633 - Tracking Oral Feeding Development in Premature Infants Using Neoneur Feeding System

Publication Number: 1610.633

Justine Pirozzi, Thomas Jefferson University Hosital, Philadelphia, PA, United States; Amy J. Sloane, Nemours Children's Health at Thomas Jefferson University, Dresher, PA, United States; Geetika Kennady, Nemours Children's Health, Swedesboro, NJ, United States; Alicia M. Graf, Sidney Kimmel Medical College at Thomas Jefferson University, Monroeville, NJ, United States; Caroline VLS. Hoedemaker, Neoneur LLC, Pennington, NJ, United States; Dermis de Jesus, Jefferson Health, Philadelphia, PA, United States; Barbara medoff Cooper, University of Pennsylvania, Philadelphia, PA, United States; Zubair H. Aghai, Nemours Children's Hospital, Philadelphia, PA, United States

Background: The suck-swallow-breathing mechanism in premature infants typically matures between 32-34 weeks' gestation and may be influenced by clinical and respiratory co-morbidities. Currently, objective tools to assess maturation are limited. The Neoneur Feeding System (NFS) is a handheld 2-inch device compatible with standard nipples and bottles. It measures patterns of oral cavity pressure and respiration, generating real-time tracings of suck, swallow, and breathing during feeds. This device is currently pending FDA approval for clinical use.

Objective: To evaluate feeding and respiratory skills in premature infants using NFS clinical biomarkers and track maturation in infants achieving full oral feeds.

Design/Methods: This prospective, non-randomized longitudinal study enrolled infants < 34 weeks' gestation from the level III neonatal intensive care unit at Thomas Jefferson University Hospital. Each infant had a minimum of 6 feeds recorded over 3 weeks. Six NFS biomarkers were analyzed: intersuck width, swallow rate, swallow burst rate, maximum pressure/burst, suck width, and rests between bursts. Biomarker trajectories were assessed using simple linear regression, and were compared to published normative data.

Results: This preliminary analysis included a total of 42 infants with mean gestational age of 29.9 weeks (SD: 2.73), mean birth weight of 1377g (SD: 485g) and mean birth weight Z-score of -0.27 (SD: 0.92). A subset of the data was assessed including 216 feeds on infants with full oral feeding at time of discharge. The dataset demonstrated patterns of feeding maturation based on developmental age, supported by previously published data of six clinical NFS biomarkers.

Conclusion(s): NFS-derived biomarkers can potentially offer an objective method to track feeding skill development in preterm infants. Preliminary findings suggest these measures may complement clinical observation and provide new insights into feeding maturation.

Corrected Gestational Age vs. Neoneur Feeding System Clinical Biomarkers
Figure 1. (A) Swallow rate/sec in bursts, (B) Intersuck width, (C) Suck rate, (D) Adjusted maximum pressure of burst, (E) Suck width, (F) Rests between bursts. Data from figures C-F demonstrated validation of reliability showing comparable trends to normative data.