Heart Rate Variability in Premature Infants During Feeding

Abstract

Early mother-infant interaction, a potentially major contributor to the development of a premature infant's behavioral and physiologic regulation, has received very little research attention. This study examined the development of physiologic regulation in relation to maternal-infant feeding interaction for 43 premature infants, from the time caregiving responsibility was transferred to the mother through each infant's 4th postterm month. Infants and mothers were seen in a special care nursery just before discharge and in home at 1 and 4 months postterm age. General linear mixed models were used to examine the changes in infant heart rate variability (HRV) and Positive Affective Involvement and Sensitivity/Responsiveness scores over time and infant HRV over feeding conditions (prefeeding, feeding, and postfeeding). Significant differences were found for high-frequency and low-frequency HRV over time (p < .001 and p = .014, respectively). However, maternal feeding behavior did not show a significant effect of time (p = .24). The feeding condition effect on high-frequency HRV was significant (p < .001), with HRV lower during feeding compared to both prefeeding and postfeeding. Maternal feeding behavior was not associated with infant HRV. Discovering the ways in which maternal feeding behavior contributes to infant physiologic regulation may require study of the relationship of HRV to infant feeding behavior.

Mary Ainsworth’s legacy: a systematic review of observational instruments measuring parental sensitivity

“…Positive affect is not a part of the sensitivity construct described in the sensitivity item. However, the studies that use the PCERA do not report on a single sensitivity scale, but all report on composite sensitive responsiveness scales that include other PCERA items that do clearly refer to positive affect (e.g., Brown, 2007;Bystrova et al, 2009;Scher, 2001). Thus, it seems that the sensitivity item is not used as a separate scale.…”

Predictors of parenting stress trajectories in premature infant–mother dyads.

“…The PCERA has an acceptable range of internal consistency (Clark, 1999; in the current study, on average, across times: PCERA 1 = .95, PCERA 2 = .89, PCERA 3 = .93) and discriminate validity between high-risk and well-functioning mothers (Clark, Paulson, & Conlin, 1993). The PCERA has been used previously with preterm infants (Brown, 2007), and has been linked to their subsequent developmental and behavioral outcomes (Poehlmann, Schwichtenberg, Bolt, et al, 2011; Poehlmann, Schwichtenberg, Shlafer, et al, 2011). …”

Heart Rate Variability as a Feeding Intervention Outcome Measure in the Preterm Infant

“…4–6,23–30 The majority of these have been descriptive studies of the changes that occur in HRV measures as infants develop over time 4,24–26,29 or how birth characteristics, such as birth weight, gestational age, or congenital heart disease, affect HRV responses to feeding. 23–25,28,30 Consistent with Polyvagal Theory, Portales, 27 McCain, 6 and Suess 28 all found that HF HRV decreased during feeding.…”

“…Feeding has been shown to produce changes in HRV. 4–6 It is theorized that HRV may be a more sensitive measure of physiologic stress or provide important information about infant response to feeding in addition to these traditional measures. It remains unknown whether HRV is a useful outcome measure of physiologic stress in intervention studies where the intervention aims to change the level of stress experienced by the infant.…”