Effects of a valved infant-bottle with ergonomic teat on the coordination of sucking, swallowing, and respiration in late-preterm infants. The Safe Oral Feeding randomized Trial

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience

This was a nationwide prospective study carried out in Italy between 2005 and 2007, involving 34 centers with a neonatal intensive care unit. The study reports the Italian Neonatal Study charts for weight, length, and head circumference of singletons born between 23 and 42 gestational weeks, comparing them with previous Italian data and with the most recent data from European countries. Single live born babies with ultrasound assessment of gestational age within the first trimester, and with both parents of Italian origin. Only fetal hydrops and major congenital anomalies diagnosed at birth were excluded. The reference set consists of 22,087 girls and 23,375 boys. At each gestational age, boys are heavier than girls by about 4%. Later-born neonates are heavier than firstborn neonates by about 3%. The effects of sex and birth order on length and head circumference are milder. No differences were observed between babies born in central-north Italy and southern Italy. A large variability emerged among European neonatal charts, resulting in huge differences in the percentage of Italian Neonatal Study neonates below the 10th centile, which is traditionally used to define small-for-gestational-age babies. In the last 2 decades prominent changes in the distribution of birth weight emerged in Italy and in the rest of Europe, in both term and preterm neonates. The existing European neonatal charts, based on more or less recent data, were found to be inappropriate for Italy. Until an international standard is developed, the use of national updated reference charts is recommended. Show more

Our objectives were to establish normative maturational data for feeding behavior of preterm infants from 32 to 36 weeks of postconception and to evaluate how the relation between swallowing and respiration changes with maturation. Twenty-four infants (28 to 31 weeks of gestation at birth) without complications or defects were studied weekly between 32 and 36 weeks after conception. During bottle feeding with milk flowing only when infants were sucking, sucking efficiency, pressure, frequency, and duration were measured and the respiratory phase in which swallowing occurs was also analyzed. Statistical analysis was performed by repeated-measures analysis of variance with post hoc analysis. The sucking efficiency significantly increased between 34 and 36 weeks after conception and exceeded 7 mL/min at 35 weeks. There were significant increases in sucking pressure and frequency as well as in duration between 33 and 36 weeks. Although swallowing occurred mostly during pauses in respiration at 32 and 33 weeks, after 35 weeks swallowing usually occurred at the end of inspiration. Feeding behavior in premature infants matured significantly between 33 and 36 weeks after conception, and swallowing infrequently interrupted respiration during feeding after 35 weeks after conception. Show more