VCU receives $1.5 million research grant from NIH

By Michael Ford
University News Services

RICHMOND, Va. – A Virginia Commonwealth University researcher will use a $1.5 million grant from the National Institutes of Health to study the feeding abilities of preterm infants.

As the project’s principal investigator, Rita Pickler, Ph.D., R.N., P.N.P., professor of maternal-child nursing, will develop reliable criteria for determining when preterm babies are ready to bottle feed. The study also will develop ways to help preterm babies become better feeders.

"As preterm infants gain weight and get close to hospital discharge, they have to be able to take all their feeding orally before they go home," Pickler said. "It’s for safety reasons, but we also want to be sure the infant is receiving adequate nutrition."

Before they can feed orally, preterm infants are tube fed. Infants in the study will range from 34 weeks to, as young as, 22 weeks of gestational age. Full-term births occur at 40 weeks of gestational age.

The interdisciplinary research team will seek to predict when preterm infants have coordinated three critical actions: sucking, swallowing and breathing. Pickler said coordinating all three is a complex skill for tiny infants who often interrupt their breathing while sucking and swallowing, which temporarily can leave them with a diminished oxygen supply and exhausted from feeding.

"Their breathing becomes rapid because they’re trying to re-oxygenate themselves. So it becomes a very complex and difficult milestone for preterm infants," Pickler said. "It’s critical to their well-being that they’re able to feed safely and that they’re able to feed in a way that doesn’t cost them more in energy than they take in by way of nutrition."

Statistics show that, American women give birth annually to 450,000 preterm infants. Nearly 250 preterm babies were treated at MCV Hospitals in 1997. In 1998, 131 pre-term babies stayed an average of 49 days at the hospital’s Neonatal Intensive Care Unit.

Pickler will enroll 95 preterm babies at VCU’s Medical College of Virginia Hospitals during the four-year study, funded by the National Institute of Nursing Research.

Following six months of training for study contributors, the first 16 infants will be enrolled in July. Researchers will observe and evaluate feedings every day for two weeks after preterm infants begin bottle-feeding at 32 weeks post-conceptional age.

Five other VCU faculty are study collaborators: Gerald E. Miller, Ph.D., associate dean for graduate studies and chairman of bio-medical engineering in the School of Engineering; Stephen J. Goldberg, Ph.D., professor of anatomy and an expert in neurophysiology; Al M. Best III, Ph.D., associate professor of biostatistics and psychiatry, whose areas of expertise include data management and statistical analysis; Kathryn W. Kerkering, M.D., associate professor of pediatrics in the Division of Neonatal-Perinatal Medicine; and Barbara Reyna, M.S., R.N., a newborn nurse practitioner in the Neonatal Intensive Care Unit.