My observation, like other therapists, is that many of the micro preemies and/or babies that have had very involved respiratory issues and complex treatment needs because of these issue, often require increased sensory input related to feeding (temperature variance, thickened consistency). What we have observed is that these babies often benefit from increased FIO2 during feeds despite having adequate O2 levels. Do you have any thoughts on this matter? Our primary Neonatologist says that there is no physiological reason that this rational would be helpful. I believe the extra flow provides the sensory input that these babies often need, especially while learning to feed.
Answered by: Sue Thoyre, PHD, RN, FAAN,Francis Hill Fox Distinguished Term Professor , School of Nursing, The University of North Carolina at Chapel Hill
Oxygen is a stabilizer of the smooth muscles of the pharynx. Another reason it may be helping is that RR decreases overall by 5-10 breaths per minute during feeding so oxygen reserves are quickly depleted.
I do not agree with giving thickener – this is altering the infant’s microbiome and leading to a need for a larger bore nipple which increases the bolus size, increases the need for swallowing and reduces the opportunity for breathing.
Prioritize support on the respiratory system with good postural/diaphragm support, resting within the first minute of the feeding and often thereafter, pacing individualized to the child’s respiratory rate (higher rate, less duration of sucking), low flow nipples, side lying.