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Experience with a "Feed and Swaddle" program in infants up to six months of age
Leah B Templeton1, Michael J Norton1, Eduardo J Goenaga-Díaz1
1Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Insights
The feed and swaddle technique is a successful and safe method for infant brain MRI. This approach is recommended over anesthesia due to its high success rate and lack of complications.
Area of Science:
- Pediatric Radiology
- Neonatal Imaging
- Diagnostic Imaging Techniques
Background:
- The feed and swaddle technique involves feeding infants and allowing them to sleep to facilitate diagnostic imaging.
- This study evaluates the efficacy and safety of the feed and swaddle method for brain MRI in infants up to six months old, comparing it to imaging under anesthesia.
Purpose of the Study:
- To assess the diagnostic success and complication rates of the feed and swaddle technique for brain MRI in premature and term infants.
- To compare the outcomes of the feed and swaddle technique with those of brain MRI performed under anesthesia in infants.
Main Methods:
- A retrospective chart review of infants aged six months or younger who underwent brain MRI between January 2013 and March 2016.
- Data collected included demographic information, scan indications, scan duration, prematurity status, anesthetic use, complications, and diagnostic success or failure.
Main Results:
- The feed and swaddle technique demonstrated high diagnostic success rates: 91.1% in term infants under 90 days, 95.0% in term infants 90-181 days, and 92.5% in premature infants.
- No complications were observed in infants undergoing the feed and swaddle technique.
- Brain MRI under anesthesia had a 100% success rate but was associated with significant complications, including hypoxemia (14.3%), hypothermia (18.9%), bradycardia (10.1%), and hypotension (4.2%).
Conclusions:
- The feed and swaddle technique is a highly successful and complication-free method for brain MRI in infants up to six months old.
- Given the risks associated with anesthesia, a trial of the feed and swaddle technique should be the preferred initial approach for infant brain MRI.
Background:
Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia.
Methods:
We reviewed the charts of all infants ≤6 months who underwent brain MRI at our institution between 1 January 2013 and 31 March 2016. We recorded and analyzed demographic information, scan indication, scan length, prematurity status, anesthetic technique if used, complications, and diagnostic success or failure.
Results:
One hundred and sixty-four term infants underwent brain MRI using a feed and swaddle technique. The success rate in term infants <90 days was 91.1% (113/124) versus 95.0% (38/40) in infants ≥90 days and ≤181 days old. Fifty-three premature infants underwent feed and swaddle for brain MRI with a diagnostic success rate of 92.5% (49/53). No complications were noted in any feed and swaddle patients. Those who received anesthesia had a diagnostic success rate of 100% (70/70) but experienced complications including hypoxemia, 14.3% (10/70); hypothermia, 18.9% (10/53); bradycardia, 10.1% (7/69); and hypotension, 4.2% (3/70).
Conclusion:
Given the high rate of success and absence of complications with feed and swaddle in children ≤6 months for brain MRI and the presence of anesthesia-related complications, most infants should undergo a trial of feed and swaddle prior to undergoing brain MRI with anesthesia.
