Preterm children represent 6–7% of all children born in Slovenia. Because of their premature birth preterm children have numerous problems. These health problems can be caused by complications during pregnancy or birth, immaturity of the muscular and nervous system or by suboptimal hospital environment in the first months of their life. Because premature birth abruptly interrupts the child’s development in the uterus, many preterm children have feeding and swallowing disorders.
The aim of our research was to identify the prevalence of feeding and swallowing disorders in preterm infants, factors which predict swallowing and feeding disorders and the consequences these disorders have on the preterm infants and their parents. For the purpose of research, a questionnaire based on literature was composed for parents of preterm children born in the maternity hospital in Ljubljana between 2013 and 2015 with birth weight less or equal to 1500 grams. The questionnaire was sent to parents of 427 children that met our criteria. We received 136 correctly answered questionnaires. For the analysis descriptive statistical methods, parametric and non-parametric statistical tests were performed using Excel and IBM SPSS program.
Feeding and swallowing disorders were present in 42,6% of all preterm infants included. They appeared mainly as fatigue during sucking, difficulty when starting to suck, prolonged feeding and insufficient amount of food intake. Statistically important differences relating to birth weight (up to and including 1000 grams or from 1001 to 1500 grams) were gestational age at birth (p=0,000), singleton pregnancy (p=0,011), accompanying diseases, problems and syndromes (p=0,019), breastfeeding (p=0,034), signs of feeding and swallowing disorders (p=0,006), insufficient amount of food intake (p=0,009), stress when feeding the infant (p=0,000) and speech and language therapy later in childhood (p=0,018). Low birth weight of less or equal to 1000 grams (p=0,011), low gestational age (p=0,018), baby's length at birth (p=0,000), accompanying diseases, problems and syndromes (p=0,002) were identified as factors that predict the appearance of feeding and swallowing disorders. Problems with saliva control (p=0,011) and abnormal oral sensitivity (p=0,002) were also characteristic for children with swallowing and feeding problems. As consequences of feeding and swallowing disorders not being able to be breastfed (p=0,001), stress when feeding the infant (p=0,000) and speech and language problems later in childhood (p=0,022) were recognized. The statistically significant parameters were included in a logistic regression model but only baby's length at birth (p=0.042) and accompanying diseases, problems and syndromes (p=0.034) remained as a statistically significant predictor of feeding and swallowing disorders. As a frequent and very important factor the experience of stress by parents was recognized, as 38% of them ever experienced stress during child feeding.
An integrated and on-time treatment of feeding and swallowing disorders in preterm infants demands an interdisciplinary team of various professionals in which a speech and language therapist is still not included enough. It was discovered that 35% of preterm children visited a speech and language therapist and that speech and language problems are more common in preterm children with serious feeding and swallowing disorders. Therefore, we believe the inclusion of a speech and language therapist in the treatment team from birth onwards is reasonable and essential not only as an expert for feeding and swallowing disorders but also for speech and language disorders.
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