Grants and Contracts Details
Description
Feeding is arguably the most complex skill a newborn infant must master in order to achieve independent
survival. The integration of suck-swallow-breath rhythms is essential for development of effective feeding
behavior Patterns of suck-swallow-breath rhythms during feeding become more uniform as preterm infants
grow and these rhythms are disrupted in infants with bronchopulmonary dysplasia (BPD). Inability to
coordinate these rhythms may be a marker of poor neurologic outcome. Cervical auscultation (CA) with an
laccelerometer with digital signal processing (DSP) technology can be used to quantitatively compare the
sounds of infant feeding by calculating the Variance Index (VI) of swallow-associated sounds This method
has been used to show that the swallow-associated sounds of low-risk preterm infants become more uniform
with increasing post-menstrual age. As with other feeding rhythms, this progression is not seen in infants
with BPD No studies have correlated CNDSP data with developmental outcomes The objectives of this
project are: 1) to identify factors inherent in the development of stability, and sources of variability, of
swallow-associated sounds in infant feeding, 2) to correlate CNDSP measurements of swallow-associated
sounds during early rhythmic suckle feeding with long-term neurologic/developmental outcomes, 3) to
identify differences in rhythmic suckle feeding of infants with various pathologic conditions and 4) to measure
the effects of therapeutic interventions such as speech therapy on swallow-associated sounds. Objectives 1,
2 and 3 will be met with a prospective cohort study following 6 groups of infants, healthy term cohort, HIE
term cohort, drug-exposed cohort, low-risk preterm cohort, BPD cohort and a Grade IIIIIV IVH cohort (n = 25
per group) The infants will be followed from the beginning of oral feeding to two years of life. CNDSP and
biometric data will be collected during feeding. Vis will be compared between groups at various time points
and within each group over time. CNDSP data will be correllated with neurobehavioral and developmental
outcome data. By correlating the VI and other DSP parameters with behavioral and developmental data,
CNDSP data may be used to identify infants who are at higher risk of a poor long-term outcome, thus
allowing earlier developmental intervention to take place. For objective 4, we will enroll an additional 25
infants with BPD and randomize the total group so that half of the infants (25) receive speech therapy and
the other half do not. CNDSP results will be compared before and after feeding therapy. We hypothesize
that if therapy is successful, the VI for the intervention group will approximate the VI for the low-risk preterm
infants. By successfully completing these projects, we will increase our understanding of the development of
successful feeding behavior and make CNDSP technology more available as a non-invasive diagnostic
technique.
Status | Finished |
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Effective start/end date | 9/27/06 → 8/31/11 |
Funding
- National Institute of Child Health and Human Develop: $540,000.00
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