A recent study suggests that a modified pacifier and AI algorithms can be used to assess whether newborns are developing the proper nursing skills. The study, conducted by researchers at the University of Califo, measured the suckling strength and pattern of babies based on eight independent parameters to determine if they are breastfeeding effectively.California San Diego conducted a study to assess if infants are developing enough suckling strength for breastfeeding and if they are following a consistent sucking pattern based on eight independent parameters.
The findings, which were reported in the April 18 online edition of IEEE Journal of Translational Engineering in Health and Medicine, offer researchers concrete data that indicates traditional assessments could be enhanced and potentially lead to the avoidance of surgical interventions.
At present, clinicians use two measures to determine if an infant is breastfeeding effectively. One measure is objective: is the baby gaining enough weight? The other is more subjective: clinicians observe the frequency and effectiveness of the infant’s sucking.”The method we developed with our clinical partners replaces this subjective assessment with objective data,” said James Friend, a professor in the Department of Mechanical and Aerospace Engineering and the Department of Surgery at UC San Diego and one of the paper’s senior authors. The testing method has two components. One is a device made up of a simple pacifier, connected to a 36-inch-long tube connected in turn to a vacuum sensor and a chip that collects the data from the sensor. The device can connect to any laptop. “We wanted to keep the device as simple and inexpensive as possible,” said Saad Bhamla, an assistant professor in the George W. Woodruff School of Mechanical Engineering at Georgia Tech and one of the paper’s senior authors.Friend, who is a faculty member at the UC San Diego Jacobs School of Engineering, emphasized the importance of keeping the technology simple by using readily available and cost-effective components to encourage its use in clinical settings. Another crucial component is the software, which not only displays the data but also utilizes machine learning algorithms to detect any irregularities or deviations. As the infant uses the pacifier, the software captures and compares the data, and two distinct machine learning algorithms analyze it to identify any abnormal patterns. Previous research has demonstrated that Using a pacifier for non-nutritive suckling can provide valuable data for assessing breastfeeding,” said Erin Walsh, co-senior author of the study and a speech-language pathologist and lactation consultant at UC San Diego Health. “Having scientific evidence to support my evaluations is reassuring. We hope that our results will offer support to parents struggling with breastfeeding and lead to better long-term health outcomes.”
The study’s findings generally confirmed the assessments made by clinicians. However, the study also revealed that the subjective assessment of an infant’s suckling ability by a clinician inserting a fingertip into the infant’s mouth,
“The current standard practice could be improved by utilizing the data generated by the device,” said Phuong Truong, a Ph.D. student in Friend’s lab and the first author of the paper. Truong emphasized the importance of early detection of breastfeeding difficulties within the first month, as it aligns with the crucial phase of milk establishment and susceptibility to breast injury.
Truong also pointed out that while mothers can seek medical assistance, the lack of precise measurement tools often leads to delayed identification of underlying issues, potentially causing a decline in breastfeeding rates. “Our measurement system aims to provide rapid and accurate data on an infant’s Truong mentioned that the ability to identify suckling issues early on can help healthcare providers address the underlying problems quickly and possibly reduce the likelihood of breastfeeding cessation. Is surgery to correct tongue-tie necessary? Around 7% of infants are diagnosed with tongue-tie, a condition where the connection between the tongue and the floor of the mouth is too tight, restricting tongue movement. This condition can make breastfeeding difficult and often requires a surgical procedure called frenotomy, which involves cutting the connective tissue between the tongue and the floor of the mouth. Information from the device indicated that There was no improvement in half of the infants studied before and after undergoing a frenotomy. However, the other half, whose data showed abnormal patterns and were identified by the algorithms as needing a frenotomy, did see a significant improvement in suckling behavior after the surgery.
These findings indicate that in some cases, surgical interventions may be avoidable.
The device’s data also detected abnormal nursing behavior in five babies that had not been noticed during a clinical examination.
These results are significant because the number of frenotomies has increased tenfold in less than a decade. “Our information indicates that frenotomies are not a universal solution for breastfeeding difficulties,” Walsh stated.
How the research was conducted
The proof of concept study was approved by UC San Diego’s Internal Review Board. Parents of healthy full-term infants under 30 days old were recruited from the UC San Diego Center for Voice and Swallowing, UC San Diego Health La Jolla Pediatrics, and the UC San Diego Jacobs Medical Center.
Altogether, the 91 participants in the proof of concept study were recruited during routine postpartum care with their general pediatrician at UC San Diego Health or while consulting with feed.feeding specialists at their respective locations. The criteria for including infants was that they needed to be healthy full-term infants who were establishing breastfeeding and did not have any major birth or postpartum complications.
In this study, clinicians did not have access to the device data and conducted evaluations based on standard practice. After the clinical assessments, parents were given the opportunity to use the modified pacifier for 60 seconds to measure their infant’s intraoral suckling vacuum.
Future Steps
The next steps involve conducting a clinical trial outside of UC San Diego Health, with the ultimate goal of making both theThe use of this device and algorithm is becoming more common in pediatric practices, where they can be utilized during an infant’s initial appointment. Friend and Walsh are working on starting a company to obtain the rights to the technology from UC San Diego and make it available in clinics. The study received funding from various sources including the Galvanizing Engineering in Medicine initiative at UC San Diego, National Institutes of Health, the Willia H. and Mattie Wattis Harris Foundation, and the UC San Diego Krupp Center for Integrative Research.