31 Oral Feeding Disorders at Hospital Discharge: A Unique Marker of Disability?

Abstract

Listen

Translate article

The purpose of this study was to determine the prevalence of oral feeding problems at hospital discharge for preterm infants and to assess if these could be markers of later disability. This was a retrospective review of patients enrolled in a follow-up clinic database. Infants included were ≤ 32 wk GA, seen for the initial clinic visit between January 1, 2002 to December 31, 2004. 71/328 (22%) infants had oral feeding disorders (OFD) as defined by having one or more of the following at hospital dismissal: use of tubes and/or feeding pump, feeding more frequently than every 3 hours secondary to poor volume tolerance, and/or less than 100% of feeding orally. A comparison group of infants was determined by matching each study infant with the next infant in the database without a feeding problem but with the same GA (± 1 wk) and BW (± 100g). Medical complications and limited outcome data were obtained by database review. Group differences were determined by chi-square and univariate analysis of variance with significance indicated by P<.05. There were no group differences in BW (1023 ± 370 and 1026 ± 345 g, OFD and control, respectively), GA (27.6 ± 2.5 wk, both), or gender. OFD infants were, on average, discharged from the hospital 5 weeks later and 880 g heavier than comparisons (P=.000). There were no group differences in rates of severe IVH or ROP. OFD infants were more likely to have CLD (52% and 35%, P=.04) and be discharged on a home apnea monitor (47% and 25%, P=.009). 39% of OFD infants had neither CLD or IVH. A subset of infants had 24-month developmental screening using the Bayley Infant Neurodevelopmental Screener (BINS). Controlling for CLD and maternal race, OFD infants (n=14) tended to have a lower mean BINS scores than comparisons (n=30), 6.9 ± 3.6 and 4.3 ± 3.2, P=.08. Preterm infants appear to frequently have oral feeding problems at hospital discharge. Additional study of this population is needed to determine possible etiologies and long-term implications of delayed oral feeding, which could be a unique marker of disability.