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Safety and Efficacy of Oral Feeding in Infants with BPD on Nasal CPAP

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Abstract

Safety and efficacy of oral feeding was examined in infants with bronchopulmonary dysplasia (BPD) on nasal continuous positive airway pressure (NCPAP). We hypothesized that repetitive oral feeding enhances aero-digestive outcomes and reduces resource utilization. Data from infants with BPD (37–42 weeks post menstrual age) that were orally fed while on NCPAP (n = 26) were compared with those that were exclusively gavage fed on NCPAP (n = 27). Subject assignment was random and physician practice based. Specifically, we compared the differences in aero-digestive milestones, resource utilization, and safety metrics. Demographic characteristics such as gender distribution, gestational age, and birth weight, clinical characteristics such as frequency of intraventricular hemorrhage and patent ductus arteriosus needing surgical ligation were similar in both groups (p > 0.05). Characteristics of respiratory support and airway milestones were similar in both groups (p > 0.05). However, infants in NCPAP-oral fed group had earlier acquisition of full oral feeding milestone by 17 days (median) versus infants who were not orally fed during NCPAP (p < 0.05). Discharge weights and the frequency of gastrostomy tube placement were also similar in both groups (p > 0.05). There were no tracheostomies in either group. There was no incidence of clinically significant aspiration pneumonia in infants during the period of the oral feeding while on NCPAP. Controlled introduction of oral feedings in infants with BPD during NCPAP is safe and may accelerate the acquisition of oral feeding milestones.

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Acknowledgments

We acknowledge the Comprehensive Center for Broncho-Pulmonary Dysplasia at Nationwide Children’s Hospital for invaluable cooperation. Jadcherla’s efforts are supported in part by Grants NIH R01(DK) 068158 and NIH P01(DK) 068051.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neonatal Occupational Therapy, Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Melissa Hanin

  2. Division of Neonatology, Department of Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, 77030, USA

    Sushma Nuthakki

  3. Neonatal Aero-digestive Pulmonary Program, Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Division of Neonatology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, 43202, USA

    Manish B. Malkar & Sudarshan R. Jadcherla

  4. Division of Pediatric Gastroenterology and Nutrition, Division of Neonatology, Innovative Feeding Disorders Research Program, Center for Perinatal Research, Nationwide Children’s Hospital Research Institute, 700 Children’s Drive, Columbus, OH, 43205, USA

    Sudarshan R. Jadcherla

Authors
  1. Melissa Hanin
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  2. Sushma Nuthakki
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  3. Manish B. Malkar
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  4. Sudarshan R. Jadcherla
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Corresponding author

Correspondence to Sudarshan R. Jadcherla.

Additional information

Melissa Hanin and Sushma Nuthakki contributed equally to manuscript and were co-first authors.

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Hanin, M., Nuthakki, S., Malkar, M.B. et al. Safety and Efficacy of Oral Feeding in Infants with BPD on Nasal CPAP. Dysphagia 30, 121–127 (2015). https://doi.org/10.1007/s00455-014-9586-x

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  • DOI: https://doi.org/10.1007/s00455-014-9586-x

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