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Changes in rhythmic suckle feeding patterns in term infants in the first month of life
Misbah A Qureshi1, Frank L Vice, Vicki L Taciak
1University of Maryland School of Medicine, Department of Pediatrics, UMMS, Baltimore 21201, USA.
Insights
Healthy term infants develop more organized and efficient suckle feeding patterns within their first month of life. This study tracks changes in suck and swallow rates, run organization, and feeding efficiency in newborns.
Area of Science:
- Neonatal physiology
- Infant feeding behavior
- Developmental pediatrics
Background:
- Suckle feeding is crucial for infant growth and development.
- Understanding normal feeding patterns in healthy term infants is essential for identifying deviations.
Purpose of the Study:
- To quantify parameters of rhythmic suckle feeding in healthy term infants.
- To assess developmental changes in suckle feeding during the first month of life.
Main Methods:
- Pharyngeal and nipple pressure were recorded in 16 healthy term infants.
- Measurements were taken at 1-4 days of age and again at 1 month.
Main Results:
- Suck rate increased from 55/min to 70/min; swallow rate increased from 46/min to 50/min.
- Feeding efficiency (volume per suck/swallow) nearly doubled.
- Rhythmic stability of suck and swallow patterns was established by term, with increased variability in suck-swallow ratios by 1 month.
Conclusions:
- Term infants exhibit significant developmental changes in suckle feeding within the first month.
- These changes indicate improved organization and efficiency, with established rhythmic stability by term.
- This data provides a gold standard for assessing high-risk infants and identifying potential neurodevelopmental or feeding issues.
Abstract:
To quantify parameters of rhythmic suckle feeding in healthy term infants and to assess developmental changes during the first month of life, we recorded pharyngeal and nipple pressure in 16 infants at 1 to 4 days of age and again at 1 month. Over the first month of life in term infants, sucks and swallows become more rapid and increasingly organized into runs. Suck rate increased from 55/minute in the immediate postnatal period to 70/minute by the end of the first month (p<0.001). The percentage of sucks in runs of > or =3 increased from 72.7% (SD 12.8) to 87.9% (SD 9.1; p=0.001). Average length of suck runs also increased over the first month. Swallow rate increased slightly by the end of the first month, from about 46 to 50/minute (p=0.019), as did percentage of swallows in runs (76.8%, SD 14.9 versus 54.6%, SD 19.2; p=0.002). Efficiency of feeding, as measured by volume of nutrient per suck (0.17, SD 0.08 versus 0.30, SD 0.11 cc/suck; p=0.008) and per swallow (0.23, SD 0.11 versus 0.44, SD 0.19 cc/swallow; p=0.002), almost doubled over the first month. The rhythmic stability of swallow-swallow, suck-suck, and suck-swallow dyadic interval, quantified using the coefficient of variation of the interval, was similar at the two age points, indicating that rhythmic stability of suck and swallow, individually and interactively, appears to be established by term. Percentage of sucks and swallows in 1:1 ratios (dyads), decreased from 78.8% (SD 20.1) shortly after birth to 57.5% (SD 25.8) at 1 month of age (p=0.002), demonstrating that the predominant 1:1 ratio of suck to swallow is more variable at 1 month, with the addition of ratios of 2:1, 3:1, and so on, and suggesting that infants gain the ability to adjust feeding patterns to improve efficiency. Knowledge of normal development in term infants provides a gold standard against which rhythmic patterns in preterm and other high-risk infants can be measured, and may allow earlier identification of infants at risk of neurodevelopmental delay and feeding disorders.