Dietary transition in preterm children

• Grant number: 13/13734-2
• Support type: Scholarships in Brazil - Master
• Effective date (Start): March 01, 2014
• Effective date (End): November 30, 2015
• Field of knowledge: Health Sciences - Speech Therapy
• Principal researcher: Suelly Cecilia Olivan Limongi
• Grantee: Carla Lucchi Pagliaro
• Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Prematurity may be a risk condition that predisposes the newborn to a number of difficulties for adaptation and evolution in postnatal life. Preterm infants have high risk of developing feeding disorders. The present study has the aim to verify the feeding practice, correlated to food consistency, according to age range, in preterm infants after hospital discharge, during outpatient routine. The specific purposes are to verify orofacial motor skills and possible dysfunctions during feeding, and to analyze the interference of the following variables: birth weight, gestational age, intubation time, oxygen support time, nasoenteral tube time, date of introduction of oral feeding (OF) and transition time to exclusive OF. Forty infants of both genders will be divided into research (RG) and control group (CG) for a longitudinal study that will last approximately 18 months. The CG will comprise full-term infants, with no history of development complications, and the RG will be composed of preterm infants with corrected age between four and 18 months. All subjects will be submitted to sessions of assessment/observation of feeding dynamics and stomatognathic system performance. The Schedule for Oral Motor Assessment (SOMA) protocol will be applied in all stages of food consistency transition (Brazilian Pediatric Society, 2008), that is: the consistencies fruit puree and juice will be assessed at four and six months; the semi-solid consistency will be assessed at eight months; the solid consistency, at twelve months; and the cracker consistency, at fifteen months. Each child will be assessed/observed in each category separately (the food consistency assessed will depend on the age of the child), with "pass/fail" criteria applied in the test for competence in each ability, attributing score zero (0) or one (1), respectively. In the orofacial motor category of puree, the minimum score is 3; in the semi-solid, 4; in the solid, 4; in the cracker, 11 points; in the bottle category, minimum score is 5; in the training cup, 15; and in the cup category, 5 points. A questionnaire based on literature and elaborated for the study will be applied to the parents of the subjects, regarding themes related to their feeding history, such as: age of introduction of the consistencies puree, semi-solid, solid; the introduction of feeding utensils; signs of refusal, crying, and swallowing difficulties. All sessions will be filmed, and data will be analyzed according to a specific protocol. Statistical analysis will be performed to test for repeated measures over time using the technique of mixed design, which will verify the evolution of RG participants compared with themselves and with CG subjects. The variables obtained from the medical records will be correlated to the orofacial motor abilities presented by the participants in each assessment/observation. Twenty percent of the assessment sessions will be randomly selected and judged by two speech-language pathologists with great experience in child feeding and dysphagia, who will not participate in the project.

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

PAGLIARO, CARLA LUCCHI; BUEHLER, KARINA ELENA BERNARDIS; IBIDI, SILVIA MARIA; OLIVAN LIMONGI, SUELLY CECILIA. Dietary transition difficulties in preterm infants: critical literature review. Jornal de Pediatria, v. 92, n. 1, p. 7-14, JAN-FEB 2016. Web of Science Citations: 4.

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

. Development of oral motor abilities for feeding in premature infants during the first year of life. 2015. Master's Dissertation - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.