Modulations in breathing patterns during intermittent feeding in term infants and preterm infants with bronchopulmonary dysplasia

Craig, Cathy; Lee, D N; Freer, Yvonne; Laing, Ian

doi:10.1017/s0012162299001279

Cited by 37 publications

(11 citation statements)

References 17 publications

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“…9 This may be because of issues such as irregular breathing patterns associated with oral feedings and/or delays in the normal maturation of stable suck/swallow rhythms. 16,17 Infants such as these may also benefit from a more individualized approach to oral feeding as our study proposes.…”

Section: Discussionmentioning

confidence: 95%

Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants

2007

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Objective: To study whether a cue-based clinical pathway for oral feeding initiation and advancement of premature infants would result in earlier achievement of full oral feeding.Study Design: Age of achievement of full oral intake was compared for two groups of preterm infants; a prospective study group vs historic cohort controls. Study infants had oral feedings managed by nurses using a clinical pathway that relied on infant behavioral readiness signs to initiate and advance oral feedings. Controls had oral feedings managed by physician orders.Result: Fifty-one infants (n ¼ 28 study and n ¼ 23 control) were studied. Gender distribution, gestational age, birth weight and ventilator days were not different between groups. Study infants reached full oral feedings 6 days earlier than controls (36±1 3/7 weeks of postmenstrual age (PMA) vs 36 6/7±1 4/7 weeks of PMA, P ¼ 0.02). Conclusion:The cue-based clinical pathway for oral feeding initiation and advancement of premature infants resulted in earlier achievement of full oral feeding.

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Section: Discussionmentioning

confidence: 95%

Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants

2007

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“…Craig et al found that babies with severe BPD had a lower tolerance for breathing pause during sucking and swallowing than term infants. The shorter than normal breath pauses in the BPD infants were followed by a period of irregular hyperventilation (Craig et al 1999). In some preterm infants, these periods of hyperventilation are followed by an apnea (Gryboski 1969).…”

Section: The Ventilatory Response To Hypoxiamentioning

confidence: 99%

Ventilatory control in infants, children, and adults with bronchopulmonary dysplasia

Bates

Pillers

Palta

et al. 2013

Respiratory Physiology & Neurobiology

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Bronchopulmonary dysplasia (BPD), or chronic lung disease of prematurity, occurs in ~30% of preterm infants (15,000 per year) and is associated with a clinical history of mechanical ventilation and/or high inspired oxygen at birth. Here, we describe changes in ventilatory control that exist in patients with BPD, including alterations in chemoreceptor function, respiratory muscle function, and suprapontine control. Because dysfunction in ventilatory control frequently revealed when O2 supply and CO2 elimination are challenged, we provide this information in the context of four important metabolic stressors: stresses: exercise, sleep, hypoxia, and lung disease, with a primary focus on studies of human infants, children, and adults. As a secondary goal, we also identify three key areas of future research and describe the benefits and challenges of longitudinal human studies using well-defined patient cohorts.

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“…36 It also reduces the risk of bradycardia and hypoxemia related to breathing irregularities common to preterm infants during bottle feeding. 11,12,[37][38][39][40][41][42] To prevent and/or minimize desaturation during feeding, Shiao and colleagues suggest a minimum baseline oxygen saturation of 95 percent prior to oral feeding. 12 To complete the first section of the EFS, the caregiver assesses the infant's readiness during preparation for feeding.…”

Section: Oral Feeding Readinessmentioning

confidence: 99%

The Early Feeding Skills Assessment for Preterm Infants

Thoyre

Shaker²,

Pridham³

2005

Neonatal Network

213

143

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Preterm infants develop the skills necessary to begin oral feeding as their health stabilizes and as they reach a postconceptional age that supports coordination of breathing and swallowing with oralmotor functioning. The time from initiation of oral feeding to full oral feedings (with adequate intake for growth and maintenance of physiologic stability) can vary from days to months for the preterm infant. The approach to feeding the infant during this transition period must be developmentally supportive and tailored to meet the needs of the individual. To accomplish this, caregivers-notably nurses and parents-need to communicate about the specific skills that the infant has gained, about skills that are emerging, and about skills that the infant has not yet developed. The Early Feeding Skills (EFS) Assessment is a checklist for assessing infant readiness for and tolerance of feeding and for profiling the infant's developmental stage regarding specific feeding skills: the abilities to remain engaged in feeding, organize oral-motor functioning, coordinate swallowing with breathing, and maintain physiologic stability. This article introduces the EFS.Neonatal clinicians, clinicians who work with families during the early postdischarge period, and parents of preterm infants are in an important position to observe and support the development of an emergent motor skill: oral feeding. Oral feeding skills have commonly been conceptualized by health care providers as an infant's ability to organize and coordinate oralmotor functions to efficiently consume enough calories for growth. Early feeding skills are much more complex than this, however. They also involve the infant's ability to (1) engage and remain engaged in a physiologically and behaviorally challenging task, (2) organize oralmotor movements so as to have long-term functional benefits, (3) coordinate breathing with swallowing to avoid prolonged apnea or aspiration of fluids, and (4) regulate the depth and frequency of breathing to maintain physiologic stability.Motor skill development corresponds to changes in an infant's brain, body, and experience. 1 According to research, two factors affect progression in ability to feed orally: the infant's state of health 2-6 and oral feeding experience. [7][8][9][10][11] According to other research, neuromaturation of the following contributes to an individual infant's skill in feeding: the ability to regulate oxygen, 11,12 development of alertness, 13-15 and development of sucking strength and organization of the sucking pattern. 16,17 External influences can also change the nature of the task. These include the size and speed of flow of the fluid bolus, 18-20 the impact of nasogastric tubes in place during feeding, 21 and the type of feeding support provided by the caregiver. [22][23][24][25][26] During its emergent phase, motor skill expression varies considerably. 27 Early feeding skills can vary from feeding to feeding and even across a given feeding. Some infants adapt and improve in skill as the feeding pro...

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Modulations in breathing patterns during intermittent feeding in term infants and preterm infants with bronchopulmonary dysplasia

Cited by 37 publications

References 17 publications

Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants

Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants

Ventilatory control in infants, children, and adults with bronchopulmonary dysplasia

The Early Feeding Skills Assessment for Preterm Infants

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