Abstract
BackgroundThe prevalence of neonatal oropharyngeal dysphagia (OPD) in high-risk infants in lower-middle-income countries is unknown.ObjectivesTo determine the prevalence and associated risks for OPD in high-risk neonates in order to allow timely intervention for OPD, minimising negative outcomes.MethodA prospective cross-sectional observational study was conducted in an urban hospital in South Africa. Clinical feeding assessments were conducted using the Neonatal Feeding Assessment Scale with all available neonates in neonatal care.ResultsThe sample of 81 high-risk neonates (mean chronological age = 11.7 days; standard deviation = 15.6 days) had been feeding orally for 2 days and were approaching discharge. Fifty-two participants (64.2%) had OPD. Risks likely associated with OPD included breech presentation, septicaemia and other infections, spending more than 1 day on a warm table or incubator, neurological conditions, prenatal exposure to maternal smoking, siblings with mental or neurological disability, participants with congenital disorders, preterm birth (< 37 weeks), low birth weight (< 2500 g), or retinopathy of prematurity.ConclusionAn unexpected high prevalence of OPD was found in neonates already deemed ready for oral feeding and approaching discharge. Timely early involvement of the Speech-Language Therapists (SLTs) in decision-making about feeding readiness may prevent serious complications of neonatal OPD. Findings may inform South African neonatal clinicians. The study provides motivation for early intervention from SLTs before the infant and mother are discharged from high care and dispersed to communities where intervention services may be scarce.
Highlights
Neonatal oropharyngeal dysphagia (OPD) is considered a global concern, with negative implications for growth, general development, and independent feeding skills affecting the youngest population of high-risk infants (Cafferkey & Harrington, 2018; Rawool, 2017; Shaker, 2017)
This study is the first of its kind to document the prevalence of neonatal OPD in a specific lower-middle-income setting and found that 64.2% of the 81 participants presented with OPD
This observation and the fact that neonates are often discharged from this hospital at only 1650 g, may equate to neonates possibly leaving neonatal care with unidentified, or mild OPD, because of limited beds and high patient-volumes
Summary
Neonatal oropharyngeal dysphagia (OPD) is considered a global concern, with negative implications for growth, general development, and independent feeding skills affecting the youngest population of high-risk infants (Cafferkey & Harrington, 2018; Rawool, 2017; Shaker, 2017). This high-risk neonatal population may comprise infants who are born preterm with low birth weight (LBW), or who have congenital conditions, neurological compromise, septicaemia, or recovering post-surgery (Jadcherla, 2016). The prevalence of neonatal oropharyngeal dysphagia (OPD) in high-risk infants in lower-middle-income countries is unknown
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Schedule a callMore From: The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings
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