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Impaired parasympathetic response to feeding in ventilated preterm babies

S L Smith1, A K Doig, W N Dudley

  • 1University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, USA. Sandra.smith@nurs.utah.edu

Archives of Disease in Childhood. Fetal and Neonatal Edition
|June 9, 2005
PubMed

Insights

Very low birthweight infants show underdeveloped parasympathetic nervous system (PNS) responses to feeding. Sympathetic nervous system activity dominates, potentially hindering growth and development in these vulnerable infants.

Area of Science:

  • Neonatal physiology
  • Autonomic nervous system development
  • Infant growth and development

Background:

  • Premature very low birthweight (VLBW) infants often have an underdeveloped parasympathetic nervous system (PNS).
  • This underdeveloped PNS may impair feeding responses and limit extrauterine growth and development.

Purpose of the Study:

  • To characterize autonomic nervous system responses during feeding in VLBW infants.
  • To explore the relationship between changes in heart rate variability and infant characteristics over time.

Main Methods:

  • Employed individual growth curve analysis.
  • Assessed sympathetic and parasympathetic tone via low (LF) and high (HF) frequency heart period power.

Main Results:

  • Analyzed data from 16 mechanically ventilated VLBW infants (mean corrected gestational age 30.4 weeks).
  • Observed a significant decrease in LF power (sympathetic tone) during and after feeding (slope = -17.67, p=0.0002).
  • Found a significant negative correlation between HF power slope (parasympathetic activity) and birth gestational age (r = -0.49, p = 0.05).

Conclusions:

  • Parasympathetic activity (HF power) did not increase with enteral feeding as expected.
  • Sympathetic activity (LF power) decreased post-feeding, indicating gut stimulus inhibition.
  • Critically ill VLBW infants exhibit a dominant sympathetic response, suggesting insufficient PNS development.
Abstract

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