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A saliva based gene test could predict oral feeding readiness in preemies

Posted:  Monday, February 02, 2015

In a first, American researchers developed a salivary biomarker test to determine oral feeding readiness in preterm infants. This discovery may pave the way for objective tools for caregivers to assess feeding readiness. Currently, only subjective evaluations are available for the same.

The researchers combined gene amplification techniques with advanced computational analysis tools to identify and validate the salivary biomarkers that could predict oral feeding readiness in preterm infants. The results of the study were published in the Journal of Pediatrics.

The study consisted of 2 phases; phase 1 involved examination of saliva samples from 12 preterm infants during the learning process of oral feeding to identify potential salivary genes associated with oral feeding success. In phase 2, the researchers prospectively tested 24 genes identified in phase 1 on 400 salivary samples; 200 from successful and 200 from unsuccessful feeders. They then analysed the results to identify genes that could potentially predict oral feeding readiness.

The study identified 5 genes that could predict feeding success. These genes represented a range of biological systems, namely sensory integration (NPHP4, PLXNA1); hypothalamic regulation, a region involved in hunger signalling (NPY2R); facial development (WNT3, a gene associated with lip and palate development); and energy expenditure (AMPK, a regulator of whole body energy balance). A mature feeding pattern prediction meant absence of 3 genes, NPHP4 (sensory), NPY2R (hypothalamic), and WNT3 (facial) in neonatal saliva and the presence of 2 genes, AMPK (energy expenditure) and PLXNA1 (sensory) in the same saliva sample.

The researchers found that these genes together with gender and post-conceptional age accurately predicted oral feeding readiness in 78% of newborns. Female gender and advancing post-conceptional age were positive predictors of an infant’s ability to feed orally. Talking about the study, the researchers said, “ By combining salivary gene expression profiles, post-conceptional age and sex, this predictive model not only assessed the probability of feeding success, but also, and most importantly, highlighted specific developmental pathways that were likely contributing to feeding immaturity. Identifying which infant has which deficit could allow caregivers to develop individualized treatment modalities based on each infant's salivary gene expression profile to improve quality of care.”

Oral readiness in newborns is important because attempting to feed a newborn before he or she is ready may cause choking, feeding aversion and poor growth. Thus, determining feeding readiness objectively could help avert plenty of feeding complications.

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