Acceptance of bite presentations and feeding behaviors of 8 to 12-month-old infants: A reflection of typical feeding development.

PURPOSE: The lack of age-appropriate expectations for feeding acceptance patterns in early childhood is a barrier to early and accurate identification of pediatric feeding disorder (PFD). The objective of the study was to describe the process by which typically developing children 8-12 months of age accept or refuse bite presentations and their corresponding feeding behaviors, aiming to establish age-appropriate normative data for feeding acceptance. METHOD: Using cross-sectional methodology, we studied the proportion of bite presentations accepted, the type of feeding behaviors-passive, disruptive, expulsion, feeding concerns- observed at presentation and acceptance or refusal, and the duration between presentation to acceptance or refusal in 63 healthy infants between 8 and 12 months of age. Descriptive statistics and a one-way ANOVA were conducted to compare the effect of age and texture. RESULTS: Findings reveal high levels of bite acceptance of 80 % or > for children across ages, but with lower texture-specific differences. Both passive and disruptive behaviors were present even during acceptance of bites without any expulsion. Feeding concerns showed developmental trends with rapid reduction by 12 months suggesting improvement in oral feeding skills. The duration of acceptance and refusals revealed clear patterns by age and texture with an average of 3 s for acceptance but <1 s for refusal. CONCLUSIONS: This study describes bite acceptance patterns in a cohort of typically developing infants between 8 and 12 months of age by examining the acceptance of bites, frequency and type of feeding behaviors, and duration differences when children accept versus refuse a bite. Findings may be applied in the future to provide more sensitive detection of problematic feeding patterns to aid in the detection of pediatric feeding disorder.

Automated Cardiac Pulse Cycle Analysis From Photoplethysmogram (PPG) Signals Generated From Fingertip Videos Captured Using a Smartphone to Measure Blood Hemoglobin Levels.

Two billion people are affected by hemoglobin (Hgb) related diseases. Usual clinical assessments of Hgb are conducted by analyzing venipuncture-obtained blood samples in laboratories. A non-invasive, cheap, point-of-care and accurate Hgb test is needed everywhere. Our group has developed a non-invasive Hgb measurement system using 10-second Smartphone videos of the index fingertips. Custom hardware sets were used to illuminate the fingers. We tested four lighting conditions with wavelengths in the near-infrared spectrum suggested by the absorption properties of two primary components of blood-oxygenated Hgb and plasma. We found a strong linear correlation between our measured and laboratory-measured Hgb levels in 167 patients with a mean absolute percentage error (MAPE) of 5%. In our initial analysis, critical tasks were performed manually. Now, using the same data, we have automated or modified all the steps. For all, male, and female subjects we found a MAPE of 6.43%, 5.34%, and 4.85 and mean squared error (MSE) of 0.84, 0.5, and 0.49 respectively. The new analyses however, have suggested inexplicable inconsistencies in our results, which we attribute to laboratory measurement errors reflected in a non-normative distribution of Hgb levels in our studied patients, as well as excess noise in the specific signals we measured in the videos. Based on these encouraging results, and the promise of greater accuracy with our revised hardware and software tools, we now propose a rigorous validation study to demonstrate that this approach to hemoglobin measurement is appropriate for general clinical application.