Repeatability of the sonographic assessment of fetal sucking and swallowing movements. (25/161)

OBJECTIVE: To test the repeatability of sonography in the assessment of fetal sucking and swallowing movements. METHODS: Eighty normal fetuses of pregnant women with no systemic abnormalities were examined sonographically at 30-38 weeks of gestation. Sucking and swallowing movements were observed for 15 min and the face was visualized in frontal and lateral views. The examinations were recorded for later analysis by two independent observers and the 95% limits of agreement (Bland and Altman) method was used for inter- and intraobserver comparison. RESULTS: The mean +/- SD number of swallowing movements, sucking bursts and total sucking movements recorded by Observer 1 were 8.3 +/- 4.7, 9.9 +/- 9.3 and 35.8 +/- 48.0 and the equivalent values for Observer 2 were 8.2 +/- 4.8, 9.8 +/- 9.3 and 36.4 +/- 49.0, respectively. The mean (95% limits of agreement) interobserver difference was 0.1 (-1.4; 1.6), 0.1 (-2.2; 2.3) and -0.6 (-9.0; 7.9), and the mean (95% limits of agreement) intraobserver difference was 0.4 (-3.1; 3.9), 0.1 (-2.0; 2.2) and 1.0 (-10.7; 12.7) for swallowing movements, sucking bursts and total sucking movements, respectively. CONCLUSIONS: The high degree of intra- and interobserver repeatability disclosed in the sonographic analysis of fetal sucking and swallowing movements supports the applicability of sonographic assessment in normal fetuses.  (+info)

Does the choice of bottle nipple affect the oral feeding performance of very-low-birthweight (VLBW) infants? (26/161)

BACKGROUND: There is a continuous debate regarding the best bottle nipple to be used to enhance the bottle-feeding performance of a preterm infant. AIM: To verify that feeding performance can be improved by using the bottle nipple with the physical characteristics that enhance infants' sucking skills. METHODS: Ten "healthy" VLBW infants (941+/-273 g) were recruited. Feeding performance was monitored at two time periods, when taking 1-2 and 6-8 oral feedings/d. At each time and within 24 h, performance was monitored using three different bottle nipples offered in a randomized order. Rate of milk transfer (ml/min) was the primary outcome measure. The sucking skills monitored comprised stage of sucking, suction amplitude, and duration of the generated negative intraoral suction pressure. RESULTS: At both times, infants demonstrated a similar rate of milk transfer among all three nipples. However, the stage of sucking, suction amplitude, and duration of the generated suction were significantly different between nipples at 1-2, but not 6-8 oral feedings/d. CONCLUSION: We did not identify a particular bottle nipple that enhanced bottle feeding in healthy VLBW infants. Based on the notion that afferent sensory feedback may allow infants to adapt to changing conditions, we speculate that infants can modify their sucking skills in order to maintain a rate of milk transfer that is appropriate with the level of suck-swallow-breathe coordination achieved at a particular time. Therefore, it is proposed that caretakers should be more concerned over monitoring the coordination of suck-swallow-breathe than over the selection of bottle nipples.  (+info)

Effects of 12 days of artificial rearing on morphology of hypoglossal motoneurons innervating tongue retrusors in rat. (27/161)

The purpose of this study was to examine the influence of reduced tongue activity by artificial rearing on the morphology of motoneurons innervating the extrinsic tongue retrusors. Artificially reared rat pups were fed via gastric cannula from postnatal day 3 to postnatal day 14. Artificially reared animals and dam-reared controls had cholera toxin (subunit B) conjugate of horseradish peroxidase injected into the styloglossus to label motoneurons innervating hyoglossus and styloglossus on postnatal day 13 and postnatal day 59. Following perfusion on postnatal days 14 and 60, serial transverse sections treated with tetramethyl benzidine and counterstained neutral red were used to analyze motoneuron morphology. The shorter diameter of hyoglossus motoneurons increased with age for the dam-reared but not the artificially reared group. There was a tendency for a similar pattern for styloglossus motoneurons across the two rearing groups. The changes in form factor reflected the changes in shorter diameter for both motoneuron pools. Therefore, reducing suckling activity during normal postnatal development leads to diminished motoneuron somal growth in rats. This may also be the case in premature infants necessarily fed artificially.  (+info)

Sucrose and non-nutritive sucking for the relief of pain in screening for retinopathy of prematurity: a randomised controlled trial. (28/161)

BACKGROUND: Screening is necessary for infants at risk of retinopathy of prematurity. Despite local anaesthetic drops, infants find eye examinations distressing, displaying behavioural and physiological changes indicating acute pain. Oral sucrose and non-nutritive sucking reduce pain responses associated with invasive procedures. OBJECTIVE: To evaluate the use of oral sucrose and/or pacifier for reducing pain responses during eye examinations. METHODS: Forty infants <32 weeks gestation or <1500 g birth weight, in two neonatal units, were randomised to one of four interventions administered two minutes before their first screening examination: 1 ml sterile water as placebo (group 1, n = 10), 1 ml 33% sucrose solution (group 2, n = 10), 1 ml sterile water with pacifier (group 3, n = 9), or 1 ml 33% sucrose solution with pacifier (group 4, n = 11). Examinations were videotaped. Two observers, blind to the intervention, assessed recordings. Pain responses were scored using the premature infant pain profile (PIPP). RESULTS: The groups were similar in gestation, birth weight, and age at examination. Mean PIPP scores were 15.3, 14.3, 12.3, and 12.1 for groups 1, 2, 3, and 4 respectively. Analysis of variance showed a significant difference in PIPP score between groups (p = 0.023). Infants randomised to pacifiers scored lower than those without pacifiers (p = 0.003). There was no difference between groups receiving sucrose and those receiving water (p = 0.321). CONCLUSIONS: Non-nutritive sucking reduced distress responses in infants undergoing screening for retinopathy of prematurity. The difference in response was large enough to be detected by a validated assessment tool. No synergistic effect of sucrose and pacifier was apparent in this group.  (+info)

Electromyographic analysis of the orbicularis oris muscle in oralized deaf individuals. (29/161)

Electromyography has been used to evaluate the performance of the peribuccal musculature in mastication, swallowing and speech, and is an important tool for analysis of physiopathological changes affecting this musculature. Many investigations have been conducted in patients with auditory and speech deficiencies, but none has evaluated the musculature responsible for the speech. This study compared the electromyographic measurements of the superior and inferior fascicles of the orbicularis oris muscle in patients with profound bilateral neurosensorial hearing deficiency (deafness) and healthy volunteers. Electromyographic analysis was performed on recordings from 20 volunteers (mean age of 18.5 years) matched for gender and age. Subjects were assigned to two groups, as follows: a group formed by 10 individuals with profound bilateral neurosensorial hearing deficiency (deaf individuals) and a second group formed by 10 healthy individuals (hearers). Five clinical conditions were evaluated: suction, blowing, lip projection and compression, and production of the syllable "Pa". It was found that the deaf patients presented muscle hyperactivity in all clinical conditions, and that the inferior fascicle of the orbicularis oris muscle showed higher electromyographic activity rates, suggesting the need for a hearing-speech treatment with emphasis on oral motricity.  (+info)

Surface electromyography of facial muscles during natural and artificial feeding of infants. (30/161)

OBJECTIVE: To measure and compare the activity of the masseter, temporalis and buccinator muscles in different infant feeding methods. METHOD: Cross-sectional study of 60 full-term infants with no intercurrent diseases, aged between two and three months, classified into the following groups: 1) exclusive breastfeeding; 2) breastfeeding plus bottle-feeding; and 3) exclusive breastfeeding plus cup feeding. Surface electromyography was performed during infant feeding. The Krushal-Wallis test was used, complemented by multiple paired comparisons of the groups. A 5% significance level was chosen for the tests. RESULTS: Statistically higher results were verified in the breastfeeding group in relation to the bottle-feeding one, both in the range of movement and the mean contraction of the masseter. With regard to the temporalis muscle, statistically higher results were found in the breastfeeding group comparatively to the bottle-feeding one. As to the buccinator muscle, statistically higher results were observed in the breastfeeding group in relation to the bottle-feeding one, although in this case, the difference concerned only the range of contraction. CONCLUSION: The similarities between the muscle activity in the breastfeeding and in the cup-feeding groups suggests that cup-feeding can be used as an alternative infant feeding method, being better than bottle-feeding, due to the hyperactivity of the buccinator muscle, which could result in changes to the structural growth and development of the stomatognathic system functions.  (+info)

Relationship of the first suck burst to feeding outcomes in preterm infants. (31/161)

OBJECTIVE: This study examined the relationship between the number of sucks in the first nutritive suck burst and feeding outcomes in preterm infants. The relationships of morbidity, maturity, and feeding experience to the number of sucks in the first suck burst were also examined. METHODS: A non-experimental study of 95 preterm infants was used. Feeding outcomes included proficiency (percent consumed in first 5 min of feeding), efficiency (volume consumed over total feeding time), consumed (percent consumed over total feeding), and feeding success (proficiency >or=0.3, efficiency >or=1.5 mL/min, and consumed >or=0.8). Data were analyzed using correlation and regression analysis. RESULTS AND CONCLUSIONS: There were statistically significant positive relationships between number of sucks in the first burst and all feeding outcomes-proficiency, efficiency, consumed, and success (r=0.303, 0.365, 0.259, and tau=0.229, P<.01, respectively). The number of sucks in the first burst was also positively correlated to behavior state and feeding experience (tau=0.104 and r=0.220, P<.01, respectively). Feeding experience was the best predictor of feeding outcomes; the number of sucks in the first suck burst also contributed significantly to all feeding outcomes. The findings suggest that as infants gain experience at feeding, the first suck burst could be a useful indicator for how successful a particular feeding might be.  (+info)

Association between allergic rhinitis, bottle feeding, non-nutritive sucking habits, and malocclusion in the primary dentition. (32/161)

AIM: To determine the association between allergic rhinitis, bottle feeding, non-nutritive sucking habits, and malocclusion in the primary dentition. METHODS: Data were collected on 1160 children aged 4-5 years, who had been longitudinally followed since the age of 4 months, when they were admitted to nurseries in a suburban area of Tampico-Madero, Mexico. Periodically, physical examinations were conducted and a questionnaire was given to their parents or tutors. RESULTS: Malocclusion was detected in 640 of the children (51.03% had anterior open bite and 7.5% had posterior cross-bite). Allergic rhinitis alone (adjusted odds ratio = 2.87; 95% CI 1.57 to 5.25) or together with non-nutritive sucking habits (adjusted odds ratio = 3.31; 95% CI 1.55 to 7.09) had an effect on anterior open bite. Bottle feeding alone (adjusted odds ratio = 1.95; 95% CI 1.07 to 3.54) or together with allergic rhinitis (adjusted odds ratio = 3.96; 95% CI 1.80 to 8.74) had an effect on posterior cross-bite. Posterior cross-bite was more frequent in children with allergic rhinitis and non-nutritive sucking habits (10.4%). CONCLUSIONS: Allergic rhinitis alone or together with non-nutritive sucking habits is related to anterior open bite. Non-nutritive sucking habits together with allergic rhinitis seem to be the most important factor for development of posterior open bite in children under the age of 5 years.  (+info)