Active Bottle for Home Care of Dysphagic Infants

DESCRIPTION (provided by applicant): An active infant feeding bottle is proposed for home care feeding of dysphagic infants to promote coordination of sucking, swallowing, and breathing during oral feeding. Neurogenic dysphagia among infants is characterized by difficulty with active transport of liquid to the mouth and stomach. During oral feeding, these infants are prone to aspirating fluid into the lungs, and are therefore at risk of pneumonia. Once discharged to home care, these children are likely to return frequently for outpatient treatment of their chronic feeding problems. Ultimately, the proposed active bottle will precisely dispense milk during bottle-feeding, based on measurements obtained from onboard sensors, encouraging the child to maintain an "optimum" feeding pattern. The intent of the bottle is to achieve more effective and better individualized home care treatment for each child and, hence, to reduce the dependence on hospital care. The incremental direct medical costs of low birth weight in the first year of life in the U.S. exceeded 4 billion dollars in 1988, accounting for 35% of total health care costs for infants. Furthermore, serious health consequences may result if these feeding problems persist once infants are discharged to home, including malnutrition and impaired intellectual growth. A reduction in number of hospital visits associated with oral feeding difficulty could substantially reduce health care costs and perhaps reduce the risk of later feeding-related health problems. The Phase I will necessarily focus on development and test of the home care active bottle, whereas in Phase II we will conduct human clinical trials to determine its safety and efficacy. The Phase I will consist of design and construction of an active bottle system prototype; bench testing in the laboratory of the prototype to confirm the necessary performance of each of the components of the system; and system testing in which representative sensor data (from past measurements on children) will be input to the control computer and the response of the system observed. We conclude with a planning task necessary to begin testing with infants during a Phase II.