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Mulrenin B, Pineda R, Dodds C, Velozo CA. Item-Level Psychometrics of the Neonatal Eating Outcome Assessment in Orally Feeding Infants. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023:15394492231212399. [PMID: 37981785 DOI: 10.1177/15394492231212399] [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: 11/21/2023]
Abstract
BACKGROUND The Neonatal Eating Outcome Assessment determines feeding performance based on the infant's postmenstrual age (PMA). OBJECTIVE To examine item-level measurement properties of this assessment's rating scale. METHODOLOGY In this retrospective study, Rasch analysis was completed on clinical data from the Neonatal Eating Outcome Assessment for 100 infants (52 preterm and 48 full-term) using Winsteps version 3.93.1. Instead of PMA-based scores, ordered letters converted to numerical scores were analyzed. RESULTS Analysis demonstrated that Section I (Pre-Feeding Skills) represents a separate construct from Sections II and III (Oral Feeding and End of Feeding, respectively). Sections II and III were adequately unidimensional to complete Rasch analysis. These sections fit the Rasch model overall, but rating scale category underuse was common, which may be attributed to sample characteristics. IMPLICATIONS This analysis supports using validated ordered letter scoring of Sections II and III to measure oral feeding performance in preterm and full-term newborns.
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Affiliation(s)
- Brooke Mulrenin
- Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Roberta Pineda
- University of Southern California (USC), Los Angeles, CA, USA
- Keck School of Medicine of USC, Los Angeles, CA, USA
- Washington University School of Medicine, St. Louis, MO, USA
| | - Cynthia Dodds
- Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Craig A Velozo
- Medical University of South Carolina (MUSC), Charleston, SC, USA
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Hernández Gutiérrez MF, Díaz-Gómez NM, Jiménez Sosa A, Díaz Gómez JM, Domenech Martinez E. Effectiveness of 2 interventions for independent oral feeding in preterms. An Pediatr (Barc) 2022; 96:97-105. [DOI: 10.1016/j.anpede.2020.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/10/2020] [Indexed: 10/19/2022] Open
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Rodriguez Gonzalez P, Perez-Cabezas V, Chamorro-Moriana G, Ruiz Molinero C, Vazquez-Casares AM, Gonzalez-Medina G. Effectiveness of Oral Sensory-Motor Stimulation in Premature Infants in the Neonatal Intensive Care Unit (NICU) Systematic Review. CHILDREN-BASEL 2021; 8:children8090758. [PMID: 34572190 PMCID: PMC8465336 DOI: 10.3390/children8090758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to identify and to assess the best evidence currently available on the effectiveness of oral sensory-motor stimulation in preterm infants in the neonatal intensive care unit. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews (PRISMA) statements. The search was conducted using the Pubmed, Web of Science (WOS), PEDro and Scopus databases. Clinical trials were reviewed and PEDro rating scale was used to assess the methodological quality of these studies. Results: 1267 studies were found and 11 were relevant and included in this review. Improvements were obtained in achieving independent feeding, maturation of the sucking pattern, transition to full feeding, motor function and length of hospital stay in most studies. Conclusions: there is evidence to support the benefits of the use of oral sensorimotor stimulation to achieve independent oral feeding in preterm infants, thereby reducing their stay in the Neonatal Intensive Care Unit.
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Affiliation(s)
| | - Veronica Perez-Cabezas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Avda. Ana de Viya, 52, 11009 Cadiz, Spain; (C.R.M.); (G.G.-M.)
- Investigation Group, [CTS1038] eMpOwering Health by Physical Activity, Exercise and Nutrition, University of Cadiz, 11009 Cadiz, Spain
- Correspondence: ; Tel.: +34-676-719-119
| | - Gema Chamorro-Moriana
- Department of Physiotherapy, University of Seville, Avenzoar, 6, 41009 Seville, Spain;
| | - Carmen Ruiz Molinero
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Avda. Ana de Viya, 52, 11009 Cadiz, Spain; (C.R.M.); (G.G.-M.)
| | | | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Avda. Ana de Viya, 52, 11009 Cadiz, Spain; (C.R.M.); (G.G.-M.)
- Investigation Group CTS-986, Physical Therapy and Health (FISA), University Institute of Research in Social Sustainable Development (INDESS), University of Cadiz, 11009 Cadiz, Spain
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Lane A, Pacella J, Beal JR, Sahmoun AE, Fedo-Rosvold S, Bellas WM, Brower-Breitwieser C. A cross-sectional analysis of infant-driven and traditional feeding outcomes for neonatal intensive care unit infants. J Perinatol 2021; 41:1865-1872. [PMID: 34012051 DOI: 10.1038/s41372-021-01084-9] [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] [Received: 10/13/2020] [Revised: 03/31/2021] [Accepted: 04/29/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The goal of this study was to assess the impact of infant-driven feeding (IDF) compared to traditional feeding protocols in promoting earlier successful feeding outcomes. STUDY DESIGN We performed a cross-sectional analysis of infants admitted to a level three neonatal intensive care unit (NICU) over a 2-year period. We compared infants fed with the traditional protocol to those under the IDF protocol. RESULTS Infants in the IDF group were younger at first feed (p < 0.001). There was no difference in age at nasogastric (NG) tube removal or at discharge, length of stay, or percentage breastfeeding at discharge. There were no differences in outcomes within two subgroups born at <35 and <32 weeks gestation, respectively. CONCLUSION The IDF program led to earlier initiation of oral feeding. However, this did not lead to earlier NG tube removal or discharge, a shorter length of stay, or increase in the rates of breastfeeding.
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Affiliation(s)
- Audrey Lane
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Jonathan Pacella
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
| | - James R Beal
- Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Abe E Sahmoun
- Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Susan Fedo-Rosvold
- Neonatal Intensive Care Unit, Sanford Children's Hospital Fargo, Fargo, ND, USA
| | - William M Bellas
- Neonatal Intensive Care Unit, Sanford Children's Hospital Fargo, Fargo, ND, USA
| | - Carrie Brower-Breitwieser
- Sanford Health Eating Disorders and Weight Management Center, Fargo, ND, USA. .,Department of Psychiatry and Behavioral Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
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Hernández Gutiérrez MF, Díaz-Gómez NM, Jiménez Sosa A, Díaz Gómez JM, Domenech Martinez E. [Effectiveness of 2 interventions for independent oral feeding in pre-terms]. An Pediatr (Barc) 2021; 96:S1695-4033(20)30520-8. [PMID: 33487564 DOI: 10.1016/j.anpedi.2020.12.002] [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: 09/28/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Oral feeding of pre-term newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T+K+OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge. PATIENTS AND METHODS A clinical study of 2 randomized groups (OS vs. T+K+OS) was carried out on 42 PTNB with gestational age between 27-32 weeks and birth weight>900g. The stimulation programs were carried out in sessions of 15min, for 10 days. RESULTS The PTNBs in the T+K+OS group achieved independent oral feeding earlier, compared to the OS group (24.9±10.1 vs. 34.1±15.6 days, P=.02). An analysis of covariance was performed, which confirmed that the birth weight and gestational age covariates had significant effects on time to reach suction feeding (birth weight: F[1, 38]=5.79; P=.021; gestational age: F[1, 38]=14.12; P=.001) and that once its effect was controlled, the intervention continued to have a significant effect (F[1, 38]=6.07; P=.018). The T+K+OS group, compared to the OS group, achieved an earlier hospital discharge (39±15 vs. 45±18 days), although the differences were not significant (P=.21). CONCLUSIONS Combined therapies that include T+K+OS are more effective than OS alone, in order to achieve independent oral feeding in PTNBs.
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Affiliation(s)
- María Fernanda Hernández Gutiérrez
- Servicio de Rehabilitación y Fisioterapia, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España
| | - N Marta Díaz-Gómez
- Facultad de Ciencias de la Salud, Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España.
| | - Alejandro Jiménez Sosa
- Unidad de Investigación, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España
| | - José Miguel Díaz Gómez
- Facultad de Psicología, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España
| | - Eduardo Domenech Martinez
- Profesor Honorario, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España
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Diniz CM, Lopes MVDO, Nunes MM, Menezes APD, Silva VMD, Leal LP. A Content Analysis of Clinical Indicators and Etiological Factors of Ineffective Infant Feeding Patterns. J Pediatr Nurs 2020; 52:e70-e76. [PMID: 32008831 DOI: 10.1016/j.pedn.2020.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To analyze the content of the concepts present in the nursing diagnosis of Ineffective infant feeding pattern. DESIGN AND METHODS Content validation of nursing diagnosis based on the predictive diversity model. A methodological study of the content validation of a nursing diagnosis was based on the predictive diversity model and performed in the following three stages: conceptual definition of the phenomenon of interest; organization of the phenomenon of interest; and analysis by judges of the concepts of the phenomenon of interest. RESULTS The first two stages identified 13 clinical indicators and 12 etiological factors, which were evaluated by 23 judges. The analyses of judgments were performed according to the level of expertise of the judges. All the clinical indicators were relevant to nursing diagnosis under study. Nine causal factors were analyzed, including the level of importance to the occurrence of Ineffective infant feeding pattern. CONCLUSIONS This study analyzed the diagnostic structure of Ineffective infant feeding pattern, which were considered representative of the phenomenon of interest after evaluation by the judges. PRACTICE IMPLICATIONS The use of nursing diagnosis with accurate elements facilitates clinical reasoning and favors the development of an adequate care plan.
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Affiliation(s)
- Camila Maciel Diniz
- Federal University of Ceará, 1115 Alexandre Barauna, Fortaleza, Ceará 60430160, Brazil.
| | | | - Marília Mendes Nunes
- Federal University of Ceará, 1115 Alexandre Barauna, Fortaleza, Ceará 60430160, Brazil
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Abstract
The purpose of this study was to (1) define medical and sociodemographic factors related to maternal milk feedings and (2) explore relationships between maternal milk feeding and early neurobehavioral outcome. Ninety-two preterm infants born ≤ 32 weeks gestation had maternal milk feeding and breastfeeding tracked in this retrospective analysis. At 34 to 41 weeks postmenstrual age (PMA), neurobehavior was assessed with the NICU Network Neurobehavioral Scale. Maternal milk feeding was often delayed by the use of total parenteral nutrition, administered for a median of 11 (7-26) days, impacting the timing of gastric feeding initiation. Seventy-nine (86%) infants received some maternal milk during neonatal intensive care unit (NICU) hospitalization. Twenty-one (27%) infants continued to receive maternal milk at 34 to 41 weeks PMA, with 10 (48%) of those receiving maternal milk exclusively. Among mothers who initiated maternal milk feeds, 20 (25%) put their infants directly at the breast at least once during hospitalization. Mothers who were younger (P = .02), non-Caucasian (P < .001), or on public insurance (P < .001) were less likely to provide exclusive maternal milk feedings by 34 to 41 weeks PMA. Infants who received maternal milk at 34 to 41 weeks PMA demonstrated better orientation (P = .03), indicating they had better visual and auditory attention to people and objects in the environment. Our findings demonstrate a relationship between maternal milk feedings and better neurobehavior, which is evident before the infant is discharged home from the NICU.
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Pineda R, Prince D, Reynolds J, Grabill M, Smith J. Preterm infant feeding performance at term equivalent age differs from that of full-term infants. J Perinatol 2020; 40:646-654. [PMID: 32066844 PMCID: PMC7117861 DOI: 10.1038/s41372-020-0616-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/21/2020] [Accepted: 02/04/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify differences in feeding skill performance among preterm infants at term equivalent age compared with full-term infants. STUDY DESIGN Ninety-two infants (44 preterm infants born ≤32 weeks gestation at term equivalent age and 48 full-term infants within 4 days of birth) had a standardized oral feeding assessment. RESULT Preterm infants at term equivalent age had lower Neonatal Eating Outcome Assessment scores (67.8 ± 13.6 compared with 82.2 ± 8.1; p < 0.001) and were more likely to have poor arousal (p = 0.04), poor tongue positioning (p = 0.04), suck-swallow-breathe discoordination (p < 0.001), inadequate sucking bursts (p = 0.01), tonal abnormalities (p < 0.001), discoordination of the jaw and tongue during sucking (p < 0.001), lack of positive engagement with the feeder and/or discomfort (p < 0.001), signs of aspiration (p < 0.001), difficulty regulating breathing (p < 0.001), and have an inability to maintain an appropriate state (p < 0.001), and complete the feeding (<0.001). CONCLUSION A broad range of feeding-related difficulties appear to remain evident in preterm infants at term equivalent age.
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Affiliation(s)
- Roberta Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. .,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA. .,University of Southern California, Chan Division of Occupational Science and Occupational Therapy, Keck School of Medicine-Pediatrics, California, USA.
| | - Danielle Prince
- 0000 0001 2355 7002grid.4367.6Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO USA
| | - Jenny Reynolds
- 0000 0001 2167 9807grid.411588.1Baylor University Hospital, Division of Baylor Scott & White Rehabilitation Hospital, Dallas, TX USA
| | - Molly Grabill
- 0000 0001 2355 7002grid.4367.6Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO USA
| | - Joan Smith
- 0000 0000 9953 7617grid.416775.6Department of Quality, Safety, and Practice Excellence, Saint Louis Children’s Hospital, St. Louis, MO USA
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Guilé JM, Tissot C, Boissel L. Interdisciplinary assessment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:173-181. [PMID: 32977876 DOI: 10.1016/b978-0-444-64148-9.00013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Interdisciplinary assessment (IA) is defined as the integration of clinical contributions by healthcare professionals from distinct disciplines into a comprehensive diagnostic and prognostic evaluation. This process requires the professionals to independently and simultaneously consider and gage clinical information collected via a variety of methods and from a variety of informants. A shared perception of the clinical situation is progressively achieved via team meetings. IA helps clinicians to overcome the many challenges posed in today's context for assessment and treatment planning in the field of neurodevelopmental disorders. Most national and international guidelines recommend the inclusion of IA in the diagnostic workup for complex cases (e.g., autism spectrum and attention deficit hyperactivity disorder). Hence, IA should always be part of the neurodevelopmental disorder diagnostic process in children in general and preterm infants in particular.
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Affiliation(s)
- Jean-Marc Guilé
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France; Psychiatry Residency Program, Faculty of Medicine, Université Picardie Jules Verne, Amiens, France; Child and Adolescent Psychiatry Department, Centre Hospitalier Philippe Pinel, Amiens, France; Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Chloé Tissot
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France
| | - Laure Boissel
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France; Psychiatry Residency Program, Faculty of Medicine, Université Picardie Jules Verne, Amiens, France
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Majoli M, Artuso I, Serveli S, Panella M, Calevo MG, Antonio Ramenghi L. A key developmental step for preterm babies: achievement of full oral feeding. J Matern Fetal Neonatal Med 2019; 34:519-525. [PMID: 31006291 DOI: 10.1080/14767058.2019.1610733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aims: To investigate timing of oral feeding (OF) introduction and full oral feeding (FOF) achievement in preterm infants and to explore factors associated with feeding progression.Methods: Retrospective review of 100 medical records of preterms ≤32 weeks of gestation (GA) without major complications. Outcome measures were timing of OF introduction, transition time from nasogastric tube to FOF and FOF achievement. Variables such as sex, twins, GA, birthweight, respiratory supports used and duration of tube feeding, were also considered.Results: Post menstrual age (PMA) for OF introduction was 33.6 ± 1.1 weeks. FOF was achieved at 35.1 ± 1.5 weeks. PMA at OF introduction and PMA at FOF correlated with: birthweight (p = .0001, p = .001); duration of respiratory supports (p = 0.01, p = .0001); PMA at which respiratory supports were stopped (p = .0001, p = .0001); age of introduction of gavage (p = .0001, p = .003) and time of utilization of tube feeding (p = .02, p = .0001). Transition time was 1.5 ± 8.5 days. PMA at OF introduction significantly influenced PMA at FOF (p = .0001, r = .61). OF introduction, transition time and FOF were correlated with duration of hospitalization (p = .004, p = .0001, p = .008).Conclusions: The achievement of feeding skills is confirmed to affect length of hospitalization, but the earlier you introduce OF, the earlier you reach FOF, so introduction should be anticipated. There is a clear trend to favor higher birthweight classes in FOF achievement. Feeding tube placement and need for respiratory supports may represent a nociceptive experience delaying feeding skills' achievement. This highlights the importance of prospective studies investigating the role of preventative interventions.
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Affiliation(s)
- Marta Majoli
- Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Ilaria Artuso
- Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Simona Serveli
- Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Monica Panella
- Rehabilitation Department, ASL Bi Biella Hospital, Biella, Italy
| | - Maria Grazia Calevo
- Epidemiology and Biostatistic Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
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Ratet I, Touzet M, Demouy J, Da Costa L. [Oral feeding difficulties in neonatal medicine and intensive care]. SOINS. PÉDIATRIE, PUÉRICULTURE 2019; 38:25-28. [PMID: 29162255 DOI: 10.1016/j.spp.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oral feeding difficulties represent a major health issue for the future of babies born prematurely. In a neonatal intensive care unit at the Hôpital Cochin, a multi-disciplinary group of professionals regularly meet to initiate team actions. Infants vulnerabilities and quality of life and parents supports are essential for patient management.
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Affiliation(s)
- Isabelle Ratet
- Médecine et réanimation néonatales,Hôpital de Port-Royal HUPC, AP-HP, 123 boulevard de Port-Royal, 75014, Paris, France.
| | - Marie Touzet
- Médecine et réanimation néonatales,Hôpital de Port-Royal HUPC, AP-HP, 123 boulevard de Port-Royal, 75014, Paris, France
| | - Julie Demouy
- Médecine et réanimation néonatales,Hôpital de Port-Royal HUPC, AP-HP, 123 boulevard de Port-Royal, 75014, Paris, France
| | - Lise Da Costa
- Médecine et réanimation néonatales,Hôpital de Port-Royal HUPC, AP-HP, 123 boulevard de Port-Royal, 75014, Paris, France
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Zhang X, Zhou M, Yin H, Dai Y, Li Y. The predictive value of early oral motor assessments for neurodevelopmental outcomes of moderately and late preterm infants. Medicine (Baltimore) 2017; 96:e9207. [PMID: 29390342 PMCID: PMC5815754 DOI: 10.1097/md.0000000000009207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Oral motor assessment is used to identify abnormal sucking patterns which may reflect neurodevelopmental problems in preterm infants, but few studies have focused on moderately and late preterm infants. We enrolled 118 moderately and late preterm infants (mean gestational age, 35.04 weeks; mean birth weight, 2347.59 g) and analyzed the relationship between the Neonatal Oral-Motor Assessment Scale scores of these infants and the Chinese revision of Bayley Scales of Infant Development outcomes at 6 months corrected age. And the infants with abnormal sucking pattern had significantly lower Mental Development Index and Psychomotor Development Index and showed a higher rate of below average scores than control group (P = .003, P = .029, P = .022). The incoordination of suck-swallow-respiration was a risk factor for adverse neurodevelopment (RR = 3.67, 95% CI: 1.42-9.45). These indicate that abnormal sucking patterns in moderately and late preterm infants might provide some predictive value for short-term neurodevelopmental outcomes, but the clinical predictive value for developmental delay need to be determined in a longer term follow-up. This finding may offer a basis for early intervention.
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Affiliation(s)
| | | | - Huaying Yin
- Department of Primary Healthcare, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
| | - Ying Dai
- Department of Primary Healthcare, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
| | - Yuwei Li
- Department of Primary Healthcare, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
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Bourin PF, Puech M, Woisard V. Pediatric Aspect of Dysphagia. Dysphagia 2017. [DOI: 10.1007/174_2017_138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Khanna P, Maron JL, Walt DR. Development of a Rapid Salivary Proteomic Platform for Oral Feeding Readiness in the Preterm Newborn. Front Pediatr 2017; 5:268. [PMID: 29312906 PMCID: PMC5733069 DOI: 10.3389/fped.2017.00268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022] Open
Abstract
Oral feeding competency is a major determinant of length of stay in the neonatal intensive care unit. An infant must be able to consistently demonstrate the ability to take all required enteral nutrition by mouth before discharge home. Most infants born prematurely (<37 weeks) will require days, if not weeks, to master this oral feeding competency skill. Inappropriately timed feeding attempts can lead to acute and long-term morbidities, prolonged hospitalizations, and increased health-care costs. Previously, a panel of five genes involved in essential developmental pathways including sensory integration (nephronophthisis 4, Plexin A1), hunger signaling [neuropeptide Y2 receptor (NPY2R), adenosine-monophosphate-activated protein kinase (AMPK)], and facial development (wingless-type MMTV integration site family, member 3) required for oral feeding success were identified in neonatal saliva. This study aimed to translate these five transcriptomic biomarkers into a rapid proteomic platform to provide objective, real-time assessment of oral feeding skills, to better inform care, and to improve neonatal outcomes. Total protein was extracted from saliva of 10 feeding-successful and 10 feeding-unsuccessful infants matched for age, sex, and post-conceptional age. Development of immunoassays was attempted for five oral feeding biomarkers and two reference biomarkers (GAPDH and YWHAZ) to normalize for starting protein concentrations. Normalized protein concentrations were correlated to both feeding status at time of sample collection and previously described gene expression profiles. Only the reference proteins and those involved in hunger signaling were detected in neonatal saliva at measurable levels. Expression patterns for NPY2R and AMPK correlated with the gene expression patterns previously seen between successful and unsuccessful feeders and predicted feeding outcome. Salivary proteins associated with hunger signaling are readily quantifiable in neonatal saliva and may be utilized to assess oral feeding readiness in the newborn. This study lays the foundation for the development of an informative, rapid, proteomic platform to assess neonatal oral feeding maturation.
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Affiliation(s)
- Prarthana Khanna
- Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, United States
| | - Jill L Maron
- Mother Infant Research Institute, Floating Hospital for Children at Tufts Medical Center, Boston, MA, United States
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Wyss Institute for Biologically Inspired Engineering, Harvard Medical School, Boston, MA, United States
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Longfier L, Soussignan R, Reissland N, Leconte M, Marret S, Schaal B, Mellier D. Emotional expressiveness of 5–6 month-old infants born very premature versus full-term at initial exposure to weaning foods. Appetite 2016; 107:494-500. [DOI: 10.1016/j.appet.2016.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
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Crowe L, Chang A, Wallace K. Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation. Cochrane Database Syst Rev 2016; 2016:CD005586. [PMID: 27552522 PMCID: PMC6464358 DOI: 10.1002/14651858.cd005586.pub3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND One of the most challenging milestones for preterm infants is the acquisition of safe and efficient feeding skills. The majority of healthy full term infants are born with skills to coordinate their suck, swallow and respiration. However, this is not the case for preterm infants who develop these skills gradually as they transition from tube feeding to suck feeds. For preterm infants the ability to engage in oral feeding behaviour is dependent on many factors. The complexity of factors influencing feeding readiness has led some researchers to investigate the use of an individualised assessment of an infant's abilities. A limited number of instruments that aim to indicate an individual infant's readiness to commence either breast or bottle feeding have been developed. OBJECTIVES To determine the effects of using a feeding readiness instrument when compared to no instrument or another instrument on the outcomes of time to establish full oral feeding and duration of hospitalisations. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 1), MEDLINE via PubMed (1966 to 22 February 2016), EMBASE (1980 to 22 February 2016), and CINAHL (1982 to 22 February 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA Randomised and quasi-randomised trials comparing a formal instrument to assess a preterm infant's readiness to commence suck feeds with either no instrument (usual practice) or another feeding readiness instrument. DATA COLLECTION AND ANALYSIS The standard methods of Cochrane Neonatal were used. Two authors independently screened potential studies for inclusion. No studies were found that met our inclusion criteria. MAIN RESULTS No studies met the inclusion criteria. AUTHORS' CONCLUSIONS There is currently no evidence to inform clinical practice, with no studies meeting the inclusion criteria for this review. Research is needed in this area to establish an evidence base for the clinical utility of implementing the use of an instrument to assess feeding readiness in the preterm infant population.
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Affiliation(s)
- Linda Crowe
- Mater Health ServicesNursing Research CentreBrisbaneAustralia
| | - Anne Chang
- Queensland University of TechnologySchool of NursingBrisbaneQueenslandAustralia
| | - Karen Wallace
- Mater Health ServicesMater Mothers HospitalLevel 1 Augbiny PlaceRaymond TerraceBrisbaneQueenslandAustralia
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Menier I, Dejonkheere C, Baou O, Moreno ME, Mattioni V, Madre C. Prévention des troubles de l’oralité en réanimation pédiatrique : mise au point et expérience récente de l’hôpital Robert Debré. MEDECINE INTENSIVE REANIMATION 2014. [DOI: 10.1007/s13546-014-0905-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Feştilă D, Ghergie M, Muntean A, Matiz D, Şerb Nescu A. Suckling and non-nutritive sucking habit: what should we know? CLUJUL MEDICAL 2014; 87:11-4. [PMID: 26527989 PMCID: PMC4462418 DOI: 10.15386/cjm.2014.8872.871.df1mg2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/07/2014] [Accepted: 01/26/2014] [Indexed: 11/23/2022]
Abstract
Correct breast feeding can be considered a tool for the post-natal prophylaxis of craniofacial abnormalities, or at least a way of reducing their extent. Inadequate bottle feeding forces the tongue and cheek muscles to develop a compensating and atypical function, in order to obtain the milk. As a result, there can be an adaptation change of the dental and bone structures, leading to malocclusions. Finger-sucking is normal in the first two-three years of life. It gives the child a feeling of relaxation; that is why it is usually practiced before sleeping. The effects of non-nutritive sucking on the developing dentition are minor in the child under 3 years of age and are usually limited to changes in the incisor position. Some upper or lower incisors (depend on how the finger has been sucked) become spontaneously tipped toward the lips, and/or others are prevented from erupting. Normally children abandon this habit between 2 and 4 years of age. If it persists after this age, it will be the cause for some dental-maxillary anomalies: open-bite, narrow maxilla with upper protrusion, cross-bite; all these could be accompanied by retrognathic mandible.
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Affiliation(s)
- Dana Feştilă
- Discipline of Orthodontics and Dental-Facial Orthopedics, Faculty of Dental Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mircea Ghergie
- Discipline of Orthodontics and Dental-Facial Orthopedics, Faculty of Dental Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandrina Muntean
- Discipline of Pediatric Dentistry, Faculty of Dental Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daiana Matiz
- Discipline of Orthodontics and Dental-Facial Orthopedics, Faculty of Dental Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alin Şerb Nescu
- Discipline of Orthodontics and Dental-Facial Orthopedics, Faculty of Dental Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Frequency Modulation and Spatiotemporal Stability of the sCPG in Preterm Infants with RDS. Int J Pediatr 2012; 2012:581538. [PMID: 22888359 PMCID: PMC3408657 DOI: 10.1155/2012/581538] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 05/29/2012] [Indexed: 11/17/2022] Open
Abstract
The nonnutritive suck (NNS) is an observable and accessible motor behavior which is often used to make inference about brain development and pre-feeding skill in preterm and term infants. The purpose of this study was to model NNS burst compression pressure dynamics in the frequency and time domain among two groups of preterm infants, including those with respiratory distress syndrome (RDS, N = 15) and 17 healthy controls. Digitized samples of NNS compression pressure waveforms recorded at a 1-week interval were collected 15 minutes prior to a scheduled feed. Regression analysis and ANOVA revealed that healthy preterm infants produced longer NNS bursts and the mean burst initiation cycle frequencies were higher when compared to the RDS group. Moreover, the initial 5 cycles of the NNS burst manifest a frequency modulated (FM) segment which is a significant feature of the suck central pattern generator (sCPG), and differentially expressed in healthy and RDS infants. The NNS burst structure revealed significantly lower spatiotemporal index values for control versus RDS preterm infants during FM, and provides additional information on the microstructure of the sCPG which may be used to gauge the developmental status and progression of oromotor control systems among these fragile infants.
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Crowe L, Chang A, Wallace K. Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation. Cochrane Database Syst Rev 2012:CD005586. [PMID: 22513933 DOI: 10.1002/14651858.cd005586.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND One of the most challenging milestones for preterm infants is the acquisition of safe and efficient feeding skills. The majority of healthy full term infants are born with skills to coordinate their suck, swallow and respiration. However, this is not the case for preterm infants who develop these skills gradually as they transition from tube feeding to suck feeds. For preterm infants the ability to engage in oral feeding behaviour is dependent on many factors. The complexity of factors influencing feeding readiness has led some researchers to investigate the use of an individualised assessment of an infant's abilities. A limited number of instruments that aim to indicate an individual infant's readiness to commence either breast or bottle feeding have been developed. OBJECTIVES To determine the effects of using a feeding readiness instrument when compared to no instrument or another instrument on the outcomes of time to establish full oral feeding and duration of hospitalisation. SEARCH METHODS We used the standard methods of the Cochrane Neonatal Review Group, including a search of the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 2), MEDLINE via EBSCO (1966 to July 2010), EMBASE (1980 to July 2010), CINAHL via EBSCO (1982 to July 2010), Web of Science via EBSCO (1980 to July 2010) and Health Source (1980 to July 2010). Other sources such as cited references from retrieved articles and databases of clinical trials were also searched. We did not apply any language restriction. We updated this search in March 2012. SELECTION CRITERIA Randomised and quasi-randomised trials comparing a formal instrument to assess a preterm infant's readiness to commence suck feeds with either no instrument (usual practice) or another feeding readiness instrument. DATA COLLECTION AND ANALYSIS The standard methods of the Cochrane Neonatal Review Group were used. Two authors independently screened potential studies for inclusion. No studies were found that met our inclusion criteria. MAIN RESULTS No studies met the inclusion criteria. AUTHORS' CONCLUSIONS There is currently no evidence to inform clinical practice, with no studies meeting the inclusion criteria for this review. Research is needed in this area to establish an evidence base for the clinical utility of implementing the use of an instrument to assess feeding readiness in the preterm infant population.
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Affiliation(s)
- Linda Crowe
- Mothers' and Babies Health, Mater Medical Research Institute, South Brisbane, Brisbane, Australia.
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21
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Pediatric Aspect of Dysphagia. Dysphagia 2012. [DOI: 10.1007/174_2012_583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yildiz A, Arikan D, Gözüm S, Taştekın A, Budancamanak I. The effect of the odor of breast milk on the time needed for transition from gavage to total oral feeding in preterm infants. J Nurs Scholarsh 2011; 43:265-73. [PMID: 21884372 DOI: 10.1111/j.1547-5069.2011.01410.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to investigate the effect of the application of the odor of breast milk in preterm infants during gavage feeding on the period of transition to total oral feeding. DESIGN This prospective experimental study was performed on a total of 80 preterm infants: 40 infants in the study group and 40 in the control group. METHODS This experimental study was performed in eastern Turkey at the Neonatal Intensive Care and Premature Unit of a university hospital between September 2007 and December 2008. The demographic data were collected via a questionnaire, and an intervention and follow-up table was prepared by the researcher based on relevant literature. The study was approved by the local institution, and written informed consent was obtained from all parents. FINDINGS The findings of the study indicated that the preterm infants who were stimulated by the odor of breast milk during gavage feeding transitioned to oral feeding 3 days earlier than control subjects. Moreover, the mean hospitalization time of these infants was 4 days shorter. CONCLUSIONS The results show that stimulation with breast milk odor is an effective method for decreasing transition of preterm infants from gavage to oral feeding. CLINICAL RELEVANCE Nurses can train mothers to pump their breast milk, stimulate their infants with the odor of their breast milk, and feed it to their infants in the premature unit. This may lead to a quicker transition to oral feeding.
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Affiliation(s)
- Aynur Yildiz
- Department of Child Health Nursing, School of Health, AbantIzzetBaysal University, Bolu, Turkey
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Central pattern generation involved in oral and respiratory control for feeding in the term infant. Curr Opin Otolaryngol Head Neck Surg 2009; 17:187-93. [PMID: 19417662 DOI: 10.1097/moo.0b013e32832b312a] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Drinking and eating are essential skills for survival and benefit from the coordination of several pattern generating networks and their musculoskeletal effectors to achieve safe swallows. Oralpharyngoesophageal motility develops during infancy and early childhood, and is influenced by various factors, including neuromuscular maturation, dietary and postural habits, arousal state, ongoing illnesses, congenital anomalies, and the effects of medical or surgical interventions. Gastroesophageal reflux is frequent in neonates and infants, and its role in neonatal morbidity including dysphagia, chronic lung disease, or apparent life-threatening events is not well understood. This review highlights recent studies aimed at understanding the development of oral feeding skills, and cross-system interactions among the brainstem, spinal, and cerebral networks involved in feeding. RECENT FINDINGS Functional linkages between suck-swallow and swallow-respiration manifest transitional forms during late gestation through the first year of life, which can be delayed or modified by sensory experience or disease processes, or both. Relevant central pattern generator (CPG) networks and their neuromuscular targets attain functional status at different rates, which ultimately influences cross-system CPG interactions. Entrainment of trigeminal primary afferents accelerates pattern genesis for the suck CPG and transition-to-oral feed in the RDS preterm infant. SUMMARY The genesis of within-system CPG control for rate and amplitude scaling matures differentially for suck, mastication, swallow, and respiration. Cross-system interactions among these CPGs represent targets of opportunity for new interventions, which optimize experience-dependent mechanisms to promote safe swallows among newborn and pediatric patients.
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Abstract
PURPOSE OF REVIEW Feeding competency is a frequent and serious challenge to the neonatal intensive care unit survivors and to the physician-provider-parent teams. The urgency of effective assessment and intervention techniques is obviated to promote safe swallow, as attainment of oral feeding for the preterm infant/newborn is one of the prerequisites for hospital discharge. If left unresolved, feeding problems may persist into early childhood and may require management by pediatric gastroenterologists and feeding therapists. This review highlights studies aimed at understanding the motor control and development of nonnutritive and nutritive suck, swallow, and coordination with respiration in preterm populations. RECENT FINDINGS Functional linkages between suck-swallow and swallow-respiration manifest transitional forms during late gestation and can be delayed or modified by sensory experience and/or disease processes. Moreover, brainstem central pattern generator (CPG) networks and their neuromuscular targets attain functional status at different rates, which ultimately influences cross-system interactions among individual CPGs. Entrainment of trigeminal primary afferents to activate the suck CPG is one example of a clinical intervention to prime cross-system interactions among ororhythmic pattern generating networks in the preterm and term infants. SUMMARY The genesis of within-system CPG control for rate and amplitude scaling matures differentially for suck, mastication, swallow, and respiration. Cross-system interactions among these CPGs represent targets of opportunity for new interventions that optimize experience-dependent mechanisms to promote robust ororhythmic patterning and safe swallows among preterm infants.
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