Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation

Crowe, Linda; Chang, Anne M.; Wallace, Karen

doi:10.1002/14651858.cd005586.pub2

Cited by 37 publications

(45 citation statements)

References 40 publications

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“…A literature review indicates great interest in establishing feeding protocols based on an infant's readiness or behavioural state, although few studies have evaluated the clinical value of using such an approach 4 5 15. McCain et al conducted a randomised study comparing a PDF with an experimental method (non-nutritive suck for 10 min prior to feeding and infant readiness assessment) and found that the experimental group reached full NF 5 days earlier than the control group 7.…”

Section: Discussionmentioning

confidence: 99%

Infant-driven feeding in premature infants: a quality improvement project

Wellington

Perlman

2015

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 99%

Infant-driven feeding in premature infants: a quality improvement project

Wellington

Perlman

2015

Arch Dis Child Fetal Neonatal Ed

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“…These limited, qualitative assessment tools have not been properly validated and fail to identify the biological mechanisms responsible for failed oral feeding attempts 11 . By combining computational modeling of gene expression microarray data with systems biology knowledge we identified biologically relevant salivary biomarkers that provide a noninvasive window into a newborn’s developing brain, sensory systems, and facial development as they relate to oral feeding readiness.…”

Section: Discussionmentioning

confidence: 99%

“…This, in turn, has resulted in significant feeding associated morbidities, prolonged length of stay, and millions of dollars in health care expenditure. A recent Cochrane Review assessing the benefits of neonatal feeding assessment tools concluded that “there is no evidence to inform clinical practice”, highlighting the strong need for novel approaches to assess oral feeding readiness in the preterm newborn 11 .…”

mentioning

confidence: 99%

Computational Gene Expression Modeling Identifies Salivary Biomarker Analysis that Predict Oral Feeding Readiness in the Newborn

Maron

Hwang

Pathak

et al. 2015

The Journal of Pediatrics

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Objective-To combine mathematical modeling of salivary gene expression microarray data and systems biology annotation with RT-qPCR amplification to identify (phase I) and validate (phase II) salivary biomarker analysis for the prediction of oral feeding readiness in preterm infants.Study design-Comparative whole transcriptome microarray analysis from 12 preterm newborns pre-and post-oral feeding success was used for computational modeling and systems biology analysis to identify potential salivary transcripts associated with oral feeding success (phase I). Selected gene expression biomarkers (15 from computational modeling; 6 evidencebased; and 3 reference) were evaluated by RT-qPCR amplification on 400 salivary samples from successful (n=200) and unsuccessful (n=200) oral feeders (phase II). Genes, alone and in combination, were evaluated by a multivariate analysis controlling for sex and post-conceptional age (PCA) to determine the probability that newborns achieved successful oral feeding.Results-Advancing post-conceptional age (p < 0.001) and female sex (p = 0.05) positively predicted an infant's ability to feed orally. A combination of five genes, NPY2R (hunger signaling), AMPK (energy homeostasis), PLXNA1 (olfactory neurogenesis), NPHP4 (visual behavior) and WNT3 (facial development), in addition to PCA and sex, demonstrated good accuracy for determining feeding success (AUROC = 0.78). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The authors declare no conflicts of interest. Conclusions-We have identified objective and biologically relevant salivary biomarkers that noninvasively assess a newborn's developing brain, sensory and facial development as they relate to oral feeding success. Understanding the mechanisms that underlie the development of oral feeding readiness through translational and computational methods may improve clinical decision making while decreasing morbidities and health care costs. NIH Public AccessPreterm births affect an estimated 11.5% of all pregnancies in the United States resulting in medical costs exceeding $26 billion annually 1 . Prior to discharge, each infant must demonstrate mature oral feeding skills in accordance to the American Academy of Pediatrics' guidelines 2 . The determination of oral feeding readiness in the preterm newborn remains a significant clinical challenge 3 . Oral feeding is a complex developmental task requiring maturation and integration of the nervous, gastrointestinal, sensory, skeletal muscular and hypothalamic systems 4 . Disruption or delayed maturation in one or several of these developmental syst...

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“…Most of these infants do not have the developmental maturity to successfully feed by mouth and must confront the challenges of learning to feed orally before they can be discharged from the hospital. Currently, there are no strategies available to objectively assess oral feeding maturity in newborns (56). This lack of an objective assessment tool has resulted in missed opportunities to feed infants with mature oral feeding skills, while placing immature oral feeders at risk for significant feeding-associated morbidities (57).…”

Section: Future Directionsmentioning

confidence: 99%

Salivary Diagnostics Using a Portable Point-of-Service Platform: A Review

Khanna¹,

Walt²

2015

Clinical Therapeutics

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Clinical diagnostics can be improved by faster and more accessible disease detection. Our laboratory has developed a point of service (POS) device capable of rapid, sensitive, automated and multiplexed biomarker detection using human saliva instead of other biofluids. In this article, we review the technology that led to the development of this POS device. This POS technology can advance clinical diagnostics by saving time due to faster diagnosis, saving money due to a shorter hospital stay and ultimately improving clinical care.

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Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation

Abstract: Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation.

Cited by 37 publications

References 40 publications

Infant-driven feeding in premature infants: a quality improvement project

Infant-driven feeding in premature infants: a quality improvement project

Computational Gene Expression Modeling Identifies Salivary Biomarker Analysis that Predict Oral Feeding Readiness in the Newborn

Salivary Diagnostics Using a Portable Point-of-Service Platform: A Review

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