Preterm babies: survival is good, but 90% suffer from dysphagia
Over 30 thousand children are born preterm in Italy every year. Fragile, highly complex, in need of a special and privileged relationship, starting from the nutritional aspect. If on the one hand technology and scientific progress have favored the survival of preterm infants, on the other the problems of neonatal dysphagia have increased (today equal to 90%), i.e. the inability to switch from enteral nutrition, with a nasogastric tube , oral feeding and, therefore, the achievement of complete oral feeding, necessary for the discharge of the newborn from the NICU.
The speech therapist is fundamental to encouraging this dynamic, as he is a key figure due to his high skills in the field of communication and oral functions. “Simple gestures, great results” is therefore not only the slogan of the World Prematurity Day which takes place today, but it is also the commitment and mission of modern neonatology and the departments of excellence throughout Italy, which guarantee the survival of the little ones premature. There are many awareness initiatives today in Italy. Info on www.fli.it.
Research
“Progress in scientific, technological and therapeutic research – he explains Tiziana Rossetto, president of the Italian Speech Therapists Federation – has favored the significantly increased survival of premature newborns, small patients who are difficult to treat due to the related complexities. Among these, for example, neonatal dysphagia, i.e. the natural inability to switch from feeding with a nasogastric tube (enteral feeding) to oral feeding, until reaching the so-called ‘full oral feeding’, i.e. the condition that allows discharge from the newborn from the NICU, according to the guidelines of the American Academy of Pediatrics (2008-2011)”.
This dynamic involves the management of the newborn by a multidisciplinary team, where the speech therapist has a key role due to his high skills in the field of communication and oral functions, and ‘guidance’ in the rehabilitation process, according to a so-called ‘ co-regulation’. “The latter – he adds Sara Panizzolo, speech therapist at the NICU Complex Operating Unit of the Monaldi hospital in Naples -. is based on the principles of developmental care: a pool of actions and interventions, also implemented by the speech therapist, which allow, in terms of neuroprotection, the harmonious psycho-physical evolution of the vulnerable newborn, completely changing the paradigms of nutrition. In fact, we have moved from quantity criteria, which required newborns to eat all the milk prescribed and unconditionally to encourage their growth, to quality criteria based on reading the newborn’s communicative responses as a guide for the caregiver”.
The role of the speech therapist
“The speech therapist, through guided learning training, transfers this information and skills to the parent so that he can adopt them and put them into practice independently even after resigning – concludes Rossetto -. These are actions also promoted by the major scientific societies in the sector, both international (EFCNI, European Foundation for the Care of Newborn Infants) and national (SIN, Italian Society of Neonatology)”.
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