Clinical evidence indicates clearly that some preterm infants whether healthy or ill, are more physiologically stressed by handling than are others of the same gestational age. Age alone is not a sufficient criteria on which care to these fragile infants can be based. However, there are not few reliable and valid assessment tools which can be used to plan appropriate care. The purpose of this project is to develop a clinically useful assessment tool by characterizing in detail one facet of infant behavior, nutritive sucking, which can serve as an index of neurobehavioral integrity in the full term and preterm infant.
The specific aims are: 1) develope normative data base; 2) examine the relationship of gestational age to changes in sucking patterns; 3) examine the relationship of cardiovascular parameters and behavioral state, concurrent measures of neurobehavioral organization, to nutritive sucking; and 4) investigate the physiologic stress associated with nutritive sucking in preterm infants. The sample will include 300 full term and preterm infants with post-conceptual ages at the time of measurement ranging from 32 to 40+ weeks. The data collections instruments include the Kron Nutritive Sucking Apparatus, Nellcor pulse oximeter, Dinamapp blood pressure monitor, and the Anderson Behavioral State Scale. Infants in the full term nursery will have a 5 minute sucking measurement completed on the first and second days of life. Preterm infants in the intermediate care nursery will have weekly sucking measurement from 32-33 weeks until hospital discharge. Cardiovascular measurements and behavioral state will be measured concurrently. Data analysis will include means, standard deviations, standard error of the means, t-tests, MANOVAs and ANOVAs with repeated measures. It is anticipated that this investigation will (a) provide clinicians with a means of assessing neurobehavioral development through sucking behaviors; (b) supply clinically useful information on maturational changes of sucking patterns in preterm infants; and (c) provide new information on the relationship of cardiovascular parameters and behavioral state with nutritive sucking. This research will lead to the development of a clinically useful tool for the assessment of neurobehavioral status in the neonatal period.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
1R01NR002093-01A1
Application #
3392043
Study Section
Nursing Research Study Section (NURS)
Project Start
1989-07-15
Project End
1992-06-30
Budget Start
1989-07-15
Budget End
1990-06-30
Support Year
1
Fiscal Year
1989
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Type
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Medoff-Cooper, Barbara; Irving, Sharon Y; Hanlon, Alexandra L et al. (2016) The Association among Feeding Mode, Growth, and Developmental Outcomes in Infants with Complex Congenital Heart Disease at 6 and 12 Months of Age. J Pediatr 169:154-9.e1
O'Byrne, Michael L; Glatz, Andrew C; Goldberg, David J et al. (2015) Accuracy of Transthoracic Echocardiography in Assessing Retro-aortic Rim prior to Device Closure of Atrial Septal Defects. Congenit Heart Dis 10:E146-54
Trabulsi, Jillian C; Irving, S Y; Papas, M A et al. (2015) Total Energy Expenditure of Infants with Congenital Heart Disease Who Have Undergone Surgical Intervention. Pediatr Cardiol 36:1670-9
O'Byrne, Michael L; Glatz, Andrew C; Sunderji, Sherzana et al. (2014) Prevalence of deficient retro-aortic rim and its effects on outcomes in device closure of atrial septal defects. Pediatr Cardiol 35:1181-90
Irving, Sharon Y; Medoff-Cooper, Barbara; Stouffer, Nicole O et al. (2013) Resting energy expenditure at 3 months of age following neonatal surgery for congenital heart disease. Congenit Heart Dis 8:343-51
Hartman, Diane M; Medoff-Cooper, Barbara (2012) Transition to home after neonatal surgery for congenital heart disease. MCN Am J Matern Child Nurs 37:95-100
Anderson, Jeffrey B; Marino, Bradley S; Irving, Sharon Y et al. (2011) Poor post-operative growth in infants with two-ventricle physiology. Cardiol Young 21:421-9
Torowicz, Deborah; Irving, Sharon Y; Hanlon, Alexandra L et al. (2010) Infant temperament and parental stress in 3-month-old infants after surgery for complex congenital heart disease. J Dev Behav Pediatr 31:202-8
Medoff-Cooper, Barbara; Bilker, Warren; Kaplan, Joel M (2010) Sucking patterns and behavioral state in 1- and 2-day-old full-term infants. J Obstet Gynecol Neonatal Nurs 39:519-24
Medoff-Cooper, Barbara; Naim, Maryam; Torowicz, Deborah et al. (2010) Feeding, growth, and nutrition in children with congenitally malformed hearts. Cardiol Young 20 Suppl 3:149-53

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