Non-nutritive suck and voice onset time: Examining infant oromotor coordination

Non-Nutritive Suck Parameters Measurements Using a Custom Pressure Transducer System

The non-nutritive suck (NNS) device is a transportable, user-friendly pressure transducer system that quantifies infants' NNS behavior on a pacifier. Recording and analysis of the NNS signal using our system can provide measures of an infant's NNS burst duration (s), amplitude (cmH2O), and frequency (Hz). Accurate, reliable, and quantitative assessment of NNS has immense value in serving as a biomarker for future feeding, speech-language, cognitive, and motor development. The NNS device has been used in numerous research lines, some of which have included measuring NNS features to investigate the effects of feeding-related interventions, characterizing NNS development across populations, and correlating sucking behaviors with subsequent neurodevelopment. The device has also been used in environmental health research to examine how exposures in utero can influence infant NNS development. Thus, the overarching goal in research and clinical utilization of the NNS device is to correlate NNS parameters with neurodevelopmental outcomes to identify children at risk for developmental delays and provide rapid early intervention.

Experiences of Indonesian nurses in improving preterm oral feeding readiness in special care units: A qualitative descriptive study

Background

Many preterm infants face feeding difficulties during the transition from enteral to oral feeding due to organ immaturity, resulting in aspiration, airway instability, and oral feeding intolerance. These challenges can increase morbidity and mortality among preterm infants. Nurses play a vital role in providing interventions to minimize negative impacts and enhance the safety of preterm oral feeding.

Objective

This study aimed to explore the experiences of Indonesian nurses in improving preterm oral feeding readiness.

Methods

A qualitative descriptive study was conducted involving ten nurses working in intensive care units as participants through purposive sampling. Data were collected through semi-structured, in-depth interviews conducted from January to March 2023. Thematic analysis was applied for data analysis.

Results

Four key themes developed in this study: 1) comprehensive and holistic nursing assessment, 2) challenging and complex nursing issues, 3) the need for nutritional management skills, and 4) the necessity of collaborative support.

Conclusion

Nurses play a pivotal role in enhancing oral feeding readiness among premature infants. Their responsibilities include assessing oral feeding readiness, addressing nursing challenges, and implementing multidisciplinary stimulation involving parents. This study provides a foundational framework for developing interventions to improve preterm oral feeding readiness.

The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants

BACKGROUND

It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems.

METHODS

Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography).

RESULTS

We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles.

CONCLUSIONS

sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.

Conformity between Pacifier Design and Palate Shape in Preterm and Term Infants Considering Age-Specific Palate Size, Facial Profile and Lip Thickness

This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9−11 months of age, which has no clinical meaning, and the nipple length at <37 weeks of age, which bears a resemblance to the maternal nipple during non-nutritive sucking. It can be concluded that the age-size concept of the studied pacifiers does not correspond to any natural growth pattern. Physiologically aligned, pacifiers do not achieve the age-specific dimensions of the palate. The effects attributed to the products on oral health in term infants cannot be supposed.

The home environment and its relation to vocalizations in the first year of life

Background

Prior data has shown that the home environment impacts child development; however, there remains a paucity of research on how the home environment relates to child and adult words. Therefore, the aim of this prospective and quantitative study was to examine the relationship between the home environment and the quantity of vocalizations or words, and conversational turns produced by infants and parents at 3 and 12 months of age.

Methods

Seventy-two (56% male) full-term infants were assessed at 3 and 12 months of age. The home environment was assessed in person via interview and observation of the child's home using the Infant-Toddler Home Observation for Measurement of the Environment (IT-HOME) Inventory subscales. Vocalizations were measured using the Language Environment Analysis (LENA) device, which measures the adult word count, child vocalization count and conversational turn count. These measures were then averaged for the most voluble, or vocal hour, in the recording period.

Results

At 3 months, IT-HOME Learning Materials scores were significantly associated with a decrease in adult words. We found a statistically significant difference in LENA outcomes between 3 and 12 months when stratified by sex. Specifically, male infants had significantly fewer vocalizations at 12 months when compared to 3 months, whereas females had more vocalizations. There was also a statistically significant difference in IT-HOME Learning Materials, Organization, Responsivity, and Total scores when comparing 3- and 12-month time points.

Conclusions

These findings reveal that the home environment changes significantly over the first year of life. At 3 months, Learning Materials in the home were related to adult words, while between 3 and 12 months, several aspects of the home significantly changed. Male children had reduced vocalizations between 3 and 12 months; whereas, female children had increased vocalizations during the same time points. Future research should focus on examining these outcomes with multiple measures, time points, and patient populations.