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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal feeding performance as a predictor of neurodevelopmental outcome at 18 months
1Chiba Children's Hospital, Division of Neonatology, 579-1, Heta-cho, Midori-ku, Chiba City, Chiba, Japan 266-0007. katsuorobi@aol.com
Insights
Neonatal feeding performance in infants with feeding problems can predict neurodevelopmental outcomes at 18 months. Early feeding assessments offer higher sensitivity and specificity than ultrasounds for detecting developmental issues.
Area of Science:
- Neonatology
- Neurodevelopmental Pediatrics
- Pediatric Feeding Disorders
Background:
- Infants with feeding problems often face challenges in neurodevelopmental progression.
- Predictive markers for neurodevelopmental outcomes in at-risk infants are crucial for early intervention.
- Existing methods like brain ultrasound have limitations in predicting long-term outcomes.
Purpose of the Study:
- To investigate the predictive value of neonatal feeding performance on neurodevelopmental outcomes at 18 months of age.
- To compare the prognostic accuracy of feeding assessments with brain ultrasound findings.
- To identify early indicators of potential developmental delays in infants with feeding difficulties.
Main Methods:
- Sixty-five infants with feeding problems underwent feeding performance assessments (expression, sucking pressures) at 1-2 weeks post-oral feeding initiation.
- Feeding performance was categorized into four classes based on suction and expression patterns.
- Neurodevelopmental outcomes were evaluated at 18 months using the Bayley Scales of Infant Development-II.
- Brain ultrasounds were performed on the day of feeding assessment for comparison.
Main Results:
- A significant correlation (p < 0.001) was found between neonatal feeding assessment and 18-month neurodevelopmental outcomes.
- Improved feeding patterns at the second assessment correlated with better neurodevelopmental outcomes.
- Feeding performance assessment demonstrated higher sensitivity and specificity compared to ultrasound in predicting outcomes.
Conclusions:
- Neonatal feeding performance is a valuable prognostic tool for identifying infants at risk of future developmental problems.
- Early and repeated feeding assessments can provide crucial insights into neurodevelopmental trajectories.
- Feeding assessment offers a more accurate and sensitive method for predicting neurodevelopmental outcomes than neonatal brain ultrasound.
Abstract:
This study aimed to determine whether neonatal feeding performance can predict the neurodevelopmental outcome of infants at 18 months of age. We measured the expression and sucking pressures of 65 infants (32 males and 33 females, mean gestational age 37.8 weeks [SD 0.5]; range 35.1 to 42.7 weeks and mean birthweight 2722g [SD 92]) with feeding problems and assessed their neurodevelopmental outcome at 18 months of age. Their diagnoses varied from mild asphyxia and transient tachypnea to Chiari malformation. A neurological examination was performed at 40 to 42 weeks postmenstrual age by means of an Amiel-Tison examination. Feeding performance at 1 and 2 weeks after initiation of oral feeding was divided into four classes: class 1, no suction and weak expression; class 2, arrhythmic alternation of expression/suction and weak pressures; class 3, rhythmic alternation, but weak pressures; and class 4, rhythmic alternation with normal pressures. Neurodevelopmental outcome was evaluated with the Bayley Scales of Infant Development-II and was divided into four categories: severe disability, moderate delay, minor delay, and normal. We examined the brain ultrasound on the day of feeding assessment, and compared the prognostic value of ultrasound and feeding performance. There was a significant correlation between feeding assessment and neurodevelopmental outcome at 18 months (p < 0.001). Improvements of feeding pattern at the second evaluation resulted in better neurodevelopmental outcome. The sensitivity and specificity of feeding assessment were higher than those of ultrasound assessment. Neonatal feeding performance is, therefore, of prognostic value in detecting future developmental problems.
