Probability of Perioral Touch or Steady Chin Pressure Enhancing Feeding Engagement in Infants with Congenital Heart Disease

Abstract

Background/Purpose: Many infants with complex congenital heart disease (CCHD) have feeding difficulties. This study aimed to describe how common feeder oral support interventions influence feeding engagement in infants with CCHD undergoing surgical intervention. Theoretical framework: Thoyre’s Dynamic Systems framework was used to assess the potential effect of feeder support on infant behavioral response. Methods: This descriptive case study included neonates ≥ 37 weeks gestation following surgery for single- or two-ventricle conditions and with low engagement in the first post-operative feeding. The Dynamic Early Feeding Skills Assessment Tool measured infant engagement and feeder intervention (perioral touch and steady chin/face pressure) in videorecorded feedings. Lag sequential analysis was used to examine the probability of feeder behavior altering infant engagement. Results: Data from 12 single-ventricle and 9 two-ventricle infants was analyzed. Among single-ventricle infants, feeder steady pressure showed no change in low engagement in 10/12 infants, and two with 20% and 100% probabilities of disengagement/distress. Feeder oral touch showed no change in low engagement in 9/12 infants, with three showing 8-100% probabilities of subsequent disengagement/distress. Among two-ventricle infants, feeder steady pressure resulted in no change in 8/9 infants, with one showing a 50% probability of subsequent disengagement/distress. Feeder oral touch resulted in no change in 7/9 infants, with one showing a 25% probability of disengagement/distress, and one showing a 33% probability of a subsequent brief distress cue. Conclusions: Common feeder interventions may not enhance feeding engagement in infants with either single- or two-ventricle CCHD. Further research is needed to develop interventions promoting successful feeding in this vulnerable population.This project was funded by NIH/NINR 1F31NR018586-01.A five-year embargo was granted for this item.Academic Major: Nursin