RESUMO
OBJECTIVE: To compare infant sucking and swallowing patterns during feeding with a new artificial nipple and during breast-feeding. METHODS: Fifteen healthy, term infants were fed successfully for 1 week with use of the new tricut nipple; then each infant's oral cavity was examined during feeding by using real-time ultrasonography. Measurements of nipple length and compression were made, together with observations concerning the integrity of the seal formed by the infant's mouth around the nipple. These data were compared with similar data from previous studies of 16 breast-fed infants. RESULTS: Although no artificial feeding system exactly simulates breast-feeding, the new tricut nipple was sucked in a manner similar to the way the human nipple is sucked and delivered milk posteriorly to the foramen cecum region of the tongue, just as the breast does. CONCLUSION: Although further studies are necessary, to evaluate other characteristics of the new tricut nipple, the measurements from this investigation are useful additions to the ultrasound data these investigators have accumulated on various artificial feeding systems. These data may also prove helpful in determining the most appropriate nipples for infants with various feeding disorders.
Assuntos
Alimentação com Mamadeira , Aleitamento Materno , Boca/diagnóstico por imagem , Comportamento de Sucção/fisiologia , Humanos , Lactente , Recém-Nascido , UltrassonografiaRESUMO
Using a commercially available computer-based analysis of ventilation and esophageal pressure (PeDs), we studied 11 healthy term neonates with serial pulmonary mechanics measurements during the first 3 days of life to determine the intrasubject variability of repeated measurements. Three consecutive pulmonary function tests were obtained before and after repositioning of the esophageal catheter, for a total of six measurements per day in each subject. The daily coefficient of variation for these 11 subjects ranged from 6% to 32% for respiratory rate; 6% to 27% for tidal volume; 3% to 28% for specific dynamic compliance, and 11% to 69% for pulmonary resistance. Repositioning the esophageal catheter did not produce significant differences in measurements of pulmonary mechanics (p greater than 0.05). We conclude that within a given subject, the maximum variability (mean + 2 SD) was 28% for specific dynamic compliance and 56% for pulmonary resistance. These intrasubject variability limits are important when one is interpreting pulmonary mechanics measurements in neonates before and after specific treatment, such as bronchodilators, diuretics, surfactant, or steroids.