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Neonatal narcotic abstinence: Effects of pharmacotherapeutic agents and maternal drug usage on nutritive sucking behavior.

An uncoordinated and ineffectual sucking reflex is a major manifestation of neonatal narcotic abstinence and may have important consequences for the infant's subsequent well being. Measures of nutritive sucking were used to monitor the severity of neonatal narcotic abstinence in a series of infants born to narcotic-dependent mothers who were either attending the methadone clinic or else were "street addicts." In all these infants, sucking measures were significantly reduced relative to normal control subjects. Furthermore, the sucking behavior of infants born to mothers attending the methadone clinic was significantly more depressed than that of infants born to street addicts. In regard to the salutary effects of pharmacotherapy for neonatal narcotic abstinence, infants treated with paregoric approached normal control levels and showed significantly better sucking than those treated with phenobarbital or diazepam. The latter drug practically eliminated all spontaneous nutritive sucking behavior.

Diazepam

[Rumen fluid studies in calves with abnormal and normal sucking behavior].

Ruminal fluid and blood samples were analysed in 39 calves with poor suckling behaviour and reduced milk intake (group 1) and in 21 calves with normal suckling behaviour (group 2). The pH level and chloride concentration was determined in the ruminal fluid as well as in the blood. In addition Gram stains and subsequent microscopical examinations of the ruminal fluids were carried out. Blood samples were submitted for blood gas analysis. Notable differences were found between the two groups. The pH level of the ruminal fluid was less than 5.5 in 29 of the 39 calves in group 1 (74.4%); in contrast, the pH was always above 5.5 in group 2. In group 1, 22 calves with a pH of less than 5.5 also revealed a metabolic acidosis of the blood. Mainly gram-positive bacteria were found in the ruminal fluid of 74.4% of the calves in group 1. On the other hand, 76.2% of the calves in group 2 revealed a mainly gram-negative flora. There was no difference in the chloride concentration, either in the blood or in the ruminal fluid and the values showed a high range of scatter.

Animals

Pattern of sucking in the infant rat during spontaneous milk ejection.

Two methods are described for measuring the sucking of rat pups on the nipples of the mother. The first uses pressure recording of the cannulated teatduct; the second uses direct observation of sucking behavior. Using these methods, the sucking behavior of the pups during sequences of milk ejections was investigated. Pressure recordings of the sucking of individual pups on the nipple showed that between milk ejections the pups sucked intermittently in bursts. During milk ejection itself there was a longer period of vigorous and continuous sucking. Behavioral observations on the level of sucking in whole litters of pups showed that the background bursts of sucking from the litter as a whole were randomly distributed in relation to the inferred time of oxytocin release. These results indicate that once the pups are sucking on the nipples, variations in the sucking behavior of the litter have no role in the timing of milk ejections in the mother.

Animals

Effect of nonnutritive sucking on behavioral state in preterm infants before feeding.

To describe the effect of nonnutritive sucking (NNS) on behavioral state (BSt) in preterm infants before feedings 24 preterm infants were randomly assigned and studied before each of their first 16 bottle feedings. Twelve received NNS by pacifier for 5 minutes; 12 did not receive a pacifier. BSt was measured with a 12-category scale for 30 seconds before the 5-minute period (BSt1) and for 30 seconds after (BSt2). Sleep states decreased for both groups. BSts considered more optimal for feeding increased more during NNS (86 vs. 46). Restless states were three times less frequent after NNS (23 vs. 68). Differences between groups were nonsignificant at BSt1, but were significant at BSt2, p less than .001. In the absence of self-regulatory feeding policies based on early hunger cues, NNS for 5 minutes prefeeding is simple, brief, and suitable for implementation in busy neonatal intensive care units. Nonnutritive sucking was an effective modulator of behavioral state for this sample.

Child Behavior

Nonnutritive sucking modulates behavioral state for preterm infants before feeding.

Forty-two pre-term infants were studied to determine the effect of nonnutritive sucking pre-feeding on behavioral state. Infants were randomly assigned to pacifier or rest groups. Pacifiers or rest were given for 5 minutes following routine caregiving and before each of the first 16 bottle feedings. A 12-category scale was used to measure state immediately before the 5-minutes and after. Frequencies of states that precede optimal feedings changed for infants given pacifiers versus rest: alert inactivity (+6 vs. -2), quiet awake (+19 vs. -6), and active awake (-24 vs. +12); infants given pacifiers had more sleep and fewer restless states. Group differences were non-significant before nonnutritive sucking (p = 0.16) but significant after (p = 0.00001). When self-regulatory feeding policies based on early hunger cues are not allowed, nonnutritive sucking for 5 minutes pre-feeding is simple, brief, and appropriate for busy intensive care units. These findings confirm those from earlier less conclusive research and indicate that nonnutritive sucking modulates behavioral state.

Feeding Behavior

A new method for delivering a taste without fluids to preterm and term infants.

A new method for administering a taste to preterm and term infants has been developed that does not necessitate the delivery of rapid solutions. Sucrose, a sugar that in solution was shown to potentiate sucking behavior, was embedded in gelatin-based nipples that continuously release sweet taste when mouthed or sucked. The gelatin nipples and comparable latex nipples were adapted to measure sucking behavior and were tested in a within-subject design. The gelatin nipples potentiated sucking in preterm and term infants by increasing the frequency and strength of the responses. Few sucking measures varied significantly for preterm and term infants. Those that did vary might be attributable to differences in physical stamina, rather than to orosensory or hedonic factors. It was concluded that the flavored gelatin nipple provides an effective method for studying taste in infants and offers the possibility of routine chemosensory stimulation for research and clinical applications.

Discrimination Learning

Early developmental change in bitter taste responses in human infants.

Human newborns (birth-6 days) and older infants (14-180 days) were allowed to ingest both urea (0.12-0.24 M) in a mildly sweet diluent and the diluent alone, and multiple measures of responsivity were obtained (relative intake, sucking behavior, and hedonic ratings based on facial expressions and body movements). For newborns, there was no indication of rejection of urea relative to the diluent in measures of intake or sucking behavior; rather, their responses were predominantly controlled by the order of presentation of the two tastes. In contrast, older infants tended to reject all concentrations of urea according to these measures. Hedonic ratings provided an indication of limited rejection of the bitter taste by newborns, but older infants were still found to respond more consistently. These data suggest there is an early developmental change in bitter taste perception.

Facial Expression

Effects of auditory stimulation upon non-nutritive sucking by premature infants.

Changes in non-nutritive sucking contingent upon presentation of an auditory stimulus previously found capable of eliciting heart-rate acceleration was investigated in a sample of 24 premature infants. Across 30 10-sec. presentations of the stimulus, only transient changes in sucking rate during the first 6 trials were observed, and these effects obtained primarily for those infants showing few abnormalities in their non-nutritive sucking behavior. These results were discussed as reflecting possible differences in infants' attention associated with sucking pathology and the dependence of psychological assessment upon the specific response index used.

Attention

Neonatal nutritive sucking: effects of taste stimulation upon sucking rhythm and heart rate.

The sucking behavior and heart rate of 22 full-term newborns were recorded. Half of the infants sucked for 9 minutes in 3 blocks of 3 minutes, first receiving a 0.02-ml drop of 5% sucrose for each criterion suck, then no fluid contingent upon such sucks, and finally a 0.02-ml drop of 15% sucrose for each suck. The other half received these conditions in reverse order. Regardless of the order in which the 2 nutrient conditions were administered, intersuck intervals were longer under the sweeter condition, but heart rate was also higher. Possible interpretations include a hedonic explanation suggesting that sucking rate is modulated to facilitate savoring of the sweeter fluid.

Heart Rate

The stability and interrelationships of newborn sucking and heart rate.

The sucking behavior of 44 newborns was recorded along with heart rate (HR) and respiration. These 3 systems showed stability over a 24-hr period. Sucking parameters varied markedly depending upon whether the infant was sucking for sucrose or under a no-fluid condition. Moreover, HR was strikingly affected by sweetness. The direction of HR change was toward increasing rates when sucking for sweet, even though sucking for sweet substances occurs more slowly than for no fluid.

Female

An efficacy study of occupational therapy with high-risk neonates.

This single-subject research study with replication evaluated the effect of daily occupational therapy on the nutritive and nonnutritive sucking behaviors of three high-risk, premature infants. At the time of entrance into the study, the infants were 34 to 35 weeks old and were documented poor feeders. Treatment consisted of individual, multimodal sensory stimulation, with emphasis on proprioceptive and vestibular input, graded to the sensory needs of the infants. Movement components of the jaw and tongue during nutritive and nonnutritive sucking were measured during baseline and intervention phases to assess the infants' sucking ability. A comparison of testing results revealed that during intervention the total sucking scores improved significantly for two of the three infants and that rapid changes occurred in the oral-motor function of all three infants. The results of the study suggest that occupational therapy can improve the rate of development of sucking in the premature neonate. However, future research needs to be done to isolate the specific techniques of treatment that produce positive changes.

Feeding Behavior

Maternal and neonatal behavior.

Maternal and neonatal behavior differs among food-producing mammals, and our management must reflect these differences. Sows will show more elaborate preparturient behavior than the other species as they attempt to build a nest that will last for several days. Because the nest is the focal point of maternal behavior for several days, the sow does not need to recognize her piglets until they are about 1 week of age. Although this facilitates the fostering of piglets between litters, the teat order developed by piglets during the first day or two makes it difficult for alien piglets to suckle when first fostered. Piglets are weaned at a relatively early age, and this results in conflict as neonatal behavior persists in an environment that requires better developed feeding patterns. Restrictions placed on ewes and cows by confinement at the time of parturition may result in their being unable to select an appropriate birth site. Our management must accommodate these needs by providing sites that are protected from the harsh environment and also allow separation from the rest of the flock. This is particularly important for ewes bearing multiple young, for lambs frequently become separated from the ewe while she is caring for another lamb. Both cows and ewes must be allowed to bond to their offspring soon after birth if they are to provide adequate maternal care. Fostering in these species involves manipulation of identifying stimuli to overcome the dam's ability to recognize her own young shortly after birth. Suckling problems, due to pendulous udders on cows and multiple lambs in sheep, may require attention by the stockman shortly after birth. Weaning does not result in major behavioral problems in sheep or beef cattle that are weaned after the young are consuming solid feed on a regular basis. Dairy calves, which are initially weaned onto milk replacer at a very early age, may develop inappropriate sucking behaviors that persist beyond weaning onto a solid diet. Despite our growing knowledge of maternal and neonatal behavior, mortality among piglets, lambs, and calves is still high. However, many of the most recent findings have yet to be incorporated into management procedures or standard practice. As this occurs, we should be able to reduce losses of young animals.

Animals

A study on the ecological habit of Armigeres subalbatus in Dawa area of the Mengshan Mountain in Shandong Province.

Armigeres subalbatus (A.s.) was reported in Shandong Province for the first time in 1965 and found in five counties of south Shandong including Pingyi, Linyi etc. in 1986. In Dawa area of the Mengshan mountain A.s. alults could be found in the first ten days of May, which increased in number in July, and become the dominant species in mosquito colonies in Aug. and Sept., then decreased gradually in number in Oct. and disappeared in Nov. There were two peaks of activity and blood-sucking behavior during the 24 hours of a day, one at dusk and the other at dawn. When the temperature dropped to 16 degrees C and below in the last ten days of Oct., the wigglers began their diapause period. The survival ratio reached 90.5% after 12 h freezing at -5 degrees C and none survived after 60 hours freezing. When the temperature rose to 17 degrees C and above the over-winterting larvae developed into adults, which could suck blood only at the temperature above 17.5 degrees C.

Animals

Olfactory bulbectomy and nursing behavior in rat pups (Wistar DAB).

To determine whether bilateral olfactory bulbectomy led to a change in nursing behavior, and thus death, we bilaterally bulbectomized (BX) pups from 14 litters at 2, 7, and 11 days of age. Litters treated on Days 2 and 7 consisted of 3 BX pups, 2 surgical control (SC) pups, and 2 handling control (HC) pups. Litters treated on Day 11 consisted of 1 or 2 BX, 1 or 2 incompletely bulbectomized pups (IBX), 2 SC pups, and 2 HC pups. These litters and 3 additional nontreated litters were observed on Days 4,7,10,13, and 16. A smaller number of BX pups survived through Day 10 than SC, HC, IBX, and nontreated pups. Differential treatment of the BX pups by females or littermates was not found. The females' mammary glands were functional but the BX pup stomachs had little or no milk. The BX pups spent less time nursing and more time away from the female and their littermates than did the other pups.

Animals

Effects of ethyl alcohol on behaviour in nursing female mice.

Effects of administering 10% ethyl alcohol as drinking fluid to mice during pregnancy and lactation have been examined by ethological analysis of behaviour of nursing females in their home cages at 1 day, 5--7 days, and 12--14 days postpartum. The treatment with alcohol did not affect gestation period or litter size, and fluid intake of treated mice remained similar to that of controls, the average intake of alcohol amounting to 29 mg/g body weight during lactation. Increase in frequency of exploration at 1 day postpartum was the only significant behavioural effect of alcohol on the nursing female mice. Duration of Non-Social Behaviour was unaltered, and no effects of the treatment on Maternal Behaviour or on Social and Sexual Investigation of male partners could be demonstrated. Behaviour of nursing females changed with increase in age of their pups. This occurred to a similar extent in treated and control animals. Maternal and Non-Social Behaviours declined in frequency as the pups became older although the time spent in these behaviours remained fairly constant. Social Investigation of the male partner declined both in frequency and duration while females were nursing their pups.

Animals

A noninvasive method for determining patterns of milk intake in the breast-fed infant.

A noninvasive adaptation of the test-weighing method has been devised for continuously monitoring milk intake in breast-fed infants. This procedure consists of counting the number of swallows from videotaped sessions of individual feeds and correlating them to the corresponding pre- and postnursing weights of the infants. The method has been tested on four nursing sessions in twins aged 1 1/2 to 2 1/2 months. A high correlation was found between swallow counts and weight gain of the babies. The patterns of milk intake as monitored by these two parameters were similar. This method has the advantage of not disrupting the natural nursing process because test-weighing during the feeding session is not necessary. In addition, it allows for longitudinal studies and uses relatively simple equipment, i.e., a balance and a video camera. It is further suggested that monitoring swallowing in the manner described herein may be a valuable addition to studies on sucking behavior in human infants. Finally, it is noted from the data presented that the pattern of milk transfer in a mother breast-feeding twins is different from that observed in mothers breast-feeding singletons who were monitored by means of a cross-sectional test-weighing procedure.

Breast Feeding