Premature infants born less than 33 weeks gestational age, or born at term with congenital heart disease, have a higher risk of brain injury than healthy term infants. These two groups of infants are also more likely to experience swallowing and other coordination problems during bottle feedings. Swallowing disorder due to neurological abnormality is called neurogenic dysphagia. During care in the NICU, and eventually during the long term home care after hospital discharge, infants with neurogenic dysphagia may require a feeding protocol that manipulates the properties of fluids being fed to them. This research is aimed at the development of a computer-controlled milk delivery system that would (1) encourage and maintain proper oral feeding behavior in infants with neurogenic dysphagia, (2) reduce development of aspiration-induced pneumonia, (3) hasten NICU discharge of infants with neurogenic dysphagia, reducing NICU cost, and allowing infants to come home to their families sooner. During Phase I, our engineering partner, Infoscitex, successfully designed and built a prototype of a computer-controlled bottle feeding system for dispensing either thin-consistency or nectar-thick liquids to dysphagic infants on the basis of sucking and respiration sensor signals. Phase II makes several major advances in the design and capabilities of the active bottle that have resulted from the Phase I bench tests and ongoing research by the PI into infant swallowing. The active bottle is evaluated during Phase II by means of a clinical trial consisting of tests involving dispensing of thin or thick liquids. Positive clinical results, along with the evolution of the active bottle towards a more ergonomic, less expensive, home care system will allow infants with feeding problems due to neurological insult a safer and more effective means for feeding.
