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IEEE Journal of Translational... 2023Infant breastfeeding diagnostics remain subjective due to the absence of instrumentation to objectively measure and understand infant oral motor skills and suckling...
Infant breastfeeding diagnostics remain subjective due to the absence of instrumentation to objectively measure and understand infant oral motor skills and suckling characteristics. Qualitative diagnostic exams, such as the digital suck assessment which relies upon a clinician's gloved finger inserted into the infant's mouth, produce a diversity of diagnoses and intervention pathways due to their subjective nature. In this paper, we report on the design of a non-nutritive suckling (NNS) system which quantifies and analyzes quantitative intraoral vacuum and sucking patterns of full-term neonates in real time. In our study, we evaluate thirty neonate suckling profiles to demonstrate the technical and clinical feasibility of the system. We successfully extract the mean suck vacuum, maximum suck vacuum, frequency, burst duration, number of sucks per burst, number of sucks per minute, and number of bursts per minute. In addition, we highlight the discovery of three intraoral vacuum profile shapes that are found to be correlated to different levels of suckling characteristics. These results establish a framework for future studies to evaluate oromotor dysfunction that affect the appearance of these signals based on established normal profiles. Ultimately, with the ability to easily and quickly capture intraoral vacuum data, clinicians can more accurately perform suckling assessments to provide timely intervention and assist mothers and infants towards successful breastfeeding outcomes.
Topics: Female; Humans; Infant; Infant, Newborn; Breast Feeding; Eating; Mouth; Sucking Behavior; Vacuum; Pacifiers
PubMed: 36619906
DOI: 10.1109/JTEHM.2022.3231788 -
Maternal and Child Health Journal Feb 2023To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices.
METHODS
We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models.
RESULTS
The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format.
CONCLUSION
Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.
Topics: Female; Humans; Infant; Male; Infant Care; Infant Equipment; Parents; Pediatricians; Sleep; Sudden Infant Death; Blogging
PubMed: 36604380
DOI: 10.1007/s10995-022-03579-z -
HSOA Journal Neonatology & Clinical... 2022Seventy percent of preterm infants experience challenges with oral feeding and commonly require tube feedings. Yet it is not well understood how these behaviors change...
PURPOSE
Seventy percent of preterm infants experience challenges with oral feeding and commonly require tube feedings. Yet it is not well understood how these behaviors change over time while infants are receiving tube feedings only and through the transition to oral feedings. The purpose of this pilot study was to describe the change in behaviors surrounding feeding and with respect to advancing Post Menstrual Age (PMA) for preterm infants who received extended tube feedings during hospitalization in the Neonatal Intensive Care Unit (NICU).
METHODS AND MEASURES
A prospective pilot study was conducted in a NICU. We recruited thirty-five infants who were born between 28 to 32 weeks gestational age and expected to have at least two weeks of tube feedings. Infant health status and feeding progression were obtained from the medical record. Behaviors surrounding feeding included infant state, social interactive behaviors, orally directed behaviors, and hunger/satiation cues were evaluated via weekly recorded videos.
RESULTS
During the pre-feeding segment, we noted an increase over time for awake, facial gaze, gaze aversion, tongue protrusion, fussing, mouthing, vocalization, and interest in the pacifier. During the intra-feeding segment, we found an increase over time for fussing, and a decrease for eye widening, eye searching, and vocalization.
CONCLUSION
To our knowledge, this was the first pilot study to comprehensively describe the changes in behaviors surrounding feeding over time and with respect to advancing PMA for preterm infants who received extended tube feedings during the NICU hospitalization. Infants demonstrated distinct behaviors surrounding feeding as young as 28 weeks post menstrual age. These behaviors may vary among infants and change significantly with advancing post-menstrual age. Assessment of subtle behaviors surrounding feeding is important to ensure oral feeding readiness.
PubMed: 36590457
DOI: 10.24966/ncp-878x/100092 -
The Cleft Palate-craniofacial Journal :... May 2024To describe current postoperative management practices following cleft palate repair.
OBJECTIVE
To describe current postoperative management practices following cleft palate repair.
DESIGN
A survey was administered to cleft surgeons to collect information on their demographic characteristics, surgical training, surgical practice, and postoperative management preferences.
SETTING
Eighteen tertiary referral hospitals across the United States.Participants: Surgeons (n = 67) performing primary cleft palate repair.
RESULTS
Postoperative diet restrictions were imposed by 92% of surgeons; pureed foods were allowed at one week after surgery by 90% of surgeons; a regular diet was allowed at one month by 80% of surgeons. Elbow immobilizers and/or mittens were used by 85% of surgeons, for a median duration of two weeks. There was significant disagreement about postoperative use of bottles (61% allow), sippy cups (68% allow), pacifiers (29% allow), and antibiotics (45% prescribe). Surgeon specialty was not associated with any aspect of postoperative management ( > 0.05 for all comparisons). Surgeon years in practice, a measure of surgeon experience, was associated only with sippy cup use ( < 0.01). The hospital at which the surgeon practiced was associated with diet restrictions ( < 0.01), bottle use ( < 0.01), and use of elbow immobilizers or mittens ( < 0.01); however, many hospitals still had disagreement among their surgeons.
CONCLUSIONS
Surgeons broadly agree on diet restrictions and the use of elbow immobilizers or mittens following palate repair. Almost all other aspects of postoperative management, including the type and duration of diet restriction as well as the duration of immobilizer use, are highly individualized.
Topics: Humans; United States; Cleft Palate; Surveys and Questionnaires; Surgeons; Postoperative Period; Postoperative Complications; Cleft Lip
PubMed: 36536584
DOI: 10.1177/10556656221146891 -
MCN. the American Journal of Maternal...A large community hospital in South Texas began distributing safe sleep baby boxes to reduce sudden unexplained infant death (SUID) in 2017.
BACKGROUND
A large community hospital in South Texas began distributing safe sleep baby boxes to reduce sudden unexplained infant death (SUID) in 2017.
PURPOSE
To describe safe sleep practices among new mothers who received a safe sleep baby box at hospital discharge.
METHODS
An information sheet containing a link to an online survey was mailed to all women who received a safe sleep baby box prior to discharge from the hospital from January 2018 to January 2019.
RESULTS
N = 84 women participated. Most reported using the safe sleep baby box only during nap time (n = 62, 88.6%). Only 70.2% of participants reported that baby always slept their back (n = 59). Most reported their baby did not use a pacifier (n = 62, 73.8%), and many reported they were not breastfeeding their baby (n = 38, 45.2%).
CLINICAL IMPLICATIONS
Many women were not using the safe sleep baby box as intended and were not following many of the other safe sleep guidelines. Nurses should ask their patients about plans for infant safe sleep after discharge to provide individualized education or recommend specific resources to address the family's needs.
Topics: Infant; Humans; Female; Child; Sudden Infant Death; Patient Discharge; Mothers; Breast Feeding; Sleep; Hospitals; Infant Care
PubMed: 36469892
DOI: 10.1097/NMC.0000000000000880 -
Frontiers in Epidemiology 2022Infant non-nutritive suck (NNS) has been used as an early marker of neonatal brain function. Although there is an established relationship between prenatal exposure to...
BACKGROUND/AIM
Infant non-nutritive suck (NNS) has been used as an early marker of neonatal brain function. Although there is an established relationship between prenatal exposure to certain metals and brain development, the association between metal exposure and NNS has not been explored. Therefore, in this study we assessed associations between maternal urinary metal(loid) concentrations and NNS measurements among infants from the Puerto Rico PROTECT birth cohort. We hypothesized that maternal urinary metal(loid) concentrations are significantly associated with infant NNS measures in a sex-dependent manner.
METHODS
We measured urinary concentrations of 14 metal(loid)s in pregnant women at up to three time points in pregnancy. The geometric mean of each metal(loid) for each pregnant woman was calculated and used as an exposure measurement across gestation. NNS measurements (duration, frequency, amplitude, bursts/min, cycles/burst, cycles/min) were collected from infants between 4 and 6 (±2 weeks) weeks of age using our custom research pacifier. Linear regression was used to estimate associations between urinary metal(loid) concentrations across pregnancy and continuous NNS variables. Sex-specific effects were estimated using interaction terms between NNS variables and infant sex.
RESULTS
We observed significant positive associations between mercury, manganese, and tin with NNS duration (mercury: %Δ = 1.08, 95% CI: 0.42, 1.74; manganese: %Δ = 0.67, 95% CI: 0.15, 1.20; tin: %Δ = 0.83, 95% CI: 0.17, 1.49) and NNS cycles/burst (mercury: %Δ = 1.85, 95% CI: 0.58, 3.11; manganese: (%Δ = 1.37, 95% CI: 0.40, 2.34; tin: %Δ = 1.68, 95% CI: 0.46, 2.91). Furthermore, the association between NNS cycles/min with cadmium (%Δ = 8.06, 95% CI: 3.33, 12.78), manganese (%Δ = 4.44, 95% CI: 1.40, 7.47), and tin (%Δ = 4.50, 95% CI: 0.81, 8.18) were in the opposite direction from its association with zinc (%Δ = -9.30, 95% CI: -14.71, -3.89), as well as with copper (%Δ = -6.58, 95% CI: -12.06, -1.10). For the sex-stratified analysis, the negative associations between metal(loid)s and NNS duration were predominantly driven by male infants; however, the negative associations between metal(loid)s and NNS bursts/min were mainly driven by female infants.
CONCLUSION
We observed significant associations between prenatal metal(loid) exposure and NNS measurements among infants from the ongoing Puerto Rico PROTECT cohort. Similar to previous studies that have demonstrated associations between NNS and subsequent neurodevelopment, this study highlights the potential of NNS as a quantitative index to measure altered neurodevelopment from prenatal metal(loid) exposures. We believe this study will inform future efforts aimed at reducing health risks related to early life metal exposures, such as developing early identification of metal-induced adverse outcomes in child neurodevelopment.
PubMed: 38455310
DOI: 10.3389/fepid.2022.1057515 -
International Journal of Dentistry 2022This study aimed to evaluate the impact of nonnutritive sucking habits on the presence of oral .
OBJECTIVES
This study aimed to evaluate the impact of nonnutritive sucking habits on the presence of oral .
METHODS
One hundred and twenty children aged 3-5 years old were enrolled in the present case-control study, as follows: 60 children with continuous pacifier and thumb sucking habits (study group) and 60 children without any sucking habits (control group). The children in the two groups were matched in terms of age and gender. Information was gathered from the parents concerning their children using a special sheet. Sterile swabs were taken from both groups and cultured on agar plates. Then, they were subjected to further biochemical tests to identify species. The mean of the count was determined for each child. Descriptive, independent -test and chi-square test statistics were used. The level of significance was set at < 0.05.
RESULTS
The presence of nonnutritive sucking habits was related to a higher carriage of among children.
CONCLUSION
Nonnutritive sucking habits may act as a predisposing factor that enhances the colonization of oral .
PubMed: 36419951
DOI: 10.1155/2022/1216727 -
Journal of Family Medicine and Primary... Aug 2022Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health,...
BACKGROUND
Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health, there is a dearth of comprehensive studies covering all important aspects of infant care in an individual study.
OBJECTIVES
To determine practices regarding infant feeding, infant sleep, use of pacifiers, and immunization, and to explore the association of these practices with mother's demographic data.
METHODS
A cross-sectional study was conducted using a self-administrated questionnaire distributed among mothers attending well-baby clinics in Primary Health Care Centers (PHCCs), Unaizah city, Qassim region, Saudi Arabia. By using the two-stage cluster sampling method, 50 women participated from each of the four selected PHCCs, leading to a total of 200 participants. The survey was conducted from December 2020 to February 2021. Data were analyzed using SPSS software.
RESULTS
A total of 124 (62%) respondents were between the ages of 26 and 35 years, 64% had a bachelor's degree, and 69.5% were housewives. Breastfeeding was practiced by 88% of women, 48% began infant weaning at 6 months of age, and 49% put their infant to sleep on their back. Up-to-date vaccination was reported for 188 (94%) infants. Infant pacifier use was reported by 58% of the respondents, and 82.5% of the participants had been offered formula milk for the newborn at the hospital. Vaginal delivery, absence of complications during pregnancy or labor, presence of a housemaid, and family income of more than 10,000 Saudi Riyals were significantly associated with better infant care practices.
CONCLUSION
The study participants have good practices for certain infant care aspects such as immunization; however, improvement is needed for other practices, including weaning at the proper age, infant sleep position, and the use of pacifiers. Administrative measures are required to monitor the use of formula milk at hospitals and to enhance health education for mothers.
PubMed: 36353048
DOI: 10.4103/jfmpc.jfmpc_329_22 -
Revista Latino-americana de Enfermagem 2022to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant's life.
OBJECTIVE
to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant's life.
METHOD
this is a cohort study of 105 adolescent mothers followed at the child's 2-, 4- and 6-months of age. The epidemiological approach was adopted, supported by the positivism paradigm. Exposure variables were those directly related to breastfeeding and sociodemographic, family, maternal and child conditions. Data were collected by interview and analyzed by bivariate and multivariate statistics. The Hazard Ratio (HR) was calculated with a 95% confidence interval (95%CI). The tests were performed, admitting an error type I of 5%. The confidentiality of data was ensured.
RESULTS
the cumulative incidences of exclusive breastfeeding abandonment were 33.3%, 52.2% and 63.8%, at 2, 4 and 6 months, respectively. The variables that remain in the final multivariate model were maternal perception of milk quality (HR=11.6; 95%CI 3.6-37.5), pacifier use (HR=1.9; 95%CI 1.2-3.3), and time of first breastfeeding session (HR=1.4; 95%CI 0.5-12.9).
CONCLUSION
the highest abandonment rate occurs before the fourth month. A perception of having poor-quality milk by the adolescent mother and pacifier use are factors that favor the abandonment of exclusive breastfeeding. Determining the factors associated with breastfeeding abandonment may allow their timely management, especially in more vulnerable populations.
KEYPOINTS
(1) The highest abandonment rate of exclusive breastfeeding occurs before the fourth month. (2) A perception of having poor-quality milk may increase the abandonment of exclusive breastfeeding. (3) Pacifier use may increase the abandonment of exclusive breastfeeding. (4) Knowing the factors associated with exclusive breastfeeding may allow for timely management of them. (5) Exclusive breastfeeding promotion strategies must be adopted early, before and after birth.
Topics: Infant; Adolescent; Pregnancy; Female; Child; Humans; Breast Feeding; Cohort Studies; Adolescent Mothers; Health Services; Parturition; Mothers
PubMed: 36351091
DOI: 10.1590/1518-8345.6252.3786 -
Cureus Sep 2022Introduction Communication is the exchange of information through speaking, writing, and other mediums. Speech is the expression of thoughts in spoken words. Language is...
Introduction Communication is the exchange of information through speaking, writing, and other mediums. Speech is the expression of thoughts in spoken words. Language is the principal method that humans use for relaying information; consisting of words conveyed by speech, writing, or gestures. Language is the conceptual processing of communication. Problems in communication or oral motor function are called speech and language disorders. Developmental delay is diagnosed when a child does not attain normal developmental milestones at the expected age. Speech and/or language disorders are amongst the most common developmental difficulties in childhood. Such difficulties are termed 'primary' if they have no known etiology, and 'secondary' if they are caused by another condition such as hearing and neurological impairment, and developmental, behavioral, or emotional difficulties. Objectives The objective of our study was to observe the risk factors for speech and language delay in the children presenting to the speech therapy clinic of a tertiary care hospital in a large urban center. Methodology A cross-sectional study was conducted on 150 children presenting at the speech therapy clinic of Lahore General Hospital from July to August 2021. A well-designed questionnaire was used to collect data about the sociodemographic profile, and biological, developmental, and environmental risk factors of speech and language delay in children. SPSS, version 25 (IBM Corp., Armonk, NY) was used to enter and analyze the data. Results Parents or caretakers of a total of 98 male and 52 female children took part in this study aged 2-11 years. The average age of speech and language delay among the children was 5.65 years, 66.7% of which went to normal school while 31.3% went to special school; 66.7% were from urban areas. Around 60% had middle ear infections, and 34.7% were found to have oropharyngeal anomalies. A history of intrapartum complications was found in 68.4% of children; 46.7% of children had a history of use of a pacifier and 38% had a history of thumb sucking. Nearly 39% of children belonged to a multilingual family environment and 66.7% had a family history of screen viewing for more than two hours. Conclusion The major risk factors contributing to speech and language delay in children are family history of speech and language delay, prolonged sucking habits, male gender, oropharyngeal anomalies, hearing problems, and middle ear infections. Measures should be taken to educate people regarding risk factors, courses, and management of speech and language delay in children.
PubMed: 36320964
DOI: 10.7759/cureus.29623