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Vanzele PAR, Sparvoli LG, de Camargo PP, Tragante CR, Beozzo GPNS, Krebs VLJ, Cortez RV, Taddei CR. Establishment of oral microbiome in very low birth weight infants during the first weeks of life and the impact of oral diet implementation. PLoS One 2023; 18:e0295962. [PMID: 38100452 PMCID: PMC10723731 DOI: 10.1371/journal.pone.0295962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
Very low birth weight (VLBW) infants, mostly preterm, have many barriers to feeding directly from the mother's breast, and need to be fed alternatively. Feeding is a major influencer in oral microbial colonization, and this colonization in early life is crucial for the promotion of human health. Therefore, this research aimed to observe the establishment of oral microbiome in VLBW infants during their first month of life through hospitalization, and to verify the impact caused by the implementation of oral diet on the colonization of these newborns. We included 23 newborns followed during hospitalization and analyzed saliva samples collected weekly, using 16S rRNA gene sequencing. We observed a significant decrease in richness and diversity and an increase in dominance over time (q-value < 0.05). The oral microbiome is highly dynamic during the first weeks of life, and beta diversity suggests a microbial succession in early life. The introduction of oral diet does not change the community structure, but affects the abundance, especially of Streptococcus. Our results indicate that although time is related to significant changes in the oral microbial profile, oral feeding benefits genera that will remain colonizers throughout the host's life.
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Affiliation(s)
- Pedro A. R. Vanzele
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Luiz Gustavo Sparvoli
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Patricia P. de Camargo
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Carla R. Tragante
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Glenda P. N. S. Beozzo
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Vera L. J. Krebs
- Neonatal Intensive Care Center, Children’s Institute, Hospital das Clínicas, São Paulo Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Ramon V. Cortez
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Carla R. Taddei
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
- School of Arts, Sciences and Humanity, University of São Paulo, São Paulo, SP, Brazil
- Division of Clinical Laboratory, University Hospital ‐ University of São Paulo, São Paulo, SP, Brazil
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Chen G, Li X, Pan R. Prefeeding interventions improve oral feeding in preterm infants. Int J Pediatr Otorhinolaryngol 2022; 162:111324. [PMID: 36137472 DOI: 10.1016/j.ijporl.2022.111324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess whether oral stimulation (OS), nonnutritive sucking (NNS) and combined tactile/kinesthetic (T/K) interventions can improve the effects of oral feeding in preterm infants. METHODS A retrospective review was performed from 2014 to 2016, in which one hundred thirty preterm infants were separated into two intervention groups (the OS + NNS group and the OS + NNS + T/K group) and one control group. Infants in the two intervention groups received 30 min of interventions a day. All interventions started 48 h after stopping nasal continuous positive airway pressure until participants reached complete oral feeding. RESULTS The transition times of the OS + NNS, OS + NNS + T/K, and control groups from the introduction of oral feeding to independent oral feeding were 9.03 ± 0.58, 7.20 ± 0.28, and 12.17 ± 0.64 days, respectively (P < 0.05). The infants' weights at full oral feeding in the OS + NNS, OS + NNS + T/K, and control groups were 1834.58 ± 47.96, 1999.17 ± 92.62, and 1725.87 ± 40.34 g, respectively (P = 0.007). Further post hoc analyses indicated that the weight gain at full oral feeding in the OS + NNS and OS + NNS + T/K groups were more significant than the control group (P = 0.012 and P = 0.036, respectively)Conclusion: OS + NNS and OS + NNS + T/K interventions could shorten the transition time from tube feeding to independent oral feeding; OS + NNS and OS + NNS + T/K interventions improved weight gain compared to the control group. Furthermore, the OS + NNS + T/K group was superior to the OS + NNS group regarding transition time and weight gain.
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Affiliation(s)
- Gaoyan Chen
- Department of Pediatrics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Xiaogang Li
- Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Rui Pan
- Department of Pediatrics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
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Méziane S, Brévaut-Malaty V, Garbi A, Busuttil M, Sorin G, Tosello B, Gire C. Cardio-Respiratory Events and Food Autonomy Responses to Early Uni-Modal Orofacial Stimulation in Very Premature Babies: A Randomized, Controlled Study. CHILDREN 2021; 8:children8121188. [PMID: 34943384 PMCID: PMC8700206 DOI: 10.3390/children8121188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 12/03/2022]
Abstract
Uni-modal orofacial stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants. Our study was randomized, controlled, prospective, and unicentric. The preterm included were born between 26–29 weeks gestational age (GA) with a corrected postnatal age <33 weeks GA. They were randomized into two groups: the experimental group underwent OFS, according to a protocol established, over 10 consecutive days, and the control group underwent no OFS. The primary outcome was the number of cardiorespiratory events: apnea–bradycardia (with or without desaturations) or number of isolated desaturations, which were evaluated at four separate times. Measurements occurred during the first, fourth and eighth independent feedings. Seventeen patients were included in the experimental group and 18 in the control group. The number of cardiorespiratory events for all independent feeding times was significantly reduced in the OFS group (p = 0.003) with univariate analysis, but not with multivariable analysis. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of hospitalization were similar in the two groups. While our study does not affirm that an early unimodal OFS improves premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings.
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Affiliation(s)
- Sahra Méziane
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
| | - Véronique Brévaut-Malaty
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
| | - Aurélie Garbi
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
| | - Muriel Busuttil
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
| | - Gaelle Sorin
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
| | - Barthélémy Tosello
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
- CNRS, EFS, ADES, Aix-Marseille University, 13344 Marseille, France
- Correspondence: ; Tel.: +33-(0)4-91-96-83-00; Fax: +33-(0)4-91-96-46-75
| | - Catherine Gire
- Department of Neonatology, North Hospital, APHM, Chemin des Bourrely, 13015 Marseille, France; (S.M.); (V.B.-M.); (A.G.); (M.B.); (G.S.); (C.G.)
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
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Basso CSD, Arroyo MADS, Fucuta PDS, Maia AB. Feeding of children with tracheostomy at hospital discharge. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212353321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
ABSTRACT Purpose: to describe the work of speech-language-hearing therapists and verify which was the most prevalent feeding method in the sample studied. Methods: a descriptive observational study based on data surveyed from medical records. The following variables were used: age, medical diagnosis, hospital ward, feeding method before and after the tracheostomy, time of speech-language-hearing care, and speech-language-hearing discharge. The data were submitted to descriptive statistical analysis with the appropriate tests to compare the categorical variables. All infants and children with tracheostomy performed either before or during hospital stay between July 2017 and July 2018, who received speech-language-hearing care upon request of the physician, were included. Results: a total of 51 children took part in the study, most of whom were males (56.9%), with a median age of 12 months, ranging from 1 month to 12 years old at the time of the speech-language-hearing assessment. The feeding methods at hospital discharge were described as follows: full oral feeding (37%), partial oral feeding (25.5%), nasogastric/nasoenteral tube (19.6%), and gastrostomy (17.6%). Conclusion: the full oral diet of tracheostomized children was the most prevalent feeding method at hospital speech-language-hearing discharge.
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Lau C. To Individualize the Management Care of High-Risk Infants With Oral Feeding Challenges: What Do We Know? What Can We Do? Front Pediatr 2020; 8:296. [PMID: 32582596 PMCID: PMC7297031 DOI: 10.3389/fped.2020.00296] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022] Open
Abstract
The increase in preterm infants' survival over the last 30 years has shed light over their inability to feed by mouth safely and efficiently. With adverse events such as increased risks for oxygen desaturation, bradycardia, penetration/aspiration, infants' hospitalization in neonatal intensive care units (NICUs) are understandably prolonged. Unfortunately, this leads to delayed mother-infant reunion, maternal stress, breastfeeding obstacles, and increased medical costs. Such impediments have stimulated clinicians and researchers to better understand the underlying causes and develop evidence-based solutions to assist these infants. However, it is notable that the research-to-practice translation of this knowledge has been limited as there are still no validated guidelines or protocols as how to best diagnose and care for these infants. This report revisits the immature physiologic functions at the root of these infants' oral feeding difficulties, the current practices, and the recent availability of evidence-based efficacious tools and interventions. Taking advantage of the latter, it presents a renewed perspective of how management strategies can be tailored to the specific needs of individual patients.
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Affiliation(s)
- Chantal Lau
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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Nunes JDA, Bianchini EMG, Cunha MC. Oxygen saturation and heart rate in premature: comparison between cup and finger feeding techniques. Codas 2019; 31:e20180221. [PMID: 31800880 DOI: 10.1590/2317-1782/20192018221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 04/16/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the oxygen saturation, heart rate, length of hospital stay and weight preterm infants or preterm newborns (PTNBs) (in the Neonatal Intensive Care Unit in the diet supply by cup and finger feeding techniques, simultaneously with breastfeeding. METHODS Simultaneous randomized clinical trial. Twenty-five preterm infants admitted to the Neonatal Intensive Care Unit of the Public Hospital from October 2011 to February 2012 were selected. The sample was divided into two groups: Eight preterm infants who received the diet in the cup probe group (CPG) who were born on the same day, and 17 by finger probe group (FPG) who were born on the odd day. In the diet offer, the minimum and maximum values of oxygen saturation (O2 Sat) and heart rate (HR) were recorded: before offering the diet, during and after the offer. RESULTS Regarding the variables O2 Sat and HR, no statistically significant differences were observed between the groups, but in the group vs time factor, the groups showed differences, not continuous in the O2 Sat variable. Regarding weight, a statistically significant gain was observed for both groups, and in CPG the highest weight gain was due to the longer hospitalization time. It was verified that FPG presented shorter hospitalization time. CONCLUSION There were no differences regarding O2 Sat and HR. However, when analyzing the time factor, the groups presented some differences, not continuous, indicating the need for other studies for a better understanding of the effect. The FPG presented shorter hospitalization time and the CPG infants had greater weight gain due to longer hospitalization time.
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Affiliation(s)
| | | | - Maria Claudia Cunha
- Pontifícia Universidade Católica de São Paulo - PUCSP - São Paulo (SP), Brasil
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Yi YG, Oh BM, Shin SH, Shin JY, Kim EK, Shin HI. Association of uncoordinated sucking pattern with developmental outcome in premature infants: a retrospective analysis. BMC Pediatr 2019; 19:440. [PMID: 31722705 PMCID: PMC6854670 DOI: 10.1186/s12887-019-1811-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/29/2019] [Indexed: 01/24/2023] Open
Abstract
Background Stress signals during sucking activity such as nasal flaring, head turning, and extraneous movements of the body have been attributed to incoordination of sucking, swallowing, and respiration (SSR) in premature infants. However, the association of uncoordinated sucking pattern with developmental outcomes has not yet been investigated. The aim of this study was to investigate whether uncoordinated sucking pattern during bottle-feeding in premature infants is associated with the developmental outcomes at 8–12 and 18–24 months of age (corrected for prematurity). Methods We retrospectively reviewed the medical records and video recordings for the Neonatal Oral-Motor Assessment Scale (NOMAS) of premature infants and divided them into two groups based on the presence or absence of incoordination. The Bayley-III cognition composite scores of the incoordination-positive and incoordination-negative group were compared at 8–12 and 18–24 months of age. Results Seventy premature infants exhibited a disorganized sucking pattern according to the NOMAS. The average Bayley-III cognition composite scores at 8–12 months of age were 92.5 ± 15.6 and 103.0 ± 11.3 for the incoordination-positive (n = 22) and incoordination-negative groups (n = 48), respectively (p = 0.002). The average Bayley-III cognition composite scores at 18–24 months were 90.0 ± 17.9 and 100.7 ± 11.5 for the incoordination-positive (n = 21) and incoordination-negative groups (n = 46), respectively (p = 0.005). A multiple linear regression analysis indicated that the presence of uncoordinated sucking pattern, grade 3 or 4 germinal matrix hemorrhage–intraventricular hemorrhage, and moderate to severe bronchopulmonary dysplasia were independently associated with cognitive development at 18–24 months of age. Conclusions Uncoordinated sucking pattern in premature infants was independently associated with a higher risk of abnormal developmental outcome in the cognitive domain of the Bayley-III at both 8–12 and 18–24 months. There may be a need for periodic follow-up and early intervention for developmental delay when incoordination of SSR that results in stress signals on the NOMAS is observed before 40 weeks postmenstrual age.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Seung Han Shin
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Jin Yong Shin
- Division of Occupational Therapy, Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Ee-Kyung Kim
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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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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Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants: An Evidence-Based Systematic Review. Adv Neonatal Care 2019; 19:E3-E20. [PMID: 30339552 DOI: 10.1097/anc.0000000000000546] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preterm infants often experience difficulty with the transition from tube to oral feeding. While many unimodal and multimodal sensorimotor interventions have been generated to optimize oral feeding skills, there has been little cohesion between interventions. PURPOSE The aims of this systematic review were to examine the effect of sensorimotor interventions on oral feeding outcomes and to determine whether multimodal interventions lead to better oral feeding performances than unimodal interventions. SEARCH STRATEGY A systematic search of CINAHL, Embase, MEDLINE, and PsycINFO databases was conducted. Studies were reviewed to assess the types of interventions used to improve transition to full oral feeding, volume intake, weight gain, and length of hospital stay. RESULTS The search identified 35 articles. Twenty-six studies examined a unimodal intervention, with the majority focusing on oral sensorimotor input and the others on tactile, auditory, and olfactory input. Nine studies assessed multimodal interventions, with the combination of tactile and kinesthetic stimulation being most common. Results varied across studies due to large differences in methodology, and caution is warranted when interpreting results across studies. The heterogeneity in the studies made it difficult to make any firm conclusions about the effects of sensorimotor interventions on feeding outcomes. Overall, evidence on whether multimodal approaches can lead to better oral feeding outcomes than a unimodal approach was insufficient. IMPLICATIONS FOR PRACTICE The use of sensorimotor interventions to optimize feeding outcomes in preterm infants varies based on methods used and modalities. These factors warrant caution by clinicians who use sensorimotor interventions in the neonatal intensive care unit. IMPLICATIONS FOR RESEARCH Large randomized clinical trials using a standardized approach for the administration of sensorimotor input are needed to further establish the effects on feeding outcomes in preterm infants.
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Yi YG, Oh BM, Shin SH, Shin JY, Kim EK, Shin HI. Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants. Front Pediatr 2018; 6:54. [PMID: 29594085 PMCID: PMC5857543 DOI: 10.3389/fped.2018.00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/26/2018] [Indexed: 11/13/2022] Open
Abstract
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included. Video recordings of at least 2 min of oral feeding were further analyzed retrospectively by two assessors and the premature infants who exhibited disorganized sucking patterns (n = 109) were divided into three clusters (clusters 2-4). The observational items compatible with disorganization in the original NOMAS were divided into three groups: cluster 2 (disorganized: arrhythmical), cluster 3 (disorganized: arrhythmical + unable to sustain), and cluster 4 (disorganized: arrhythmical + incoordination ± unable to sustain) and further divided into incoordination-positive (cluster 4) and incoordination-negative groups (clusters 2 and 3). Premature infants in the incoordination-positive group (cluster 4, which means stress signals) showed a median transition time of 22 days (range: 4-121 days) which was longer than that in the incoordination-negative group (median 6 days; range: 1-25 days). Univariate linear regression analysis revealed that the presence of incoordination among disorganized sucking patterns (NOMAS cluster 4 vs. clusters 2 and 3), birth weight, total parenteral nutrition (TPN) duration, non-invasive positive pressure ventilation duration, the presence of moderate to severe bronchopulmonary dysplasia, pulmonary hypertension, sepsis, small for gestational age (SGA), and necrotizing enterocolitis are associated with the transition time to FOF. In a multivariate linear regression analysis, the variables revealed to be associated with the transition time were TPN duration, SGA, and the presence of stress signals (incoordination-positive group) among disorganized sucking patterns. When selecting premature infants to be treated with swallowing therapy, it is reasonable to pay more attention to the incoordination-positive group described in the NOMAS, that is, premature infants with stress signals to shorten the time to attain FOF.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Han Shin
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Jin Yong Shin
- Department of Pediatric Occupational Therapy, Seoul National University Children's Hospital, Seoul, South Korea
| | - Ee-Kyung Kim
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Comparison of the finger‐feeding versus cup feeding methods in the transition from gastric to oral feeding in preterm infants. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Comparison of the finger-feeding versus cup feeding methods in the transition from gastric to oral feeding in preterm infants. J Pediatr (Rio J) 2017; 93:585-591. [PMID: 28711457 DOI: 10.1016/j.jped.2016.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/11/2016] [Accepted: 12/14/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To assess the finger-feeding technique when compared with the cup feeding method during the early stage of preterm infant feeding transition regarding milk loss, milk ingestion period, and complications. METHODS Experimental, randomized, prospective study including 53 preterm infants with gestation age<37 weeks, clinically stable, and with a score of >28 points in the Oral Feeding Readiness Assessment Scale. The preterm babies were randomized to be included in the control group, which underwent the feeding transition using a cup or in the experimental group, which used the finger-feeding technique. The analysis of data was performed using Student's t-test to evaluate differences between mean values of the appointed variables, and Fischer's test for categorical variables; the asymmetric variables were assessed by the Kruskal-Wallis ANOVA test. RESULTS When compared with the control group, the experimental group showed lower milk loss, longer milk ingestion time, and a lower frequency of complications during feeding. The significance level was set at 5%, with a confidence interval of 90%. CONCLUSION The finger-feeding technique was shown to be a better feeding transition method regarding efficacy when compared with cup feeding method, due to lower milk loss and fewer complication episodes.
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Gosa M, Dodrill P. Pediatric Dysphagia Rehabilitation: Considering the Evidence to Support Common Strategies. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig13.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Memorie Gosa
- Department of Communicative Disorders, The University of Alabama Tuscaloosa, AL
| | - Pamela Dodrill
- Feeding & Developmeantal Therapy Team, Brigham & Women’s Hospital NICU Boston, MA
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Evidence-Based Reviews From Other Sources. J Obstet Gynecol Neonatal Nurs 2015. [DOI: 10.1016/s0884-2175(15)35346-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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