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Lee S, Marshall J, Clarke M, Smith CH. Feeding and Swallowing Outcomes in Children Who Use Long-Term Ventilation: A Scoping Review. Dysphagia 2024; 39:666-683. [PMID: 38180625 DOI: 10.1007/s00455-023-10648-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/17/2023] [Indexed: 01/06/2024]
Abstract
The last two decades have seen increasing use of long-term ventilation (LTV) as an intervention in childhood. Children who use LTV have many risk factors for feeding and swallowing difficulties, including their underlying respiratory and/or neurological etiology, long hospitalizations, medical interventions, and limited exposure to oral feeding experiences. This review aimed to answer two questions: 1) 'What specific swallowing and feeding characteristics do these children experience?'; and 2) 'What impacts do these swallowing and feeding characteristics have on health status and quality of life?'. Texts were identified across bibliographic databases, reference lists, and grey literature. Studies were analyzed according to ventilation, feeding and swallowing, assessment and intervention, and quality of life parameters. Overall, 1919 papers were screened, with 31 papers included in the final data extraction process. A range of feeding and swallowing characteristics were observed, including oral secretion management difficulties, oral aversion, swallowing difficulties, and clinical signs of aspiration. Non-oral feeding was found to be the primary feeding method used. Little information on health status and quality of life was reported in scoping review texts. Children with LTV needs present with a range of feeding and swallowing concerns, and non-oral feeding is common. Further research is needed to understand the feeding and swallowing journey of this population. This will assist in future service planning and delivery, and in turn contribute to improving patient outcomes and quality of life.
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Affiliation(s)
- Sabrena Lee
- Evelina London Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
- Faculty of Brain Sciences, University College London, London, UK
| | - Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Michael Clarke
- Department of Speech, Language and Hearing Sciences, San Francisco State University, San Francisco, USA
| | - Christina H Smith
- Faculty of Brain Sciences, University College London, London, UK
- Department of Clinical Neurosciences, NHS Lothian, Edinburgh, Scotland
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Mace EL, Krishnapura SG, Golinko M, Phillips JD, Belcher RH. Pre-Operative Characteristics Helping to Avoid Gastrostomy Tube After Mandibular Distraction in Neonates With Pierre-Robin Sequence: A Institutional Case-Series and Review of the Literature. Ann Otol Rhinol Laryngol 2024; 133:679-685. [PMID: 38712740 PMCID: PMC11179316 DOI: 10.1177/00034894241249547] [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: 05/08/2024]
Abstract
OBJECTIVE to investigate the ability of mandibular distraction osteogenesis (MDO) to avoid gastrostomy tube (G-tube). DATA SOURCES PubMed, EBSCOhost, Cochrane, and Embase. REVIEW METHODS We retrospectively reviewed the number of MDO cases performed at our institution for patients with Robin Sequence (RS) over the past 10 years. In our institutional review, patients were excluded if they had a G-tube already placed at the time of surgery. We also performed a systematic review of the literature. Articles were excluded if they did not detail feeding outcomes after MDO, or if MDO was performed on patients that did not have RS. RESULTS In our systematic review, 12 articles were included that comprised a total of 209 neonates with RS that underwent MDO. A total of 174 (83.3%) patients avoided a G-tube once MDO was performed. A total of 14 patients met the inclusion criteria at our institution. Of the 14 RS patients, 9 (64%) avoided having a G-tube placed and all (14/14) avoided tracheostomy. The average birth weight of patients avoiding a G-tube was 3.11 kg compared to 2.25 kg (P = .045) in the group requiring a G-tube. In the group avoiding a G-tube, the average weight at time of operation was 3.46 kg compared to 2.83 kg (P = .037) in the group requiring a G-tube. CONCLUSION MDO may be considered as a surgical option to prevent G-tube placement for neonates with non-syndromic RS who have difficulty with PO feeding but whose airway obstruction is not severe enough to require respiratory support. Based on our institutional experience, a minimum weight of 3.00 kg correlated with higher success rates of PO intake and avoiding a G-tube.
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Affiliation(s)
- Emily L Mace
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Michael Golinko
- Vanderbilt Department of Plastic Surgery, Nashville, TN, USA
| | - James D Phillips
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Cleft and Craniofacial Program, Nashville, TN, USA
| | - Ryan H Belcher
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Cleft and Craniofacial Program, Nashville, TN, USA
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Ibrahim C, Grabill M, Smith J, Pineda R. Relationships between preterm medical factors and feeding behaviors at term-equivalent age. Early Hum Dev 2024; 191:105975. [PMID: 38492414 PMCID: PMC11019834 DOI: 10.1016/j.earlhumdev.2024.105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/18/2024]
Abstract
AIM To identify relationships between early medical factors and preterm infant feeding behaviors at term-equivalent age. METHODS Forty-three very preterm infants born ≤32 weeks gestation had standardized feeding assessments using the Neonatal Eating Outcome Assessment at term-equivalent age (36-42 weeks postmenstrual age). Medical factors were collected and analyses were run to determine if associations between different medical factors and feeding performance exist. RESULTS Lower Neonatal Eating Outcome Assessment scores at term-equivalent age were associated with lower estimated gestational age (p < .01), lower birthweight (p < .01), older postmenstrual age at discharge (p < .01), longer length of stay in the neonatal intensive care unit (p < .01), chronic lung disease (p = .03), as well as more days on total parenteral nutrition (p = .03), endotracheal intubation (p < .01), and noninvasive mechanical ventilation (p < .01). CONCLUSION More feeding problems are observed in infants born earlier, with longer hospital stays, and with complex medical courses. Knowledge of the association between these medical factors and feeding difficulties allows for identification of infants who may benefit from early, targeted interventions to optimize the feeding process.
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Affiliation(s)
- Carolyn Ibrahim
- College of Health Sciences, Rush University, Chicago, IL, United States of America
| | - Molly Grabill
- Washington University Program in Occupational Therapy, St. Louis, MO, United States of America
| | - Joan Smith
- Saint Louis Children's Hospital Department of Quality, Safety & Practice Excellence, St. Louis, MO, United States of America
| | - Roberta Pineda
- Washington University Program in Occupational Therapy, St. Louis, MO, United States of America; Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
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Skaaning D, Brødsgaard A, Kronborg H, Kyhnæb A, Pryds O, Carlsen E. Maternal Reasons for Early Termination of Exclusive Breastfeeding in Premature Infants: A Prospective Study. J Perinat Neonatal Nurs 2024; 38:88-97. [PMID: 37115952 DOI: 10.1097/jpn.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
PURPOSE Maternal concerns for health and growth in prematurely born infants affect the breastfeeding duration. METHOD This prospective observational study evaluated whether maternal concerns regarding insufficient milk supply were supported by inadequate nutrients in human milk or low infant growth. The study followed mothers of 211 premature born infants for 6 months after delivery. RESULTS Of the 211 infants, 156 were not exclusively breastfed for the recommended 6 months after delivery. For 79 of these 156 infants, termination was due to maternal concerns regarding insufficient milk supply. There was no difference in human milk nutrients or infant growth when comparing infants who were exclusively breastfed with those who were not. CONCLUSION Maternal concern regarding insufficient milk supply was the primary explanation for termination of exclusive breastfeeding after premature delivery. Concerns regarding insufficient milk supply were not found associated with inadequate nutrients in the human milk, nor with low infant growth. IMPLICATIONS Breastfeeding support should remain in focus in this population.
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Affiliation(s)
- Diana Skaaning
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark (Drs Skaaning, Brødsgaard, Pryds, and Carlsen and Ms Kyhnæb); and Department of Public Health, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark (Drs Skaaning, Brødsgaard, and Kronborg)
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Johnson ML, Steer KE, Edmonds CE, Adjerid K, German RZ, Mayerl CJ. Nipple properties affect sensorimotor integration during bottle feeding in an infant pig model. JOURNAL OF EXPERIMENTAL ZOOLOGY. PART A, ECOLOGICAL AND INTEGRATIVE PHYSIOLOGY 2023; 339:767-776. [PMID: 37438924 PMCID: PMC10528713 DOI: 10.1002/jez.2727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 07/14/2023]
Abstract
Infant feeding is a critical neurological milestone in development defined by the coordination of muscles, peripheral nerves, and brainstem nuclei. In infants, milk flow rate is often limited to improve feeding performance without treating the underlying deficiencies in the sucking and swallowing processes. Modification of the neuromotor response via sensory information from the nipple during bottle feeding is an unexplored avenue for physiology-based interventions. In this study, we assessed how differences in nipple hole size and nipple stiffness affect sucking muscle activation and subsequent movement. We fabricated four bottle nipples of varying hole size and stiffness to determine how variation in nipple properties affects the sucking behavior of infant pigs. Our results demonstrate that sensory information from the nipple affects sucking motor output. Nipple hole sizes and stiffnesses with a larger milk flow rate resulted in greater muscle activity and kinematic movement. Additionally, our results suggest that sensorimotor interventions are better directed toward modulating tongue function rather than the mandible movements due to a greater response to sensory information. Understanding how sensory information influences infant feeding is instrumental in promoting effective infant feeding.
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Affiliation(s)
- ML Johnson
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH
| | - KE Steer
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
| | - CE Edmonds
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH
| | - K Adjerid
- Department of Biomedical Engineering, Tulane University, New Orleans, LA
| | - RZ German
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH
| | - CJ Mayerl
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
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Mohandas S, Rana R, Sirwani B, Kirubakaran R, Puthussery S. Effectiveness of Interventions to Manage Difficulties with Breastfeeding for Mothers of Infants under Six Months with Growth Faltering: A Systematic Review Update. Nutrients 2023; 15:nu15040988. [PMID: 36839345 PMCID: PMC9961185 DOI: 10.3390/nu15040988] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
(1) Background: The current evidence on management of infants under six months (u6m) with growth faltering is limited and of low quality. This review aimed at updating an existing review to inform the WHO guideline update on prevention and management of growth faltering in infants u6m. The objective is to synthesise evidence on interventions to manage breastfeeding difficulties in mothers or caregivers of infants u6m with growth faltering to improve breastfeeding practices and breastmilk intake. (2) Methods: We searched PubMed, CINAHL, and Cochrane Library from December 2018 to December 2021 for experimental studies. Using RoB 2.0 and ROBINS-I tools, we assessed study quality and results were synthesised narratively. Using the GRADE approach, we assessed the quality of evidence for four outcome domains-breastfeeding (critical), anthropometric (important), mortality (important), and morbidity (important). (3) Results: We identified seven studies, conducted among neonates (mainly preterm, n = 14 to 607), and assessed the following interventions: (a) non-nutritive sucking (NNS) on breast (n = 2) and (b) alternative supplemental feeding techniques (n = 5, cup feeding, spoon feeding, supplemental feeding tube device, and syringe feeding), and reported breastfeeding and anthropometric outcomes. None of the studies reported mortality and morbidity outcomes. The reported breastfeeding outcomes included LATCH (Latch, Audible swallowing, Type of nipple, Comfort, Hold) total score, PIBBS (Preterm Infants Breastfeeding Behaviour Scale) total score, EBF (exclusive breastfeeding) at various time points and time to transition to full breastfeeding, and reported anthropometric outcomes included weight gain and weight at different time points. Studies had 'serious' indirectness and 'serious' to 'very serious' risks of bias. From the limited studies we found, NNS on breast compared to NNS on finger may have some benefits on PIBBS total score; NNS on breast compared to NNS on pacifier may have some benefits on EBF at discharge; and cup feeding compared to bottle feeding may have some benefits on EBF at discharge, at three months and at six months. (4) Conclusions: Evidence on the effectiveness of interventions to manage breastfeeding difficulties in mothers or caregivers of infants u6m with growth faltering to improve breastfeeding practices and increase breastmilk intake is 'limited' and of 'low' to 'very low' quality. As the majority of the infants in the included studies were neonates, no new recommendations can be made for infants from one to six months due to lack of evidence in this population. We need more studies targeting infants from one to six months of age. The review was registered with PROSPERO (CRD42022309001).
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Affiliation(s)
- Saranya Mohandas
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India
| | - Ritu Rana
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India
- Correspondence:
| | - Barkha Sirwani
- Department of Public Health Programmes, Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India
| | - Richard Kirubakaran
- Prof BV Moses Centre for Evidence Informed Health Care, Christian Medical College, Vellore 632004, Tamil Nadu, India
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, Bedfordshire, UK
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Rinat S, Mackay M, Synnes A, Holsti L, Zwicker JG. Early feeding behaviours of extremely preterm infants predict neurodevelopmental outcomes. Early Hum Dev 2022; 173:105647. [PMID: 36029558 DOI: 10.1016/j.earlhumdev.2022.105647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Infants born extremely preterm are at high risk for early feeding difficulties, as well as poor neurodevelopmental outcomes in childhood. Feeding, a complex motor skill, may be predictive of later neuromotor outcomes. AIMS To determine the relationship between feeding behaviours of extremely preterm-born infants (<28 weeks gestational age) at 4-months corrected age (CA) and neurodevelopmental outcomes at 4-5 years. STUDY DESIGN Retrospective cohort design with prospectively collected data. SUBJECTS Infants born extremely preterm from September 1999 - October 2013 [n = 412, mean gestational age 25.4 (1.3) weeks; mean birth weight 771 (168) grams]. Oral feeding was assessed at 4-months CA by an experienced occupational therapist; infants were classified as either having poor suck-swallow ('feeding difficulties') or no feeding difficulties. OUTCOME MEASURES Motor outcomes were assessed at 4-5 years using the Movement Assessment Battery for Children (MABC). Children were categorized as: (1) typical motor development (TMD; n = 214); (2) Developmental Coordination Disorder (DCD; n = 116); or (3) major neurodevelopmental disorder (MND; n = 82). RESULTS Feeding behaviour at 4-months CA predicted DCD (OR = 2.95, CI 1.13-7.68) and MND (OR = 3.67, CI 1.35-9.96) after controlling for confounders. Infants with feeding difficulties were more likely to be diagnosed with DCD (40 % of poor feeders) or MND (36 %) at 4-5 years, compared to infants without feeding issues. CONCLUSIONS Early feeding behaviours significantly predicted motor outcomes at 4-5 years. Infants born extremely preterm with early feeding difficulties should be identified as at high risk for poor motor outcomes later in childhood and screened for early diagnosis and intervention.
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Affiliation(s)
- Shie Rinat
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
| | - Margot Mackay
- Neonatal Follow-Up Program, BC Women's Hospital, Vancouver, Canada
| | - Anne Synnes
- Neonatal Follow-Up Program, BC Women's Hospital, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada; Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Liisa Holsti
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada; Healthy Starts Theme, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Jill G Zwicker
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada; Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada.
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8
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Yun WZ, Kassab YW, Yao LM, Khairuddin N, Ming LC, Hadi MA. Effectiveness and safety of early versus late caffeine therapy in managing apnoea of prematurity among preterm infants: a retrospective cohort study. Int J Clin Pharm 2022; 44:1140-1148. [PMID: 35915341 DOI: 10.1007/s11096-022-01437-0] [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: 03/06/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early administration of intravenous (IV) caffeine (initiation within 2 days of life) is an effective treatment strategy for the management of apnoea of prematurity among infants. However, the safety and effectiveness of early administration of oral caffeine treatment is not be fully established. AIM We aimed to compare the effectiveness and safety of early versus late caffeine therapy on preterm infants' clinical outcomes. METHOD A retrospective matched cohort study was conducted using data of patients admitted to neonatal intensive care units of two tertiary care hospitals between January 2016 and December 2018. The clinical outcomes and mortality risk between early caffeine (initiation within 2 days of life) and late caffeine (initiation ≥ 3 days of life) were compared. RESULTS Ninety-five pairs matched based on gestational age were included in the study. Compared to late initiation, preterm infants with early caffeine therapy had: a shorter duration of non-invasive mechanical ventilation (median 5 days vs. 12 days; p < 0.001); shorter length of hospital stay (median 26 days vs. 44 days; p < 0.001); shorter duration to achieve full enteral feeding (median 5 days vs. 11 days; p < 0.001); and lower frequency of bronchopulmonary dysplasia (BPD) (4.5% vs. 12.9%; p = 0.045). They also had a reduced risk of osteopenia of prematurity (OP) (OR 0.209; 95% CI 0.085-0.509; p = 0.001). CONCLUSION Early oral caffeine therapy can potentially improve respiratory outcomes among infants with apnoea of prematurity. However, an increase in mortality associated with early caffeine therapy requires further investigation.
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Affiliation(s)
- Won Zi Yun
- Department of Pharmacy, Putrajaya Hospital, Ministry of Health Malaysia, 62250, Putrajaya, Malaysia.
| | - Yaman Walid Kassab
- College of Pharmacy, National University of Science and Technology, Muscat, Oman.
| | - Liew Mei Yao
- Department of Pharmacy, Serdang Hospital, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Norliyana Khairuddin
- Department of Pharmacy, Putrajaya Hospital, Ministry of Health Malaysia, 62250, Putrajaya, Malaysia
| | - Long Chiau Ming
- PAP Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
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Robinson L, Heng L, Fucile S. Investigating the Developmental Trajectory of Long-term Oral Feeding Problems in 'Healthy' Preterm Infants. Dev Neurorehabil 2022; 25:309-313. [PMID: 35034546 DOI: 10.1080/17518423.2021.2011975] [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: 11/03/2022]
Abstract
PURPOSE To investigate the occurrence of oral feeding problems in preterm infants up to one year after hospital discharge. METHODS Thirty-six infants born <34 weeks gestation were enrolled in a prospective exploratory longitudinal pilot study prior to hospital discharge. Parents of eligible infants completed telephone questionnaires at 3, 6, and 12 months corrected gestational age. The occurrence and type of feeding problems; medical problems; and rehabilitation services received were collected. RESULTS A total of 26 (72.2%) parents responded, with 11 (42%) identifying feeding problems that developed within the first year of life. Avoidant behavior (including crying, agitated/fussy, and refusing to eat) was the most common feeding problem that occurred. CONCLUSION Feeding problems in 'healthy' preterm infants may occur at any point in development within the first year of life. Increased screening after hospitalization is needed for early identification and to make appropriate referrals in a timely manner to prevent and/or reduce the severity of long-term feeding problems.
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Affiliation(s)
| | - Lydia Heng
- Queen's University, Kingston, ON, Canada
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10
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Vitale FM, Chirico G, Lentini C. Sensory Stimulation in the NICU Environment: Devices, Systems, and Procedures to Protect and Stimulate Premature Babies. CHILDREN-BASEL 2021; 8:children8050334. [PMID: 33923031 PMCID: PMC8146433 DOI: 10.3390/children8050334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 01/30/2023]
Abstract
Prematurity deprives infants of the prenatal sensory stimulation essential to their correct development; in addition, the stressful environment of the NICU impacts negatively on their growth. The purpose of this review was to investigate the effects of NICU noise pollution on preterm infants and parents. We focused on the systems and projects used to control and modulate sounds, as well as on those special devices and innovative systems used to deliver maternal sounds and vibrations to this population. The results showed beneficial effects on the preterm infants in different areas such as physiological, autonomic, and neurobehavioral development. Although most of these studies highlight positive reactions, there is also a general acknowledgement of the current limits: small and heterogeneous groups, lack of structured variable measurements, systematic control groups, longitudinal studies, and normative values. The mother's presence is always preferred, but the use of music therapy and the devices analyzed, although not able to replace her presence, aim to soften her absence through familiar and protective stimuli, which is a very powerful aid during the COVID-19 pandemic.
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Affiliation(s)
- Francesco Massimo Vitale
- Psicologia Magistrale (LM-51), Clinical and Rehabilitation Psychology, Università Niccolò Cusano, 00166 Roma, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Gaetano Chirico
- Neonatology and Neonatal Intensive Care Unit, Children Hospital, ASST Spedali Civili, 25123 Brescia, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Carmen Lentini
- Neonatal Pathology/NICU, Ospedale Civile Padova—AOPD, 35128 Padova, Italy;
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11
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Dodrill P. Treatment of Feeding and Swallowing Disorders in Infants and Children. Dysphagia 2021. [DOI: 10.1016/b978-0-323-63648-3.00016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Disorders Affecting Feeding and Swallowing in Infants and Children. Dysphagia 2021. [DOI: 10.1016/b978-0-323-63648-3.00014-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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Skaaning D, Kronborg H, Brødsgaard A, Solmer R, Pryds O, Carlsen EM. No long-term effect of oral stimulation on the intra-oral vacuum in healthy premature infants. Acta Paediatr 2020; 109:2025-2032. [PMID: 32259301 DOI: 10.1111/apa.15289] [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] [Received: 09/20/2019] [Revised: 02/28/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
Abstract
AIM Exclusive breastfeeding is recommended for the first 6 months of life, but the breastfeeding rate in premature infants is low. We examined the effect of oral stimulation on infant's strength of suction and the relation between this intra-oral vacuum and breastfeeding duration. METHOD Between 2016 and 2018, 211 infants in a Danish neonatal unit were randomised 1:1 and of these 108 to oral stimulation intervention and 103 to control. Suction was measured as peak vacuum at enrolment and a corrected age of 6 weeks. Breastfeeding duration was registered. RESULTS Vacuum increased from enrolment to a corrected age of 6 weeks in all infants, and no effect of oral stimulation intervention was demonstrated P = .08. Infants born ≤32 gestational weeks had lower vacuum compared with infants born after, 350 vs 398 mbar P < .001. For infants born after 32 gestational weeks, the odds ratio for exclusive breastfeeding at 6 months was 1.99 per 100 mbar increase in vacuum P = .01. CONCLUSION In our study, infant's intra-oral vacuum increased with age and was not affected by the oral stimulation intervention. For infants born after 32 gestational weeks, the exclusive breastfeeding rate was positively associated with a strong vacuum.
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Affiliation(s)
- Diana Skaaning
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Hvidovre Hvidovre Denmark
| | - Hanne Kronborg
- Department of Public Health Faculty of Health Sciences Aarhus University Aarhus Denmark
| | - Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Hvidovre Hvidovre Denmark
- Department of Public Health Faculty of Health Sciences Aarhus University Aarhus Denmark
| | - Rasmus Solmer
- Department of Product Development Technical University of Denmark Lyngby Denmark
| | - Ole Pryds
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Hvidovre Hvidovre Denmark
| | - Emma Malchau Carlsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Hvidovre Hvidovre Denmark
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14
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Garand KLF, McCullough G, Crary M, Arvedson JC, Dodrill P. Assessment Across the Life Span: The Clinical Swallow Evaluation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:919-933. [PMID: 32650662 DOI: 10.1044/2020_ajslp-19-00063] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This clinical focus article considers the roles of the clinical swallow examination (CSE) as a clinically meaningful assessment method used in both adult and pediatric populations. Method This clinical focus article explores the utility of the CSE across the life span. Specifically, components, reliability, standardized assessments, and limitations of the CSE within the adult and pediatric populations are highlighted. Conclusions The CSE remains a crucial assessment tool for the speech-language pathologist. The experienced clinician can make important judgments regarding patient safety and function. If the CSE is conducted mindfully and methodically, findings can help chart the course of care for individuals needing additional assessment and possibly intervention.
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Affiliation(s)
| | - Gary McCullough
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC
| | - Michael Crary
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Joan C Arvedson
- Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin-Milwaukee
| | - Pamela Dodrill
- Department of Otolaryngology, Boston Children's Hospital Boston, MA
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Poor oral intake in a late preterm twin - usual symptom with an unusual diagnosis. Heart Lung 2018; 47:162-165. [PMID: 29331441 DOI: 10.1016/j.hrtlng.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/30/2017] [Accepted: 11/12/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND At three weeks of age, a previous 34 weeks' gestation male infant (twin A) was transferred to our regional perinatal center (RPC) with complaints of poor oral feeding and intermittent tachypnea. Twin B was discharged at 37 weeks with an uneventful course. CASE Twin A briefly required respiratory support but continued to have difficulty transitioning from gavage to oral feeding. Initially, his inability to feed orally was thought to be secondary to nasal congestion and prematurity, but with worsening respiratory distress he was transferred for further evaluation and management. DIAGNOSIS & CONCLUSION On admission to RPC, the examination prompted a cardiac assessment which revealed a large aortic-pulmonary window type II. After surgery, the infant quickly improved and went home on-demand oral feeds. Cardiac lesions are more common in monochorionic twins but should be suspected in dichorionic twins especially if one twin has a normal course.
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Su PF, Chung CH, Wang YW, Chi Y, Chang YJ. Power and sample size calculation for paired recurrent events data based on robust nonparametric tests. Stat Med 2017; 36:1823-1838. [PMID: 28183151 DOI: 10.1002/sim.7241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 12/28/2016] [Accepted: 01/17/2017] [Indexed: 11/08/2022]
Abstract
The purpose of this paper is to develop a formula for calculating the required sample size for paired recurrent events data. The developed formula is based on robust non-parametric tests for comparing the marginal mean function of events between paired samples. This calculation can accommodate the associations among a sequence of paired recurrent event times with a specification of correlated gamma frailty variables for a proportional intensity model. We evaluate the performance of the proposed method with comprehensive simulations including the impacts of paired correlations, homogeneous or nonhomogeneous processes, marginal hazard rates, censoring rate, accrual and follow-up times, as well as the sensitivity analysis for the assumption of the frailty distribution. The use of the formula is also demonstrated using a premature infant study from the neonatal intensive care unit of a tertiary center in southern Taiwan. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Chia-Hua Chung
- Department of Statistics, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Yu-Wen Wang
- Institute of Allied Health Science, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Yunchan Chi
- Department of Statistics, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Ying-Ju Chang
- Institute of Allied Health Science, National Cheng Kung University, Tainan, 70101, Taiwan.,Department of Nursing, National Cheng Kung University, Tainan, 70101, Taiwan
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17
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Nieuwenhuis T, Verhagen EA, Bos AF, van Dijk MWG. Children born preterm and full term have similar rates of feeding problems at three years of age. Acta Paediatr 2016; 105:e452-7. [PMID: 27170494 DOI: 10.1111/apa.13467] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/22/2016] [Accepted: 05/09/2016] [Indexed: 11/29/2022]
Abstract
AIM We determined the prevalence of feeding problems and their association with perinatal risk factors in three-year-old children born preterm and compared them with a full-term reference group. METHODS This pilot study assessed feeding problem scores in 35 preterm children, with a median gestational age of 30 weeks (range 26-32) and median birthweight of 1260 grams (730-2250), who were enrolled during their admission to a neonatal intensive care unit. These were compared with existing data on 248 term children from child healthcare centres at the age of three. We excluded children with severe perinatal complications from the reference group. The Screeningslijst Eetgedrag Peuters (SEP), a validated Dutch version of the Montreal Children's Hospital Feeding Scale, was used to identify feeding problems. RESULTS We found no difference in SEP scores between the preterm children and the reference group (p = 0.217) and did not identify any perinatal risk factors for developing feeding problems. Only 23% of the parents of preterm or term children with moderate-to-severe feeding problems consulted a medical professional. CONCLUSION Using a parental report instrument showed that the prevalence of feeding problems in three-year-old preterm children was low and similar to that of term children.
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Affiliation(s)
- Tjitske Nieuwenhuis
- Beatrix Children's Hospital; Division of Neonatology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Elise A. Verhagen
- Beatrix Children's Hospital; Division of Neonatology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Arend F. Bos
- Beatrix Children's Hospital; Division of Neonatology; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Marijn W. G. van Dijk
- Department of Developmental Psychology; University of Groningen; Groningen The Netherlands
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Tamilia E, Formica D, Visco AM, Scaini A, Taffoni F. An automated system for quantitative analysis of newborns' oral-motor behavior and coordination during bottle feeding. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:7386-9. [PMID: 26737998 DOI: 10.1109/embc.2015.7320098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this work a novel unobtrusive technology-aided system is presented and tested for the assessment of newborns' oral-motor behavior and coordination during bottle feeding. A low-cost monitoring device was designed and developed in order to record Suction (S) and Expression (E) pressures from a typical feeding bottle. A software system was developed to automatically treat the data and analyze them. A set of measures of motor control and coordination has been implemented for the specific application to the analysis of sucking behavior. Experimental data were collected with the developed system on two groups of newborns (Healthy vs. Low Birth Weight) in a clinical setting. We identified the most sensitive S features to group differences, and analyzed their correlation with S/E coordination measures. Then, Principal Component Analysis (PCA) was used to explore the system suitability to automatically identify peculiar oral behaviors. Results suggest the suitability of the proposed system to perform an objective technology-aided assessment of the newborn's oral-motor behavior and coordination during the first days of life.
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Abstract
Preterm births are defined as those before 37 weeks of gestation. With advances in fertility medicine and neonatal medicine, the numbers of preterm children in the community have significantly increased. Developmental delays and complications among preterm children are well recognized. Much less consideration is given to the dental complications of preterm children. Manifestations include palatal deformations, enamel defects, tooth size variations and tooth shape deformities, malocclusions, and increased risks of early childhood caries and tooth wear. This article explores orodental risks and orodental needs of preterm children and suggests preventive and management strategies for optimizing the oral health of special needs children.
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Affiliation(s)
- Annetta Kit Lam Tsang
- Gold Coast Oral Health Service, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland 4215, Australia; Griffith Health, Griffith University, Gold Coast Campus, Queensland 4222, Australia.
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20
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Disorders Affecting Feeding and Swallowing in Infants and Children. Dysphagia 2016. [DOI: 10.1016/b978-0-323-18701-5.00013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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21
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Tamilia E, Formica D, Scaini A, Taffoni F. An Automated System for the Analysis of Newborns' Oral-Motor Behavior. IEEE Trans Neural Syst Rehabil Eng 2015; 24:1294-1303. [PMID: 26540691 DOI: 10.1109/tnsre.2015.2496150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The assessment of oral-motor behavior (OMB) represents one the earliest noninvasive ways to evaluate newborns' well-being and neuromotor behavior. This work aimed at developing a new low-cost, easy-to-use and noninvasive system for a technology-aided assessment of newborns' OMB during bottle feeding. A SUcking MOnitoring Device (SUMOD) was designed and developed to be easily integrated on a typical feeding bottle. A software system was developed to automatically treat and analyze the acquired data: proper algorithms for a fully automatic segmentation and features extraction are proposed and implemented. A set of measures of motor control and coordination are introduced and implemented for the specific application to the OMB analysis. Experimental data were collected on two groups of newborns (healthy versus low birth weight) with the SUMOD in a clinical setting.
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Chorna OD, Slaughter JC, Wang L, Stark AR, Maitre NL. A pacifier-activated music player with mother's voice improves oral feeding in preterm infants. Pediatrics 2014; 133:462-8. [PMID: 24534413 PMCID: PMC3934339 DOI: 10.1542/peds.2013-2547] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants. METHODS Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team. RESULTS Ninety-four infants (46 and 48 in the PAM intervention and control groups, respectively) completed the study. The intervention group had significantly increased oral feeding rate (2.0 vs. 0.9 mL/min, P < .001), oral volume intake (91.1 vs. 48.1 mL/kg/d, P = .001), oral feeds/day (6.5 vs. 4.0, P < .001), and faster time-to-full oral feedings (31 vs. 38 d, P = .04) compared with controls. Weight gain and cortisol levels during the 5-day protocol were not different between groups. Average hospital stays were 20% shorter in the PAM group, but the difference was not significant (P = .07). CONCLUSIONS A PAM using mother's voice improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth.
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Affiliation(s)
| | | | - Lulu Wang
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ann R. Stark
- Division of Neonatology, Department of Pediatrics, and
| | - Nathalie L. Maitre
- Division of Neonatology, Department of Pediatrics, and,Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee; and
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Setting the stage for successful oral feeding: the impact of implementing the SOFFI feeding program with medically fragile NICU infants. J Perinat Neonatal Nurs 2014; 28:59-68. [PMID: 24476653 DOI: 10.1097/jpn.0000000000000003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To evaluate the impact of implementing the Supporting Oral Feeding in Fragile Infants (SOFFI) program in a tertiary-level neonatal intensive care unit (NICU) on the oral feeding, growth, and length of stay outcomes of a heterogeneous population of medically fragile infants at discharge and feeding and growth outcomes postdischarge at 3 to 5 months postterm. Data related to feeding, growth, and length of stay from a convenience sample of 81 infants recruited pre-SOFFI training were compared with data for 75 infants recruited post-SOFFI training of the NICU staff. Subjects were not excluded on the basis of level of illness or medical diagnoses. To establish comparability of subject groups, infants were assigned scores using the Neonatal Medical Index. At 3 to 5 months postterm, semistructured parent phone interviews related to feeding and growth at home were conducted (n = 128). Post-SOFFI infants born at less than 37 weeks' gestation achieved full oral feedings in significantly fewer days than pre-SOFFI infants (P = .01). Time to achieve full oral feedings was not significantly different in post-SOFFI infants born at 37 or more weeks' gestation. Growth and length of stay were not significantly different at discharge. At follow-up, parents of post-SOFFI infants reported significantly fewer feeding problems overall (P = .01), less arching (P = .003), less vomiting (P = .006), and fewer infants seeing feeding specialists (P = .03). Results of the study support that NICU implementation of the SOFFI feeding program positively influences feeding outcomes before and following discharge.
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Ross ES, Browne JV. Feeding Outcomes in Preterm Infants After Discharge From the Neonatal Intensive Care Unit (NICU): A Systematic Review. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.nainr.2013.04.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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