Effect of Body Position on Physiological Alteration While Feeding Infants: A Systematic Review

Jahed, Nazanin Azimi; Borimnejad, Leili; Haghani, Hamid

doi:10.32598/jccnc.3.2.119

Cited by 3 publications

(3 citation statements)

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“…In addition, certain additional strategies and techniques can be used to facilitate and increase the success of feeding (Dailey, 2013; Masarei et al, 2007; Shahzad & Sanati‐Mehrizy 2022; Green & Resnick, 2021; Sırıken et al, 2021). Some of these strategies include placing the infant in a 45°–60° elevated supine (ESU) position while feeding, manually supporting the jaw, cheeks, and lips, increasing the consistency of liquid feeds, positioning the nipple of the bottle away from the cleft part of the mouth, using a bottle or nipple suitable for the infant's age, adjusting the food flow rate, feeding at a pace consistent with feeding cues, burping the infant frequently, using pacifiers (Azimi Jahed et al, 2017; Dailey, 2013; Green & Resnick, 2021; Katge et al, 2014; Masarei et al, 2007; Turner et al, 2001), and limiting feeding time to 30 min (Burca et al, 2016; Dailey, 2013; Masarei et al, 2007; Reid et al, 2006; Shahzad & Sanati‐Mehrizy 2022). The important aspect of choosing a feeding method is to present systems incorporating techniques that increase weight gain while minimizing the stress on the infant and parents/caregivers (Reid, 2004; Snyder & Ruscello, 2019).…”

Section: Introductionmentioning

confidence: 99%

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

Erdost,

Gözen

2024

Specialist Pediatric Nursing

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PurposeThis single‐group, quasiexperimental study was conducted to determine the effect of feeding position on the physiological parameters and feeding performance of term‐born infants with cleft lip and palate (CLP) in the preoperative period.MethodsThe study sample consisted of 45 infants aged 0–6 months with CLP followed up preoperatively in our outpatient clinic between January 2021 and 2022. Infants who were being fed with a specialty bottle for babies with CLP and whose families consented to participate in the study were included. After 2 h of fasting, the infants were fed in the elevated supine (ESU) position for the first meal, then in the elevated side‐lying (ESL) position for the second meal after another 2 h of fasting. The infants' heart rate and oxygen saturation values before, during, and after each feed and indicators of feeding performance were compared between the positions.ResultsThere was no significant difference between the positions in terms of heart rate and oxygen saturation before, during, or after feeding (p > .05). There was no statistically significant difference in measures of feeding performance according to the infants' feeding position (p > .05).ConclusionAccording to the findings obtained in this study, infants with CLP showed no statistically significant differences in heart rate, oxygen saturation, or feeding performance when fed in the ESL and ESU positions.Practice ImplicationsHowever, despite the lack of statistical significance, both physiological values and feeding performance tended to be better when the infants were fed in the ESL position, nurses can practice ESL position according to the infant's opposite direction of the side of the cleft lip or palate.

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Section: Introductionmentioning

confidence: 99%

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

Erdost,

Gözen

2024

Specialist Pediatric Nursing

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“…These studies had smaller sample sizes and demonstrated conflicting results on the benefits of the side-lying versus the upright positions. A systematic review examining the effects of positioning during bottle feeding in preterm infants determined that the evidence to define the role of positioning on physiological stability was still insufficient ( 15 ). Furthermore, these studies did not include infants with unilateral VCP or directly examine the effects of the elevated side-lying position versus the upright position on airway protection using measures such as the MBSS ( 16 , 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

Monaghan,

McGhee,

Yuen

et al. 2023

TAO

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Objective: To evaluate laryngeal penetration and aspiration in upright and side-lying positions in children with unilateral vocal cord paralysis (VCP) who underwent modified barium swallow study (MBSS). Methods: A retrospective chart review (Pro00089051) of pediatric patients who were diagnosed with unilateral VCP and underwent MBSS was performed. Patients were identified using diagnostic code for VCP and based on diagnosis via flexible laryngoscopy. Once identified, MBSS notes were reviewed for data regarding laryngeal penetration, tracheal aspiration, and body position during the exam. Information was collected on the various consistencies of liquids used. The order of positioning was recorded in patients who had undergone both positions during the study. Data was analyzed using chi-square analysis. Results: 811 patients had undergone MBSS between 2011 and 2014. Of these, 90 patients were isolated with unilateral VCP, and of those 90 patients, 23 (26%) had undergone MBSS in both side-lying and upright positions. When all 90 patients were evaluated, there was no difference in penetration or aspiration noted in the side-lying or upright position with thin liquids. Importantly, among the 23 (26%) patients that had been studied in both positions, there were no significant differences in penetration or aspiration relating to body position with any consistency. Conclusion: Rates of penetration and aspiration were not associated with body position in patients who had undergone MBSS at our institution. However, due to an incomplete data set and a small sample size of those who underwent MBSS in both positions, these results should be further explored in prospective studies.

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“…Bottle feeding research has not led to a consensus regarding an “ideal” feeding position, with research predominantly limited to premature infants and using physiologic outcome measures such as oxygen saturation, respiratory rate, heart rate, and heart rate variability. 27-30 Willette et al’s 20 study on FEES in breastfeeding infants in 2015 suggested positional modification in 15% of the infants as a strategy to improve feeding, but they did not include any details on how or when this strategy might be utilized and did not provide evidence for its use. The positioning of an infant for breastfeeding is well recognized as being important for achieving maternal comfort and efficient milk transfer at the breast, with a variety of positions existing that accommodate the variability in both maternal and infant anatomy.…”

Section: Introductionmentioning

confidence: 99%

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

Mills

Keesing

Geddes

et al. 2020

Ann Otol Rhinol Laryngol

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Objectives: This retrospective cohort study uses endoscopic assessment of the pharyngeal phase of swallowing in infants with laryngomalacia, to ascertain the impact of infant positioning on airway compromise and fluid dynamics during breastfeeding. The study aims to identify whether modification of infant positioning at the breast may improve the possibility of safe, successful breastfeeding in infants with laryngomalacia and concurrent breastfeeding difficulty. Methods: Twenty-three infants referred for noisy breathing and difficulty feeding were assessed with flexible endoscopic evaluation of swallowing (FEES) during breastfeeding. All had endoscopically confirmed laryngomalacia. During FEES, observations were made of clinical signs of airway compromise as well as endoscopically observable anatomical features and swallowing dynamics during breastfeeding, including tongue base position, view of laryngeal inlet and vocal folds, dynamic supraglottic soft tissue collapse, timing of milk flow into pyriform fossae/hypopharynx relative to sucking, and presence of penetration and/or aspiration. If airway and/or swallowing compromise was present, the infant’s initial position at the breast was altered from supine or semi lateral decubitus position to semi-prone, with a description of the clinical and endoscopically observable changes that subsequently occurred. Results: Signs of dynamic airway obstruction and/or compromised airway protection with swallowing were present in 20 of the 23 infants (87%) in their initial supine or semi lateral decubitus position. These 20 infants were repositioned to semi-prone, with improvement and/or resolution of stridor and an improved ability to maintain latch in all infants. Continued endoscopic evaluation following positional change was possible in 16 infants, identifying anterior positioning of the tongue base, reduced dynamic supraglottic tissue collapse, reduced volume of milk flow into pyriform fossae during pauses in sucking and resolution of penetration and aspiration. Conclusion: This study has shown how alteration of breastfeeding position to semi-prone may improve dynamic airway obstruction and reduce aspiration risk in infants with laryngomalacia.

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Effect of Body Position on Physiological Alteration While Feeding Infants: A Systematic Review

Cited by 3 publications

References 10 publications

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

The effect of position on feeding performance in infants with cleft lip and palate: Quasiexperimental study

Effects of Body Positioning on Laryngeal Penetration and Aspiration in Children with Unilateral Vocal Cord Paralysis

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

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