Browsing by Subject "feeding"

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    Open Access
    Feeding and swallowing in neonates with Hypoxic Ischemic Encephalopathy (HIE): a descriptive study
    (2024) Branfield, Samantha; Norman, Vivienne; Rhoda, Natasha; Joemat, Janine
    Background: Intrapartum-related complications, including intrapartum hypoxia and subsequent hypoxic ischemic encephalopathy (HIE), are the second highest cause of neonatal deaths in South Africa. For survivors, such complications may be associated with a substantial burden of impairment, including the inability to feed well and swallow safely, thus representing a possible neurological cause of oropharyngeal dysphagia (OPD). HIE may result in disturbances of physiological stability, state regulation, neuromuscular integration, coordinated oral movements, and/or feeding endurance. However, feeding and swallowing characteristics in this population of neonates are not well described in the literature. Research Aims: To describe the feeding and swallowing profile of neonates with HIE in a neonatal unit in Cape Town, South Africa, including characteristics of oral feeding readiness, oromotor skill, oropharyngeal swallowing and clinical signs and symptoms of OPD, time taken to reach full oral feeds, and feeding method at discharge from the neonatal unit. Method: A descriptive, exploratory, longitudinal design consisting of both prospective and retrospective data collection methods was used to examine the feeding and swallowing characteristics in a sample of 52 participants with HIE of varying severities. Clinical feeding and swallowing assessments were conducted for 13 participants using the Neonatal Feeding Assessment Scale (NFAS), and medical folder reviews were conducted for 39 participants. The medical and feeding information was documented using data collection forms, including the feeding management received from the on-site speech-language therapist. Data from both data collection methods were amalgamated onto Excel spreadsheets, and information from medically similar participants was identified and grouped together for descriptive and statistical analysis. Statistical analysis comprised the nonparametric Kruskal-Wallis test and the Mann-Whitney U test. Results: A main effect of oral feeding readiness was indicated with a median of 4 days (p = 0.036), and an interquartile range of 4 – 5 days (standard deviation = 3.7 days). The median number of days to full oral feeds for the sample was 5 days (p = 0.016) with an interquartile range of 4 – 6.8 days (standard deviation = 4.3 days). Participants with a severely abnormal initial aEEG and who did not receive cooling treatment demonstrated the longest average time to oral feeding readiness and,subsequently, to full oral feeds. Participants of all severities presented with feeding and swallowing difficulties primarily in the oral phase of swallowing. Few pharyngeal signs and symptoms of OPD were identified. Most participants (96.2%; n = 50) were discharged on full oral feeds, while the remaining 3.8% (n = 2) were discharged on nasogastric tube feeds (NGT) while awaiting gastrostomy placement. ii | P a g e Conclusion: Regardless of severity, neonates with HIE face an increased risk of feeding and swallowing difficulties. The findings highlight that neonates with HIE should be screened by a speech-language therapist for feeding and swallowing difficulties before discharge from hospital. This study contributes to the small body of research on feeding and swallowing difficulties in neonates with HIE, and may guide future research.
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    Open Access
    Mothering a neonate/young infant with feeding and swallowing difficulties: barriers, facilitators, and support
    (2025) Meyer, Cecilia; Norman, Vivienne; Morrow, Brenda
    Background: The anticipation of a new infant is typically characterised by feelings of joy, excitement, and hopeful expectations for the future. However, these positive emotions can be altered when mothers are faced with the reality of caring for an ill, hospitalised infant, particularly one with feeding and swallowing difficulties (FSD). FSD in infants significantly impacts not only the infant's health and development but also the mother's emotional and psychological wellbeing. Caring for neonates and young infants with FSD in hospital settings presents unique challenges, especially in resource-constrained environments like South Africa. Limited research exists exploring mothering an infant with FSD, highlighting a gap in understanding the maternal experience. Research aim and objective: This research aimed to explore ‘mothering' a neonate/young infant with FSD in a South African healthcare context. To achieve the aim, mothers' experiences of barriers, facilitators and support needs within a neonatal healthcare context are described. Methods: A qualitative, exploratory case study design was used. Semi-structured interviews were conducted with mothers whose infants presented with FSD in neonatal/infant units. A total of seven mothers were interviewed (n=7) whose infants (aged from birth to three months) were admitted at either Mowbray Maternity Hospital or Red Cross War Memorial Children's Hospital, for a minimum of seven days. The data were thematically analysed, allowing the emergence of key themes that represent maternal experiences. Results: The overarching theme of ‘mothering' emerged, encapsulated by the quote: “Baby comes first in everything.” Six distinct themes then emerged from the overarching theme, represented by relevant quotes from the participants: “Information helps”; “They help a lot”, “It's not home”, “Everything on you”, “It affects me emotionally”, “Not on your own” and lastly, “It's my baby”. These themes emerged from the accounts of the mothers, which were then described in terms of barriers such as separation and burden of care, facilitators such as information and maternal strength, and support structures. The findings outline the dedication and resilience of mothers when navigating the challenges of caring for infants with FSD, while also highlighting the intricate and often dichotomous realities they face in the hospital setting. Conclusion: This study highlights the complex experiences of mothers caring for infants with FSD in South African healthcare settings. While deeply committed to their infants' wellbeing and feeding, mothers face barriers such as inadequate communication, separation, and limited support, which heighten stress and guilt. Facilitators, including clear communication, practical support from healthcare professionals, and peer and family networks empower mothers and alleviate their emotional burden. A collective effort by healthcare professionals, families, and hospital systems is essential to ensure care that supports both the recovery of infants and the wellbeing of their mothers. These insights can inform healthcare practices and future research in similar resource-limited settings.
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    Open Access
    Penguins
    (2014-09-12) Sherley, Richard; Neary, Tim
    In this radio broadcast, Richard Sherley discusses penguin tracking in South Africa, and how tracking mechanisms support research on feeding, breeding and migration patterns. Also discussed are how the miniturisation of tracking devices has dramatically improved information gathering, especially for tracking young birds and breeding populations. This information feeds into the Departmental of Environmental Affairs and the Department of Agriculture, Forestry and Fisheries for national planning purposes. Image provided courtesy of Namastesa under a Creative Commons Attribution 1.0 Generic license.