Effect of Body Position on Physiological Alteration While Feeding Infants: A Systematic Review

Abstract

Background: An infant should be able to coordinate sucking, swallowing, and breathing to have a safe and effective feeding, which is developed with the increasing gestational age. Any problem in each of these functions can lead to the risk of aspiration, pneumonia, decreased oxygenation saturation, apnea, and bradycardia. The changed body positions may cause changes in the physiological efficiencies of the preterm infants. The objective of this review is to determine the impact of body position on the physiological alternations in the preterm infants while bottle feeding. Methods: In order to review the previous studies, we referred the related resources from existing databases such as Scopus,

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

“…In addition, certain additional strategies and techniques can be used to facilitate and increase the success of feeding (Dailey, 2013; Masarei et al, 2007; Shahzad & Sanati‐Mehrizy 2022; Green & Resnick, 2021; Sırıken et al, 2021). Some of these strategies include placing the infant in a 45°–60° elevated supine (ESU) position while feeding, manually supporting the jaw, cheeks, and lips, increasing the consistency of liquid feeds, positioning the nipple of the bottle away from the cleft part of the mouth, using a bottle or nipple suitable for the infant's age, adjusting the food flow rate, feeding at a pace consistent with feeding cues, burping the infant frequently, using pacifiers (Azimi Jahed et al, 2017; Dailey, 2013; Green & Resnick, 2021; Katge et al, 2014; Masarei et al, 2007; Turner et al, 2001), and limiting feeding time to 30 min (Burca et al, 2016; Dailey, 2013; Masarei et al, 2007; Reid et al, 2006; Shahzad & Sanati‐Mehrizy 2022). The important aspect of choosing a feeding method is to present systems incorporating techniques that increase weight gain while minimizing the stress on the infant and parents/caregivers (Reid, 2004; Snyder & Ruscello, 2019).…”

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

“…In addition, certain additional strategies and techniques can be used to facilitate and increase the success of feeding (Dailey, 2013; Masarei et al, 2007; Shahzad & Sanati‐Mehrizy 2022; Green & Resnick, 2021; Sırıken et al, 2021). Some of these strategies include placing the infant in a 45°–60° elevated supine (ESU) position while feeding, manually supporting the jaw, cheeks, and lips, increasing the consistency of liquid feeds, positioning the nipple of the bottle away from the cleft part of the mouth, using a bottle or nipple suitable for the infant's age, adjusting the food flow rate, feeding at a pace consistent with feeding cues, burping the infant frequently, using pacifiers (Azimi Jahed et al, 2017; Dailey, 2013; Green & Resnick, 2021; Katge et al, 2014; Masarei et al, 2007; Turner et al, 2001), and limiting feeding time to 30 min (Burca et al, 2016; Dailey, 2013; Masarei et al, 2007; Reid et al, 2006; Shahzad & Sanati‐Mehrizy 2022). The important aspect of choosing a feeding method is to present systems incorporating techniques that increase weight gain while minimizing the stress on the infant and parents/caregivers (Reid, 2004; Snyder & Ruscello, 2019).…”

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

“…These studies had smaller sample sizes and demonstrated conflicting results on the benefits of the side-lying versus the upright positions. A systematic review examining the effects of positioning during bottle feeding in preterm infants determined that the evidence to define the role of positioning on physiological stability was still insufficient ( 15 ). Furthermore, these studies did not include infants with unilateral VCP or directly examine the effects of the elevated side-lying position versus the upright position on airway protection using measures such as the MBSS ( 16 , 17 , 18 ).…”

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

“…Bottle feeding research has not led to a consensus regarding an “ideal” feeding position, with research predominantly limited to premature infants and using physiologic outcome measures such as oxygen saturation, respiratory rate, heart rate, and heart rate variability. 27-30 Willette et al’s 20 study on FEES in breastfeeding infants in 2015 suggested positional modification in 15% of the infants as a strategy to improve feeding, but they did not include any details on how or when this strategy might be utilized and did not provide evidence for its use. The positioning of an infant for breastfeeding is well recognized as being important for achieving maternal comfort and efficient milk transfer at the breast, with a variety of positions existing that accommodate the variability in both maternal and infant anatomy.…”

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

“…In addition, certain additional strategies and techniques can be used to facilitate and increase the success of feeding (Dailey, 2013; Masarei et al, 2007; Shahzad & Sanati‐Mehrizy 2022; Green & Resnick, 2021; Sırıken et al, 2021). Some of these strategies include placing the infant in a 45°–60° elevated supine (ESU) position while feeding, manually supporting the jaw, cheeks, and lips, increasing the consistency of liquid feeds, positioning the nipple of the bottle away from the cleft part of the mouth, using a bottle or nipple suitable for the infant's age, adjusting the food flow rate, feeding at a pace consistent with feeding cues, burping the infant frequently, using pacifiers (Azimi Jahed et al, 2017; Dailey, 2013; Green & Resnick, 2021; Katge et al, 2014; Masarei et al, 2007; Turner et al, 2001), and limiting feeding time to 30 min (Burca et al, 2016; Dailey, 2013; Masarei et al, 2007; Reid et al, 2006; Shahzad & Sanati‐Mehrizy 2022). The important aspect of choosing a feeding method is to present systems incorporating techniques that increase weight gain while minimizing the stress on the infant and parents/caregivers (Reid, 2004; Snyder & Ruscello, 2019).…”

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

“…These studies had smaller sample sizes and demonstrated conflicting results on the benefits of the side-lying versus the upright positions. A systematic review examining the effects of positioning during bottle feeding in preterm infants determined that the evidence to define the role of positioning on physiological stability was still insufficient ( 15 ). Furthermore, these studies did not include infants with unilateral VCP or directly examine the effects of the elevated side-lying position versus the upright position on airway protection using measures such as the MBSS ( 16 , 17 , 18 ).…”

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

“…Bottle feeding research has not led to a consensus regarding an “ideal” feeding position, with research predominantly limited to premature infants and using physiologic outcome measures such as oxygen saturation, respiratory rate, heart rate, and heart rate variability. 27-30 Willette et al’s 20 study on FEES in breastfeeding infants in 2015 suggested positional modification in 15% of the infants as a strategy to improve feeding, but they did not include any details on how or when this strategy might be utilized and did not provide evidence for its use. The positioning of an infant for breastfeeding is well recognized as being important for achieving maternal comfort and efficient milk transfer at the breast, with a variety of positions existing that accommodate the variability in both maternal and infant anatomy.…”

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

“…In addition, certain additional strategies and techniques can be used to facilitate and increase the success of feeding (Dailey, 2013; Masarei et al, 2007; Shahzad & Sanati‐Mehrizy 2022; Green & Resnick, 2021; Sırıken et al, 2021). Some of these strategies include placing the infant in a 45°–60° elevated supine (ESU) position while feeding, manually supporting the jaw, cheeks, and lips, increasing the consistency of liquid feeds, positioning the nipple of the bottle away from the cleft part of the mouth, using a bottle or nipple suitable for the infant's age, adjusting the food flow rate, feeding at a pace consistent with feeding cues, burping the infant frequently, using pacifiers (Azimi Jahed et al, 2017; Dailey, 2013; Green & Resnick, 2021; Katge et al, 2014; Masarei et al, 2007; Turner et al, 2001), and limiting feeding time to 30 min (Burca et al, 2016; Dailey, 2013; Masarei et al, 2007; Reid et al, 2006; Shahzad & Sanati‐Mehrizy 2022). The important aspect of choosing a feeding method is to present systems incorporating techniques that increase weight gain while minimizing the stress on the infant and parents/caregivers (Reid, 2004; Snyder & Ruscello, 2019).…”

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

“…These studies had smaller sample sizes and demonstrated conflicting results on the benefits of the side-lying versus the upright positions. A systematic review examining the effects of positioning during bottle feeding in preterm infants determined that the evidence to define the role of positioning on physiological stability was still insufficient ( 15 ). Furthermore, these studies did not include infants with unilateral VCP or directly examine the effects of the elevated side-lying position versus the upright position on airway protection using measures such as the MBSS ( 16 , 17 , 18 ).…”

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

“…Bottle feeding research has not led to a consensus regarding an “ideal” feeding position, with research predominantly limited to premature infants and using physiologic outcome measures such as oxygen saturation, respiratory rate, heart rate, and heart rate variability. 27-30 Willette et al’s 20 study on FEES in breastfeeding infants in 2015 suggested positional modification in 15% of the infants as a strategy to improve feeding, but they did not include any details on how or when this strategy might be utilized and did not provide evidence for its use. The positioning of an infant for breastfeeding is well recognized as being important for achieving maternal comfort and efficient milk transfer at the breast, with a variety of positions existing that accommodate the variability in both maternal and infant anatomy.…”