Effects of Swaddling on Infants During Feeding
Effects of Swaddling on Infants During Feeding
The purpose of this randomized, within-subject, cross-over study is to examine if swaddling
 affects bottle feeding performance in infants born preterm. Results from research will have
 implication on neurobehavioral and physiologic outcomes as important indicators for the
 possible effect of swaddling during bottle feeding.
Once an infant is orally feeding a minimum of two times per nursing shift for four
 consecutive nursing shifts, the infant will be randomly assigned to receive the intervention
 (swaddling) or control condition (no swaddling) first, by the research OT randomly choosing
 an envelope with the assignment enclosed. The intervention and control feedings for each
 infant will be consecutive and will take place at the infant's bedside in the NICU. Infants
 will be assessed at each nursing care time for feeding readiness by the research OT and
 feeding OT according the policies of the NYU Langone Medical Center NICU, which utilizes the
 Infant-Driven Feeding Scale-Readiness (Appendix B) (Ludwig & Waitzman, 2006). When the infant
 demonstrates readiness, the first condition will be initiated. At the next feeding when the
 infant demonstrates readiness, the opposite condition will be applied. If the infant is not
 available due to procedures or not demonstrating feeding readiness, at the next two
 caregiving times after the first feeding, the infant will be discontinued for that day and
 will start the study over the next day.
Inclusion Criteria:

 -  all infants born before 34 weeks gestational age will be included as long as they do
 not have any exclusion criteria

 -  infants born before 34 weeks gestational age is 33 weeks 3 days to 35 weeks 0 days,
 with attainment of exclusive bottle feeding at 36 weeks gestational age at the
 earliest.

 -  Infants who are multiples will be included but restricted to twins and triplets.

 -  Infants will only be included if their parents provide informed consent for
 participation of their infant in the study.

 Exclusion Criteria:

 The exclusion criteria are factors commonly associated with feeding problems in infants
 beyond prematurity, including:

 -  Infants who are exclusively breastfed

 -  Higher order multiples than twins and triplets (ie. quadruplets)

 -  Infants with conditions that may affect feeding performance:

 1. Grades III and IV intraventricular hemorrhage

 2. Necrotizing enterocolitis

 3. Congenital cardiac anomalies (except medically managed patent ductus arteriosus)

 4. Genetic syndromes

 5. Craniofacial abnormalities