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Feeding-facilitating techniques for the nursing infant with Robin sequence
Edamil Nassar1, Ilza Lazarinni Marques, Alceu Sergio Trindade
1Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Bauru, Brazil.
Insights
Feeding-facilitating techniques improved oral feeding in infants with Robin sequence. These methods, including specialized bottle nipples and positioning, significantly increased milk intake and reduced feeding times.
Area of Science:
- Pediatrics
- Craniofacial Anomalies
- Neonatal Care
Background:
- Robin sequence is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction.
- Feeding difficulties are common in infants with Robin sequence due to glossoptosis, impacting oral intake and growth.
- Effective feeding strategies are crucial for the management of infants with this condition.
Purpose of the Study:
- To evaluate the efficacy of specific feeding-facilitating techniques in infants diagnosed with Robin sequence.
- To compare the outcomes of two different management approaches for feeding in these infants.
Main Methods:
- A study involving 26 infants under 2 months old with Robin sequence, all experiencing respiratory obstruction solely from glossoptosis.
- Two groups were formed: 13 infants managed with prone positioning (Group 1) and 13 with nasopharyngeal intubation (Group 2).
- Both groups received daily feeding-facilitating interventions including pacifier use, tongue massage, specialized bottle nipples, specific positioning, and nipple manipulation during feeding.
Main Results:
- Initially, Group 1 (prone position) consumed 36.15 mL in 44.62 minutes, while Group 2 (intubation) consumed 20.00 mL in 30.38 minutes.
- After a mean of 10.7 days, both groups showed a significant increase in oral milk volume (Group 1: 63.46 mL; Group 2: 55.00 mL) (p < .01).
- The mean duration of feeding sessions decreased in both groups, indicating improved efficiency.
Conclusions:
- Feeding-facilitating techniques are effective in promoting oral feeding in infants with Robin sequence.
- These techniques can help overcome feeding challenges associated with glossoptosis.
- The study highlights the potential of non-invasive methods to improve nutritional intake in this population.
Objective:
To determine the effectiveness of feeding-facilitating techniques in children with Robin sequence.
Setting:
Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Bauru, São Paulo, Brazil.
Patients:
Twenty-six children less than 2 months of age with Robin sequence, whose only cause of respiratory obstruction was glossoptosis. Thirteen infants were treated by being placed in the prone position (Group 1), and 13 were treated by nasopharyngeal intubation (Group 2).
Interventions:
During hospitalization, the following feeding-facilitating techniques were applied daily to all children: pacifier, massage to relax and anteriorize the tongue, long and soft bottle nipple with original or enlarged hole, global symmetric position, rhythmic movement of the nipple during suction, and insertion of the nipple on the tongue.
Results:
During the first evaluation, Group 1 patients accepted 36.15 +/- 33.05 mL milk orally within a period of 44.62 +/- 42.94 minutes, whereas Group 2 ingested 20.00 +/- 20.51 mL milk within 30.38 +/- 25.77 minutes. A significant increase (p < .01) in the volume of ingested milk was observed for the two groups at hospital discharge after a mean treatment period of 10.7 days (Group 1: 63.46 +/- 22.58 mL and Group 2: 55.00 +/- 13.07 mL). The mean duration of feeding decreased in the two groups, with a value of 21.54 +/- 7.18 minutes for Group 1 and of 20.28 +/- 8.53 minutes for Group 2.
Conclusion:
The results showed that feeding-facilitating techniques can foster oral feeding in infants with Robin sequence.
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