With the improvements in the survival of low birth weight (LBW) infants there are compelling needs to enhance the quality of their life and shorten hospitalization time. Improved strategies for enteral nutritional support will optimize developmental outcome and shorten hospitalization through early independent oral feeding. Critical data are needed for the evaluation of the most appropriate time at which to begin enteral feedings (early vs late feeding), the type of feeding regimen (intermittent bolus vs continuous infusion), and when to introduce oral feeding. The effectiveness of feeding strategies depends upon the proper maturation of the infant's physiological functions. The hypotheses advanced in this application are: 1) that specific tube-feeding strategies differentially affect the maturation of physiological indices and the time of attainment of independent oral feeding; and 2) that relationships exist among physiological indices which influence the responses of the infant to a feeding strategy. This application will evaluate the following 2 specific aims: 1) To determine the effects of 4 tube-feeding strategies (early-onset intermittent bolus, early-onset continuous infusion, late-onset intermittent bolus, and late-onset continuous infusion) on the maturation of physiological indices: nutrition/metabolism (growth, mineral balance, bone mineralization, biochemical and hormonal responses), GI function (absorption, motility, permeability), and oral-motor kinetics (feeding proficiency, stress-related effects) as well as on the time at which the infant attains independent oral feeding; 2) To test the relationship between the attainment of independent oral feeding and the above physiological indices. Eighty LBW infants, 26 to 29 weeks gestation, stratified by gestational age, will be assigned to one of four treatments in a balanced two-way design where the two factors are time of initiation of feeding (early-onset vs late-onset) and the method of feeding (intermittent bolus vs continuous infusion). The results from this prospective, carefully controlled interdisciplinary study of infant feeding will provide practical information for caretakers of LBW infants as well as insight into the mechanisms by which feeding strategy affects the maturation of the LBW infant.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD028140-03
Application #
2200899
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Project Start
1992-02-01
Project End
1997-01-31
Budget Start
1994-02-01
Budget End
1995-01-31
Support Year
3
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Baylor College of Medicine
Department
Pediatrics
Type
Schools of Medicine
DUNS #
074615394
City
Houston
State
TX
Country
United States
Zip Code
77030
Lau, Chantal (2016) Development of infant oral feeding skills: what do we know? Am J Clin Nutr 103:616S-21S
Lau, Chantal (2015) Development of Suck and Swallow Mechanisms in Infants. Ann Nutr Metab 66 Suppl 5:7-14
Lau, C; Fucile, S; Schanler, R J (2015) A self-paced oral feeding system that enhances preterm infants' oral feeding skills. J Neonatal Nurs 21:121-126
Schanler, R J; Fraley, J K; Lau, C et al. (2011) Breastmilk cultures and infection in extremely premature infants. J Perinatol 31:335-8
Fucile, Sandra; Gisel, Erika; Schanler, Richard J et al. (2009) A controlled-flow vacuum-free bottle system enhances preterm infants' nutritive sucking skills. Dysphagia 24:145-51
Amaizu, N; Shulman, Rj; Schanler, Rj et al. (2008) Maturation of oral feeding skills in preterm infants. Acta Paediatr 97:61-7
Lau, C; Hurst, N M; Smith, E O et al. (2007) Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants. J Perinatol 27:399-408
Scheel, C E; Schanler, Richard J; Lau, Chantal (2005) Does the choice of bottle nipple affect the oral feeding performance of very-low-birthweight (VLBW) infants? Acta Paediatr 94:1266-72
Schanler, Richard J; Lau, Chantal; Hurst, Nancy M et al. (2005) Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 116:400-6
Fucile, S; Gisel, E G; Lau, C (2005) Effect of an oral stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol 47:158-62

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