Dysphagia and Oral Feeding Problems in the Premature Infant

2002 ◽  
Vol 21 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Martha Wilson Jones ◽  
Elaine Morgan ◽  
Jean Shelton
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Term Infant ◽  
Oral Feeding ◽  
Feeding Disorders ◽  
Feeding Problems ◽  
The Past ◽  
Common Problems

FEEDING DISORDERS AND dysphagia are common problems seen in premature infants following their discharge from the NICU. A major factor in the growing incidence of these problems is the number of infants born and surviving between 23 and 25 weeks gestational age, which has increased dramatically over the past decade. These infants experience both a lengthier exposure to noxious oral stimuli and a longer time until they develop the suck/swallow coordination that makes oral feeding safe.1 Oral feeding is generally not offered before 32–34 weeks gestational age, when the preterm infant’s sucking pattern begins to resemble that of a term infant.2,3 Therefore, there may be an 8- to 9-week lag between birth and oral feedings in a 23- or 24-week gestational age infant.

THE POSTNATAL DEVELOPMENT OF THE COAGULATION SYSTEM IN THE PREMATURE INFANT

1987 ◽  
Author(s):  
M Andrew ◽  
B A Paes ◽  
R A Milner ◽  
P J Powers ◽  
M Johnston ◽  
...  
Keyword(s):  
Premature Infant ◽  
Postnatal Development ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Term Infant ◽  
Full Term ◽  
Screening Tests ◽  
Coagulation System ◽  
Term Infants

A cohort study was performed to determine the postnatal development of the coagulation system in the “healthy” premature infant. Mothers were approached for consent and a total of 132 premature infants were entered into the study. The group consisted of 64 infants with gestational ages of 34-36 weeks (prem 1) and 68 infants whose gestational age was 33 weeks or less (prem 2). Demographic information and a 2 ml blood sample were obtained on days 1, 5, 30, 90, and 180. Plasma was fractionated and stored at −70°C for batch assaying of the following tests: screening tests, PT, APTT; factor assays (biologic (B)); fibrinogen, II, V, VII, VIII:C, IX, X, XI, XII, prekallikrein, high molecular weight kininogen, XIII (immunologic (I)); inhibitors (I), antithrombin III, aα2-antiplasmin, α2-macroglobulin, α-anti-trypsin, Cl esterase inhibitor, protein C, protein S, and the fibrinolytic system (B); plasminogen. We have previously reported an identical study for 118 full term infants. The large number of premature and full term infants studied at varying time points allowed us to determine the following: 1) coagulation tests vary with the gestational age and postnatal age of the infant; 2) each factor has a unique postnatal pattern of maturation; 3) near adult values are achieved by 6 months of age; 4) premature infants have a more rapid postnatal development of the coagulation system compared to the full term infant; and 5) the range of reference values for two age groups of premature infants has been established for each of the assays. These reference values will provide a basis for future investigation of specific hemorrhagic and thrombotic problems in the newborn infant.

scholarly journals Premature: growth and its relation to oral skills

CoDAS ◽  
2015 ◽  
Vol 27 (4) ◽  
pp. 378-383
Author(s):  
Camila Lehnhart Vargas ◽  
Luana Cristina Berwig ◽  
Eduardo Matias dos Santos Steidl ◽  
Leila Sauer Prade ◽  
Geovana Bolzan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Tube Feeding ◽  
Oral Feeding ◽  
Feeding Performance ◽  
Time Of Feeding ◽  
Oral Skills

OBJECTIVE: To evaluate the influence of oral motor skills of premature infants on their oral feeding performance and growth, during neonatal hospitalization.METHODS: Fifty-one newborns hospitalized in the neonatal intensive care unit of a hospital in Southern Brazil, between July 2012 and March 2013, were evaluated. The evaluation of oral feeding skills, according to Lau and Smith, was applied after prescription for starting oral feeding. The oral feeding performance was analyzed using the following variables: days taken to start independent oral feeding and hospital discharge. Growth was measured by weight, length, and head circumference, using the curves of Fenton, at birth, first and independent oral feeding, and hospital discharge.RESULTS: At birth, 71% preterm infants were proper for gestational age, most of them were males (53%), with average of 33.6 (±1.5) weeks of gestational age. The gestational age in the assessment did not influence the oral feeding performance of the premature infant and did not differ between levels. Time of transition from tube feeding to oral feeding and hospital stay was shorter when the oral skills were higher. At birth, there was a tendency of low weight and low oral feeding performance. Level IV premature infants in the release of oral feeding presented higher weights.CONCLUSION: The level of oral skills of the premature infant interfered positively on time of feeding transition from tube to independent oral feeding and hospital stay. Growth, represented by weight gain, was not affected by the level of oral skill.

scholarly journals Bronchopulmonary dysplasia in extremely premature infant with congenital lobar emphysema: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bingchun Lin ◽  
Huitao Li ◽  
Chuanzhong Yang
Keyword(s):  
Premature Infant ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Gestational Age ◽  
Middle Lobe ◽  
Severe Respiratory Distress ◽  
Congenital Lobar Emphysema ◽  
X Ray ◽  
Chest X Ray ◽  
Lobar Emphysema

Abstract Background Congenital lobar emphysema (CLE) is a congenital pulmonary cystic disease, characterized by overinflation of the pulmonary lobe and compression of the surrounding areas. Most patients with symptoms need an urgent surgical intervention. Caution and alertness for CLE is required in cases of local emphysema on chest X-ray images of extremely premature infants with bronchopulmonary dysplasia (BPD). Case presentation Here, we report a case of premature infant with 27 + 4 weeks of gestational age who suddenly presented with severe respiratory distress at 60 days after birth. Chest X-ray and computed tomography (CT) indicated emphysema in the middle lobe of the right lung. The diagnosis of CLE was confirmed by histopathological examinations. Conclusions Although extremely premature infants have high-risk factors of bronchopulmonary dysplasia due to their small gestational age, alertness for CLE is necessary if local emphysema is present. Timely pulmonary CT scan and surgical interventions should be performed to avoid the delay of the diagnosis and treatment.

Round Table Discussion

PEDIATRICS ◽  
1951 ◽  
Vol 8 (3) ◽  
pp. 431-434
Author(s):  
HEYWORTH N. SANFORD ◽  
J. HAROLD ROOT ◽  
R. H. GRAHAM
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Death Rate ◽  
Round Table ◽  
Term Infant ◽  
Full Term ◽  
Round Table Discussion ◽  
Premature Births ◽  
Term Infants ◽  
Full Term Infant

Chairman Sanford: Dr. Herman N. Bundesen, Commissioner of Health of Chicago, organized 12 years ago the "Chicago Premature Plan." This consists in registering all premature infants with the City Health Department within a few hours after birth. The premature infant who is born at home, or in a hospital that does not have adequate premature care, is transported in an oxygenated incubator ambulance to a hospital which specializes in such care. From 1936 to 1947 premature infant deaths in Chicago have been lowered 6½%. The full term infant death rate during the same period has been lowered about 3%. Inasmuch as the premature death rate has been lowered about double that of the full term infant rate, we believe this procedure has been the cause of reduction. In 1936 there were 47,000 live births in Chicago. In 1947 there were 82,000, or an increase of 80%. In this number the full term infants increased from 45% to 60%, whereas the premature infants increased from 2000 to over 5000, or about 140% increase of premature infants born in Chicago during the last 10 years. This adds a considerable increase to the number of infants for our available premature infants beds. Where formerly we planned 5 premature births to each 100 full term births, we now find that prematures have increased to 8 per 100 full term infants. Causes of prematurity are multiple births, toxemia, heart disease, syphilis, tuberculosis, infections, accidents, premature separation of the placenta and abnormalities of the reproduction tract. It is generally understood that there is a tendency for more premature births among the Negro race than the white race.

scholarly journals Uncommon surgical emergencies in neonatology

2014 ◽  
Vol 36 (5-6) ◽  
Author(s):  
R. Angotti ◽  
A.L. Bulotta ◽  
F. Ferrara ◽  
F. Molinaro ◽  
E. Cerchia ◽  
...  
Keyword(s):  
Gestational Age ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Oral Feeding ◽  
Clinical Approach ◽  
Associated Anomalies ◽  
Multiple Factors ◽  
The Past ◽  
Surgical Emergencies

Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

The effect of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in premature infants: A single-blind randomized–clinical trial

2021 ◽  
Vol 14 (3) ◽  
pp. 379-387
Author(s):  
Alireza Alidad ◽  
Maryam Tarameshlu ◽  
Leila Ghelichi ◽  
Hamid Haghani
Keyword(s):  
Hospital Stay ◽  
Premature Infants ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Feeding Problems ◽  
Feeding Performance ◽  
Oral Motor ◽  
Nutritive Sucking ◽  
Combined Intervention ◽  
Single Blind

PURPOSE: Feeding problems are common in premature infants (PIs) and may lead to negative consequences such as malnutrition, dehydration, excessive weight loss, as well as developmental and psychological deficits. Moreover, they are associated with increased length of hospital stay/cost. There is not enough evidence on how feeding problems should be treated in PIs. The goal of this study was to investigate the effects of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in PIs. METHODS: A single-blind randomized clinical trial was performed on 44 PIs with feeding problems. Patients were randomly categorized into two groups: (1) combined intervention (CI) and (2) non-nutritive sucking (NNS). The CI group received NNS, oral motor stimulation and oral support simultaneously. Infants in both groups received 14 treatment sessions for 14 consecutive days. The Preterm Oral Feeding Readiness Assessment Scale (POFRAS) was used as the primary outcome measure. Weight, volume of milk intake, time to achieve full oral feeding, and length of hospital stay were secondary outcome measures. All measures were assessed before treatment, after the 7th session, after the 14th session, and after 7 days after the end of treatment. RESULTS: Both groups improved in all outcome measures across time (P < 0.001). The improvements in the POFRAS, volume of milk intake, and time to achieve full oral feeding were significantly greater in the CI group than the NNS group (P < 0.001). The improvements attained in weight and length of hospital stay were not significantly different between the CI and NNS groups (P > 0.05). Large effect sizes were found for POFRAS score in both CI (d = 3.98) and NNS (d = 2.19) groups. CONCLUSION: The current study showed that the combined intervention including NNS, oral motor stimulation, and oral support significantly improved the feeding performance in PIs.

scholarly journals Organic and Nonorganic Feeding Disorders

2015 ◽  
Vol 66 (Suppl. 5) ◽  
pp. 16-22 ◽  
Author(s):  
Anna Rybak
Keyword(s):  
Premature Infants ◽  
Failure To Thrive ◽  
Feeding Disorders ◽  
Food Refusal ◽  
Healthy Children ◽  
Disabled Children ◽  
Feeding Problems ◽  
Behavioral Issues ◽  
Negative Behaviors ◽  
Feeding Style

Feeding is one of the most important interactions between caregiver and child in the first few years of life and even later on in handicapped children. Feeding disorders can present as food refusal or low quantity of food intake due to behavioral issues or underlying organic conditions. This situation concerns mostly infants and children below 6 years of age; however, feeding problems can appear also later on in life. Feeding disorders are a concern for over 10-25% of parents of otherwise healthy children below 3 years of age, but only 1-5% of infants and toddlers suffer from severe feeding problems resulting in failure to thrive. In case of premature infants or neurologically disabled children, this rate is much higher. Feeding disorders may appear as an isolated problem, mainly due to negative behaviors during feeding, or as a concomitant disorder with an underlying organic disease or structural anomaly. The newest classification also includes the feeding style presented by the caregiver (responsive, controlling, indulgent or neglectful) as a separate cause of feeding disorders.

LEVEL OF HYALURONIDASE INHIBITOR IN THE SERUM OF PREMATURE INFANTS WITH RETROLENTAL FIBROPLASIA

PEDIATRICS ◽  
1952 ◽  
Vol 10 (5) ◽  
pp. 533-537
Author(s):  
JULIA B. MACKENZIE
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Term Infant ◽  
Full Term ◽  
Retrolental Fibroplasia ◽  
Full Term Infant ◽  
Hyaluronidase Inhibitor ◽  
Order Of Magnitude ◽  
Severity Of The Disease

The serum of the premature infant contains material which inhibits bovine hyaluronidase. This inhibitor was found to be present to about the same degree in infants with and without retrolental fibroplasia and appeared to be unrelated to the severity of the disease. The level of the physiologic inhibitor of hyaluronidase found in the blood of the premature and full term infant is approximately of the same order of magnitude.

MATERNAL, CORD, AND SERIAL VENOUS BLOOD: PROTEIN-BOUND IODINE, THYROID-BINDING GLOBULIN, THYROID-BINDING ALBUMIN, AND PREALBUMIN VALUES IN PREMATURE INFANTS

PEDIATRICS ◽  
1965 ◽  
Vol 35 (5) ◽  
pp. 759-764
Author(s):  
Ralph E. Perry ◽  
Joan E. Hodgman ◽  
Paul Starr
Keyword(s):  
Cord Blood ◽  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Venous Blood ◽  
Blood Protein ◽  
Term Infants ◽  
Protein Levels ◽  
Weight Groups ◽  
Abrupt Rise

1. P.B.I. and thyroid-binding protein levels in mothers delivering premature infants of varying weights are the same as those reported for mothers delivering at term. The maternal T.B.G. is from 50-60% greater than the T.B.G. of the cord blood. 2. The cord P.B.I. in the smallest infants is significantly lower than their mothers' and is lower than that of the babies weighing over 1,500 gm. 3. The characteristic newborn P.B.I. pattern of abrupt rise in the 48 hours after birth followed by a more gradual fall has been established for the premature infant. The magnitude of rise is less in the smallest prematures. The increase in P.B.I. following delivery is found in all weight groups and does not appear to be associated with the gestational age. 4. T.B.G. levels in prematures are the same as those reported in term infants, and are stable throughout the first 10 days. The rise in P.B.I. cannot be attributed to a change in T.B.G. 5. A pattern of alterations in T.B.A. and T.B.P.A. has been described.

Biochemical markers in the assessment of protein-calorie malnutrition in premature neonates.

1986 ◽  
Vol 32 (7) ◽  
pp. 1269-1273 ◽  
Author(s):  
L Nadeau ◽  
J C Forest ◽  
M Masson ◽  
I Morrissette ◽  
F Larivière ◽  
...  
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Biochemical Markers ◽  
Interindividual Variability ◽  
Oral Feeding ◽  
Control Group ◽  
Total Proteins ◽  
Premature Neonates ◽  
Clinical Problems

Abstract We studied 135 premature newborns of 26 to 36 weeks gestation, divided into three groups: the control group, 66 premature infants with uncomplicated course; 51 premature neonates with appropriate birth weight for gestational age (AGA), who suffered from clinical problems that delayed oral feeding; and 18 premature infants with small birth weight for gestational age (SGA). When neonates of the same postnatal age were compared, prealbumin concentrations were the lowest in the SGA group at the third and fourth postnatal week. Although the AGA group had the most infants with serious illnesses and the lowest protein-calorie intakes, their prealbumin concentrations did not differ significantly from those of the control group. But when the infants of each group were subdivided on the basis of intakes and weight gain regardless of postnatal age, those with greater intakes showed significantly higher prealbumin values; however, in all groups, the infants with higher intakes were also significantly older. Total proteins and albumin showed similar changes in all groups. Prealbumin concentrations showed great interindividual variability in infants of the same postnatal age. We conclude that prealbumin, albumin, and serum total proteins are not sufficiently sensitive biochemical markers to assess alterations of the nutritional status of premature infants.

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