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Respiratory control during nipple feeding in preterm infants
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Insights
Respiratory control is immature in premature infants during feeding, with frequent apnea and bradycardia observed in the first two weeks of nipple feeds. These cardiorespiratory disturbances indicate ongoing developmental challenges in preterm infants at 35-36 weeks postconception.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Developmental Physiology
Background:
- Premature infants often experience cardiorespiratory challenges.
- Assessing respiratory control during feeding is crucial for infant development.
Purpose of the Study:
- To investigate the development of respiratory control during feeding in premature infants.
- To evaluate the frequency and nature of cardiorespiratory disturbances during nipple feeding.
Main Methods:
- Polygraphic monitoring was used to assess cardiorespiratory events in 24 premature infants.
- Infants were studied within one week of initiating nipple feeds and reevaluated 7-10 days later.
Main Results:
- During initial feeding, 15 infants had short apnea (≥10 sec) and 3 had prolonged apnea (≥20 sec).
- Bradycardia occurred in 7 infants, preceded by apnea and decreased oxygen saturation.
- Apnea during feeding was significantly more frequent than during sleep (P<0.05).
- Reevaluation showed persistent apnea during sleep in 4 infants.
- Most apneic episodes were mixed apnea.
Conclusions:
- High frequency of cardiorespiratory disturbances during the first 2 weeks of nipple feeding suggests immature respiratory control.
- Preterm infants at 35-36 weeks postconceptional age exhibit significant challenges with respiratory regulation during feeding.
Abstract:
The present study was designed to investigate the development of respiratory control during feeding in premature infants. Cardiorespiratory disturbances during feeding were evaluated with polygraphic monitoring in 24 premature infants within 1 week of beginning nipple feeds. During the initial study, 15 infants exhibited one or more episodes of short apnea (greater than or equal to 10 sec) and three infants exhibited prolonged apnea (greater than or equal to 20 sec). Bradycardia developed in seven infants; apnea and decreases in oxygen saturation invariably preceded the development of bradycardia. In contrast, short apnea occurred during sleep in five infants and associated bradycardia developed in four infants. Occurrence of apnea during sleep was significantly lower than that observed during feeding (P less than 0.05). Subsequently, 18 of these infants were reevaluated 7-10 days later. Seven infants developed one or more episodes of short apnea, five developed prolonged apnea, and four developed bradycardia. These occurrences were not significantly different from those observed during the initial study (P greater than 0.05). Short apnea persisted during sleep in four infants during reevaluation. Most of the apneic episodes in both studies were mixed apnea. The high frequency of cardiorespiratory disturbances during the first 2 weeks of nipple feeding indicates that in most preterm infants respiratory control during feeding is still immature at the postconceptional age of 35-36 weeks.