Behavioral state and the premature’s readiness performance to begin oral feeding

Abstract

Objective: to evaluate the influence of behavioral states on the readiness of the premature infant to initiate breastfeeding. Methods: the study was transversal, observational and descriptive with 51 premature infants, attended at the Neonatal Intensive Care Unit (NICU), from a Baby-Friendly Hospital. The infants were evaluated using the «Preterm Oral Feeding Readiness Assessment Scale». The evaluation occurred close to the feeding time and was performed in preterm infants in two behavioral states, in deep sleep and alertness. Thus, preterm infants were self-controlled. For the data analysis, the T-Test and the McNemar Test were applied, with a significance level of 0.05. Results: there was a statistically significant difference in the behavior of premature infants in alert behavior and deep sleep. In the alert state, preterm infants showed greater readiness for oral feeding in the breast. The results highlight the importance of the behavioral state of prematurity for professionals working in NICUs. Conclusion: the behavioral state influences the beginning of premature infant feeding. The alertness behavioral status of premature infants is essential during neonatal speech therapy assistence.

The Interrater and Intrarater Reliability of the Preterm Infant Oral Feeding Readiness Assessment Scale

“…Infantʼs lip posture and tongue posture in every infant is different in various states [21]. Fujinaga et al indicated a high level of interobserver agreement while our research demonstrated lower level of agreement, especially in lip posture compared to that in the study by Fujinaga and associates.…”

“…Stress sign was the only unsatisfactory item that was the same between Fujinaga et al and our study. One of the reasons for the low level of interobserver agreement is the alteration of infantʼs clinical [20,21].…”

“…These differences may be due to the difficulty of measurements because the assessment of the PIOFRA scale is subjective and both items rely on tactile sensitivity and exact observation. Moreover, the infant's behavioral state may influence sucking patterns [21].…”

Correlation of facial anthropometry data of late preterm newborns and oral feeding readiness

“…Higher bigonial measurements may be related to the configuration of the musculature and orofacial structures, as well as to the stomatognathic functions exercised by the individual. Considering this finding, other studies (8)(9)(10)(11) also showed the possibility of a relationship between elevated horizontal dimensions and the configuration of orofacial structures.…”

“…Fifty-two newborns who used an orogastric tube as a means of feeding participated in the study. The sample calculation was done for the primary study, with 26 newborns per group, and the sample size was calculated based on the study by Fujinaga (9) , considering the proportion of 30.39% and 2.9% among groups of newborns in a state of deep sleep and alertness respectively, with a significance level of 5% and two-tailed test power of 80%. Only the sample of 52 newborns was considered in this article.…”