Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

Aim: Convalescing preterm infants often require non-invasive respiratory support, such as nasal continuous positive airway pressure or high-flow nasal cannulas. One challenging milestone for preterm infants is achieving full oral feeding. Some teams fear nasal respiratory support might disrupt sucking–swallowing–breathing coordination and induce severe cardiorespiratory events. The main objective of this study was to assess the safety of oral feeding of preterm lambs on nasal respiratory support, with or without tachypnoea.Methods: Sucking, swallowing and breathing functions, as well as electrocardiogram, oxygen haemoglobin saturation, arterial blood gases and videofluoroscopic swallowing study were recorded in 15 preterm lambs during bottle-feeding. Four randomly ordered conditions were studied: control, nasal continuous positive airway pressure (6 cmH2O), high-flow nasal cannulas (7 L•min–1), and high-flow nasal cannulas at 7 L•min–1 at a tracheal pressure of 6 cmH2O. The recordings were repeated on days 7–8 and 13–14 to assess the effect of maturation.Results: None of the respiratory support impaired the safety or efficiency of oral feeding, even with tachypnoea. No respiratory support systematically impacted sucking–swallowing–breathing coordination, with or without tachypnoea. No effect of maturation was found.Conclusion: This translational physiology study, uniquely conducted in a relevant animal model of preterm infant with respiratory impairment, shows that nasal respiratory support does not impact the safety or efficiency of bottle-feeding or sucking–swallowing–breathing coordination. These results suggest that clinical studies on bottle-feeding in preterm infants under nasal continuous positive airway pressure and/or high-flow nasal cannulas can be safely undertaken.

Knowledge, Attitude, and Practice Analysis among Rural Mothers of 6 to 24 Month Age Child Regarding Complementary Feeding

Introduction: According to WHO, exclusive breastfeeding is essential for first 6 moth of life, afterward by six months to meet raised energy and nutrient needs of growing infant complementary feeding is necessary [1]. Proper complementary feeding very essential for the proper physical, neurocognitive development of the child. Objectives: To assesses the knowledge, attitude, and practice among rural Indian mothers of age 6 to 24 month child regarding complementary feeding. Methods: This cross-sectional analysis study was conducted at a tertiary care teaching rural hospital in India between December 2020 and June 2021. A self-administrated questionnaire was distributed to mothers of 6 to 24 month age children attending pediatrics outpatient department at hospital. The questionnaire consisted of 3 parts; first part consist of demographic variables, second and third part regarding knowledge, attitude and practice of mother towards complementary feeding practice. SPSS 21 was used for data analysis. Results: Out of the 250 participants, 220(88%) completed questionnaire completely and validly, 96% mothers initiated breastfeeding within first 48 hrs of birth, and about 62% mothers continue exclusive breastfeeding till six moth age. 72 % mother knew that complementary feeding should start at 6 month of age but only 66% mother able to start at that age, major reason for delayed start is mother perception that her feeding is sufficient for baby, other that family member’s advice. 64% mother believe in homemade complementary feeds and 26% mothers believe in commercial feeds, though major source of knowledge is family members (69%), electronic media(12%) also important source of knowledge while only 19% mothers get information from health professionals. Significant number of mother have knowledge about iron rich foods(63%), iodized salt (50%) etc. however only 36% mother knows about dietary diversity. During illness 52% mothers prefer to decrease in feeding while, 10% prefer to withhold it. 91% mother practice washing hands before cooking and 85% practice giving boil water to baby. However, still 70% mother practice bottle feeding for their children’s. Conclusion: Though there is good knowledge among mothers regarding exclusive breastfeeding, complementary feeding in term of age of start, type of feeding, nutrient value of feeding, importance of consistency, however still there is lack of knowledge about dietary diversity, cultural and social food taboos, bottle feeding etc. Strategies need to employ like health education, awareness programs, training programs for mothers to improve their practice and attitude towards complementary feeding.

Maternal Perception of Breastfeeding in Children with Unilateral Cleft Lip and Palate: A Qualitative Research Work

Background : Unilateral cleft lip and / or palate (UCLP) is one of the most common congenital craniofacial difference. The objective of this study was to describe maternal perception of breastfeeding in children with unilateral cleft lip and palate and to assess the role of breastfeeding counseling. Methods : Qualitative descriptive method and phenomenological analysis were used to analyze the narratives. 28 mothers of patients with nonsyndromic UCLP treated with nasoalveolar molding (NAM) between April 2015 and April 2018 were strategically selected and interviewed after NAM treatment. Framework analysis was conducted for qualitative data. The CES University ethical committee approved the study. Results : The findings resulted in six main categories: First contact with the CLP program, access to early diagnosis and timely treatment, perceptions of parents about health personnel on breastfeeding of CLP patients, perceptions of mothers toward breastfeeding, perception of advantages and disadvantages of the NAM technique regarding breastfeeding and assessment of the CLP program. The interviewed mothers, both prenatally and postnatally, stated the advantages of initiating the process prenatally. There are still difficulties for reaching a timely diagnosis. Several mothers stated that health professionals and assistants determined the hospitalization, installation of a nasogastric tube or feeding through a baby bottle or syringe, which prevented the first contact between mother and child. Even though the breastfeeding process is difficult for these mothers, they acknowledged its immense advantages. Interviewed mothers considered the use of the NAM advantageous as the obturator allowed a better bottle-feeding process. The program generates satisfaction, motivation, expectations and happiness to the mothers who initiated this therapy with their children. Conclusion : The participants related difficulties with breastfeeding. Mothers acknowledged the clinical results when using the NAM obturator, as well as the support provided by the breastfeeding consultant.

Appraisal of Behaviour-change Models and Application of Transtheoretical Model-based Motivational Interviewing for Bottle Feeding Cessation- A Qualitative Study

Behaviour change is the key to prevention of diseases; oral diseases being no exception. Behaviours such as frequent consumption of sugar sweetened beverages (SSBs), feeding milk using a bottle and lack of oral hygiene maintenance are a few examples of behaviours that can cause early childhood caries. Dentists must adopt skills to counsel patients in a manner that will elicit behaviour change. Motivational Interviewing (MI) based on the transtheoretical model of behaviour-change has been effective in tobacco cessation and also has been shown effective in oral health behaviours. This qualitative study demonstrates effectiveness of MI practiced by a paediatric dentist for bottle-feeding cessation. Sixteen mothers were counselled by a single trained MI counsellor in one-to-one counselling sessions and followed up telephonically. Fifteen mothers could stop the practice of bottle feeding. Mothers reported positive feedback on the counselling sessions and satisfaction with the result.

Correlation between maternal eating disorder and early infant feeding regulation: a cross -sectional study

Background The post-partum period is a vulnerable time for mothers in terms of eating disorder symptoms and is critical for the establishment of feeding patterns in infants. This study aimed to investigate the relationships between maternal eating disorder symptoms and objective indices of feeding regulation at 3 months, as well as perceived breastfeeding self-efficacy. Methods A sample of n = 73 full-term mother-child dyads (44% female) participated in the study. Mothers self-reported eating disorder symptoms and breastfeeding self-efficacy and objective indices of infant feeding regulation were obtained in the home. Results Findings revealed the existence of relationships between higher maternal eating disorder symptoms, and objective indices of infant feeding regulation with substantial gender differences in the patterns emerging. Among mother-daughter dyads, maternal weight and shape concerns were associated with higher infant transfer volume and rate during bottle feeding. In contrast, among mother-son dyads, higher maternal eating disorder symptoms, including weight, shape, and eating concern, were associated with lower infant transfer volume and rate as well as lower levels of proficiency while taking their bottle. Conclusion Relationships emerged between higher maternal eating disorder symptoms and feeding regulation with substantial gender differences in these patterns. Additional research clarifying the underlying mechanisms of these associations is warranted and further efforts should be directed towards supporting mothers during the postpartum period.

Real-Time Implementation of a Fully Automated Industrial System Based on IR 4.0 Concept

With the advent of modern communication and control strategies, existing industrial enterprises are now being transformed as per Industrial Revolution (IR) 4.0 standards to maximize production rates and monetary gains. To cope with the pace of the modern technological revolution, the Government of Saudi Arabia has launched “Vision 2030”. This research article presents the full automation process of an existing production line at the College of Engineering, King Saud University, as per “Vision 2030” guidelines. Initially, a production line was designed to produce flavored yogurt bottles from a user-defined flavor and plain yogurt mixture. The research project was completed in two phases. During phase I, smart sensing, control, and automation equipment were used to minimize human intervention, the so-called semi-automated mode of operation. A bottle-feeding mechanism and robotic arms were later integrated to eliminate human intervention during the second phase. Moreover, during phase II, Node-RED, Telegram Bots, and a Raspberry Pi 4 controller were used to achieve IoT-based monitoring and control as per Industry 4.0 requirements. A comparative performance analysis was conducted between semi-automated and fully automated modes of operation to demonstrate the benefits of the fully automated operational mode. The performance of the fully automated system was found to be superior in comparison with the semi-automated system.

Pengaruh Kebiasaan Buruk Oral terhadap Malrelasi Gigi pada Anak Panti Asuhan Usia 7-13 Tahun

Pertumbuhan dan perkembangan gigi anak turut dipengaruhi oleh pertumbuhan dan perkembangan fisik serta mental anak. Kebiasaan buruk oral merupakan suatu kebiasaan yang ditandai dengan durasi sedikitnya enam jam sehari dan dapat menyebabkan malrelasi gigi apabila frekuensi dan intensitasnya cukup tinggi. Anak yang tidak memiliki orangtua atau keluarga, atau tinggal di panti asuhan biasanya kurang mendapatkan kasih sayang yang cukup. Munculnya kebiasaan buruk oral merupakan salah satu cara mereka untuk mendapatkan kenyamanan. Penelitian ini bertujuan untuk melihat pengaruh kebiasaan buruk oral terhadap malrelasi gigi pada anak usia 7-13 tahun yang tinggal di Panti Asuhan Nurul Haq Yogyakarta. Desain penelitian ini adalah observasional analitik dengan pendekatan cross-sectional. Sebanyak 26 anak dilakukan pemeriksaan untuk melihat relasi giginya, kemudian dilakukan wawancara mendalam, dan pencetakan rahang. Data dianalisis menggunakan uji chi-square. Prevalensi mengisap ibu jari sebesar 30.7%; menggigit jari sebesar 11.5%; menggigit kuku, bibir, prolonged bottle-feeding, dan bruxism sebesar 7.7%; dan bernapas lewat mulut 3.8%. Prevalensi protrusi sebesar 23.1%; open bite sebesar 15.4%; deep bite sebesar 11.5%; dan cross bite sebesar 7.7%. Signifikansi nilai uji chi-square sebesar 0.008 (p0.05). Kesimpulan dari hasil penelitian ini adalah terdapat pengaruh kebiasaan buruk oral terhadap malrelasi gigi pada anak panti asuhan usia 7-13 tahun.

Feeding practices and early childhood caries among children with primary dentition

Background: Early childhood caries (ECC) is major oral health problem of young children. Risk factors for ECC are poor oral hygiene and feeding practices. Prevalence and severity of ECC is increasing with change in lifestyle and diet pattern in developing countries. Objectives: To assess the association between feeding practices and severity of early childhood caries in preschool children. Methods: An analytical cross-sectional study was conducted with convenient sample of 96 children up to six years age in Peoples Dental College from July to December 2020. Clinical examination included the recording of dental caries (dmft) using WHO criteria. The self-validated questionnaire consisting seven questions about feeding practices was asked to mothers. The Chi-square test was performed to determine association between severity of ECC and feeding pattern. Results: Mean dmft was 6.77 ± 5.91. Prevalence of severe-ECC (S-ECC) was highest in youngest age group. Caries experience was similar in breast fed, bottle fed, and mixed. There was no significant difference in non-severe ECC and ECC in relation to duration of breast or bottle feeding but frequency of night feeding was associated with S-ECC. Children given ready-made infant formula solid food had more S-ECC (13, 92%) compared to non-severe ECC (1, 7.1%) which was statistically significant. Children given homemade gram flour food were noted to have less of S-ECC (5, 27.5%) than nonsevere ECC (13, 72.5%) which was statistically significant. Conclusion: Present study revealed that multiple night feeding and weaning with readymade food are significant factors for S-ECC.

Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review

Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory.