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Completed

NCT Number: NCT02661360

Effects of Swaddling on Infants During Feeding

The purpose of this randomized, within-subject, cross-over study is to examine if swaddling affects bottle feeding performance in infants born preterm. Results from research will have implication on neurobehavioral and physiologic outcomes as important indicators for the possible effect of swaddling during bottle feeding.

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Key information

Conditions

Premature Birth Female Urogenital Diseases and Pregnancy Complications Obstetric Labor Complications Obstetric Labor, Premature Pregnancy Complications Urogenital Diseases

Age range

1 day and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

New York University School of Medicine

New York, 10016, United States

About this study

Once an infant is orally feeding a minimum of two times per nursing shift for four consecutive nursing shifts, the infant will be randomly assigned to receive the intervention (swaddling) or control condition (no swaddling) first, by the research OT randomly choosing an envelope with the assignment enclosed. The intervention and control feedings for each infant will be consecutive and will take place at the infant's bedside in the NICU. Infants will be assessed at each nursing care time for feeding readiness by the research OT and feeding OT according the policies of the NYU Langone Medical Center NICU, which utilizes the Infant-Driven Feeding Scale-Readiness (Appendix B) (Ludwig & Waitzman, 2006). When the infant demonstrates readiness, the first condition will be initiated. At the next feeding when the infant demonstrates readiness, the opposite condition will be applied. If the infant is not available due to procedures or not demonstrating feeding readiness, at the next two caregiving times after the first feeding, the infant will be discontinued for that day and will start the study over the next day.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • all infants born before 34 weeks gestational age will be included as long as they do not have any exclusion criteria
  • infants born before 34 weeks gestational age is 33 weeks 3 days to 35 weeks 0 days, with attainment of exclusive bottle feeding at 36 weeks gestational age at the earliest.
  • Infants who are multiples will be included but restricted to twins and triplets.
  • Infants will only be included if their parents provide informed consent for participation of their infant in the study.

Exclusion criteria

The exclusion criteria are factors commonly associated with feeding problems in infants beyond prematurity, including:

  • Infants who are exclusively breastfed
  • Higher order multiples than twins and triplets (ie. quadruplets)
  • Infants with conditions that may affect feeding performance:
  • Grades III and IV intraventricular hemorrhage
  • Necrotizing enterocolitis
  • Congenital cardiac anomalies (except medically managed patent ductus arteriosus)
  • Genetic syndromes
  • Craniofacial abnormalities

Treatment and study plan

Swaddling Intervention for Preterm Infants

Behavioral

Procedure for swaddling includes folding one corner of the blanket down two thirds of the way down the blanket in order to make the blanket into a triangular shape. The infant will be positioned with shoulders at the fold of the blanket. The infant will be positioned with the blanket so that elbows, hips, and knees flexed with hands near the face by wrapping one side of the blanket across the chest holding the hands in place, pulling the bottom corner up toward the infant's face, and securing the blanket with the last corner pulled across the infant's chest again and around their back. The blanket will be tight enough to keep extremities in place but one finger will be able to be placed between the infant and the blanket.

Unswaddled Control

Behavioral

Procedure for control is blanket loosely draped across the infant without providing containment and without touching the anterior surface of the infant.

Primary outcomes

  1. Oral feeding readiness measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

  2. Feeding engagement measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

  3. Oral motor organization measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

  4. Swallow coordination measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

  5. Physiologic stability measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

    Stability of heart rate and respiratory rate are indicative of the ability of the infant born preterm to cope with stress during bottle feeding

  6. Feeding recovery measured by subtest of Early Feeding Skills Assessment (EFS)

    Time frame: 1 Day

  7. Number of significant changes in heart rate (bradycardia

    Time frame: 1 Day

  8. Number of significant oxygen desaturations

    Time frame: 1 Day

Sponsors and collaborators

Lead sponsor

NYU Langone Health

Other

Registry information

Official study title

Effects of Swaddling During Bottle Feeding on Infants Born Preterm

Important dates

Study start
2015
Primary completion
2016
Study completion
2016
First posted
Jan 22, 2016
Registry last updated
Jan 27, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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