Juan Pérez-Ocasio, MPH, RT
Natalia Borges-Rivera
Lourdes García-Fragoso, MD, FAAP
Karla Colón-Romero, EdD, MS
Lourdes García-Tormos, EdD, CCC-SLP, BCS-S

Universidad Central del Caribe
UPR School of Medicine, Department of Pediatrics, Neonatology Section

Introduction

Neonatal encephalopathy (NE) is characterized by neurologic dysfunction after birth and may affect the newborn’s ability to feed successfully. Therapeutic hypothermia is the standard of care to decrease neurodevelopmental impairments. Brain magnetic resonance imaging (MRI) is a valuable tool for diagnosing neurological disorders in affected newborns. This study aims to describe feeding disorders in newborns with NE and their association with brain MRI findings.

Methods

Retrospective medical record review. Subjects included infants admitted to the University Pediatric Hospital Neonatal Intensive Care Unit in 2023-2024, diagnosed with NE, who received therapeutic hypothermia, and were referred to Speech Pathology. Intellectus Statistics was used for descriptive analysis and nonparametric tests. IRB approved.

Results

Interim analysis of 21/26 subjects showed seizures in 31% and abnormal neurological findings in 29%. Abnormal MRI findings were present in 48% [hemorrhage (33%), infarction (15%), ventriculomegaly (10%), thrombus (5%)]. Only 19% had mature sucking pattern, 62% presented disorganized sucking, and 19% dysfunctional sucking. Pediatric feeding disorder was present in 65%. Feeding disorder was not associated with birth weight, gestational age, APGAR scores, abnormal MRI findings, or abnormal neurological findings (p=NS).

Conclusion

Feeding disorders prevalence in newborns with NE is remarkable. Infants screened by MRI with neurological injuries may benefit from early, targeted interventions aimed at improving their feeding skills. Centers offering therapeutic hypothermia should be able to evaluate oral motor and feeding skills as these may be related to neurodevelopmental outcomes. Increasing our sample size will help assess factors associated with feeding disorders in newborns with NE.

Funding

Funded by the Department of Education, US Federal Government, Title V Project, Grant #PO31S200104