Very early introduction of semisolid foods in preterm infants does not increase food allergies or atopic dermatitis.

BACKGROUND: The optimal age for the introduction of solid foods for infants has long been a controversial issue. OBJECTIVE: To determine whether the early introduction of semisolid foods influences the incidence of food allergy or atopic dermatitis among preterm infants. METHODS: Retrospective data from 464 preterm infants born in Oulu University Hospital between 2008 and 2012 were analyzed. Age- and sex-matched full-term control children from the general population were identified. The primary outcome of the study was the difference in timing of the introduction of complementary feeding between preterm and full-term infants. The secondary outcomes were the incidences of food allergies and atopic dermatitis by the ages of 1 and 2 years. RESULTS: Semisolid food was introduced at the median corrected age of 1.4 months for all preterm infants, at 1.9 months for late preterm, at 0.9 months for very preterm, and at 0.1 months for extremely preterm infants. The cumulative incidence, either of food allergies or of atopic dermatitis, did not differ significantly between preterm infants and controls by the ages of 1 and 2 years. CONCLUSION: The very early introduction of complementary foods into the diet of preterm babies did not increase the incidence of food allergies or atopic dermatitis even among the most preterm infants. This finding supports the hypothesis that the gut-associated lymphoid tissue of preterm infants is ready to encounter food proteins and to begin the maturation process within 3 to 6 months of birth, regardless of gestational age.

Early vocalization of preterm infants with extremely low birth weight (ELBW), Part I: From birth to expansion stage.

The vocalization of preterm infants with extremely low birth weight (ELBW) up to the expansion stage was systematically described and compared with those of healthy full-term infants. The sample consisted of 18 preterm ELBW infants and the control group of 11 full-term infants. The follow-up was performed intensively using video-recordings. The vocalization of the preterm and full-term infants was analyzed quantitatively according to the categorical stages created by Oller. A descriptive analysis of all the vocalizations produced by the infants was performed. The preterm infants entered the primitive articulation stage later than the full-term infants and failed to produce more skills during that stage. According to this sample, there was no difference in entering the expansion stage, but the preterm infants failed to produce more skills than the full-term infants. The number of vocalization acts varied differently by age between the groups.

Early vocalization of preterm infants with extremely low birth weight (ELBW), Part II: From canonical babbling up to the appearance of the first word.

The aim of this study was to systematically describe the preverbal development of preterm infants from canonical babbling up to the first word and to compare it with that of healthy full-term infants. In addition, the amount of vocalization between the preterm and full-term groups was compared. The sample consisted of 18 preterm infants with extremely low birth weight and 11 full-term infants. The development of preverbal vocalization before variegated babbling did not differ between the groups. Instead, the preterm infants failed to produce more different kinds of canonical syllable types than the full-term infants. However, they showed a larger variance of variegated babbling skills and remained in the babbling phase longer before reaching the first meaningful word compared with the full-term infants. Following the onset of canonical babbling, the preterm infants produced fewer vocalizations than the full-term infants and they reached the first word later than the full-term infants.

Feeding skill milestones of preterm infants born with extremely low birth weight (ELBW).

AIM: To compare the feeding development of preterm infants with that of full-term infants. PARTICIPANTS: Nineteen preterm infants with extremely low birth weight, and 11 healthy full-term infants. METHODS: Intensive follow-up study. Feeding situations were analyzed by NOMAS (Neonatal Oral Motor Assessment Scale) and by an oral motor patterns checklist based on video recorded sessions. RESULTS: Most of the preterm infants showed a disorganized sucking pattern and most of the full-term infants a normal sucking pattern, as long as suckling was present. However, the early suckling pattern did not predict the schedule of later feeding development. Preterm infants seemed to learn the various feeding skills at the same corrected ages as full-term infants, with the exception of munching, which they learned earlier than the full-term infants. However, the age range for gaining these skills was wider for the preterm infants. Preterm infants also seemed to have feeding problems more often than full-term infants when qualitative features of feeding were considered. Feeding was prolonged and messy, and the preterm infants were sensitive to different qualities of food. CONCLUSION: Feeding development of preterm and full-term infants is similar except for suckling, when only oral motor skills are concerned. When the qualitative characteristics of feeding are taken into account, the preterm infants suffer from feeding problems that create a risk for early interaction and communication.