scholarly journals Comparison of Feeding Behaviors in Term and Preterm Infants at Six Months Corrected Age

2021 ◽  
Vol 20 (2) ◽  
pp. 140-149
Author(s):  
Mohadese Gholamiyan Arefi ◽  
◽  
Nasrin Shahouzaei ◽  
Zahra Esmaeili ◽  
Aliye Abedini ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Feeding Problems ◽  
Speech And Language ◽  
Feeding Behaviors ◽  
Term Infants ◽  
Significant Difference

Background and Objectives: This study compares feeding behaviors and problems of in term Infants and preterm infants at 6 months corrected age. Subjects and Methods The study was of observational-sectional type (descriptive and analytic) and sampling was one-step cluster probability of the available population in the form of the whole number. Feeding behaviors of 90 infants, including 60 term infants and 30 preterm infants, were assessed by speech and language pathologists through interviews with parents and recorded in a questionnaire. The information in this questionnaire includes feeding behaviors, feeding problems, feeding period, infant weight at 2, 4, 6 months and the age of the child to start complementary feeding, SPSS software version 24 was used to analyze the data. In all the present study, P-value less than 5% was considered as a significant level. Results The results showed that the two groups were significantly different in the mean score of feeding behavior (P= 0.001), feeding problems (P= 0.047) and weight gain (P<0.001). While in feeding duration (P= 0.53) and Frequency of feeding (P= 0.1) there was no significant difference. Of the 90 infants studied, more than 80% of them started feeding in the form of puree in the age group of 4-6 months. Conclusion Premature infants have more feeding problems and less weight gain than normal infants. It is recommended that the speech and language pathologist evaluate and intervene appropriately for oral skills and nutrition of premature infants admitted to the neonatal intensive care unit.

87 Validation of a Costing Algorithm in the Neonatal Intensive Care Unit and Identification of Cost Drivers for Neonates

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e62-e64
Author(s):  
Elias Jabbour ◽  
Sharina Patel ◽  
Juan David Rios ◽  
Petros Pechlivanoglou ◽  
Prakesh Shah ◽  
...  
Keyword(s):  
Intensive Care ◽  
Real Time ◽  
Preterm Infants ◽  
Congenital Anomalies ◽  
Neonatal Intensive Care ◽  
Case Mix ◽  
P Value ◽  
Term Infants ◽  
Time Costs ◽  
Financial Software

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Neonatal Intensive Care Units (NICUs) account for over 35% of pediatric in-hospital clinical costs, thus implying that a better understanding of care expenditures within these units is the first step for improving efficiency of care. The Canadian Neonatal Network (CNN) algorithm is the first to provide case-specific costs based on resource usage among preterm infants born &lt; 37 weeks but has not yet been validated for other populations in the NICU. Objectives To validate the CNN costing algorithm in six case-mix categories with real-time costs obtained from hospital-specific financial software (CPSS) in a tertiary-level NICU and assess the variations in proportion of cost centers across case-mixes. Design/Methods A retrospective cohort study of all patients admitted within 24h of birth to a Level 3 medico-surgical NICU 2016-2019. Patient demographics, clinical information and CNN predicted costs were obtained from the CNN database. Real-time costs were obtained from the hospital financial software (CPSS). Total and daily costs were compared between sources using Pearson correlation coefficient (r) and paired Student’s t-test. Costs were adjusted to account for inter-institutional and -provincial price variations using the Cost of Standard Hospitalization Stay from the Canadian Institute for Health Information. Proportions of each cost center across the different case-mix categories were compared using Chi-square analyses. Results Among the 1795 live infants admitted into the NICU, 167 (9.3%) were &lt; 29 weeks gestational age (GA), 193 (11%) were 29-32 weeks GA, 457 (25.5%) were 33-36 weeks GA, 144 (8%) had major congenital anomalies, 179 (10%) were term infants diagnosed with Hypoxic-Ischemic Encephalopathy (HIE) and 672 (37%) were term infants with no HIE or major congenital anomalies. Median NICU costs varied according to each case-mix from $10,025 for term infants without HIE or congenital anomaly to $180,145 for infants born &lt; 29 weeks (Figure 1). Despite high variation in total NICU costs, there were small variations in median daily costs (range: $1,312-$1,941). Overall, the CNN algorithm strongly correlated with CPSS total costs across all 6 case-mix categories (r range 0.90-1.00, p-value &lt; 0 .01) (Figure 2). We report a consistent strong predictive performance of the algorithm in 5/8 pre-specified cost centers among preterm infants (r range 0.77-0.99, p-value &lt; 0 .01). Unit producing personnel (nurses and physicians) consistently comprised the largest proportion of total costs (64-78%) for all case-mix categories. Conclusion The CNN algorithm accurately predicts NICU total costs for six case-mix categories. Costs per day were comparable across different case-mix categories, and unit producing personnel represented the highest proportion of costs suggesting that reductions in length of stay would be the most efficient method to reduce NICU costs.

scholarly journals The somatic growth pattern of preterm infants until term age

2009 ◽  
Vol 49 (1) ◽  
pp. 39
Author(s):  
Ida Bagus Andhita ◽  
Soetjianingsih Soetjianingsih ◽  
I. Wayan Retayasa
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Growth Pattern ◽  
Somatic Growth ◽  
Mortality Rates ◽  
Term Infants ◽  
Important Indicator ◽  
Breastfed Infants ◽  
Significant Difference ◽  
The Mean

Background  Pre term infants contribute substantially to neonatalmorbidity  and  mortality rates. Somatic growth  is  consideredto be  an  important indicator  of  an  infant's health status.  Themeasurement parameters include body weight (BW), body length(BL), head circumference (HC), and ponderal index (PI). Specificdata  on  the somatic growth pattern  of  preterm infants in Indonesiaare unavailable.Objectives  To  identify the somatic  pattern  of  preterm infantsuntil term age  and  the influence  of  gender, nutrition, and nursingmethod  on  BW,  BL,  HC,  and  PI growth during the first week  oflife.Methods  We  recruited premature infants born in Sanglah Hopsital,Denpasar, Bali,  and  collected data  on  BW,  BL,  HC,  and  PI>All  data  were presented  as  mean (SD)  and  plotted in curves.The  relationships among several factors and the somatic growthparameters were analyzed with  ANOV  A.  The  level  of  significancewas set  at  P  <  0.05.Results  Among  100  infants, significant differences were detectedin  the  mean  ofBW,  BL,  HC, and PI, particularly in early preterminfants. Breastfed infants had the highest values with BW  2199grams (SD  198),  HC  31.4  em  (SD  1.71),  and PI  2.48  grams/cm 3(SD  0.36).  Infants nursed with the kangaroo method had thehighest values  of  BW  [2450  grams (SD  259)]  and  BL  [48  em(SD  2.34)].Conclusion  A significant difference was  detected  in somaticgrowth according to some parameters, particularly in the earlypreterm infants group. Thus, breast feeding and the kangaroomethod contribute to better somatic growth, and specifically BW.

scholarly journals Feeding Performance in Preterm Infants and Full Term Infants at 40 Weeks Postmenstrual Age

2016 ◽  
Vol 36 (2) ◽  
pp. 136-140
Author(s):  
Gunjan Gupta ◽  
Kaniyanoor Venkatesan Vijay Kumar ◽  
R. Anitha ◽  
Binu Ninan
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Feeding Behaviour ◽  
Full Term ◽  
Term Infants ◽  
Feeding Performance ◽  
New Born ◽  
Neural Processes ◽  
Significant Difference ◽  
Innate Behaviour

Introduction: Feeding problems are commonly reported among preterm infants. As premature infants are born before adequate maturation, inadequate feeding capabilities are common among preterm infants. Feeding is an innate behaviour in a new born. Swallowing is evident in a foetus by 16th week of gestation (Tuchman, 1994). By 40th week of gestation, neural processes are expected to mature completely. Feeding is an innate behaviour in a new born. Swallowing is evident in a foetus by 16th week of gestation. By 40th week of gestation, neural processes are expected to mature completely. Since the premature infants are born before adequate maturation of the systems, it is not unusual for them to have inadequate feeding capabilities.Material and Methods: This study aimed to compare feeding performance in preterm (between 30 and 34 weeks GA) and full term infants at 40 weeks Post menstrual age. Seventy infants and their mothers served as participants. A close ended questionnaire documented the oral reflexes, oro-motor skills, oro-sensory skills and feeding history in infants.Results: Results were tabulated under feeding history, (viz; history of use of nasogastric feeding, duration of feeding, episodes of coughing/ choking and vomiting, fussing during feeding, noisy breathing) and oral skills. Significant difference in feeding behaviour was observed between the term and preterm infants at 40 weeks post menstrual age. Conclusion: Hence the need for Speech Language Pathologist to evaluate feeding behaviour at 40 weeks post menstrual age becomes necessary.

scholarly journals Axial Length and Ocular Development of Premature Infants without ROP

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Yi Zha ◽  
Guangdong Zhu ◽  
Jinfei Zhuang ◽  
Haihua Zheng ◽  
Jianqiu Cai ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Axial Length ◽  
Growth Parameters ◽  
Anterior Chamber Depth ◽  
Term Infants ◽  
Ocular Development ◽  
Significant Difference ◽  
Preterm Group

Purpose. To investigate the ocular parameters of premature infants without ROP at gestational age (GA) more than 28 weeks and their relationship with growth parameters. Methods. 76 preterm infants without ROP and 65 term infants were involved to undergo portable slit lamp, RetCam3, ultrasonic A-scan biometry, and cycloplegic streak examination at their 40 weeks’ postconceptional ages (PCA). Ocular parameters of infants’ right eye and growth parameters were used for analysis. Results. All the infants were examined at 40 weeks’ PCA. No significant difference was found between male and female in axial length of preterm infants (p = 0.993) and term infants (p=0.591). Significant differences were found in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous depth (VD) between preterm and term infants. No significant correlation was found between AL and spherical equivalent in preterm infants’ group. In preterm group, AL was significantly correlated with gestational age (GA), birth weight (BW), and head circumference (HC). Conclusions. Preterm infants had shorter AL, shallow ACD, thicker LT, and thinner VD compared to term infants. Refractive error in preterm infants at GA between 28 to 37 weeks was not related to axial length. Among all the growth parameters of preterm infants, GA, BW, and HC had effect on axial length.

scholarly journals Comparative study on the effect of oral motor intervention protocols on oral motor skills of preterm infants from tertiary care hospital in metropolitan city: pilot study

2020 ◽  
Vol 7 (7) ◽  
pp. 1506
Author(s):  
Shailaja S. Jaywant ◽  
Jayashri S. Kale
Keyword(s):  
Motor Control ◽  
Weight Gain ◽  
Preterm Infants ◽  
Premature Infants ◽  
State Regulation ◽  
Care Hospital ◽  
Positive Effects ◽  
Oral Motor ◽  
Significant Difference ◽  
Experimental Group

Background: Premature infants often have feeding difficulties leading to morbidity or developmental co-morbidities. Premature infant oral motor intervention (PIOMI), has shown the positive effects on feeding progression of the premature infants. PIOMI with the massage technique, may help in improving oral motor activity, weight gain in preterm infants along with better neurobehavioral organization. The study was done to analyse effect of this combined protocol on achieving oral motor control and Neurobehavioral state regulation and evaluate its efficacy against PIOMI.Methods: A total 72 clinically stable infants admitted in premature care unit, fulfilling inclusion criterion were enrolled. They were allocated in control and experimental group. Infants from control group received PIOMI and experimental group received PIOMI with massage therapy (M technique), for 10 minutes each day. Data was collected for oral motor abilities, behavioural assessment, weight and day of achieving full feeds.Results: Gestational age at full feeds was 33.65 weeks and 32.89 weeks in control and experimental groups respectively with ‘p’ value 0.002. The number of days of full feed in experimental group was 3.7 days earlier (p=0.04). Infants from experimental group showed higher oral motor score and more weight gain with significant difference The behavioral regulation in infants of both the groups improved after 8 day.Conclusions: PIOMI with M technique was well tolerated by preterm infants. The modified protocol has resulted in achieving early oral feeds and reducing hospital stay. It has also shown the benefit of behavioural regulation along with better oral motor control.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT

PEDIATRICS ◽  
1953 ◽  
Vol 12 (2) ◽  
pp. 151-157
Author(s):  
JOSEPH DANCIS ◽  
JOHN J. OSBORN ◽  
HANS W. KUNZ
Keyword(s):  
Antibody Response ◽  
Newborn Infant ◽  
Premature Infants ◽  
Single Injection ◽  
Diphtheria Toxoid ◽  
Birth Date ◽  
Term Infants ◽  
Normal Birth ◽  
Significant Difference

The antibody response of premature infants immunized at birth with a single injection of diphtheria toxoid was compared to that of a group of term infants similarly immunized. No significant difference was demonstrated. A group of premature infants was immunized about the time that was estimated to be their normal birth date and the antibody response compared to that of term infants at birth. The performance of the premature infants was superior to that of the term infants. The significance of these findings is discussed.

Reduction in Obstructive Breathing Events During Body Rocking: A Controlled Polygraphic Study in Preterm and Full-Term Infants

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 64-68
Author(s):  
J. Groswasser ◽  
M. Sottiaux ◽  
E. Rebuffat ◽  
T. Simon ◽  
M. Vandeweyer ◽  
...  
Keyword(s):  
Eye Movement ◽  
Preterm Infants ◽  
Upper Airway ◽  
Periodic Breathing ◽  
Full Term ◽  
Rapid Eye Movement ◽  
Term Infants ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Obstructive Sleep Apneas

Objective. To investigate the effect of body rocking on infant respiratory behavior during sleep. Methods. Eighteen infants with documented obstructive sleep apneas were studied. There were eight premature infants with persistent bradycardias and 10 infants born full-term, admitted after an idiopathic apparent life-threatening event. No cause for the obstructive apneas was found. The infants were recorded with polygraphic techniques during two successive nights. They were randomly assigned to a rocking or a nonrocking mattress. The conditions were reversed the following night, in a crossover design. Results. In both groups of infants, no significant difference was seen between the two consecutive nights for most of the variables studied: total sleep time, the proportion of non-rapid-eye-movement and rapid-eye-movement sleep, the number of arousals, the number and maximal duration of central apneas, the frequency of periodic breathing, the level of oxygen saturation, and heart rate. During the nonrocking nights, all infants had repeated obstructive breathing events. In seven of the eight preterm infants and in nine of the 10 full-term subjects, body rocking was associated with a significant decrease in the frequency of obstructive events. During rocking, in the preterm infants the obstructions fell from a median of 2.5 to 1.8 episodes per hour (P = .034). In the full-term infants, rocking reduced the obstructive events from a median of 1.5 obstructions per hour to 0.7 (P = .005). No difference was seen for the duration of the obstructive episodes. Conclusion. In preterm and full-term infants prone to obstructive sleep apneas, gentle side-to-side body rocking is associated with a significant decrease in the frequency of upper-airway obstructions.

Nonpharmacological Techniques to Reduce Pain in Preterm Infants Who Receive Heel-Lance Procedure: A Randomized Controlled Trial

2014 ◽  
Vol 28 (4) ◽  
pp. 335-348 ◽  
Author(s):  
Piera Bergomi ◽  
Michele Chieppi ◽  
Antonella Maini ◽  
Tiziana Mugnos ◽  
Debora Spotti ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Wolfgang Amadeus Mozart ◽  
Controlled Trial ◽  
Standard Procedure ◽  
Blood Collection ◽  
Randomized Controlled ◽  
Heel Lance

Introduction: The heel-lance (HL) method for blood collection from the newborn is controversial for the pain it causes. This is the first randomized controlled trial on the management and reduction of pain using the music of Wolfgang Amadeus Mozart (“Sonata K. 448”) in premature infants hospitalized in a neonatal intensive care unit (NICU). This study has compared nonpharmacological techniques with standard procedure for reducing pain during HL procedure. Methods: Thirty-five premature infants were enrolled, each for 3 HL procedures, of which each was randomized to 1 of the 3 study arms. Arms were then compared in terms of the Premature Infant Pain Profile (PIPP) changes by analysis of variance (ANOVA). Results: One hundred five HL procedures were available for analysis (35 standard procedure, 35 music, 35 glucose). Median baseline PIPP was 3, and median PIPP after the HL procedure was 5. PIPP scale change was +3 in the control arm, +1 in the glucose arm, +2 in the music arm (p = .008). Discussion: Both glucose and music were safe and effective in limiting pain increase when compared to standard procedure in HL procedures in preterm infants.

Gastroesophageal Reflux and Prokinetic Agents

2005 ◽  
Vol 24 (2) ◽  
pp. 51-58 ◽  
Author(s):  
Davita Hammer
Keyword(s):  
Weight Gain ◽  
Gastroesophageal Reflux ◽  
Lower Esophageal Sphincter ◽  
Preterm Infants ◽  
Aspiration Pneumonia ◽  
Main Mechanism ◽  
Term Infants ◽  
Gastric Contents ◽  
Esophageal Sphincter ◽  
Poor Weight Gain

GASTROESOPHAGEAL REFLUX (GER), a common problem in preterm and term infants, occurs when there is retrograde movement of gastric contents into the esophagus. The severity of the reflux is related to the height of the gastric contents up into the esophagus or the oral pharynx. Transient lower esophageal sphincter relaxation is the main mechanism thought to be responsible for GER in infants.1–3In a study conducted by Marino and associates, approximately 60 percent of preterm infants were affected by reflux.4GER is associated with irritability, apnea and bradycardia, poor weight gain, aspiration pneumonia, and esophagitis.2,5–7

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