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The effects of body positioning on sucking behaviour in sick neonates
K Mizuno1, M Inoue, T Takeuchi
1Chiba Children's Hospital, Department of Neonatology, Japan. katsuorobi@aol.com
Insights
Bottle-feeding infants in the prone position improves oxygenation and breathing efficiency. This body position enhances sucking performance, potentially reducing issues associated with oral feeding in infants.
Area of Science:
- Neonatal physiology
- Pediatric nutrition
- Respiratory medicine
Background:
- Infants sometimes exhibit better oxygenation when bottle-fed in the prone position compared to the supine position.
- The underlying physiological reasons for this difference in oxygenation are not well understood.
Purpose of the Study:
- To investigate the impact of body position (prone vs. supine) on infant oral feeding performance.
- To analyze effects on sucking parameters (pressure, frequency, efficiency) and ventilation during bottle feeding.
Main Methods:
- 14 infants (12 full-term, 2 preterm) with frequent oxygen desaturation (SpO2 < 90%) during feeding were studied.
- Infants were fed in both supine and prone positions, with oxygen saturation monitored.
- Sucking pressure, ventilation volume, and tidal volume were measured using specialized equipment.
Main Results:
- The prone position led to significantly better oxygenation (97.2% vs. 92.5%) compared to the supine position.
- Tidal volume was significantly larger in the prone position (6.4 ml/kg) than in the supine position (4.9 ml/kg).
- While minute ventilation was similar, the prone position showed higher sucking pressure and frequency with shorter suck duration.
Conclusions:
- Prone positioning during bottle feeding enhances oxygenation and improves ventilation parameters in infants.
- Sucking mechanics are positively affected by the prone position, potentially mitigating feeding-related respiratory challenges.
Unlabelled:
Some infants show better oxygenation in the prone position compared to the supine position while they are bottle-fed; however, the reason for this phenomenon is not clear. The purpose of this study was to obtain a better understanding of the effects of body position on the oral feeding performance, i.e. the sucking pressure, frequency, efficiency, and ventilation. A total of 14 infants (12 full-term, 2 preterm), who often showed O2 desaturation (SpO2 < 90) during oral feeding, were enrolled in the study. The infants were fed either in the supine position or in the prone position throughout feeding. Oxygen saturation was recorded with a pulse oxymeter. The sucking pressure was measured with a 1 mm I.D. silicone tube inserted into the artificial nipple. The ventilation volume during bottle feeding was measured with a pneumotachograph. The prone position resulted in better oxygenation (97.2 +/- 0.6% prone, 92.5 +/- 0.9% supine, P < 0.05) and larger tidal volume (6.4 +/- 0.8 ml/kg prone and 4.9 +/- 0.6 ml/kg supine, P < 0.05), although the minute ventilation during bottle-feeding was not different from that in the supine position. In the prone position, the sucking pressure and frequency were higher and the duration of each suck was shorter.
Conclusion:
Sucking in the prone position may to some extent reduce disadvantages of oral feeding on ventilation.