Big Breakthrough for the Tiniest Hearts

A novel feeding device developed at the University of Pennsylvania School of Nursing may decrease the risk of failure to thrive (FTT), which currently affects half of all newborns with congenital heart defects even after their surgical lesions are corrected.

Professor and nurse practitioner Barbara Medoff-Cooper, PhD, CRNP, of Penn Nursing invented a device that analyzes an infant’s ability to organize feeding by sucking, swallowing, and breathing effectively. This device, developed in collaboration with Penn bioengineers, allows healthcare professionals to assess infants at risk for dysfunctional feeding and poor weight gain as often seen in both premature infants and infants with complex congenital heart disease. The data also can be correlated with growth or developmental problems that may occur during the first year of life.

“Feeding actually speaks loudly to us about the brain,” says Dr. Medoff-Cooper. “If a child is feeding well, it gives us one fewer major issue to worry about. Conversely, even a full-term infant who is not feeding well is at high risk for developmental problems.”

Dr. Medoff-Cooper conducted the first comprehensive evaluation of feeding difficulties in infants with complex congenital heart defects. Her work has demonstrated that feeding behaviors can predict developmental outcomes in high-risk infants because of the complicated interplay of movements and physiologic responses needed in the feeding process. The premise of her work is that feeding effectiveness corresponds to how well infants will achieve other developmental milestones.

The University of Pennsylvania School of Nursing is one of the premier research institutions in nursing, producing new knowledge in geriatrics, pediatrics, oncology, quality-of-life choices, and other areas. Researchers here consistently receive more research funding from the National Institutes of Health than any other private nursing school, and many Master’s programs are ranked first in the country. This year, faculty, students, alumni, and staff celebrate 125 years of nursing at Penn.

In the first few years of life most kids gain weight and grow much more quickly than they will later on. Sometimes, however, kids don't meet expected standards of growth. Most still follow growth patterns that are variations of normal, but others are considered to have "failure to thrive."

This is a general diagnosis, with many possible causes. Common to all cases, though, is the failure to gain weight as expected, often accompanied by poor height growth.

Diagnosing and treating a child who fails to thrive focuses on identifying any underlying problem. From there, doctors and the family work together to get the child back into a healthy growth pattern.

About Failure to Thrive

Although it's been recognized for more than a century, failure to thrive lacks a precise definition, in part because it describes a condition rather than a specific disease. Kids who fail to thrive don't receive or are unable to take in, retain, or utilize the calories needed to gain weight and grow as expected.