Feeding Behaviors & Energy Cost in Infants with CHD

进食行为

• 批准号: 6750041
• 负责人: BARBARA S MEDOFF-COOPER
• 金额: $ 60.17万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-06-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6750041
• 关键词: behavioral /social science research tag; cardiovascular function; child behavior; clinical research; congenital heart disorder; developmental neurobiology; dysphagia; eating disorders; electrocardiography; human subject; infant human (0-1 year); infant nutrition disorder; neuropsychological tests; newborn human (0-6 weeks); oral behavior; patient oriented research; pediatric nursing; swallowing

DESCRIPTION: (provided by applicant) This proposal requests continued support for a NINR funded study that had been entitled: Nutritive sucking: Physiological and Behavioral correlates. In the present proposal, we (1) deepen our analysis of feeding organization by integrating measures of sucking, swallowing and breathing over the course of full meals and (2) characterize the feeding patterns of another at-risk population - infants with congenital heart disease (CHD), and (3) relate feeding performance and energy expenditure to problems in growth and development over the first year of life in CHD infants. These infants are often difficult to feel, even when their surgery has improved their cardiac function. Indeed, the success of the surgery often unmasks their severe nutritional syndrome, failure to thrive (FTT). To address this important clinical problem, we propose to measure feeding performance and energy expenditures over the first hear of life in 120 infants who have undergone surgery during the first month of life to correct or palliate sever cardiac abnormalities and 60 healthy newborn controls. The specific aims of our proposed study are as follows: 1) to establish which aspects of feeding performance (e.g. suck/swallow/breathe coordination, temporal patterning of sucking with meals, suck pressure generation, adaptation to variation in flow rate) are most subject to disruption in CHD infant after corrective or palliative surgery; 2) to determine infants' pattern of oropharyngeal adaptation to variations in the flow rate through an artificial nipple, and whether flow rate adjustment represents a viable strategy for improving meal size outcomes; and 3) to determine the relative contributions of disrupted feeding organization and (potentially elevated) energy expenditure to unfavorable growth outcomes, i.e. (i) relate disrupted feeding to growth, (ii) relate energy expenditure to growth, and (iii) integrate energetic and feeding-performance characteristics in a predictive model of failure to thrive in infants with CHD. This study addresses what we believe is the central role of feeding organization in the nutritional status of this patient population; as such, it represents an approach toward early identification, based on feeding performance and energetic profiles, of infants most at risk for developing FTT by the age of one. The present work may offer prospects for targeted behavioral interventions involving modification of flow rates and paced feeds.

产品说明：（由申请人提供）该提案要求继续支持NINR资助的研究，该研究的标题为：营养吸吮：生理和行为相关性。在目前的建议中，我们（1）通过整合全餐过程中的吸吮、吞咽和呼吸措施来深化我们对喂养组织的分析，（2）描述另一个高危人群-先天性心脏病（CHD）婴儿的喂养模式，（3）将喂养表现和能量消耗与CHD婴儿出生后第一年的生长和发育问题联系起来。这些婴儿通常很难感觉到，即使他们的手术改善了他们的心脏功能。事实上，手术的成功往往揭示了他们严重的营养综合征，未能茁壮成长（FTT）。为了解决这一重要的临床问题，我们建议测量喂养性能和能量消耗的第一次听到生命中的120名婴儿谁经历了手术，在生命的第一个月，以纠正或减轻严重的心脏异常和60名健康新生儿对照。本研究的具体目的如下：1）确定哪些方面的摄食性能（例如，吮吸/吞咽/呼吸协调、进餐时吮吸的时间模式、吮吸压力的产生、对流速变化的适应）在CHD婴儿中最容易在矫正或姑息手术后受到破坏; 2）确定婴儿对通过人工乳头的流速变化的口咽适应模式，以及流速调节是否代表改善膳食量结果的可行策略;和3）确定摄食组织破坏的相对贡献，（可能升高的）能量消耗与不利的生长结果相关，即（i）将中断的进食与生长相关，（ii）将能量消耗与生长相关，和（iii）在患有CHD的婴儿不能茁壮成长的预测模型中整合能量和喂养性能特征。这项研究解决了我们所认为的喂养组织在这一患者人群的营养状况中的核心作用;因此，它代表了一种基于喂养性能和能量谱的早期识别方法，即在1岁时最有可能发生FTT的婴儿。目前的工作可能提供有针对性的行为干预，包括修改流速和节奏的饲料的前景。