Supporting Oral Feeding Skills Through Bottle Selection

2015 ◽  
Vol 24 (2) ◽  
pp. 50-57 ◽  
Author(s):  
Erin Ross ◽  
Lauren Fuhrman
Keyword(s):  
Influencing Factors ◽  
Flow Rate ◽  
Oral Feeding ◽  
Primary Therapy ◽  
Flow Rates ◽  
Feeding Difficulties ◽  
Optimal Flow ◽  
Young Infants ◽  
Feeding Skills ◽  
Major Consideration

Infants who have feeding difficulties often struggle with coordinating sucking, swallowing, and breathing, and have difficulty eating sufficient quantities for adequate growth. Speech-language pathologists (SLPs) need advanced expertise across a number of areas (e.g., development, medical, swallowing) to work effectively with these young infants, and they use a variety of strategies when treating this population. Therapists working with infants who have feeding difficulties use bottles as a primary therapy tool; how the infant tolerates the flow rate from the bottle/nipple is a major consideration. Caregivers must understand the influence of bottle/nipple flow rates on eating skills, so they can support the emerging oral skill development for these fragile infants, and help parents decide what bottle system to use in their home. Both infant and equipment factors influence bottle/nipple flow rates. This article discusses the influencing factors that need to be considered when determining the optimal flow rate for an individual infant.

Feeding Difficulties in Preterm Infants

2011 ◽  
Vol 3 (6) ◽  
pp. 324-331 ◽  
Author(s):  
Pamela Dodrill
Keyword(s):  
Risk Factor ◽  
Preterm Infants ◽  
Oral Feeding ◽  
Early Feeding ◽  
Feeding Difficulties ◽  
Milk Flow ◽  
Feeding Skills ◽  
Clinical Questions ◽  
Feeding Difficulty ◽  
Therapy Interventions

Preterm infants often display difficulty establishing oral feeding in the weeks following birth. This article aims to provide an overview of the literature investigating the development of feeding skills in preterm infants, as well as of interventions aimed at assisting preterm infants to develop their feeding skills. Available research suggests that preterm infants born at a lower gestational age and/or with a greater degree of morbidity are most at risk of early feeding difficulties. Respiratory disease was identified as a particular risk factor. Mechanisms for feeding difficulty identified in the literature include immature or dysfunctional sucking skills and poor suck–swallow–breath coordination. Available evidence provides some support for therapy interventions aimed at improving feeding skills, as well as the use of restricted milk flow to assist with maintaining appropriate ventilation during feeds. Further research is needed to confirm these findings, as well as to answer remaining clinical questions.

scholarly journals Simulation-Based Training Improves Student Assessment of Oral Feeding Skills in Preterm Infants

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Courtney Broadfoot ◽  
Julie Estis
Keyword(s):  
Health Care ◽  
Preterm Infants ◽  
Student Assessment ◽  
Oral Feeding ◽  
Feeding Difficulties ◽  
Entry Level ◽  
Undergraduate Nursing ◽  
Clinical Recommendation ◽  
Simulation Based ◽  
Feeding Skills

Advancements in medical technology have contributed to increased rates of preterm birth. Prematurity places infants at high risk for feeding difficulties, however. Early identification and assessment of preterm infant dysphagia is critical to maximize nutrition and hydration, feeding safety, and growth and development. The purpose of this study was to assess the ability of a simulation-based training toolto increase non-health care and entry-level clinical student sensitivity to signs of feeding distress in preterm infants. Data were collected from 60 students (20 masters-level Speech-Language Pathology, 20 undergraduate nursing, 20 undergraduate non-health care) in a pre-test/post-test design. All participants completed a brief simulation training protocol, and accuracy percentages were calculated based on their ability to determine the following: physiological and behavioral signs of feeding distress, oral feeding skill level (OFS), and clinical recommendation for further feeding evaluation. Our results revealed that this simulation-based training improved the identification of behavioral (p < 0.001) and physiological (p < 0.001) signs of feeding distress, OFS level (p < 0.001), and ability to make appropriate clinical recommendations (p < 0.001).This study has identified a successful method to effectively train entry-level clinical and non-clinical students to screen feeding skills in preterm infants. This training approach has the potential to improve identification of feeding distress and to recognize the need for a dysphagia evaluation to optimize clinical outcomes in this fragile population.

scholarly journals Oral Feeding Competences of Healthy Preterm Infants: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
N. Bertoncelli ◽  
G. Cuomo ◽  
S. Cattani ◽  
C. Mazzi ◽  
M. Pugliese ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Search Strategy ◽  
Survival Rates ◽  
Oral Feeding ◽  
Feeding Difficulties ◽  
Nutritive Sucking ◽  
Feeding Skills

Background.With increasing sophistication and technology, survival rates hugely improved among preterm infants admitted to the neonatal intensive care unit. Nutrition and feeding remain a challenge and preterm infants are at high risk of encountering oral feeding difficulties.Objective.To determine what facts may impact on oral feeding readiness and competence and which kind of interventions should enhance oral feeding performance in preterm infants.Search Strategy.MEDILINE database was explored and articles relevant to this topic were collected starting from 2009 up to 2011.Main Results.Increasingly robust alertness prior to and during feeding does positively impact the infant’s feeding Skills. The review found that oral and non-oral sensorimotor interventions, provided singly or in combination, shortened the transition time to independent oral feeding in preterm infants and that preterm infants who received a combined oral and sensorimotor intervention demonstrated more advanced nutritive sucking, suck-swallow and swallow-respiration coordination than those who received an oral or sensorimotor intervention singly.

scholarly journals Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized

2015 ◽  
Vol 24 (4) ◽  
pp. 671-679 ◽  
Author(s):  
Britt F. Pados ◽  
Jinhee Park ◽  
Suzanne M. Thoyre ◽  
Hayley Estrem ◽  
W. Brant Nix
Keyword(s):  
Flow Rate ◽  
Coefficient Of Variation ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Flow Rates ◽  
Milk Flow ◽  
Breast Pump ◽  
Level 1 ◽  
Wide Neck ◽  
Selection Of

Purpose This study tested the milk flow rates and variability in flow of currently available nipples used for bottle-feeding infants who are hospitalized. Method Clinicians in 3 countries were surveyed regarding nipples available to them for feeding infants who are hospitalized. Twenty-nine nipple types were identified, and 10 nipples of each type were tested by measuring the amount of infant formula expressed in 1 min using a breast pump. Mean milk flow rate (mL/min) and coefficient of variation were used to compare nipples within brand and within category (i.e., Slow, Standard, Premature). Results Flow rates varied widely between nipples, ranging from 2.10 mL/min for the Enfamil Cross-Cut to 85.34 mL/min for the Dr. Brown's Y-Cut Standard Neck. Variability of flow rates among nipples of the same type ranged from a coefficient of variation of 0.05 for Dr. Brown's Level 1 Standard- and Wide-Neck to 0.42 for the Enfamil Cross-Cut. Mean coefficient of variation by brand ranged from 0.08 for Dr. Brown's to 0.36 for Bionix. Conclusions Milk flow is an easily manipulated variable that may contribute to the degree of physiologic instability experienced by infants who are medically fragile during oral feeding. This study provides clinicians with information to guide appropriate selection of bottle nipples for feeding infants who are hospitalized.

Neurodevelopmental Intervention Strategies to Improve Oral Feeding Skills in Infants With Congenital Heart Defects

2019 ◽  
Vol 4 (6) ◽  
pp. 1492-1497
Author(s):  
Hema Desai ◽  
Audrey N. Lim
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Muscle Tone ◽  
Heart Defects ◽  
Tube Feeding ◽  
State Regulation ◽  
Oral Feeding ◽  
Neural Pathways ◽  
Feeding Difficulties ◽  
Feeding Skills

Purpose Full-term infants with congenital heart defects (CHD) are at high risk for developmental and feeding difficulties secondary to a complex combination of immature neurological structures, early surgical intervention, postsurgical complications, and disruption in typical care. Infants with CHD often present with neurobehavioral immaturity that resembles that of premature infants, resulting in difficulties in achieving stability in the physiological and behavioral subsystems. This results in poor arousal, muscle tone abnormalities, and poor state regulation, which affect their ability to achieve oral feeding readiness and progress in their oral feeding skills. In fact, a significant number of infants with CHD require supplemental tube feeding upon hospital discharge to meet their nutritional needs. However, despite these unique barriers, the feeding experience for infants with CHD is frequently overlooked and the focus tends to be on higher level oral motor and swallowing skills and volume intake. Conclusion Given the growing evidence of neurological immaturity and subsequent neurodevelopmental delays in this population, it is crucial for therapists to recognize neurobehavioral stability as a foundation for a complex neuromotor activity such as oral feeding. This article will discuss how to utilize infant neurobehavioral intervention as part of feeding treatment for children with CHD to help develop appropriate neural pathways for oral feeding.

Hydraulic model of a water cooling system in a chemical plant

1988 ◽  
Vol 53 (4) ◽  
pp. 788-806
Author(s):  
Miloslav Hošťálek ◽  
Jiří Výborný ◽  
František Madron
Keyword(s):  
Flow Rate ◽  
Cooling System ◽  
Cooling Water ◽  
Graph Algorithm ◽  
Automatic Generation ◽  
Hydraulic Calculation ◽  
Return Flow ◽  
Flow Rates ◽  
Pressure Losses ◽  
Controlled Flow

Steady state hydraulic calculation has been described of an extensive pipeline network based on a new graph algorithm for setting up and decomposition of balance equations of the model. The parameters of the model are characteristics of individual sections of the network (pumps, pipes, and heat exchangers with armatures). In case of sections with controlled flow rate (variable characteristic), or sections with measured flow rate, the flow rates are direct inputs. The interactions of the network with the surroundings are accounted for by appropriate sources and sinks of individual nodes. The result of the calculation is the knowledge of all flow rates and pressure losses in the network. Automatic generation of the model equations utilizes an efficient (vector) fixing of the network topology and predominantly logical, not numerical operations based on the graph theory. The calculation proper utilizes a modification of the model by the method of linearization of characteristics, while the properties of the modified set of equations permit further decrease of the requirements on the computer. The described approach is suitable for the solution of practical problems even on lower category personal computers. The calculations are illustrated on an example of a simple network with uncontrolled and controlled flow rates of cooling water while one of the sections of the network is also a gravitational return flow of the cooling water.

scholarly journals Geometrical Optimization of a Venturi-Type Microbubble Generator Using CFD Simulation and Experimental Measurements

Designs ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 4
Author(s):  
Dillon Alexander Wilson ◽  
Kul Pun ◽  
Poo Balan Ganesan ◽  
Faik Hamad
Keyword(s):  
Water Flow ◽  
Flow Rate ◽  
Cfd Simulation ◽  
Air Flow ◽  
Bubble Diameter ◽  
Diameter Ratio ◽  
Experimental Measurements ◽  
Cfd Model ◽  
Flow Rates ◽  
Throat Diameter

Microbubble generators are of considerable importance to a range of scientific fields from use in aquaculture and engineering to medical applications. This is due to the fact the amount of sea life in the water is proportional to the amount of oxygen in it. In this paper, experimental measurements and computational Fluid Dynamics (CFD) simulation are performed for three water flow rates and three with three different air flow rates. The experimental data presented in the paper are used to validate the CFD model. Then, the CFD model is used to study the effect of diverging angle and throat length/throat diameter ratio on the size of the microbubble produced by the Venturi-type microbubble generator. The experimental results showed that increasing water flow rate and reducing the air flow rate produces smaller microbubbles. The prediction from the CFD results indicated that throat length/throat diameter ratio and diffuser divergent angle have a small effect on bubble diameter distribution and average bubble diameter for the range of the throat water velocities used in this study.

scholarly journals Comparison of different models to calculate the viscosity of biogas and biomethane in order to accurately measure flow rates for conformity assessment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Karine Arrhenius ◽  
Oliver Büker
Keyword(s):  
Binary Mixtures ◽  
Flow Rate ◽  
Correction Method ◽  
Gas Mixtures ◽  
Conformity Assessment ◽  
Flow Rates ◽  
Unknown Composition

AbstractThe study presents an optimised method to correct flow rates measured with a LFE flowmeter pre-set on methane while used for gas mixtures of unknown composition at the time of the measurement. The method requires the correction of the flow rate using a factor based on the viscosity of the gas mixtures once the composition is accurately known. The method has several different possible applications inclusive for the sampling of biogas and biomethane onto sorbent tubes for conformity assessment for the determination of siloxanes, terpenes and VOC in general. Five models for the calculation of the viscosity of the gas mixtures were compared and the models were used for ten binary mixtures and four multi-component mixtures. The results of the evaluation of the different models showed that the correction method using the viscosity of the mixtures calculated with the model of Reichenberg and Carr showed the smallest biases for binary mixtures. For multi-component mixtures, the best results were obtained when using the models of Lucas and Carr.

Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis

ORL ◽  
2021 ◽  
pp. 1-5
Author(s):  
Jingjing Liu ◽  
Tengfang Chen ◽  
Zhenggang Lv ◽  
Dezhong Wu
Keyword(s):  
Flow Rate ◽  
Oxygen Therapy ◽  
Preliminary Investigation ◽  
Nasal Cannula ◽  
Low Flow ◽  
Antiplatelet Drugs ◽  
Flow Rates ◽  
The Past ◽  
Oxygen Inhalation ◽  
Significant Difference

<b><i>Introduction:</i></b> In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis. <b><i>Methods:</i></b> We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospital over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years. <b><i>Results:</i></b> No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ<sup>2</sup> = 1.007, <i>p</i> &#x3e; 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ<sup>2</sup> = 2.082, <i>p</i> &#x3e; 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate &#x3c;5 L/min and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ<sup>2</sup> = 0.838, <i>p</i> &#x3e; 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ<sup>2</sup> = 18.428, <i>p</i> &#x3c; 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ<sup>2</sup> = 26.194, <i>p</i> &#x3c; 0.001). <b><i>Discussion/Conclusion:</i></b> Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated epistaxis to a certain extent.

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