Effects of milk flow on the physiological and behavioural responses to feeding in an infant with hypoplastic left heart syndrome

Britt F. Pados, Suzanne M. Thoyre, Hayley H. Estrem, Jinhee Park, George J. Knafl, Brant Nix

Research output: Contribution to journalArticle

  • 2 Citations

Abstract

Infants with hypoplastic left heart syndrome often experience difficulty with oral feeding, which contributes to growth failure, morbidity, and mortality. In response to feeding difficulty, clinicians often change the bottle nipple, and thus milk flow rate. Slow-flow nipples have been found to reduce the stress of feeding in other fragile infants, but no research has evaluated the responses of infants with hypoplastic left heart syndrome to alterations in milk flow. The purpose of this study was to evaluate the physiological and behavioural responses of an infant with hypoplastic left heart syndrome to bottle feeding with either a slow-flow (Dr. Brown's Preemie) or a standard-flow (Dr. Brown's Level 2) nipple. A single infant was studied for three feedings: two slow-flow and one standard-flow. Oral feeding, whether with a slow-flow or a standard-flow nipple, was distressing for this infant. During slow-flow feeding, she experienced more coughing events, whereas during standard-flow she experienced more gagging. Disengagement and compelling disorganisation were most common during feeding 3, that is slow-flow, which occurred 2 days after surgical placement of a gastrostomy tube. Clinically significant changes in heart rate, oxygen saturation, and respiratory rate were seen during all feedings. Heart rate was higher during standard-flow and respiratory rate was higher during slow-flow. Further research is needed to examine the responses of infants with hypoplastic left heart syndrome to oral feeding and to identify strategies that will support these fragile infants as they learn to feed. Future research should evaluate an even slower-flow nipple along with additional supportive feeding strategies.

LanguageEnglish (US)
Pages139-153
Number of pages15
JournalCardiology in the Young
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Hypoplastic Left Heart Syndrome
Milk
Nipples
Respiratory Rate
Gagging
Heart Rate
Bottle Feeding
Gastrostomy
Research
Oxygen
Morbidity
Mortality

Keywords

  • bottle feeding
  • feeding methods
  • Hypoplastic left heart syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of milk flow on the physiological and behavioural responses to feeding in an infant with hypoplastic left heart syndrome. / Pados, Britt F.; Thoyre, Suzanne M.; Estrem, Hayley H.; Park, Jinhee; Knafl, George J.; Nix, Brant.

In: Cardiology in the Young, Vol. 27, No. 1, 01.01.2017, p. 139-153.

Research output: Contribution to journalArticle

@article{4101c0d28ad24c209c0bf337d07c3e10,
title = "Effects of milk flow on the physiological and behavioural responses to feeding in an infant with hypoplastic left heart syndrome",
abstract = "Infants with hypoplastic left heart syndrome often experience difficulty with oral feeding, which contributes to growth failure, morbidity, and mortality. In response to feeding difficulty, clinicians often change the bottle nipple, and thus milk flow rate. Slow-flow nipples have been found to reduce the stress of feeding in other fragile infants, but no research has evaluated the responses of infants with hypoplastic left heart syndrome to alterations in milk flow. The purpose of this study was to evaluate the physiological and behavioural responses of an infant with hypoplastic left heart syndrome to bottle feeding with either a slow-flow (Dr. Brown's Preemie) or a standard-flow (Dr. Brown's Level 2) nipple. A single infant was studied for three feedings: two slow-flow and one standard-flow. Oral feeding, whether with a slow-flow or a standard-flow nipple, was distressing for this infant. During slow-flow feeding, she experienced more coughing events, whereas during standard-flow she experienced more gagging. Disengagement and compelling disorganisation were most common during feeding 3, that is slow-flow, which occurred 2 days after surgical placement of a gastrostomy tube. Clinically significant changes in heart rate, oxygen saturation, and respiratory rate were seen during all feedings. Heart rate was higher during standard-flow and respiratory rate was higher during slow-flow. Further research is needed to examine the responses of infants with hypoplastic left heart syndrome to oral feeding and to identify strategies that will support these fragile infants as they learn to feed. Future research should evaluate an even slower-flow nipple along with additional supportive feeding strategies.",
keywords = "bottle feeding, feeding methods, Hypoplastic left heart syndrome",
author = "Pados, {Britt F.} and Thoyre, {Suzanne M.} and Estrem, {Hayley H.} and Jinhee Park and Knafl, {George J.} and Brant Nix",
year = "2017",
month = "1",
day = "1",
doi = "10.1017/S1047951116000251",
language = "English (US)",
volume = "27",
pages = "139--153",
journal = "Cardiology in the Young",
issn = "1047-9511",
publisher = "Cambridge University Press",
number = "1",

}

TY - JOUR

T1 - Effects of milk flow on the physiological and behavioural responses to feeding in an infant with hypoplastic left heart syndrome

AU - Pados,Britt F.

AU - Thoyre,Suzanne M.

AU - Estrem,Hayley H.

AU - Park,Jinhee

AU - Knafl,George J.

AU - Nix,Brant

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Infants with hypoplastic left heart syndrome often experience difficulty with oral feeding, which contributes to growth failure, morbidity, and mortality. In response to feeding difficulty, clinicians often change the bottle nipple, and thus milk flow rate. Slow-flow nipples have been found to reduce the stress of feeding in other fragile infants, but no research has evaluated the responses of infants with hypoplastic left heart syndrome to alterations in milk flow. The purpose of this study was to evaluate the physiological and behavioural responses of an infant with hypoplastic left heart syndrome to bottle feeding with either a slow-flow (Dr. Brown's Preemie) or a standard-flow (Dr. Brown's Level 2) nipple. A single infant was studied for three feedings: two slow-flow and one standard-flow. Oral feeding, whether with a slow-flow or a standard-flow nipple, was distressing for this infant. During slow-flow feeding, she experienced more coughing events, whereas during standard-flow she experienced more gagging. Disengagement and compelling disorganisation were most common during feeding 3, that is slow-flow, which occurred 2 days after surgical placement of a gastrostomy tube. Clinically significant changes in heart rate, oxygen saturation, and respiratory rate were seen during all feedings. Heart rate was higher during standard-flow and respiratory rate was higher during slow-flow. Further research is needed to examine the responses of infants with hypoplastic left heart syndrome to oral feeding and to identify strategies that will support these fragile infants as they learn to feed. Future research should evaluate an even slower-flow nipple along with additional supportive feeding strategies.

AB - Infants with hypoplastic left heart syndrome often experience difficulty with oral feeding, which contributes to growth failure, morbidity, and mortality. In response to feeding difficulty, clinicians often change the bottle nipple, and thus milk flow rate. Slow-flow nipples have been found to reduce the stress of feeding in other fragile infants, but no research has evaluated the responses of infants with hypoplastic left heart syndrome to alterations in milk flow. The purpose of this study was to evaluate the physiological and behavioural responses of an infant with hypoplastic left heart syndrome to bottle feeding with either a slow-flow (Dr. Brown's Preemie) or a standard-flow (Dr. Brown's Level 2) nipple. A single infant was studied for three feedings: two slow-flow and one standard-flow. Oral feeding, whether with a slow-flow or a standard-flow nipple, was distressing for this infant. During slow-flow feeding, she experienced more coughing events, whereas during standard-flow she experienced more gagging. Disengagement and compelling disorganisation were most common during feeding 3, that is slow-flow, which occurred 2 days after surgical placement of a gastrostomy tube. Clinically significant changes in heart rate, oxygen saturation, and respiratory rate were seen during all feedings. Heart rate was higher during standard-flow and respiratory rate was higher during slow-flow. Further research is needed to examine the responses of infants with hypoplastic left heart syndrome to oral feeding and to identify strategies that will support these fragile infants as they learn to feed. Future research should evaluate an even slower-flow nipple along with additional supportive feeding strategies.

KW - bottle feeding

KW - feeding methods

KW - Hypoplastic left heart syndrome

UR - http://www.scopus.com/inward/record.url?scp=84961204175&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961204175&partnerID=8YFLogxK

U2 - 10.1017/S1047951116000251

DO - 10.1017/S1047951116000251

M3 - Article

VL - 27

SP - 139

EP - 153

JO - Cardiology in the Young

T2 - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 1

ER -