Respiratory waveform variability during oral feeding in preterm infants

Preterm infants admitted to a neonatal intensive care unit (NICU) require successful oral feeding for discharge, but often struggle with bottle feeding due to neurodevelopmental immaturities. We have identified an objective criterion, respiratory waveform variability (RWV), to quantify the adaptability of breathing during bottle feeding. RWV is calculated using sample entropy (SE), a statistical measure of the change of complexity of physiologic processes. Analysis of RWV may be an early predictor of a neuromotor system capable of meeting the demands of feeding and subsequent discharge from the hospital. Results from this exploratory pilot study (n = 10) revealed that higher RWV was associated with significantly fewer days to discharge [β = -1.8 days per 0.1 unit change in SE (95% CI: -3.4, -0.2)]. These findings suggest that RWV is a potentially informative biomarker of physiology and may provide an objective metric to measure infant oral feeding skills in the NICU.