[Show abstract][Hide abstract] ABSTRACT: To determine whether the development of sucking patterns in small-for-gestational age (SGA) preterm infants differs from appropriate-for-gestational age (AGA) preterm infants.
We assessed sucking patterns in 15 SGA and 34 AGA preterms (gestational age<or=36 weeks) longitudinally from 34 to 50 weeks postmenstrual age (PMA) using the Neonatal Oral-Motor Assessment Scale (NOMAS). At each measurement, we scored sucking as normal, dysfunctional, or disorganized. We examined the development of their sucking patterns in relation to clinical characteristics.
SGA preterms developed a normal sucking pattern later than did AGA preterms (median, 50 versus 44 weeks PMA, P=.002). At term-equivalent age, none of the SGA and 38% of the AGA preterms showed normal sucking (P<.05); at 48 to 50 weeks PMA this was 54% and 81%, respectively (P=.064). Abnormal sucking including "incoordination" and dysfunctional sucking were more prevalent in SGA preterms than in AGA preterms (median, 11% versus 0% per infant, P<.05). A higher gestational age and z-score for birth weight were predictive of normal sucking at 50 weeks PMA.
SGA preterms developed a normal sucking pattern later than AGA preterms. Many AGA preterms also developed a normal mature sucking pattern only after they had reached term age.
The Journal of pediatrics 10/2010; 157(4):603-9, 609.e1-3. · 4.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns.
To determine the longitudinal development of sucking patterns from birth until 10 weeks' post-term age in pre-term infants with and without BPD.
The sucking patterns of 16 pre-term infants with BPD and 15 pre-term infants without BPD were prospectively assessed with the Neonatal Oral-Motor Assessment Scale. The infants were matched for gestational age (<30 weeks). We recorded approximately 12 feeding episodes per infant, from 34 until 50 weeks' post-menstrual age. We diagnosed the infants' sucking patterns as normal, dysfunctional, or disorganized. Then, we examined the development of the sucking patterns in relation to relevant clinical characteristics.
Thirty (21%) of 142 feeding episodes of the pre-term infants with BPD and 36 (23%) of 156 of those without BPD were diagnosed as normal (non-significant). Of the abnormal patterns, 3 were diagnosed as dysfunctional and 229 as disorganized. Before term-equivalent age, definitely abnormal sucking patterns were more prevalent in the pre-term infants with BPD than in those without BPD: 69 (49%) and 47 (30%) episodes, respectively (χ(2) = 10.7, p < 0.01). In particular, the abnormal patterns including the item 'incoordination', defined as the inability to coordinate sucking and swallowing with breathing, were more prevalent: 36 and 15%, respectively (χ(2) = 6.37, p < 0.05). There was no difference between the two groups regarding the age at which they acquired normal sucking patterns. Relevant clinical characteristics did not influence the development of the sucking patterns.
The developmental characteristic of sucking patterns in infants with BPD was that these infants were unable to coordinate swallowing with breathing. This was the case especially prior to term-equivalent age; after term-equivalent age, the development of sucking closely resembled that of pre-term infants without BPD.
[Show abstract][Hide abstract] ABSTRACT: Several studies on visual development support the notion that healthy, low-risk preterm infants benefit from their early exposure to the visual world. It has been suggested, however, that mainly early developing sensory and motor processes are enhanced as a result of visual experience and early exercise, whereas later maturing processes might not. This study investigates whether preterm infants' visual and attentional development is accelerated as a consequence of their early visual experience and whether early and later maturing processes are affected differently. Preterm and full-term infants' performance on a gaze and attention shifting task was examined during the first six months of life. Until about 16 weeks post- term, preterm infants were faster in disengaging and shifting their attention and gaze from a stimulus in their central visual field to the periphery, whereas no difference was found for simple gaze shifts without disengagement. This finding is in contrast to earlier accounts that only early developing mechanisms might be advanced as a result of additional visual experience, whereas later developing cortical processes might depend mainly on preprogrammed maturation processes. However, it is consistent with a number of findings on visual, motor, and speech development, which have indicated accelerated cortical functioning in healthy preterm infants before.
[Show abstract][Hide abstract] ABSTRACT: To determine in preterm infants with a patent ductus arteriosus (PDA) the effect of indomethacin treatment on spontaneous motor activity.
Motor activity was assessed from repeated videotape recordings in 32 preterm infants (</=33 weeks gestation). Sixteen infants required indomethacin therapy for treatment of PDA, 16 were control infants, matched for gestational age. Indomethacin (0.2 mg/kg i.v. in 5 min) was given thrice, with an interval of 12 h. One-hour recordings were made immediately before and immediately after the first dose of indomethacin and 24 h later before and after the third dose. The same recording schedule was used for the control infants. The effects of indomethacin on quantity and quality of spontaneous motor activity were examined.
A significant reduction in the quantity of several spontaneous movement patterns and an increase in the occurrence of rest periods were found following the first indomethacin administration (p < 0.01). Concerning the quality of general movements, a reduction in the speed was found (p < 0.05). Both effects were not found after the third indomethacin administration.
In preterm infants with a PDA, treatment with indomethacin leads to a transient reduction in the quantity of spontaneous movement patterns and to a decrease in the speed of general movements. We recommend a cautious use of bolus indomethacin for the treatment of PDA.
Biology of the Neonate 11/2000; 78(3):174-80. · 1.90 Impact Factor