title: Lack of feeding progression in a preterm infant: a case study.
abstract: The purpose of this article was to present the case of a premature infant who displayed immature feeding progression because of nasal occlusion. Two male preterm infants of 33 weeks' gestational age at birth from a larger randomized trial were observed in a comparative case study. Using a prospective design, feeding assessments were conducted weekly from initiation of oral feeding until hospital discharge. Sucking organization was measured using the Medoff-Cooper Nutritive Sucking Apparatus (M-CNSA), which measured negative sucking pressure generated during oral feedings. Oral and nasogastric (NG) intake and vital signs were recorded. At 35 weeks, infant A demonstrated an immature feeding pattern with the M-CNSA NG feedings prevailing over oral feedings. When attempting to feed orally, infant A exhibited labored breathing and an erratic sucking pattern. During the third weekly feeding evaluation, nasal occlusion was discovered, the NG tube was discontinued, and phenylephrine (Neo-Synephrine) and humidified air were administered. Following treatment, infant A's sucking pattern normalized and the infant maintained complete oral feeding. Infant B demonstrated normal feeding progression. Nasal occlusion prevented infant A from achieving successful oral feeding. The M-CNSA has the ability to help clinicians detect inconsistencies in the sucking patterns of infants and objectively measures patterns of nutritive sucking. The M-CNSA has the potential to influence clinical decision making and identify the need for intervention.
authors.affiliation: Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA. rwt@uic.edu
authors.forename: Rosemary
authors.initials: R
authors.lastname: White-Traut
authors.forename: Nicole
authors.initials: N
authors.lastname: Shapiro
authors.forename: Elissa
authors.initials: E
authors.lastname: Healy-Baker
authors.forename: Lina
authors.initials: L
authors.lastname: Menchavez
authors.forename: Kristin
authors.initials: K
authors.lastname: Rankin
authors.forename: Barbara
authors.initials: B
authors.lastname: Medoff-Cooper
mesh_terms: D001835:Body Weight; D001903:Bottle Feeding / Q000379:methods; D001942:Breast Feeding / Q000379:methods; D016022:Case-Control Studies; D002657:Child Development / Q000502:physiology*; D005247:Feeding Behavior; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015508:Nasal Obstruction / Q000150:complications / Q000175:diagnosis; D009752:Nutritional Status; D011446:Prospective Studies; D018570:Risk Assessment; D013391:Sucking Behavior / Q000502:physiology*