Feeding and Swallowing Difficulties in Neonates

Viswanathan, S.; Jadcherla, Sudarshan R.

doi:10.1016/j.clp.2020.02.005

Cited by 32 publications

(19 citation statements)

References 67 publications

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“…Difficulties during this phase are mainly attributed to the physical and behavioral adjustments required for this developmental milestone. Second, the critical developmental process of acquisition of oral feeding skills occurs by full‐term gestation and may be interrupted by preterm birth or by other comorbidities (Viswanathan & Jadcherla, 2020 ). Interestingly, in the present study, we found higher percentage of preterm babies in the PFD that presented over the first year and this group was associated with impaired oral intake.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with age of presentation of pediatric feeding disorder

Galai,

Friedman,

Kalmintzky

et al. 2024

Brain and Behavior

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AimUnderstanding the association between pediatric feeding disorder (PFD) and age of presentation is limited. We aimed to investigate factors associated with PFD among different age groups.MethodsRetrospective analysis of medical records of infants and toddlers diagnosed with PFD, according to the World Health Organization‐based definition. We compared children aged 1–12 months to those aged 13–72 months.ResultsIncluded were 253 children with PFD (median [interquartile range] age 16.4 [9.5–33] months at diagnosis, 56% boys). Significantly more children in the younger age group were girls (52.6% vs. 34.4%, respectively, p = .03) and preterm (25% vs. 14%, p = .03). They had more hospitalizations (34% vs. 23%, p = .03) and needed more prescription medications (36% vs. 17%, p < .01). Additionally, disturbances in oral intake were primarily linked to feeding skills dysfunction in the younger group and nutritional dysfunction in the older group (39.6% vs. 23.7% and 55% vs. 38%, respectively, p = .02).ConclusionsInfants under 1 year old with PFD represent a distinct patient group with unique characteristics and outcomes. The age of presentation plays a significant role in children with PFD, necessitating tailored treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Factors associated with age of presentation of pediatric feeding disorder

Galai,

Friedman,

Kalmintzky

et al. 2024

Brain and Behavior

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“…The more premature an infant is at birth, the less swallowing experience they have in utero. Swallowing of amniotic fluid begins as early as eleven weeks gestation with sucking developing at about 18 weeks gestation [ 21 , 36 ]. By 28 weeks gestation, the fetus swallows around 250 mL/kg/day of amniotic fluid [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Dysphagia is more common in preterm infants which can often delay discharge [14]. Thus, safe and adequate oral intake is dependent on multi-system interactions and neuromuscular regulatory processes involving the airways, breathing, swallowing, cardiorespiratory function, and intestinal motility [15][16][17][18][19][20][21]. On the other hand, the development of a successful oral feeding plan for each infant requires understanding the infant's pathophysiology as well as the NICU processes and policies, including how they may change over time.…”

Section: Introductionmentioning

confidence: 99%

A decade of evidence: standardized feeding initiative targeting feeding milestones and predicting NICU stays in premature infants in an all-referral level IV NICU

et al. 2023

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Objective Ten-year data from the simplified, individualized, milestone-targeted, pragmatic, longitudinal and educational (SIMPLE) feeding initiative were examined by gestational age (GA) category to characterize the feeding milestones, length of hospital stays (LOHS), annual variability and predictive models for LOHS. Study Design Preterm infants (≤32 weeks GA, N = 434) in level-IV NICU had milestone-targeted feeding plans. Continuous data were analyzed for outcomes. Results Over 93% successfully attained full oral feedings. Earlier acquisition of feeding milestones correlated with earlier discharge ( P < 0.05). Year-wise analysis showed sustained maintenance of milestones ( P < 0.05). Milestones and outcomes ( P < 0.001) were significantly correlated with different GA categories. Prediction models for LOHS were derived using GA, BPD, age at full enteral, postmenstrual age (PMA) at 1 st and full oral feeds. Conclusions The SIMPLE feeding program minimized variability and promoted acquisition of feeding milestones consistently. LOHS is predictable using feeding milestones, co-morbidities, GA, and PMA at feeding milestones.

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“…The suck–swallow–breath pattern is not fully developed in an infant until around 32–34 weeks post-menstrual age (PMA) 2 . While seemingly simple for a healthy individual, this coordinated action can be difficult for preterm infants, due to differences in anatomy and neural physiology 3 – 5 . Attempts to nipple feed when not fully developed can lead to fatigue, risk of aspiration, and bradycardia during feeding 6 , 7 .…”

Section: Introductionmentioning

confidence: 99%

Effect of cue-based feeding on time to nipple feed and time to discharge in very low birth weight infants

Spagnoli¹,

Dhanireddy²,

Gannon³

et al. 2023

Sci Rep

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The objective of this study is to evaluate the effectiveness of a cue-based feeding protocol in improving time to nipple feed and time to discharge in very low birth weight infants in a Level III Neonatal Intensive Care Unit. Demographic, feeding, and discharge data were recorded and compared between the two cohorts. The pre-protocol cohort included infants born from August 2013 through April 2016 and the post-protocol cohort included infants born from January 2017 through December 2019. 272 infants were included in the pre-protocol cohort and 314 infants in the post-protocol cohort. Both cohorts were statistically comparable in gestational age, gender, race, birthweight, prenatal care, antenatal steroid use, and rates of maternal diabetes. There were statistically significant differences between the pre- versus post-protocol cohorts in median post-menstrual age (PMA) in days at first nipple feed (PO) (240 vs 238, p = 0.025), PMA in days at full PO (250 vs 247, p = 0.015), and length of stay in days (55 vs 48, p = 0.0113). Comparing each year in the post-protocol cohort, for each outcome measure, a similar trend was noted in 2017 and 2018, but not in 2019. In conclusion, the cue-based feeding protocol was associated with a decrease in the time to first PO, time to full nipple feeds, and the length of stay in very-low-birthweight infants.

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Feeding and Swallowing Difficulties in Neonates

Cited by 32 publications

References 67 publications

Factors associated with age of presentation of pediatric feeding disorder

Factors associated with age of presentation of pediatric feeding disorder

A decade of evidence: standardized feeding initiative targeting feeding milestones and predicting NICU stays in premature infants in an all-referral level IV NICU

Effect of cue-based feeding on time to nipple feed and time to discharge in very low birth weight infants

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