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New Technique Enables Better Nursing Of Robin Sequence Infants

A considerable improvement in the oral feeding habits of infants with breathing problems was observed in less than 11 days following institution of feeding facilitating techniques. //

The only option for such infant’s had been the use of a feeding tube. Prolonged use of this was however was associated with an increased risk for development of gastroesophageal reflux. With the introduction of this new technique, functional breast-feeding without the use of a feeding tube is now possible in a majority of the cases (92%). The results of this interesting study can be found in the latest issue of Cleft Palate-Craniofacial Journal.

Robin sequence is a congenital abnormality involving the respiratory system and the face. It manifests as an obstruction of the upper respiratory tract and is usually associated with a cleft palate (developmental abnormality of the face). Infants with this abnormality suffer from both breathing problems and feeding difficulties (sucking and swallowing), which makes the post-natal care very difficult.

The main focus of the study was to examine the effectiveness of feeding facilitating techniques (FFT’s), in oral feeding. If it was found to be effective, the use of the feeding tube can then be discontinued.

The study was conducted on more than 26 breast-fed infants, aged 3 months or less. The infants were placed in two different categories (Group 1: Airway patent if infant is in prone position, Group 2: nasopharyngeal intubation done owing to severe respiratory compromise) based on the severity of the clinical condition.

The technique involved a number of steps such as suction of a pacifier, massage to anteriorize and relax the tongue, support for sustaining the mandible, use of a certain type of nipple with its original hole, change in posture and the movement of the nipple inside the oral cavity in rhythmic motion and placement of the nipple exactly over the tongue.

Following training, substantial improvements in the feeding habits were noted in both the groups. The researchers intended to achieve an ingestion volume of 50 ml. At the end of the study, much higher ingestion volumes of 63.46 ml and 55 ml was achieved in group 1 and 2 respectively. The feeding time was also much shorter when compared to the previously set target of 30 minutes. Group 1 and 2 had a mean time of 21.54 and 20.38 minutes respectively.


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