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Cresi F, Maggiora E, Capitanio M, Bovio C, Borla F, Cosimi S, Enrietti D, Faggiano F, Loro S, Rovei SM, Runfola F, Scrufari M, Taglianti MV, Vignali F, Peila C, Coscia A. Effects of a valved infant-bottle with ergonomic teat on the coordination of sucking, swallowing, and respiration in late-preterm infants. The Safe Oral Feeding randomized Trial. Front Pediatr 2024; 12:1309923. [PMID: 38283629 PMCID: PMC10808751 DOI: 10.3389/fped.2024.1309923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Breastfeeding naturally enables the coordination of sucking, swallowing, and respiration patterns for safe feeding. When breastfeeding is not possible a feeding device that releases milk in response to intra-oral vacuum could potentially offer improved coordination of sucking, swallowing, and breathing patterns compared to conventional devices. The aim of the study is to evaluate the effect of a valved infant-bottle with an ergonomic teat compared to a standard infant-bottle. Methods This unblinded randomized controlled trial focused on late preterm infants fed by bottle for at least three meals over the day, admitted to the Neonatal Unit of Sant'Anna Hospital (Turin, Italy). Infants were randomized to be fed with a valved infant-bottle with an ergonomic teat (B-EXP arm) or with a standard infant-bottle (B-STD arm). Monitoring included a simultaneous synchronized recording of sucking, swallowing and respiration. The main outcome was the swallowing/breathing ratio. Results Forty infants (20 B-EXP arm; 20 B-STD arm) with a median gestational age of 35.0 weeks (IQR 35.0-36.0 weeks) completed the study. Four infants were censored for the presence of artifacts in the polygraphic traces. The median swallowing/breathing ratio was 1.11 (1.03-1.23) in the B-EXP arm and 1.75 (1.21-2.06) in the B-STD (p = .003). A lower frequency of swallowing events during the inspiratory phase of breathing was observed in B-EXP arm compared with B-STD arm (p = 0.013). Discussion The valved infant-bottle with an ergonomic teat improves the coordination of sucking-swallowing-respiration and limits the risk of inhalation reducing the frequency of swallowing during the inspiratory phase.
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Affiliation(s)
- Francesco Cresi
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Elena Maggiora
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Martina Capitanio
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Cecilia Bovio
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Federica Borla
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sara Cosimi
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Desirèe Enrietti
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Francesca Faggiano
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sara Loro
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Serena Maria Rovei
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Federica Runfola
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Mariangela Scrufari
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Michela Vigna Taglianti
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Federica Vignali
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Chiara Peila
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Alessandra Coscia
- Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Obsterics and Gynecology, Città Della Salute e Della Scienza di Torino, Turin, Italy
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Seyedkalateh P, Mirfazeli A, Rajabi A, Alaee E. Standardization of sucking patterns during breastfeeding in healthy term neonates: A cross-sectional study. J Neonatal Perinatal Med 2023; 16:649-656. [PMID: 38143378 DOI: 10.3233/npm-230008] [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: 12/26/2023]
Abstract
BACKGROUND Nutritive disorders like sucking and swallowing problems are common in infants. The necessity for a clinical tool to assess these issues has never been more evident. This study aims to evaluate sucking patterns and standardize them in healthy neonates. METHODS A cross-sectional study involving 223 neonates breastfeeding in the Maternity Ward of Shahid Sayyad Shirazi Hospital, Gorgan, Iran, from April to September 2021 was conducted. Neonatal swallowing skills (maximum sucking pressure and number of sucking actions) were assessed using a swallowing skill assessment device. The 95% confidence interval for maximal sucking pressure and the number of sucking actions within a normal distribution were estimated. RESULTS Out of 223 infants, 112 (50.2%) were female, 176 (74.9%) were delivered via cesarean section, and their mean birth weight was 3154.48±371.48 grams. The maximum sucking pressure was -6.82, with a 95% confidence interval of (-13.21, -3.52) in infants. The mean number of sucking actions within a 15-second interval was 6.74, with a 95% confidence interval of (2.23, 20.37). CONCLUSION Regarding this data and the high prevalence of sucking disorders in preterm infants worldwide, we can employ this information in conjunction with an oral-motor skill assessment tool to evaluate infant sucking patterns in hospitals, clinics, and during home visits.
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Affiliation(s)
- P Seyedkalateh
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - A Mirfazeli
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - A Rajabi
- Environmental Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - E Alaee
- Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Chen L, Lucas RF, Feng B. A Novel System to Measure Infants' Nutritive Sucking During Breastfeeding: the Breastfeeding Diagnostic Device (BDD). IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 6:2700208. [PMID: 29888144 PMCID: PMC5991864 DOI: 10.1109/jtehm.2018.2838139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/17/2018] [Accepted: 05/14/2018] [Indexed: 01/19/2023]
Abstract
Breastfeeding is optimal for infant health, but more than 66% of mothers cease exclusive breastfeeding within three months after giving birth. Evaluating infants’ sucking effort provides valuable diagnosis to mothers encountering barriers with breastfeeding. Sucking microstructure is defined as an array of metrics that comprehensively capture infants’ ability to create a sealed latch onto mother’s nipple and regulate feeding, including number of sucks, sucks per burst, number of bursts, intra suck interval, and maximal sucking pressure. In this paper, we proposed a breastfeeding diagnostic device (BDD) which allows convenient and objective measurement of infants’ sucking microstructure in both home and clinical settings. BDD utilizes an air-based pressure transducer to measure infants’ sucking behavior. We conducted pilot clinical studies on six dyads of mother and infant to test the feasibility of the BDD system. To facilitate comparison, both breastfeeding and bottle-feeding were conducted on the six dyads using the BDD in home settings, and the outcomes are comparable with prior recordings in research or clinical settings. By offering a convenient and objective measurement of the sucking microstructure, the BDD will provide clinically meaningful guidance and diagnosis to mothers struggling with breastfeeding. BDD will also serve as an objective metric useful in research areas relevant to infant behaviors, assessment of neurodevelopment, and potentially a screening tool for developmental disabilities.
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Affiliation(s)
- Longtu Chen
- Biomedical Engineering DepartmentUniversity of ConnecticutStorrsCT06269USA
| | - Ruth F Lucas
- School of NursingUniversity of ConnecticutStorrsCT06269USA
| | - Bin Feng
- Biomedical Engineering DepartmentUniversity of ConnecticutStorrsCT06269USA
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