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Energetics and mechanics of nutritive sucking in the preterm and term neonate
1Section on Newborn Pediatrics, Pennsylvania Hospital, Philadelphia 19107.
Insights
Preterm infants expend less energy for nutritive sucking compared to term infants. This study quantifies the differences in sucking mechanics and energetics between these groups.
Area of Science:
- Neonatal physiology
- Pediatric nutrition
- Infant feeding
Background:
- Nutritive sucking is crucial for infant growth and development.
- Understanding the energetics of sucking in preterm and term neonates is essential for optimizing feeding strategies.
Purpose of the Study:
- To determine the energetics and mechanics of sucking in preterm and term neonates.
- To compare the work of sucking and volume ingested between preterm and term infants.
- To describe an objective method for evaluating nutritive sucking.
Main Methods:
- Simultaneous recording of intraoral pressure, flow, volume, and work of individual sucks.
- Studying nine term infants and nine preterm infants under identical feeding conditions.
- Analyzing sucking frequency, patterns, and minute consumption.
Main Results:
- Preterm infants generated significantly lower peak intraoral pressure (48.5 cm H2O) than term infants (65.5 cm H2O).
- Term infants exhibited higher sucking frequency and a distinct suck-pause pattern.
- Preterm infants performed significantly less work per volume of feed ingested (1190 g/cm/dL) compared to term infants (2030 g.cm/dL).
Conclusions:
- Preterm infants expend less energy to ingest the same volume of feed compared to term infants.
- Sucking mechanics and energetics differ significantly between preterm and term neonates.
- The described technique provides an objective measure for assessing nutritive sucking during infant development.
Abstract:
Energetics and mechanics of sucking in preterm and term neonates were determined by simultaneous records of intraoral pressure, flow, volume, and work of individual sucks. Nine term infants (mean postconceptional age: 38.6 +/- 0.7 SD weeks; mean postnatal age: 18.4 +/- 6.1 SD days) and nine preterm infants (mean postconceptional age: 35.2 +/- 0.7 SD weeks; mean postnatal age: 21.9 +/- 5.4 SD days) were studied under identical feeding conditions. Preterm infants generated significantly lower peak pressure (mean values of 48.5 cm H2O compared with 65.5 cm H2O in term infants; P less than 0.01), and the volume ingested per such was generally less than or equal to 0.5 mL. Term infants demonstrated a higher frequency of sucking, a well-defined suck-pause pattern, and a higher minute consumption of formula. Energy and caloric expenditure estimations revealed significantly lower work performed by preterm infants for isovolumic feeds (1190 g/cm/dL in preterm infants compared with 2030 g.cm/dL formula ingested in term infants; P less than 0.01). Furthermore, work performed by term infants was disproportionately higher for volumes greater than or equal to 0.5 mL ingested. This study indicates that preterm infants expend less energy than term infants to suck the same volume of feed and also describes an objective technique to evaluate nutritive sucking during growth and development.