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 The Validity and Reliability of Early Feeding Skills Assessment and Cue-Based Feeding Scales for Preterm Infants

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Farideh Kamran ◽  
Setareh Sagheb ◽  
Seyyed Ahmadreza Khatoonabadi ◽  
Abbas Ebadi ◽  
Yaser Faryadras ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Discriminant Validity ◽  
Intraclass Correlation ◽  
Weighted Kappa ◽  
Oral Feeding ◽  
Skill Assessment ◽  
Early Feeding ◽  
Validity And Reliability ◽  
Rater Reliability ◽  
Feeding Skills

Background: One of the fundamental factors in infants’ readiness to discharge from the Neonatal Intensive Care Unit (NICU) is attaining full oral feeding. Determining the infants’ development requires instruments to comprehensively assess the infants’ oral skills and the process of feeding. Objectives: This study aimed to measure the validity and reliability of Early Feeding Skill assessment (EFS) and the subscales of the cue-based feeding (Oral Feeding Readiness scale (OFRS) and Oral Feeding Quality scale (OFQS)). Methods: Participants consisted of 30 preterm infants born at gestational age (GA) ≤ 34 weeks in Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Infants were enrolled by convenience sampling. Intraclass correlation coefficients (ICC) and Weighted Kappa were used to measure reliability, and Spearman and Pearson’s correlation coefficient were used to test convergent and discriminant validity. Results: The inter- and intra-rater reliability of all dimensions of EFS were good (ICC ranged from 0.77 to 0.95) except intra-rater reliabiltiy for the ability to maintain physiologic stability and ability to coordinate swallowing was moderate. The inter-rater reliability of the cue-based feeding scales was excellent (Weighted Kappa of > 0.74). The intra-rater reliablity indicated good agreement for OFRS (Weighted Kappa = 0.73) and excellent agreement for OFQS (Weighted Kappa = 0.75). There was an inverse correlation between most subscales of EFS and cue-based feeding scales (P < 0.05), except the ability to maintain physiologic stability and ability to coordinate swallowing dimensions (P > 0.05). There was a significant correlation between the ability to maintain physiologic stability dimension and post menstrual age (PMA) (r = 38, (P < 0.05) and between the oral feeding recovery assessment and GA (r = 0.37, (P < 0.05). OFQS was inversely correlated with GA and PMA (P < 0.05). Conclusions: EFS and cue-based feeding scales are valid and reliable scales to assess the oral feeding skills of preterm infants; however, using only one of these scales solely to evaluate infants’ feeding process is not enough.

scholarly journals The Early Feeding Skills Assessment for Preterm Infants

2005 ◽  
Vol 24 (3) ◽  
pp. 7-16 ◽  
Author(s):  
Suzanne Thoyre ◽  
Catherine Shaker ◽  
Karen Pridham
Keyword(s):  
Preterm Infants ◽  
Transition Period ◽  
Oral Feeding ◽  
Early Feeding ◽  
Adequate Intake ◽  
Motor Functioning ◽  
Oral Motor ◽  
Postconceptional Age ◽  
Feeding Skills ◽  
The Individual

Preterm infants develop the skills necessary to begin oral feeding as their health stabilizes and as they reach a postconceptional age that supports coordination of breathing and swallowing with oral-motor functioning. The time from initiation of oral feeding to full oral feedings (with adequate intake for growth and maintenance of physiologic stability) can vary from days to months for the preterm infant. The approach to feeding the infant during this transition period must be developmentally supportive and tailored to meet the needs of the individual. To accomplish this, caregivers—notably nurses and parents—need to communicate about the specific skills that the infant has gained, about skills that are emerging, and about skills that the infant has not yet developed. The Early Feeding Skills (EFS) Assessment is a checklist for assessing infant readiness for and tolerance of feeding and for profiling the infant’s developmental stage regarding specific feeding skills: the abilities to remain engaged in feeding, organize oral-motor functioning, coordinate swallowing with breathing, and maintain physiologic stability. This article introduces the EFS.

scholarly journals A Novel Approach to Assess Oral Feeding Skills of Preterm Infants

Neonatology ◽  
2011 ◽  
Vol 100 (1) ◽  
pp. 64-70 ◽  
Author(s):  
C. Lau ◽  
E.O. Smith
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Novel Approach ◽  
Feeding Skills

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.

Developing a Quality Improvement Feeding Program for NICU Patients

NeoReviews ◽  
2022 ◽  
Vol 23 (1) ◽  
pp. e23-e35
Author(s):  
Erika K. Osborn ◽  
Sudarshan R. Jadcherla
Keyword(s):  
Quality Improvement ◽  
Clinical Outcomes ◽  
Preterm Infants ◽  
Tube Feeding ◽  
Practice Variation ◽  
Oral Feeding ◽  
Evidence Based ◽  
Feeding Difficulties ◽  
Feeding Program ◽  
Hospital Stays

Practices in NICUs vary widely, particularly when clinical decisions involve complex tasks and multiple disciplines, which occurs with feeding preterm infants. Neonatal feeding difficulties in preterm infants often lead to prolonged tube feeding and therefore lengthened hospital stays. Education and compliance with evidence-based protocols and guidelines are needed on the initiation of feedings and feeding advancement to transform enteral and oral feeding practices and thus reduce practice variation and improve clinical outcomes.

scholarly journals Maturation of oral feeding skills in preterm infants

2007 ◽  
Vol 97 (1) ◽  
pp. 61-67 ◽  
Author(s):  
N Amaizu ◽  
RJ Shulman ◽  
RJ Schanler ◽  
C Lau
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Feeding Skills
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