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PubMed1985

Neonatal assessment: an overview.

The purpose of this paper is to provide an overview of assessment techniques used by physical therapists in the assessment of the neonate. An additional purpose is to provide a review of prenatal and postnatal development in the areas of muscle tone, range of motion, somatosensory skills, and reflex development. The role of the physical therapist on the neonatal team is discussed relating to the types of assessments physical therapists might use in evaluating the neonate. General considerations for assessment are provided, and specific areas including physical examination, behavioral assessment, evaluation of muscle tone, reflex assessment, oral motor evaluation, and sensory systems assessment are discussed. Physical therapy for the neonate has been considered as a specialty area of pediatrics. Physical therapists, however, are being asked to function in neonatal units in hospitals as a part of their practice in the general hospital setting. This article provides information for the inexperienced clinician who is interested in working with the neonate and for the experienced clinician.

Child Behavior↗
PubMed1999

Sociodemographic and behavioural determinants of blood lead concentrations in children aged 11-13 years. The Port Pirie Cohort Study.

OBJECTIVE: To describe the determinants of blood lead concentration in children with long term environmental exposure to lead. DESIGN: Prospective cohort study. SETTING: The lead smelting town of Port Pirie, South Australia, and surrounding townships. PARTICIPANTS: 326 children born in and around Port Pirie, 1979-1982, followed up until age 11-13 years in 1993-1994. MAIN OUTCOME MEASURES: Blood lead concentrations assessed at birth and at multiple ages up to 11-13 years; average lifetime blood lead concentration. RESULTS: Mean blood lead concentration rose sharply over the ages 6 to 15 months, reached a maximum around 2 years of age, and declined steadily as the children grew older. There was no difference in blood lead concentration between boys and girls until they reached the age of 11-13 years, when mean blood lead concentration in boys (8.4 micrograms/dL [0.41 mumol/L]) was slightly higher than in girls (7.5 micrograms/dL [0.36 mumol/L]). Residential area and father's employment site were the two variables most strongly predictive of a child's blood lead concentration at the end of primary school. Poorer-quality home environment was also found to be an independent contributor to blood lead concentrations. CONCLUSIONS: Age-related factors, and possibly recent concerted efforts to decrease entry or re-entrainment of lead into the environment at Port Pirie, have resulted in most children in our study having blood lead concentrations below 10 micrograms/dL (0.48 mumol/L) at the end of their primary school years. Lead exposure during a child's early years remains an important contributor to average lifetime exposure.

Age Factors↗
PubMed1993

Afferent control of pressor responses to feeding in young rats.

A series of experiments investigated the eliciting stimuli and physiological systems involved in triggering the blood pressure (BP) response to feeding in the young rat. The studies included 1) tongue cannula (TC) infusions of milk to nipple-attached and unattached pups; 2) TC infusions of saline, sucrose, and water to nipple-attached pups; 3) maternal milk ejections to 3-week-old pups that rarely have stretch responses; 4) gastric cannula infusions of milk to nipple-attached pups; and 5) maternal milk ejections and TC infusions to pups whose mouths were topically anesthetized. The results implicate the contact of fluid with oral and/or lingual surfaces as the critical stimulus primarily responsible for the BP rise. Although nipple attachment appears to be an important precondition for the typical pressor response, the co-occurrence of a behavioral stretch response is not essential.

Afferent Pathways↗
PubMed1997

Behavioral state activity during nipple feedings for preterm infants.

The purpose of this research was to examine the effect of behavioral state activity during nipple feeding on feeding success for a group of 20 preterm infants. The infants, fed per hospital policy at scheduled three-hour intervals, were observed during four early nipple feedings. Nine of the 20 infants were able to successfully nipple their four nipple feedings; the other 11 infants were unable to successfully complete their nipple feedings. The 9 successful feeders exhibited significantly more awake behavior during feeding than unsuccessful feeders (F = 7.82; p = .012). The unsuccessful feeders spent 53 percent of their feeding in sleep states; successful feeders were in sleep states only 30 percent of their feeding time. Along with other research, these findings suggest that infant behavioral state may be a key consideration for nipple feeding success in preterm infants.

Adult↗
PubMed1983

Minireview. Stress induced eating.

The relationship of oral behaviors to stress has long been recognized both in humans and in wild animals. In the last decade numerous advances have been made in our understanding of stress-induced feeding predominately because of the development of the simple tail-pinch model of stress induced feeding in rats. Present evidence strongly implicates monoamines and the endogenous opioid peptides as well as other neuropeptides as playing a role in the central regulation of stress-induced eating.

Animals↗
PubMed1990

A behavioral bioassay for analysis of rabbit nipple-search pheromone.

To suckle, newborn rabbits are completely dependent on a pheromone present on the doe's ventrum and also apparently contained in the milk. Pups presented in a standardized test with 30 microliters of fresh rabbit milk on a glass rod reacted with vigorous search-like movements in 93%, and with grasping of the rod in 70% of trials, but did not respond to control presentations of other odorants. The pups were found to be most reactive 1-3 hours before the once daily nursing, and although they rapidly habituated to repeated testing, a break of 30 minutes was sufficient for the recovery of responsiveness. Even milk diluted by as much as 1:10(4) elicited significantly more responses than control substances. However, when left at room temperature it lost this behavior-releasing quality within about 20 minutes, but retained it for several months when stored at -40 degrees C. Rabbit milk thus appears to represent a ready source of nipple-search pheromone, and the behavioral response of pups to be reliable enough to serve as a bioassay for further pheromonal analysis.

Aging↗
PubMed1991

Neonatal alcohol exposure alters suckling behavior in neonatal rat pups.

Prenatal alcohol exposure has been associated with a variety of suckling deficits in both humans and animals. In this study, the effect of neonatal alcohol exposure on suckling performance was examined in 15-day-old rat pups. Neonatal alcohol exposure has been used as a model to study the effects of alcohol exposure during a period equivalent to the human third trimester with respect to brain growth. Subjects were Long-Evans rats which had been artificially reared (AR) and fed through gastrostomy tubes from postnatal day (PN) 4-PN 12. The AR groups included two groups given ethanol doses of 6 g/kg/day or 4 g/kg/day and an isocaloric maltose-dextrin control group. A suckled control group raised by their natural mothers was also included to control for artificial rearing. Fifteen-day-old pups were individually placed with an anesthetized dam for a 1-h videotaped test session. Pups in the 6 g/kg alcohol group took longer to attach to the nipple and spent less time suckling than pups from all other treatment groups. Nipple-shifting behavior was disrupted in all artificially reared groups, but it was most severely affected in the 6 g/kg group. These findings suggest that neonatal alcohol exposure interferes with suckling performance and these altered behaviors may contribute to the postnatal growth deficits that have been reported following alcohol exposure in utero.

Animals↗
PubMed1980

Food supplementation of pregnant women at risk of malnutrition and their newborns' responsiveness to stimulation.

Pregnant women at risk of malnutrition were enrolled in a health care programme in Colombia, South America, and were randomly assigned to a group receiving supplementary food or to a control group at the beginning of the third trimester of pregnancy. There were no differences between the groups in social or nutritional variables. Supplementary food was found to have an effect on infants' reactions to mild aversive stimulation and their degree of irritability. Infants born to non-supplemented mothers generally responded more irritably to removal of a nipple and to the application of a cold disc to the abdomen. Female infants of non-supplemented mothers also recovered more slowly than the supplemented group from crying in response to both removal of nipple and the cold disc. The findings are believed to show a maturational effect of maternal diet during the last trimester of pregnancy.

Child Behavior↗
PubMed1994

Central administration of cocaine produces age-dependent effects on behavior in the fetal rat.

Rat fetuses were exposed to cocaine, lidocaine, or saline on Gestational Day 20 or 21 to provide information about cocaine effects on behavior during prenatal development. Cocaine was administered into the cisterna magna of individual fetal subjects to restrict effects to the CNS. Behavioral effects of cocaine were compared with lidocaine to help distinguish the effects of cocaine on monoamine systems in the brain from its properties as a local anesthetic. Cocaine promoted 3-5-fold increases in fetal motor activity in the absence of explicit sensory stimulation, in contrast to the slight suppressive effects of lidocaine. Cocaine and lidocaine also reduced coordinated behavioral responses to an artificial nipple. The behavioral effects of cocaine administered into the CNS of fetal subjects suggest specific mechanisms of action on developing neural and behavioral systems in the late prenatal period.

Animals↗
PubMed1996

Endogenous AVP systems regulate oral behavior in the rat fetus: neuropeptide systems as ontogenetic adaptations.

Pharmacological manipulation of V1 receptors in rostral and caudal brain regions alters perioral responsiveness in the E20 rat fetus. Blockade of caudal V1 receptors or activation of rostral V1 receptors reduces fetal responsiveness to perioral cutaneous stimulation. Activation of caudal V1 receptors or blockade of rostral V1 receptors increases fetal responsiveness to perioral stimulation, including oral capture and grasping of an artificial nipple. These results suggest that V1 receptor-containing neurons regulate perioral responsiveness in the E20 rat fetus and that the 2 populations of neurons exhibit functional differences. The caudal part of the arginine8-vasopressin (AVP) system increases whereas the rostral part decreases responsiveness to different types of perioral stimuli. The neuropeptide AVP may affect suckling behavior immediately after birth by regulating perioral sensory responsiveness.

Animals↗
PubMed1997

Stimulus contingencies that permit classical conditioning of opioid activity in the rat fetus.

In a prenatal model of classical conditioning, rat fetuses received presentations of an artificial nipple (conditioned stimulus; CS) paired with milk (unconditioned stimulus). Infusion of milk promotes activity in the kappa opioid system of the fetus, but after 2, 3, or 6 pairings with the artificial nipple, milk evoked both kappa and mu opioid activity. The nipple CS has no effect on opioid activity, but after pairing with milk evoked a mu opioid response. Conditioned mu opioid activity was evident in 60% of subjects tested after 1 paired conditioning trial. Significantly more fetal subjects (90%) exhibited conditioned opioid activity if preexposed to the nipple twice before conditioning. CS preexposure altered behavior during the conditioning trial, with preexposed fetuses showing more pronounced responses to milk infusion. Exposure to familiar stimuli facilitates classical conditioning of physiological responses, including opioid activity, during the first suckling episode.

Animals↗
PubMed1994

Ventilatory sparing strategies and swallowing pattern during bottle feeding in human infants.

During feeding, infants have been found to decrease ventilation in proportion to increasing swallowing frequency, presumably as a consequence of neural inhibition of breathing and airway closure during swallowing. To what extent infants decrease ventilatory compromise during feeding by modifying feeding behavior is unknown. We increased swallowing frequency in infants by facilitating formula flow to study potential ventilatory sparing mechanisms. We studied seven full-term healthy infants 5-12 days of age. Nasal air flow and tidal volume were recorded with a nasal flowmeter. Soft fluid-filled catheters in the oropharynx and bottle recorded swallowing and sucking activity, and volume changes in the bottle were continuously measured. Bottle pressure was increased to facilitate formula flow. Low- and high-pressure trials were then compared. With the change from low to high pressure, consumption rate increased, as did sucking and swallowing frequencies. This change reversed on return to low pressure. Under high-pressure conditions, we saw a decrease in minute ventilation as expected. With onset of high pressure, sucking and swallowing volumes increased, whereas duration of airway closure during swallows remained constant. Therefore, increased formula consumption was associated with reduced ventilation, a predictable consequence of increased swallowing frequency. However, when consumption rate was high, the infant also increased swallowing volume, a tactic that is potentially ventilatory sparing as a lower swallowing frequency is required to achieve the increased consumption rate. As well, when consumption rate is low, the sucking-to-swallowing ratio increases, again potentially conserving ventilation by decreasing swallowing frequency much more than if the sucking-to-swallowing ratio was constant.

Bottle Feeding↗
PubMed1990

Injection of 5,7-dihydroxytryptamine into the B3 raphe region of neonatal rat pups induces hyperalgesia but only slight alterations in ingestion-related behaviors.

The effects of intrabrainstem injections of the neurotoxin 5,7-dihydroxytryptamine (5,7-DHT) into the B3 raphe region (nucleus raphe magnus and nucleus reticularis paragigantocellularis) on early ingestive behavior and nociception were assessed in Sprague-Dawley rat pups during the first postnatal week. Lesions resulted in a marked depletion of serotonin (5HT) in hindbrain without influencing 5HT levels in forebrain. Pretreatment with desipramine (DMI) resulted in a sparing of noradrenergic neurons from neurotoxic effects. The B3 lesion resulted in significant hyperalgesia as reflected by decreased latencies in tail flick testing. Although nipple attachment latencies in suckling tests were slightly increased by the lesion, no notable effects on mouthing or other ingestive-related behaviors were observed in testing conducted in an independent ingestion paradigm. These results suggest that whereas B3 serotonergic neurons may be functioning in an adult-typical manner to regulate analgesia during the early postnatal period, this raphe region may play only a slight role in the modulation of ingestion-related behaviors early in life.

5,7-Dihydroxytryptamine↗
PubMed1989

Genetic influences on behavior of infant Mus domesticus: a comparison of results from diallels derived from single and multiple populations.

A complete diallel cross was generated from six Jax inbred strains of Mus domesticus from diverse origins and a second 6 x 6 diallel generated from strains derived from a single wild population. During their second day of life, infants from both diallels were tested for latency to orient toward and root beneath mothers and, in a separate test, for latency to attach to mother's nipple. Rooting latency showed a significant additive maternal strain effect but little systematic effect of pup genotype. Nipple attachment latencies exhibited complete genetic dominance favoring rapid attachment, with no maternal effects. Patterns of genetic and influences obtained from the two diallels were highly similar for both behaviors, suggesting that for many traits the requirement that strains be drawn from a common base population may be relaxed.

Animals↗