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Published on: January 17, 2011
Swallowing and feeding of young children on high-flow oxygen therapy
Ruhee Hoosain1, Bhavani Pillay, Shabnam Abdoola
1Department of Speech-Language, Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria. hoosainruhee@gmail.com.
Insights
Introducing oral feeds to young patients on high-flow oxygen (HFO2) is feasible with caution. This study shows that specific food consistencies can be safely introduced, emphasizing individualized care and multidisciplinary support for pediatric feeding.
Area of Science:
- Pediatric Gastroenterology
- Neonatology
- Speech-Language Pathology
Background:
- Oral feeding practices for pediatric patients receiving high-flow oxygen (HFO2) remain a subject of debate.
- Limited research exists, though emerging evidence supports the introduction of oral feeds.
Purpose of the Study:
- To document changes in swallowing and feeding behaviors in young children undergoing HFO2 therapy.
- To assess the feasibility and safety of introducing oral diets in this patient population.
Main Methods:
- A cohort of twelve pediatric patients on HFO2 were clinically assessed using the Schedule of Oral Motor Assessment.
- Assessments were performed twice: once when respiratory stability on HFO2 was achieved, and again on the final day of HFO2 therapy.
- Participants received standard inpatient care and speech therapy interventions.
Main Results:
- Most participants demonstrated typical oral motor skills for liquids, purees, and semi-solids at both assessment points.
- Purees and soft solids were successfully introduced to 91.7% of participants.
- Challenges persisted with solids and chewables; however, gagging and wet vocalization with thin liquids decreased from initial to final assessments.
Conclusions:
- High-flow oxygen therapy should not automatically prevent oral feeding.
- In this sample, cautious, individualized introduction of specific oral feeding consistencies was possible.
- A multidisciplinary approach and ongoing monitoring by a specialist feeding team are crucial for managing pediatric patients on HFO2.
Background:
Oral feeding practices of young patients on high-flow oxygen (HFO2) have been controversial. Limited literature exists on this topic, but new studies suggest introducing oral feeds.
Objective:
This study aims to describe the changes in swallowing and feeding of a group of young children on HFO2.
Method:
Twelve participants (mean age 34.17 months [s.d. = 3.97]) on HFO2 were assessed clinically at the bedside using the Schedule of Oral Motor Assessment. Assessments were conducted twice to determine the change in characteristics: upon approval from the managing doctor when respiratory stability on HFO2 was achieved and for a second time on the last day of receiving HFO2 (mean 2.6 days apart). Patients received standard in-patient care and speech therapy intervention.
Results:
Most participants displayed typical oral motor function at initial and final assessments for liquid, puree and semi-solid consistencies. Purees and soft solid consistencies were introduced to most participants (n = 11, 91.7%). Solids and chewables were challenging for all participants during both assessments. Half of the participants displayed gagging and a wet vocal quality with thin liquids at the initial assessment only.
Conclusion:
This small-scale study found that HFO2 should not preclude oral diets, but in this sample, small amounts of oral feeding could be introduced with caution, in an individualised manner, and with a collaborative multidisciplinary approach. Further research is essential.Contribution: Partial oral feeding of specific consistencies was possible during the assessment of young paediatric in-patients on HFO2. Monitoring of individual patient characteristics and risk factors by a specialist feeding team is essential.
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