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Published on: September 19, 2015
Retrospective study on growth in infants with isolated Robin sequence treated with the Tuebingen Palate Plate
Cornelia Wiechers1,2,3, Regina Iffländer1, Rieke Gerdes1
1Department of Neonatology, Tuebingen University Hospital, Calwerstraße 7, 72076, Tuebingen, Germany.
Insights
The Tuebingen treatment protocol, including a palatal plate and feeding training, improved weight gain in infants with Robin sequence (RS). This approach effectively addressed feeding difficulties and promoted better growth trajectories during infancy.
Area of Science:
- Pediatric surgery
- Neonatology
- Developmental pediatrics
Background:
- Robin sequence (RS) infants face growth failure risks due to breathing and feeding challenges.
- Existing treatments lack comprehensive data on their impact on infant weight gain.
- A functional treatment concept involving a pre-epiglottic baton plate and feeding training has been utilized for over 20 years.
Purpose of the Study:
- To evaluate the effectiveness of the Tuebingen treatment protocol on infant growth and weight trajectories.
- To assess the impact of the protocol on feeding outcomes in infants with Robin sequence.
Main Methods:
- Retrospective analysis of longitudinal data from 307 infants with isolated RS (1998-2019).
- Evaluation of anthropometric parameters and feeding support until 1-year follow-up.
- Data collected from Tuebingen University Children's Hospital electronic patient records.
Main Results:
- Infant weight Z-score improved from -1.17 at discharge to -0.44 at 1-year follow-up (p < 0.001).
- The proportion of infants requiring tube feedings decreased significantly from 55.1% to 13.7%.
- Weight Z-scores remained stable between hospital discharge and the 1-year mark.
Conclusions:
- The Tuebingen functional treatment protocol demonstrates efficacy in improving weight gain and feeding in infants with Robin sequence.
- Weight monitoring is a crucial indicator for assessing treatment effectiveness in RS infants experiencing postnatal growth failure.
- This study provides evidence supporting the functional treatment approach for managing Robin sequence.
Background:
Children with Robin sequence (RS) are at risk of growth failure, mainly due to their increased work of breathing and feeding difficulties. Various conservative and surgical treatment approaches exist, but their impact on weight gain has not yet been adequately addressed. A functional treatment concept, used in our center for > 20 years, includes a pre-epiglottic baton plate (Tuebingen palatal plate) and intensive feeding training.
Objective:
To investigate the effect of the Tuebingen treatment protocol on growth and weight trajectories during infancy.
Methods:
This retrospective study analyzed longitudinal data from infants with isolated RS admitted to Tuebingen University Children's Hospital, Germany between 1998 and 2019. Through our electronic patient database, we evaluated anthropometric parameters until reaching 1-year follow-up. Results are shown as median (IQR).
Results:
In 307 infants analyzed, median Z-score for weight decreased from - 0.28 at birth to - 1.12 upon admission to our center at a median age of 22 days. Z-score then remained largely unchanged until discharge (Z-score difference, - 0.08), while the proportion of infants receiving tube feedings decreased from 55.1 to 13.7%. Z-score subsequently increased from - 1.17 at discharge to - 0.44 at the 1-year follow-up (p < 0.001).
Conclusion:
Based on a comparatively large cohort, this functional treatment was associated with better weight gain and improved feeding. As RS infants often show postnatal growth failure, weight monitoring may be a valuable parameter for monitoring treatment effectiveness. Clinical Trial Registration Not necessary due to the retrospective design.
