Biobehavioral Efficacy of the Elevated Side-Lying Position for Feeding Preterm Infants: Study Protocol

Area of Science:

• Neonatal Physiology
• Developmental Pediatrics
• Biobehavioral Research

Background:

• Preterm infants often experience feeding difficulties during transition from tube to oral feeding.
• Optimizing feeding positions is crucial for improving physiological stability and behavioral responses in this vulnerable population.

Purpose of the Study:

• To investigate the biobehavioral efficacy of side-lying versus supine positions during oral feeding transition in preterm infants.
• To identify infant characteristics associated with differential responses to feeding positions.

Main Methods:

• A within-subject crossover design involving 60 preterm infants (≤35 weeks gestational age) from a level 3 NICU.
• Continuous physiologic (heart rate, respiratory rate, oxygen saturation, HRV, SCCO) and video data collected before and after feedings in both supine and side-lying positions.
• Assessment of suck-breathe coordination and early feeding skills using microanalysis of waveforms and videotaped feedings.

Main Results:

• Data analysis using linear mixed-effects models to compare outcomes between positions.
• Continuous monitoring of physiological parameters and detailed behavioral assessments provide a comprehensive view of infant responses.
• The study protocol is registered (NCT04942106) and adheres to SPIRIT 2013 guidelines.

Conclusions:

• This research will enhance understanding of side-lying position effects on preterm infant feeding.
• Findings will provide evidence-based guidance for clinical use of positioning strategies in neonatal care.
• The study aims to inform future efficacy trials and improve feeding management for preterm infants.