterns (NOMAS cluster 4 vs. clusters 2 and 3), birth weight, total parenteral nutrition (TPN) duration, non-invasive positive pressure ventilation duration, the presence of moderate to severe bronchopulmonary dysplasia, pulmonary hypertension, sepsis, small for gestational age (SGA), and necrotizing enterocolitis are associated with the transition time to FOF. In a multivariate linear regression analysis, the variables revealed to be associated with the transition time were TPN duration, SGA, and the presence of stress signals (incoordination-positive group) among disorganized sucking patterns. When selecting premature infants to be treated with swallowing therapy, it is reasonable to pay more attention to the incoordination-positive group described in the NOMAS, that is, premature infants with stress signals to shorten the time to attain FOF.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Han Shin
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Jin Yong Shin
- Department of Pediatric Occupational Therapy, Seoul National University Children's Hospital, Seoul, South Korea
| | - Ee-Kyung Kim
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Giannì ML, Sannino P, Bezze E, Plevani L, Esposito C, Muscolo S, Roggero P, Mosca F. Usefulness of the Infant Driven Scale in the early identification of preterm infants at risk for delayed oral feeding independency. Early Hum Dev 2017; 115:18-22. [PMID: 28843138 DOI: 10.1016/j.earlhumdev.2017.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Very preterm infants frequently experience difficulties in achieving feeding independency. The availability of feeding assessment instruments has been recommended to evaluate an infant's readiness for oral feeding and enable preterm infants' caregivers to document each infant's feeding readiness and advancements. AIMS To investigate the implementation of the Infant Driven Scale in neonatal intensive care units and to identify a cut off value associated with delayed feeding independency. STUDY DESIGN Prospective, observational, single-centre study. SUBJECTS A total of 47 infants born at a gestational age≤32weeks, consecutively admitted to a tertiary neonatal unit between July 2015 and March 2016. OUTCOMES MEASURES The infant's feeding readiness and the postmenstrual age at achievement of feeding independency. RESULTS Mean postmenstrual age at feeding independency was 35.6±1.34weeks. A linear regression analysis showed that a score≤8 at 32weeks of postmenstrual age was associated with a delay of 1.8weeks in achieving feeding independency. CONCLUSION The Infant Driven Scale appears to be a useful additional instrument for the assessment of preterm infants' oral feeding readiness and the early identification of the infants at risk for delayed feeding independency.
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Affiliation(s)
- Maria Lorella Giannì
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Patrizio Sannino
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milan, Italy.
| | - Elena Bezze
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, S.I.T.R.A. Basic Education Sector, Via Francesco Sforza 28, 20122 Milan, Italy.
| | - Laura Plevani
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Chiara Esposito
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Salvatore Muscolo
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Paola Roggero
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
| | - Fabio Mosca
- Fondazione I.R.C.C.S. Ca Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, University of Milan, Via Commenda 12, 20122 Milano, Italy.
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