Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
2 results
Search Results
Item Physiological parameters of breast-feeding in pre-term and full-term infants with feeding disorders(University of Kelaniya, Sri Lanka, 2022) Prasangi, N.T.P.G.B.; Dharmarathna, N.I.Background: Breastfeeding is the most effective technique of supplying nutrients to young infants for proper growth and development. This method uses a variety of instruments and procedures, but they all rely on factual observation. The purpose of the study was to describe physiological parameters of breast-feeding in pre-term and full-term infants with feeding disorders, in order to identify physiological manifestations of breast-feeding leading to feeding disorders in infants, as well as to determine the physiological differences of breast-feeding between preterm and full-term born infants. Methods: This research was an observational, cross-sectional study. The study setting was the Feeding/ Swallowing Support Clinic, Ayati Center, Ragama. Fifty-three (n=53) breast feeding infants from 0-12 months were used for this quantitative research study to collect video recordings of breast-feeding sessions. The videos were recorded at the middle of the breast-feeding sessions and the duration was about two minutes. Twenty (20) videos were randomly selected for the Inter-rater reliability test. The physiological parameters were collected after analysing the videos. Quantitative data analysis was conducted using SPSS (version 26.0) software. Results: We found excellent inter-rater reliability to obtain the selected set of physiological parameters of breast feeding in infants. Significant differences were reported in oxygen saturation measures (t=2.848, df =14.967, P=0.019), respiratory frequency (t=2.635, df=14.967, P=0.019) and changes in pulse rate (t= 2.933, df=50.967, P=0.005) during feeding between pre-term infants and term infants. Significantly higher oxygen saturation levels were reported in full-term infants compared to that of pre-term infants, which may indicate atypical suck-swallow-breathe coordination in pre-term infants. Pearson correlation test revealed that milk intake per feed significantly increased when the gestational age increased (r (52) = 0.444, P = <.001). Conclusion: This study shows that understanding breast-feeding with objective parameters is feasible and reliable during clinical feeding assessment, with an innovative approach to incorporate video recorded data. These measures are easy-to-obtain and no additional cost is required. This method highlights the importance of understanding the unique suck-swallow-breathe coordination in breast-feeding infants. Further, the significant physiological differences of the breast-feeding mechanism between pre-term and full-term infants will help clinicians to understand whether a preterm infant is ready to be orally fed and to compare their suck-swallow skills over time and over intervention objectively.Item Physiological differences between breast-feeding and bottle-feeding in pre-term infants(University of Kelaniya, Sri Lanka, 2022) Perera, D.T. K.; Dharmarathna, I.; Udugama, L.Background: Infants who breastfeed must have the ability to coordinate their sucking, swallowing, and breathing to achieve their nutritional and hydration needs while protecting their airways. The need for new non-invasive approaches to get objective physiological parameters of suck-swallow-breathe coordination is considerable because the gold standard, videofluoroscopy (VFSS) cannot evaluate breast feeding and FEES cannot evaluate suck-swallow physiology. Objectives: The objectives of the study were to obtain physiological parameters of the suck-swallow-breathe coordination in a cohort of premature milk-sucking infants; describe the physiological differences between breast and bottle feeding in premature infants; and determine the associations of the selected demographic factors with the physiological measures of suck- swallow-breathe coordination in premature infants. Methods: This observational cross-sectional study used a purposive sampling method to recruit sixty-two (n=62) premature (≤ 37 weeks) infants from birth to 12 months who are breastfeeding and/or bottle-fed. One-two minute video recordings of breast-feeding/ bottle-feeding capturing sucking and swallowing movements were obtained. A set of objective physiological parameters of suck-swallow-breathe coordination were measured by analysing the video recordings. Results: Excellent inter-rater reliability was reported for all the physiological parameters used in this study (ICC= .89-.98, 95% CI [.86-.1.00], p< .001). When means were compared, a significant difference was reported in the feed duration between breast-feeding and bottle-feeding (t= 3.667, df=39.765, P=.001). Further, significant differences were reported in the number of pauses (t= 4.011, df=54.813, P<0.001), changes in levels of oxygen saturation during feeding (t= 2.456, df= 59.919, P= .017), changes in heart rate during feeding (t= 2.441, df= 55.919, P= .018), milk intake per minute (t= 6.542, df= 44.636, P<0.001), suck frequency (t= 4.093, df= 52.175 , P<0.001) and swallow frequency (t= 4.339, df=50.867, P<0.001) between breast-feeding and bottle-feeding in premature infants. In the Pearson correlation test, duration of feeding decreased as the gestational age of infant increased (r (61) = -.252, P= .048). Similarly, feeding duration was significantly shorter in infants with a higher gestational week at birth (r (61) =-0.309 P = 0.015). Furthermore, with an increased chronological age of the infants, the number of pauses during feeding decreased significantly (r (61) = -0.308 P = 0.015). Further, in infants with higher gestational weeks at birth (r (61) = 0.351 P = 0.005) and infants with increased weight (r (61) = .273 P = 0.032), milk intake per minute increased significantly. Also, milk intake per minute showed a significant increase in premature infants with increased gestational age at birth (r (61) = .351 P = .005) and with the current weight of the premature infants (r (61) = .273 P = .032). Conclusion: This research showed that bottle feeding, and breastfeeding have been associated with significant physiological changes in premature infants, which is supported by the reviewed research. By providing objectivity to its findings and its interpretation, this study provides a reliable and feasible method for improving the accuracy and reliability of clinical feeding assessments of infants. This unique method is a safe and effective way to gather objective physiological parameters of coordinated suck-swallow-breathe for therapists who do not have access to instrumental swallowing assessment.