Recognizing and Resolving Infant Suck Difficulties

Palmer, Marjorie Meyer

doi:10.1177/089033440201800208

Cited by 13 publications

(6 citation statements)

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“…Full oral feeding (FOF), defined as oral feeding of more than 100 ml per kg per day without tube feeding for more than 48 h, was checked based on the evaluation time. A video was recorded to score the Neonatal Oral-Motor Assessment Scale (NOMAS) ( 20 , 21 ), and this was independently evaluated by two NOMAS-certified rehabilitation medicine specialists. The video was recorded for 2 min from the time the sucking motion started in the lateral view so that the mouth, jaw, and neck motions could be clearly seen.…”

Section: Methodsmentioning

confidence: 99%

“…The video was recorded for 2 min from the time the sucking motion started in the lateral view so that the mouth, jaw, and neck motions could be clearly seen. Sucking difficulties were categorized into normal, disorganized, and dysfunctional sucking patterns according to the classification of the original NOMAS version ( 20 ). Most of measurements were obtained once per participant.…”

Section: Methodsmentioning

confidence: 99%

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Quantitative non-nutritive sucking measurement as a predictor of oral feeding readiness in newborns

et al. 2023

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Background and purposeThe purpose of this study is to examine the relationship between the parameters of a silver nanowire-based flexible pressure sensor developed to measure the non-nutritive sucking (NNS) performance and predict the nutritive sucking status in preterm infants.MethodsPreterm infants who were referred for feeding difficulty during the transition period from tubal feeding to oral feeding were enrolled in our study. A flexible pressure sensor was used to measure the non-nutritive sucking parameters of neonates. The evaluator stimulated the infants' lips and tongue with a pacifier integrated with a sucking pressure sensor, to check whether non-nutritive sucking had occurred. When the sucking reflex was induced, it was measured. The infants' sucking characteristics were subdivided into classifications according to the NOMAS criteria and full oral feeding (FOF) status. Quantitative NNS measurement according to the feeding state was compared between groups.ResultsWhen comparing the quantitative NNS measurement by feeding characteristics, the average sucking pressure was significantly higher in infants in the FOF capable group than those in the incomplete FOF group. In addition, the maximum and average sucking pressure was significantly higher in infants with a normal sucking pattern compared to those with a disorganized sucking pattern. The average NNS pressure was divided over the range of 0–3 kPa and the same weight was assigned to each item. When the optimal cut-off value for the sensitivity and specificity of the average NNS pressure to estimate the FOF was set, a pressure of 1.5 kPa yielded the highest sensitivity (84.62%) and specificity (67.65%) on the receiver operating characteristic (ROC) curve. The area under the curve (AUC) was 0.786, and this result was statistically significant.ConclusionsThis study presents a quantitative parameter for non-nutritive sucking in preterm infants with the use of a flexible pressure sensor. Results show possible quantitative indicators that can aid in predicting when preterm infants can transition to oral feeding and their prognosis. This will serve as a basis for future research on determining the feeding transition period of newborns with health conditions that affect oral feeding.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Quantitative non-nutritive sucking measurement as a predictor of oral feeding readiness in newborns

et al. 2023

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“…The term “feeding difficulty” is used to express the problem of swallowing in the broad sense, including all states that do not allow FOF. If the abnormality of oromotor function is thought to be the cause of feeding difficulty, the evaluation is often performed to distinguish between the disorganized sucking pattern and the dysfunctional sucking pattern to interpret feeding difficulty ( 11 – 13 ). The disorganized sucking pattern refers to a lack of rhythm of the total sucking activity.…”

Section: Introductionmentioning

confidence: 99%

“…The Neonatal Oral-Motor Assessment Scale (NOMAS) is a method of visual observation that is used to assess non-nutritive and nutritive sucking in an infant from birth to 48 weeks of postmenstrual age (PMA) ( 11 , 12 ). The NOMAS consists of 28 items: 14 related to movements of the tongue and 14 related to movements of the jaw.…”

Section: Introductionmentioning

confidence: 99%

“…The NOMAS consists of 28 items: 14 related to movements of the tongue and 14 related to movements of the jaw. Both movements are classified into three groups: normal, disorganization, and dysfunction ( 11 – 13 ). da Costa et al reported that incoordination, under disorganization on the NOMAS, was more prevalent in preterm infants with bronchopulmonary dysplasia (BPD) than those without BPD ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants

Shin

et al. 2018

Front. Pediatr.

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Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included. Video recordings of at least 2 min of oral feeding were further analyzed retrospectively by two assessors and the premature infants who exhibited disorganized sucking patterns (n = 109) were divided into three clusters (clusters 2–4). The observational items compatible with disorganization in the original NOMAS were divided into three groups: cluster 2 (disorganized: arrhythmical), cluster 3 (disorganized: arrhythmical + unable to sustain), and cluster 4 (disorganized: arrhythmical + incoordination ± unable to sustain) and further divided into incoordination-positive (cluster 4) and incoordination-negative groups (clusters 2 and 3). Premature infants in the incoordination-positive group (cluster 4, which means stress signals) showed a median transition time of 22 days (range: 4–121 days) which was longer than that in the incoordination-negative group (median 6 days; range: 1–25 days). Univariate linear regression analysis revealed that the presence of incoordination among disorganized sucking patterns (NOMAS cluster 4 vs. clusters 2 and 3), birth weight, total parenteral nutrition (TPN) duration, non-invasive positive pressure ventilation duration, the presence of moderate to severe bronchopulmonary dysplasia, pulmonary hypertension, sepsis, small for gestational age (SGA), and necrotizing enterocolitis are associated with the transition time to FOF. In a multivariate linear regression analysis, the variables revealed to be associated with the transition time were TPN duration, SGA, and the presence of stress signals (incoordination-positive group) among disorganized sucking patterns. When selecting premature infants to be treated with swallowing therapy, it is reasonable to pay more attention to the incoordination-positive group described in the NOMAS, that is, premature infants with stress signals to shorten the time to attain FOF.

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Assessment of infant oral sensorimotor and swallowing function

Rogers

Arvedson

2005

Ment. Retard. Dev. Disabil. Res. Rev.

112

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The development of feeding and swallowing is the result of a complex interface between the developing nervous system, various physiological systems, and the environment. The purpose of this article is to review the neurobiology, development, and assessment of feeding and swallowing during early infancy. In recent years, there have been exciting advances in our understanding of the physiology and neurological control of feeding and swallowing. These advances may prove useful in furthering our understanding of the pathophysiology of dysphagia in infancy. Progress in developing standardized, reliable, and valid measures of oral sensorimotor and swallowing function in infancy has been slow. However, there have been significant advances in the instrumental analysis of feeding and swallowing disorders in infancy, including manometric analyses of sucking and swallowing, measures of respiration during feeding, videofluoroscopic swallow evaluations, ultrasonography, and flexible endoscopic examination of swallowing. Further efforts are needed to develop clinical evaluative measures of dysphagia in infancy.

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Recognizing and Resolving Infant Suck Difficulties

Cited by 13 publications

References 3 publications

Quantitative non-nutritive sucking measurement as a predictor of oral feeding readiness in newborns

Quantitative non-nutritive sucking measurement as a predictor of oral feeding readiness in newborns

Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants

Assessment of infant oral sensorimotor and swallowing function

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