Dysphagia

, Volume 26, Issue 3, pp 277–286 | Cite as

Quantification of Intraoral Pressures During Nutritive Sucking: Methods with Normal Infants

  • William Christopher Lang
  • Neil R. M. Buist
  • Annmarie Geary
  • Scott Buckley
  • Elizabeth Adams
  • Albyn C. Jones
  • Stephen Gorsek
  • Susan C. Winter
  • Hanh Tran
  • Brian R. Rogers
Original Article
First Online:
Received:
Accepted:

Abstract

We report quantitative measurements of ten parameters of nutritive sucking behavior in 91 normal full-term infants obtained using a novel device (an Orometer) and a data collection/analytical system (Suck Editor). The sucking parameters assessed include the number of sucks, mean pressure amplitude of sucks, mean frequency of sucks per second, mean suck interval in seconds, sucking amplitude variability, suck interval variability, number of suck bursts, mean number of sucks per suck burst, mean suck burst duration, and mean interburst gap duration. For analyses, test sessions were divided into 4 × 2-min segments. In single-study tests, 36 of 60 possible comparisons of ten parameters over six pairs of 2-min time intervals showed a p value of 0.05 or less. In 15 paired tests in the same infants at different ages, 33 of 50 possible comparisons of ten parameters over five time intervals showed p values of 0.05 or less. Quantification of nutritive sucking is feasible, showing statistically valid results for ten parameters that change during a feed and with age. These findings suggest that further research, based on our approach, may show clinical value in feeding assessment, diagnosis, and clinical management.

Keywords

Infant feeding Nutritive sucking Oral-motor function Orometer Suck Editor Deglutition Deglutition disorders 
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Notes

Acknowledgments

This work was supported by an SBIR grant (No. R43 HD-38234) to Metabolic Nutritionals from the National Institute of Child Health and Human Development.

Conflict of interest

N. Buist and S. Buckley jointly hold a patent for the Orometer. It has not been assigned to any company.

References

  1. 1.
    Rogers B, Arvedson J. Assessment of infant oral sensorimotor and swallowing function. Ment Retard Dev Disabil Res Rev. 2005;11:74–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Arvedson JC, Brodsky L. Pediatric swallowing and feeding: assessment and management. 2nd ed. Sydney: Singular Thomson Learning; 2002.Google Scholar
  3. 3.
    Medoff-Cooper BB, Bilker W, Kaplan JM. Suckling behavior as a function of gestational age: a cross-sectional study. Infant Behav Dev. 2001;24:83–94.CrossRefGoogle Scholar
  4. 4.
    Reau NR, Senturia YD, Lebailly SA, Christoffel KK. Infant and toddler feeding patterns and problems: normative data and a new direction. Pediatric practice research group. J Dev Behav Pediatr. 1996;17:149–53.PubMedCrossRefGoogle Scholar
  5. 5.
    Palmer MM, Heyman MB. Developmental outcome for neonates with dysfunctional and disorganized sucking patterns: preliminary findings. Infant Toddler Interv. 1999;9:299–308.Google Scholar
  6. 6.
    Medoff-Cooper B. Nutritive sucking research: from clinical questions to research answers. J Perinat Neonatal Nurs. 2005;19:265–72.PubMedGoogle Scholar
  7. 7.
    Sullivan PB, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford feeding study. Dev Med Child Neurol. 2000;42:674–80.PubMedCrossRefGoogle Scholar
  8. 8.
    Fung EB, Samson-Fang L, Stallings VA, Conaway M, Liptak G, Henderson RC, Worley G, O’Donnell M, Calvert R, Rosenbaum P, Chumlea W, Stevenson RD. Feeding dysfunction is associated with poor growth and health status in children with cerebral palsy. J Am Diet Assoc. 2002;102:361–73.PubMedCrossRefGoogle Scholar
  9. 9.
    March of Dimes. New report from the March of Dimes about the cost of pre-term birth. White Plains: March of Dimes; 2009.Google Scholar
  10. 10.
    Arvedson JC. Management of pediatric dysphagia. Otolaryngol Clin North Am. 1998;31(3):453–76.PubMedCrossRefGoogle Scholar
  11. 11.
    Kron RE, Ipsen J, Goddard KE. Consistent individual differences in the nutritive sucking behavior of the human newborn. Psychosom Med. 1968;30:151–61.PubMedGoogle Scholar
  12. 12.
    Gewolb IH, Vice FL, Schwietzer-Kenney EL, Taciak VL, Bosma JF. Developmental patterns of rhythmic suck and swallow in preterm infants. Dev Med Child Neurol. 2001;43:22–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Selley WG, Ellis RE, Flack FC, Brooks WA. Coordination of sucking, swallowing and breathing in the newborn: its relationship to infant feeding and normal development. Br J Disord Commun. 1990;25:311–27.PubMedCrossRefGoogle Scholar
  14. 14.
    Qureshi MA, Vice FL, Taciak VL, Bosma JF, Gewolb IH. Changes in rhythmic suckle feeding patterns in term infants in the first month of life. Dev Med Child Neurol. 2002;44:34–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Lau C, Alagugurusamy R, Schanler RJ, Smith EO, Shulman RJ. Characterization of the developmental stages of sucking in preterm infants during bottle feeding. Acta Paediatr. 2000;89:846–52.PubMedCrossRefGoogle Scholar
  16. 16.
    Lau C, Sheena HR, Shulman RJ, Schanler RJ. Oral feeding in low birth weight infants. J Pediatr. 1997;130:561–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Waterland RA, Berkowitz RI, Stunkard AJ, Stallings VA. Calibrated-orifice nipples for measurement of infant nutritive sucking. J Pediatr. 1998;132:523–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Amaizu N, Shulman R, Schanler R, Lau C. Maturation of oral feeding skills in preterm infants. Acta Paediatr. 2008;97:61–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Lau C, Kusnierczyk I. Quantitative evaluation of infant’s nonnutritive and nutritive sucking. Dysphagia. 2001;16:58–67.PubMedCrossRefGoogle Scholar
  20. 20.
    McGowan JS, Marsh RR, Fowler SM, Levy SE, Stallings VA. Developmental patterns of normal nutritive sucking in infants. Dev Med Child Neurol. 1991;33:891–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Medoff-Cooper B, Shults J, Kaplan J. Sucking behavior of preterm neonates as a predictor of developmental outcomes. J Dev Behav Pediatr. 2009;30:16–22.PubMedCrossRefGoogle Scholar
  22. 22.
    Medoff-Cooper B, Weininger S, Zukowsky K. Neonatal sucking as a clinical assessment tool: preliminary findings. Nurs Res. 1989;38:162–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Medoff-Cooper B. Changes in nutritive sucking patterns with increasing gestational age. Nurs Res. 1991;40:245–7.PubMedGoogle Scholar
  24. 24.
    Medoff-Cooper B, McGrath JM, Shults J. Feeding patterns of full-term and preterm infants at forty weeks postconceptional age. J Dev Behav Pediatr. 2002;23:231–6.PubMedCrossRefGoogle Scholar
  25. 25.
    da Costa SP, van den Engel-Hoek L, Bos AF. Sucking and swallowing in infants and diagnostic tools. J Perinatol. 2008;28:247–57.PubMedCrossRefGoogle Scholar
  26. 26.
    Buist NRM, Lang WC, Buckley S, Geary A, Adams E, Winter SC, Evered J, Rogers BR. Quantification of nutritive sucking: a new approach to developmental assessment? In: 11th International congress for inborn errors of metabolism, Society of Inherited Metabolic Disorders, San Diego, CA, August 29–September 2, 2009.Google Scholar
  27. 27.
    Palmer MM, Crawley K, Blanco IA. Neonatal oral-motor assessment scale: a reliability study. J Perinatol. 1993;13:28–35.PubMedGoogle Scholar
  28. 28.
    Palmer MM. Recognizing and resolving infant suck difficulties. J Hum Lact. 2002;18:166–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Nyqvist KH, Rubertsson C, Ewald U, Sjoden PO. Development of the preterm infant breastfeeding behavior scale (PIBBS): a study of nurse–mother agreement. J Hum Lact. 1996;12:207–19.PubMedCrossRefGoogle Scholar
  30. 30.
    Skuse D, Wolke D, Reilly S. SOMA: Schedule for oral motor assessment. London: Whurr; 2000.Google Scholar
  31. 31.
    Wolff PH. The serial organization of sucking in the young infant. Pediatrics. 1968;42:943–56.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • William Christopher Lang
    • 1
  • Neil R. M. Buist
    • 2
  • Annmarie Geary
    • 3
  • Scott Buckley
    • 3
  • Elizabeth Adams
    • 3
  • Albyn C. Jones
    • 4
  • Stephen Gorsek
    • 3
  • Susan C. Winter
    • 5
  • Hanh Tran
    • 3
  • Brian R. Rogers
    • 3
  1. 1.Department of MathematicsIndiana University SoutheastNew AlbanyUSA
  2. 2.Department of PediatricsOregon Health and Science UniversityPortlandUSA
  3. 3.Department of PediatricsOregon Health and Science UniversityPortlandUSA
  4. 4.Department of MathematicsReed CollegePortlandUSA
  5. 5.Children’s Hospital of Central CaliforniaMaderaUSA

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