The organization and control of infant sucking

Oral Touch in Young Infants: Response to Variations of Nipple Characteristics in the First Months of Life

Newborns, and one, and four month olders, were presented for 90 sec with nipples varying in shape and in shape plus material. Pressure variations applied by the infant to the nipples were recorded. Overall activity as well as sucking and exploratory patterns of response were studied by observation of the polygraph records. Results suggest that a developmental trend exists, showing an increase in oral exploration and a decrease in sucking. Further, this age trend is influenced by the type of nipple. For the younger infants the addition of the novel material appears to be the basis of a differential response. For the older infants, global shape appears to be a relevant stimulus characteristic. These findings support the contention that there is a double function of the mouth: nutritive as well as perceptual. The tactual capacity revealed here is present within the first months of life and evolves relative to certain stimulus characteristics.

Newborns Form “Prototypes” in Less Than 1 Minute

Past research demonstrated that newborns looked longer at live faces and two-dimensional still images of the mother than at the faces and images of strangers (Bushnell, Sai, & Mullin, 1989; Field, Cohen, Garcia, & Greenberg, 1985; Walton, Bower, & Bower, 1992). This study examined schema (prototype) theory as a basis for newborn's preference for the mother's face by creating composite (prototype) faces with a pixel averaging technique. Results obtained with a preferential operant-sucking procedure indicated that formation of a representation of faces was rapid. Newborns preferred to look at a composite of presented faces rather than a composite of unseen faces on the first-look presentation of each. The effect faded over the duration of the experiment.

Sucking patterns and behavioral state in 1- and 2-day-old full-term infants

OBJECTIVE

To provide a comprehensive analysis of the temporal structure of sucking in full-term neonates.

DESIGN

Descriptive study.

SETTING

Newborn nursery in a city teaching institution.

PATIENTS/PARTICIPANTS

Fifty-six full-term infants with a mean birth weight of 3,128±370 g completed sucking assessments on the first and second day of life.

METHODS

A 5-minute sucking assessment was completed on the first and second day of life. Instruments included an Infant Nutritive Sucking Apparatus and the Anderson Behavioral Assessment Scale.

RESULTS

The number of sucks (p<.001), intersuck width (p=.008) and interburst width (p<.05) were significantly different between the first and second day of life. On the second day of life the infants generated significantly more sucks, a decrease in interburst width and a decrease in intersuck width. There was a significant increase in the presence of an alert behavioral state from the first to second sucking assessment (p<.01). In addition, with a more alert infant state there was an increased time spent bursting (p<.001).

CONCLUSION

Our results show that sucking analysis is sensitive to infant status and suggest that the development of sucking methodology can be considered as a useful clinical tool to assess the normal developmental course of sucking patterns.

Hierarchical organization of a reference system in newborn spontaneous movements

In this paper, we studied spontaneous newborn movements regarding the coordination of the four limbs, arms and legs, from a dynamic perspective. We used the method of recurrence plots to analyse the kinematic data from audiovisual recordings of neonates. We identified temporal and spatial synchronization of the four limbs that resulted in high recurrence patterns of biomechanical reference configurations. Furthermore, we identified transitions between linear and nonlinear epochs in the movement behavior of newborns on different time scales by means of recurrence quantification analysis. Results are discussed in the context of the concept of a structural hierarchy, in which different time scales correspond to hierarchical levels of organization.

Recurrence plot analyses suggest a novel reference system involved in newborn spontaneous movements

The movements of newborns have been thoroughly studied in terms of reflexes, muscle synergies, leg coordination, and target-directed arm/hand movements. Since these approaches have concentrated mainly on separate accomplishments, there has remained a clear need for more integrated investigations. Here, we report an inquiry in which we explicitly concentrated on taking such a perspective and, additionally, were guided by the methodological concept of home base behavior, which Ilan Golani developed for studies of exploratory behavior in animals. Methods from nonlinear dynamics, such as symbolic dynamics and recurrence plot analyses of kinematic data received from audiovisual newborn recordings, yielded new insights into the spatial and temporal organization of limb movements. In the framework of home base behavior, our approach uncovered a novel reference system of spontaneous newborn movements.

Assessment of infant oral sensorimotor and swallowing function

The development of feeding and swallowing is the result of a complex interface between the developing nervous system, various physiological systems, and the environment. The purpose of this article is to review the neurobiology, development, and assessment of feeding and swallowing during early infancy. In recent years, there have been exciting advances in our understanding of the physiology and neurological control of feeding and swallowing. These advances may prove useful in furthering our understanding of the pathophysiology of dysphagia in infancy. Progress in developing standardized, reliable, and valid measures of oral sensorimotor and swallowing function in infancy has been slow. However, there have been significant advances in the instrumental analysis of feeding and swallowing disorders in infancy, including manometric analyses of sucking and swallowing, measures of respiration during feeding, videofluoroscopic swallow evaluations, ultrasonography, and flexible endoscopic examination of swallowing. Further efforts are needed to develop clinical evaluative measures of dysphagia in infancy.

Oral support measures used in feeding the preterm infant

BACKGROUND

Evidence that bottle-feeding is a stressor for inefficient preterm infant feeders is seen in untoward changes in the physiologic system and nutritive sucking patterns.

OBJECTIVE

To determine whether a therapeutic technique, oral support (cheek and jaw support), would influence the cardiopulmonary functions or nutritive sucking patterns of preterm infants during feeding.

METHODS

A crossover repeated measures design was used with 20 preterm infants for a total of 40 bottle-feeding sessions. The Whitney Mercury Strain Gage and a Nonin Cardiopulmonary monitor were used to observe sucking characteristics and cardiopulmonary functions during feeding.

RESULTS

Infants not receiving support paused longer (F= 6.37, df= 5, p < .001) and more frequently (F= 5.01, df= 5, p < .001) than supported infants. There were no differences between the groups in the number of sucks and bursts, the burst duration, the stability of the total sucking activity, or the rate of sucking. Oxygen saturation (SaO2) values, heart rate, and respiratory rate did not differ between the groups during feeding. Postfeeding SaO2 levels were lower than prefeeding levels for infants not receiving oral support (t= 0.96, df= 19, p= .03).

CONCLUSION

Oral support provided stability for the jaw and fostered the return of the infant's prefeeding SaO2 values, but it did not interfere with cardiopulmonary function during feeding. Further research is needed to determine whether there is a cumulative effect of oral support, and whether it influences state behavior.

Recording non-nutritive sucking in the neonate. Description of an automatized system for analysis

A new method for automatic analysis of non-nutritive sucking in newborn infants is described, which uses a specially designed computer program that analyses an analogue signal obtained from a pressure transducer inside a pacifier. Validation is done with four independent methods: electromyogram, visual identification, control of the automatic treatment and comparison of inter-observer results. A high degree of correspondence is shown. The system was applied to 58 healthy full-term neonates. Infants less than 24 h old demonstrated a significantly different sucking pattern compared with the 3-day-old infant. The duration of their bursts was longer (3.7 vs 2.8 s), the frequency of their sucking was lower (1.7 vs 2.0 Hz) and the variability of their sucking pattern was greater. These results also testify to the validity of the method inasmuch as the values for the different sucking parameters are similar to corresponding values presented earlier.

Neonatal sucking behaviors

Neonatal sucking responses or behaviors have been of great interest to researchers and clinicians since the early 1800s. Since 1960, there has been a resurgence of interest in the objective study of sucking behaviors in both the psychological and medical literature. The studies have examined both nutritive and non-nutritive sucking measurements. Sucking behaviors have been studied to understand the development of the feeding mechanism as well as to track neurobehavioral development. The relationship between sucking behaviors and behavioral organization of the newborn are considered, along with a historical perspective of sucking measurements, relevant literature on nutritive sucking, physiologic correlates, differences in breast and bottle feeding patterns, non-nutritive sucking, and factors that modify sucking organization. Implications for nursing practice will be discussed.