Filling the Gaps for Feeding Difficulties in Neonates With Hypoxic-Ischemic Encephalopathy

Abstract

Hypoxic-ischemic encephalopathy (HIE) in neonates poses long-term feeding difficulties and abnormalities of swallowing, the sequel of which is growth impairment. Such infants are also at risk of impaired selffeeding in the grown-up stage along with other motor and tone abnormalities leading to malnutrition and multiple aspiration pneumonia episodes. The lack of evidence-based and pragmatic feeding strategies in such neonates is because of varied unrecognized symptoms and lacking validated diagnostic approaches. This article approaches evidence related to the pathophysiologic basis of feeding difficulties in neonates with HIE as well as standardizing measures and techniques to improve the feeding abilities of such babies and, in turn, their long-term development. The present review provides a scaffold for putting importance on this less taken care issue of feeding problems and emphasizes that more objective and evidence-based studies are required to be added to the literature for early interventions and management of this issue so that caregivers and neonatologists are not misguided by crude subjective opinions.

Perinatal Azithromycin Provides Limited Neuroprotection in an Ovine Model of Neonatal Hypoxic-Ischemic Encephalopathy

“…Feeding difficulties are seen in >50% of severely affected cases, and especially in low-resource settings contributes to malnutrition and poor outcomes. 44 Potential reasons for the limited neuroprotection observed with azithromycin include limited duration of follow-up. Although 6 days is longer than many large animal studies, it may represent a transitional phase between tissue injury and repair mechanisms in terms of histological observations, and longer observation periods may be needed to fully capture the impact of azithromycin on neurological outcomes.…”

“…Feeding difficulties are seen in >50% of severely affected cases, and especially in low-resource settings contributes to malnutrition and poor outcomes. 44 …”

Experiencia De Lactancia Humana Frente A Condiciones Crónicas Complejas

“…Desde el rol fonoaudiológico se buscará tal y como plantean Ramirez y Sampallo el éxito de la lactancia desde la funcionalidad siempre que sea posible o bien la rehabilitación de la succión (Ramírez-Gómez & Sampallo-Pedroza, 2017). A su vez, desde la puericultura se jerarquizará la posibilidad de habilitar en estos casos la lactancia diferida como beneficio para la díada (Arora, Bhandekar, Lakra, Lakra, & Khadse, 2022). Ambas profesiones se complementarán desde sus perspectivas y quehaceres.…”

Effect of Clemastine on Neurophysiological Outcomes in an Ovine Model of Neonatal Hypoxic-Ischemic Encephalopathy

“…Although there was no significant difference in the feeding ability between the groups in our study, we did observe a trend towards poorer feeding skills in the clemastine-treated groups. It is important to note that this observation warrants thorough evaluation in a clinical setting, as neonatal HI itself can lead to feeding difficulties that may result in aspiration events [29]. We have further evaluated hemodynamic effects of clemastine administration.…”