Quantification of Intraoral Pressures During Nutritive Sucking: Methods with Normal Infants

Abstract

We report quantitative measurements of ten parameters of nutritive sucking behavior in 91 normal full-term infants obtained using a novel device (an Orometer) and a data collection/analytical system (Suck Editor). The sucking parameters assessed include the number of sucks, mean pressure amplitude of sucks, mean frequency of sucks per second, mean suck interval in seconds, sucking amplitude variability, suck interval variability, number of suck bursts, mean number of sucks per suck burst, mean suck burst duration, and mean interburst gap duration. For analyses, test sessions were divided into 4 × 2-min segments. In single-study tests, 36 of 60 possible comparisons of ten parameters over six pairs of 2-min time intervals showed a p value of 0.05 or less. In 15 paired tests in the same infants at different ages, 33 of 50 possible comparisons of ten parameters over five time intervals showed p values of 0.05 or less. Quantification of nutritive sucking is feasible, showing statistically valid results for ten parameters that change during a feed and with age. These findings suggest that further research, based on our approach, may show clinical value in feeding assessment, diagnosis, and clinical management.

Comparison of tongue muscle characteristics of preterm and full term infants during nutritive and nonnutritive sucking

“…Our method for modeling lingual biomechanics during nutritive and nonnutritive sucking offers advantages over other previously published methods (Hayashi, Hoashi, & Nara, 1997;Kron & Litt, 1971;Lang et al, 2011) as it permits noninvasive real time acquisition of tongue induced movement at the nipple. Although not pursued in the present study, other pertinent measures of lingual dynamics can be explored in future research using our approach; including the relative contributions of the anterior and posterior tongue at the nipple interface as well as the influence of the timing of tongue force production and coordination with swallowing and breathing.…”

“…Previous investigations of sucking strength have been dependent on measures of sucking pressure yielding derivative knowledge about strength (Lang et al, 2011;Medoff-Cooper, Bilker, & Kaplan, 2001). Here we derived sucking strength from direct measures of tongue force.…”

A new ecological method for the estimation of Nutritive Sucking Efficiency in newborns: Measurement principle and experimental assessment

“…The proposed method allows to estimate the volume of liquid ingested by the newborn during a burst through a non-invasive measure of hydrostatic pressure exerted at the teat base. Integrating this methodology with an ecological measure of intraoral pressure [19] that provides the number of sucks per burst, it is possible to estimate the SEF (volume of ingested milk per suck).…”

“…The reservoir is open so that the liquid surface is always at the atmospheric pressure, as assumed in section II.A. This experimental condition can be then easily fulfilled in a real application as well, by means of a venting system that vents air at the back of the feeding bottle, maintaining the air pressure constant at 1 atm regardless of suction, as Lang et al [19] report as well.…”

Ecological Sucking Monitoring of Newborns

“…The volume of milk ingested by an infant during each suck or burst may depend on several factors, e.g., the infantÕs age, weight, postconceptional age (PCA) at birth. Table I r e p o r t s t h e v a l u e s o f s e v e r a l s u c k i n g p a r a m e t e r s obtained by several authors in their studies [24], [33][36]- [38]. The values reported by Taki et al in their recent study [36] have been considered in the present work because they report both the volume of a single suck and the volume of an entire burst, unlike FadaviÕs [37] and LangÕs [38] w o r k s , a n d because they also report on longitudinal sucking performance, allowing for consideration of differences from 1 to 6 months of age.…”