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Feeding young infants with their head in upright position reduces respiratory and ear morbidity.

ABSTRACT: The influence of feeding position of the infant in the pathogenesis of ear and airway diseases has not been well established. We investigated the influence of instructing mothers to feed their 3-month old infants with their head in an upright position on ear and respiratory morbidity during a one-year follow-up. Mothers of 88 infants were instructed by trained nurses to feed their infants with their head in upright position (intervention group). The control group consisted of 75 mothers of infants of similar socioeconomic background who fed their infants without special instructions. Both groups were followed at Maternal-Child-Health clinics. Feeding position was evaluated at the beginning and the end of the twelve-month study, and parent reported morbidity data of both groups were evaluated at every 3-month's follow-up meeting. Infants from the intervention group were fed at a more upright head position. Parameters of parent reported morbidity evaluated as area under the curve were significantly lower in infants from the intervention group concerning ear diseases, respiratory diseases, prolonged fever episodes, need of bronchodilator inhalations and antibiotic courses compared to the control group. Instructing mothers to feed infants with their head in upright position was accompanied with less morbidity and treatment burden.

SUBMITTER: Avital A

PROVIDER: S-EPMC5920104 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Feeding young infants with their head in upright position reduces respiratory and ear morbidity.

Avital Avraham A Donchin Milka M Springer Chaim C Cohen Shlomo S Danino Efrat E

Scientific reports 20180426 1

The influence of feeding position of the infant in the pathogenesis of ear and airway diseases has not been well established. We investigated the influence of instructing mothers to feed their 3-month old infants with their head in an upright position on ear and respiratory morbidity during a one-year follow-up. Mothers of 88 infants were instructed by trained nurses to feed their infants with their head in upright position (intervention group). The control group consisted of 75 mothers of infan ...[more]

PMID: 29700412

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Project description:BackgroundAlthough preterm infants often experience desaturation or bradycardia during oral feeding, specific guidelines for its management are lacking.PurposeThis study aimed to investigate the effects of a commercial thickened formula (TF) on oxygen saturation and heart rate stabilization during oral feeding in preterm infants.MethodsThis retrospective study included 122 infants born at a median (interquartile range [IQR]) 31+6 weeks (29+4 -34+6 weeks) of gestation weighing 1,725 g (1,353-2,620 g) and fed commercial cornstarch-containing TF due to feeding-associated desaturation or bradycardia. We excluded infants fed TF to treat symptomatic regurgitation. Desaturation and bradycardia events were compared between 3 days prior to the change and 3 days after the change to TF. Desaturation and bradycardia were defined as SpO2 <85% and heart rate <100 beats/min during or immediately after oral bottle feeding, respectively.ResultsThe median (IQR) postmenstrual age and weight were 36+1 weeks (34+6-38+0 weeks) and 2,395 g (2,160-2,780 g), respectively, at the time of change to TF. The frequency of desaturation significantly decreased after TF feeding (median [IQR]: 2.3 [1.3-3.3] events/day vs. 0.3 [0-1.7] events/day, P< 0.001). Bradycardia also decreased after TF feeding (0.3 [0-1] events/day vs. 0 [0-0.7] events/day, P=0.006). There were no cases of diarrhea or electrolyte abnormalities after TF feeding. Defecation frequency decreased (P=0.037), and polyethylene glycol was prescribed to 27% of the TF-fed infants. In a subgroup analysis of 16 infants with bronchopulmonary dysplasia, the frequency of desaturation was reduced (2.3 [1.8-3.8] events/day vs. 0.5 [0-1.5] events/day, P=0.042), and weight gain improved (22.5 [3.1-36.3] g/day vs. 41.3 [28.1-55.1] g/day, P=0.019), after TF feeding.ConclusionTF feeding significantly reduces oral feeding-associated oxygen desaturation and bradycardia in preterm infants. TF may be useful for stabilizing oxygen saturation and heart rate among preterm infants with difficulties in oral feeding.

Project description:In most humans, speech is predominantly processed by the left hemisphere. This auditory laterality was formerly thought to be an exclusive human characteristic, but is now suggested to have pre-human origins. In studies on auditory laterality in nonhuman animals, the head turn paradigm has become very popular due to its non-invasive character. Although there are implications that the head turn direction indicates functional dominance of the contralateral hemisphere in processing a given sound, the validity of the paradigm is under debate. To validate the paradigm via comparison with imaging or electrophysiological methods, it is first necessary to establish turning biases at the individual level. Recently, the domestic cat, a common model in hearing research, has been found to show turning biases at the group level. To assess individual turning asymmetries in cats, we repeatedly presented kitten isolation calls and assessed whether differences in conveyed arousal changed the previously described left-wards lateralisation of conspecific vocalizations. Based on responses to 50 playback presentations (25 of high and 25 of low arousal), we calculated individual head turn indices. Based on the total data set, we found no consistent individual turning bias, irrespective of call category or sex of the receiver. Although the playback paradigm was chosen carefully to reduce any effects of lateralized loudness perception or changes in motivation due to habituation, individual head turn biases changed significantly in concordance with habituation to repeated playback-presentations and was predictable by small deflections in ear position prior to listening. When splitting the data set according to a decline in responsiveness after seven playback presentations, we revealed an initial left turning bias for most of our subjects (i.e., significant at the group level). We propose that this left turning bias is related to right hemisphere dominance in processes like vigilance behaviour or general arousal rather than on auditory processing, as such. Our findings suggest that both the experimental sequence and sound level differences, induced by asymmetric ear positions, strongly influence the outcome of the head turn paradigm and should be taken into account when evaluating auditory laterality at the behavioural level.

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Feeding young infants with their head in upright position reduces respiratory and ear morbidity.

Publications

Feeding young infants with their head in upright position reduces respiratory and ear morbidity.

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