Preterm infants born before 32 weeks gestation experience more symptoms of gastroesophageal reflux in the first 6 months of life than infants born at later gestational ages

In this study of 582 infants less than 6 month old, we found that infants born prior to 32 weeks gestation experienced more symptoms of gastroesophageal reflux (GER) than infants born at later gestational ages. While full-term infants experience improvement in GER symptoms over the first 6 months of life, infants born at 32 – 37 weeks do not show this same improvement. Family history of allergy was related to an increase in GER symptoms. Additional research is needed to understand the mechanisms and development of GER symptoms in infants born before 37 weeks gestation.

Authors: Britt Pados, Grace Briceno, Victoria Feaster, & Katherine Gregory

Publication information: Pediatric Medicine. 2021; 4: 12. doi: 10.21037/pm-20-100

This paper is available for free and open access on the publisher’s website, click here.

Prevalence of problematic feeding in young children born prematurely: A meta-analysis

In a meta-analysis of 22 research studies involving 4381 children born preterm (< 37 weeks gestation), we found that 42% of these children had some degree of problematic feeding in the first 4 years of life. Problematic feeding is common in infants born preterm. Healthcare providers need to screen children born preterm for feeding difficulties throughout early childhood and consider early referral to feeding specialists when feeding challenges are present.

Authors: Britt Pados, Rebecca Hill, Joy Yamasaki, Jonathan Litt, & Chris Lee

Publication information: BMC Pediatrics. 2021; 21: 110. doi: 10.1186/s12887-021-02574-7

This paper is available for free and open access on the publisher’s website, click here.

Elevated intestinal inflammation in preterm infants with signs and symptoms of gastroesophageal reflux disease

In this study of 32 infants born preterm, we found that infants with signs and symptoms of gastroesophageal reflux disease (GERD) had higher levels of intestinal inflammation as measured by fecal calprotectin. Further studies are need to explore the role of intestinal inflammation in development of gastrointestinal symptoms.

Authors: Colleen Shelly, Evgenia Filatava, Julia Thai, Britt Pados, Sara Rostas, Hidemi Yamamoto, Raina Fichorova, & Katherine Gregory

Publication information: Biological Research for Nursing. 2021; 23(3): 524-532.

To view this paper on the publisher’s website, click here.

Bottle-feeding challenges in preterm-born infants in the first 7 months of life

This study involved data from 625 infants less than 7 months old. In this study, we found that infants born very preterm (< 32 weeks gestation) had more symptoms of problematic feeding as measured by the Neonatal Eating Assessment Tool – Bottle-feeding (NeoEAT – Bottle-feeding) than infants born at later gestational ages. Infants with bronchopulmonary dysplasia, gastroesophageal reflux, and anomalies of the face and mouth were associated with problematic feeding, even when degree of prematurity was taken into account. Infants born prior to 32 weeks and infants with bronchopulmonary dysplasia, gastroesophageal reflux, and anomalies of the face and mouth should be considered at risk for problematic feeding and be monitored/screened closely. Early referral to feeding specialists should be considered to support these infants as their feeding continues to develop through infancy.

Authors: Rebecca Hill, Jinhee Park, & Britt Pados

Publication information: Global Pediatric Health. 2020; 7: 1-14. doi: 10.1177/2333794X20952688

This paper is available for free and open access on the publisher’s website, click here.

Establishing a foundation for optimal feeding outcomes in the Neonatal Intensive Care Unit

Feeding difficulties are common in infants hospitalized in the neonatal intensive care unit (NICU). Setting a foundation for successful oral feeding starts from the moment of birth. For infants born preterm or with medical complexity, this starts long before the first time a breast or bottle is presented for feeding. In this paper, we discuss strategies to protect infants from noxious stimuli and promote positive sensory experiences to support neurodevelopment for the complex task of feeding.

Authors: Britt Pados & Kristy Fuller

Publication information: Nursing for Women’s Health. 2020; 24(3): 202-209. doi: 10.1016/j.nwh.2020.03.007

To view this paper on the publisher’s website, click here.

Symptoms of feeding problems in preterm-born children at 6 months to 7 years old

This study included 57 very preterm (< 32 weeks gestation), 199 moderate to late preterm (32 – 37 weeks gestation), and 979 full-term born children who were between 6 months and 7 years old at the time of the study. Compared to children born full-term, both very preterm and moderate to late preterm born children had significantly more symptoms of problematic feeding, as measured by the Pediatric Eating Assessment Tool. Children born preterm may require careful assessment of feeding throughout childhood.

Authors: Jinhee Park, Suzanne Thoyre, Britt Pados, & Matt Gregas

Publication information: Journal of Pediatric Gastroenterology. 2019; 68(3): 416-421. doi: 10.1097/MPG.0000000000002229

To view this paper on the publisher’s website, click here.

Changes in symptoms of problematic eating over six months in infants and young children

In this study, we followed 58 children who were between the ages of 6 months and 7 years old and who were being seen in an outpatient feeding clinic. We found that the scores on the Pediatric Eating Assessment Tool (PediEAT) decreased over the 6 months that these children were followed, with the greatest change being in the Physiologic Symptoms subscale. Child characteristics that were associated with more symptoms of problematic feeding included older child age, constipation, and speech–language delay, developmental delay, food allergy, and/or genetic disorder.

Authors: Jinhee Park, Cara McComish, Britt Pados, Hayley Estrem, & Suzanne Thoyre

Publication information: Infants and Young Children. 2018; 31(4): 297-309. doi: 10.1097/IYC.0000000000000128

To view this paper on the publisher’s website, click here.

Systematic review: What is the evidence for the side-lying position for feeding preterm infants?

In this review of the literature, we examined the available evidence on the effect of side-lying position on oral feeding in preterm infants. Only 4 studies were identified that used a quasi-experimental or experimental design to examine the effect of side-lying compared to either semi-upright, cradle-hold, or semi-reclined position on feeding. Findings were inconsistent. Two studies found side-lying to positively impact physiologic stability during feeding while two studies did not find any significant differences in outcomes. There were limitations of the included studies that limit the generalizability of the findings. Additional research is needed to determine the effects of the side-lying position on preterm infant feeding.

Authors: Jinhee Park, Britt Pados, & Suzanne Thoyre

Publication information: Advances in Neonatal Care. 2018; 18(4): 285-294. doi: 10.1097/ANC.0000000000000529

To view this paper on the publisher’s website, click here.

FIRST, DO NO HARM: A response to “Oral alimentation in neonatal and adult populations requiring high-flow oxygen via nasal cannula“

This article is a response to the paper “Oral alimentation in neonatal and adult populations requiring high-flow oxygen via nasal cannula.” In this paper, we outline the reasons why the published study does not provide adequate information to support the claim that feeding neonates on high-flow oxygen is safe.

Authors: Pamela Dodrill, Memorie Gosa, Suzanne Thoyre, Catherine Shaker, Britt Pados, Jinhee Park, Nicole DePalma, Keith Hirst, Kara Larson, Jennifer Perez, & Kayla Hernandez

Publication information: Dysphagia. 2016; 31(6): 781-782. doi: 10.1007/s00455-016-9722-x

To view this paper on the publisher’s website, click here.

Mothers’ psychological distress and feeding of their preterm infants

In this descriptive study of 34 mothers and their infants hospitalized in the neonatal intensive care unit (NICU), we found that increased maternal psychological distress, particularly depressive symptoms and role stress, were associated with less use of developmentally supportive feeding behaviors. Supporting maternal well-being is a critical aspect of supporting positive early infant feeding interactions.

Authors: Jinhee Park, Suzanne Thoyre, Hayley Estrem, Britt Pados, George Knafl, & Debra Brandon

Publication information: MCN, The American Journal of Maternal/Child Nursing. 2016; 41(4): 221-229. doi: 10.1097/NMC.0000000000000248

This paper is available for free and open access through PubMed Central, click here.

Developing a co-regulated, cue-based feeding practice: The critical role of assessment and reflection

Using a case of a very preterm infant, we illustrate the assessment of early feeding skills and how reflection on the infant’s capacities and methods of adapting to feeding can be used to identify potential targets for co-regulating the feeding experience. Taking a descriptive approach to feeding assessment, we provide an example of how to account for the dynamic nature of feeding and the changes that come with infant maturation and experience.

Authors: Suzanne Thoyre, Jinhee Park, Britt Pados, & Carol Hubbard

Publication information: Journal of Neonatal Nursing. 2013; 19(4): 139-148. doi: 10.1016/j.jnn.2013.01.002

This paper is available for free and open access through PubMed Central, click here.

Safe transition to home: Preparing the near-term infant for discharge

In this review, I outline the physiologic mechanisms of increased risk for the late preterm infant born at 34 to 37 weeks gestation. A discharge education and checklist is provided as well as a handout for when to call your pediatric healthcare provider.

Authors: Britt Pados

Publication information: Newborn and Infant Nursing Review. 2007; 7(2): 106-113. doi: 10.1053/j.nainr.2007.03.002

To view this paper on the publisher’s website, click here.