Morsicatio labiorum is a form of tissue alteration caused by self-induced injury, mostly occurring on the lips, and is considered to be a rarely encountered mucocutaneous disorder. Clinically, it is a macerated grey-white patch and plaque of the mucosa caused by external stimuli (self-induced injury) such as habitual biting, chewing, or sucking of the lip. It is often confused with other dermatological disorders involving the oral mucosa, which can lead to a misdiagnosis. We herein report three cases of morsicatio labiorum; two cases were misdiagnosed as exfoliative cheilitis at the time of the first visit.
Bites and Stings ; Cheilitis ; Diagnostic Errors ; Lip ; Mastication ; Mouth Mucosa ; Mucous Membrane ; Sucking Behavior

PURPOSE: The purpose of this study was to evaluate the effects of oral stimulation interventions on the transition from tube to oral feeding in preterm infants through systematic review. METHODS: The randomized clinical trials published between 1980 and 2015 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the SIGN and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan). RESULTS: Oral stimulation intervention in preterm infants decreased the transition time from tube to oral feeding (Post Menstrual Age, Day of life). Especially, a significant medium effect size was found in the number of days needed on the transition (ES=-4.95, p=.02). The oral stimulation intervention also had a significant large effect on the length of stay at hospital (ES=-8.33, p < .001). CONCLUSION: Based on the findings, oral stimulation interventions could be useful to facilitate the transition from tube to oral feeding in preterm infants in terms of reducing the length of stay at hospital and the number of days needed on transition.
Humans ; Infant, Newborn ; Infant, Premature ; Length of Stay ; Physical Stimulation ; Sucking Behavior

OBJECTIVETo study the role of non-nutritive sucking in preterm infants requiring mechanical ventilation therapy.

METHODSIn a study of 68 preterm infants requiring mechanical ventilation, a randomly selected observation group of 35 infants was provided with non-nutritive sucking and a control group of 33 infants was not. The time to reach full enteral feeding, birth weight recovery time, body weight growth rate, hospitalization time, feeding tolerance and mechanical ventilation-related complications were compared between the two groups.

RESULTSThe time to reach full enteral feeding and hospitalization time were shorter (P<0.01), the incidence of feeding intolerance was lower (P<0.05), and the body weight growth rate was higher (P<0.05) in the observation group than in the control group. There were no significant differences in the birth weight recovery time and the incidence of mechanical ventilation-related complications between the two groups.

CONCLUSIONSThe use of non-nutritive sucking can increase growth rate, shorten hospitalization time and improve feeding tolerance in preterm infants requiring mechanical ventilation therapy. Moreover, it does not result in an increase in mechanical ventilation-related complications.

Female ; Humans ; Infant Care ; Infant, Newborn ; Infant, Premature ; growth & development ; Length of Stay ; Male ; Respiration, Artificial ; Sucking Behavior ; Weight Gain

OBJECTIVETo study the differential facial responses to four basic tastes of the newborns and the gender-related different taste sensitivity.

METHODSSixty-two newborns (31 females and 31 males) born in the Department of Obstetrics, First Hospital of the Chongqing University of Medical Sciences were tested for responses to four solutions, including 25% sucrose (sweet), 5% sodium chloride (salt), 1.43% citric acid (sour), and 0.025% berberine (bitter) 90 minutes after birth. The inclusion criteria were: (1) medically uncomplicated full-term pregnancy; (2) medically uncomplicated spontaneous vaginal delivery; (3) Apgar score of at least 8 at 1 and 5 min. All the infants were found to be normal and healthy on pediatric examination. The facial responses of the newborns were recorded by video. The facial responses were divided into nine facial action units and expressions from A1 to C3, which are also expressed as the 1 - 9 grades of intensity, crying was included as grade 9 and nausea was defined as grade 10 intensity. The distinctions of the facial responses were analyzed by chi-square test. The distinctions of sex in the facial responses were analyzed by the Wilcoxon test.

RESULTSAll the newborns were full term, excluding the medical conditions. The average birth weight of the newborns was 3324.3 g. The data from the study indicated that absence of distinctive mouth action or sucking was the major facial response of the infants to sucrose solution (P < 0.01). There were no special expressions when the newborns were given the salt solution (P > 0.01). The lip pursing with negative brow and middle face actions were major response of the infants to the sour solution (citric acid) (P < 0.01). The expressions in response to the bitter solution of the infants were the mouth gaping with negative brow and middle face actions (P < 0.01). The facial responses to the sweet and bitter solutions in the boys were more sensitive than those in the girls (P < 0.01). There was no sex difference in the intensities of the facial responses to the salt and sour solutions (P > 0.05).

CONCLUSIONSThe newborns had distinct responses to the four solutions shortly after birth. The facial expression to sweet and bitter solutions in the boys were more sensitive than in the girls.

Berberine ; administration & dosage ; Citric Acid ; administration & dosage ; Discrimination Learning ; physiology ; Facial Expression ; Female ; Humans ; Infant Behavior ; physiology ; Infant, Newborn ; growth & development ; Male ; Sex Factors ; Sodium Chloride ; administration & dosage ; Sucking Behavior ; physiology ; Sucrose ; administration & dosage ; Taste ; Taste Threshold

OBJECTIVEAlthough nonnutritive sucking (NNS) during tube feeding has some benefits on the physiology and development of premature infants, the effect on gastrointestinal function remains controversial. The aim of the study was to evaluate the effects of NNS on the gastric emptying and gastroesophageal reflux (GER) in premature infants.

METHODSThirty eight healthy appropriate-for-gestational-age premature infants (birth weight ranged from 1050 g to 1790 g, gestational age ranged from 28 weeks to 35 weeks) accepting intermittent nasogastric feeding (INGF) were randomized into NNS group and N-NNS group according to INGF with and without NNS and fed with the same milk formula. Group NNS (n = 18) received oral stimulation by means of a pacifier immediately before feeding, during feeding and then after feeding for 5 min. Group N-NNS (n = 20) served as control and received INGF alone. The following data were collected and recorded, the fluid intake (including both intravenous and oral), milk intake, caloric intake, time of caloric intake reaching 418.4 kJ/(kg x d) by enteral feeding and relevant condition to feeding. Gastric emptying was measured when oral intake reaching above 8 ml/kg while concurrently measuring 24 hour esophageal pH. Real time ultrasonic images of the gastric antrum were obtained and the antral cross sectional area (ACSA) was measured and the half emptying time (50% DeltaACSA) was calculated. Using 24-hour intraesophageal pH monitoring for evaluation of GER, the five parameters of esophageal pH were recorded: number of reflux episodes during 24 hours, reflux index, number of episodes lasting > 5 min, the duration of longest episode and the total time of pH < 4.0.

RESULTSWithin two weeks after feeding, there was no significant difference in the fluid intake, caloric intake between the two groups (P > 0.05). Gastric emptying was measured on day 13.26, milk intake had no difference between the two groups and there was no difference in prefeed ACSA. The half gastric emptying time in NNS group was significantly shorter than that in N-NNS group [(58.33 +/- 22.94) min vs. (73.75 +/- 17.76) min, P < 0.05]. Thirty-two of the 38 infants developed GER, the morbidity was 84.2%; the number of reflux episodes during 24 hours was significantly fewer in NNS group than that in N-NNS group [9 (2 - 31) vs. 14 (5 - 31), P < 0.05]; the total time pH < 4.0 and reflux index was lower in NNS than that in N-NNS, but the difference was not statistically significant. The time of reaching 418.4 kJ/(kg x d) by enteral feeding in NNS group was significantly shorter than that in N-NNS group [(12.36 +/- 4.29) d vs. (15.50 +/- 4.58) d, P < 0.05]. The incidence of feeding intolerance such as vomiting and abdominal distension was lower in NNS group than that in N-NNS group, but the difference was not statistically significant (P > 0.05). However, the morbidity of gastric residue in NNS was significantly lower than that in N-NNS (16.7% vs 50.0%, respectively, P < 0.05).

CONCLUSIONNNS used during intermittent nasogastric tube feeding is an easy and safe intervention. NNS can improve gastric emptying and decrease the number of reflux episodes, has a positive improving effect on the development of gastrointestinal motility, is beneficial to premature infants for establishing postnatal enteral nutrition.

Enteral Nutrition ; Gastric Emptying ; physiology ; Gastroesophageal Reflux ; physiopathology ; prevention & control ; Gastrointestinal Motility ; physiology ; Humans ; Infant Formula ; Infant Nutritional Physiological Phenomena ; physiology ; Infant, Newborn ; physiology ; Infant, Premature ; physiology ; Pacifiers ; Sucking Behavior

OBJECTIVETo evaluate the effects of nonnutritive sucking (NNS) on the nutrient intake, physical growth, feeding-related complications and whole gastrointestinal transit time (WGTT) in premature infants.

METHODSThirty eight healthy appropriate for gestational age premature infants (birth weights ranged from 1 050 g to 1 790 g) accepting intermittent nasogastric feeding (INGF) were randomized into NNS group and N-NNS group according to INGF with and without NNS and fed with the same milk formula. The following data were collected and recorded, the physical growth parameters (e.g, body weight, length and head circumference) and the birth-weight regaining time, the fluid intake (including both intravenous and oral), caloric intake, time of reaching 418.4 kJ/(kg.d) by enteral feeding, time of putting nasogastric tube, stool frequency and characters, and relevant complications. WGTT were monitored.

RESULTSThe birth-weight regaining time in NNS group was significantly shorter than that in N-NNS group [(8.8 +/- 3.7) d vs (11.1 +/- 3.0) d, P < 0.05]. Within two weeks after feeding, there was no significant difference in the increase of body weight, length and head circumference between the two groups (P > 0.05). The time of reaching 418.4 kJ/(kg.d) by enteral feeding in NNS group was significantly shorter than that in N-NNS group [(12.3 +/- 5.1) d vs (15.7 +/- 5.2) d, P < 0.05]; the times of putting nasogastric tube were respectively (13 +/- 10) d and (17 +/- 12) d, but the difference was not significant (P > 0.05). The morbidity of such complications as vomiting and abdominal distension was lower in NNS group than that in N-NNS group, but the difference was not statistically significant (P > 0.05). However, the morbidity of gastric residue in NNS was significantly lower than that in N-NNS (P < 0.05). WGTT of the second week in NNS group was significantly shorter than that in N-NNS [(33 +/- 13) h vs (45 +/- 20) h, P < 0.05]. Stool frequencies of the second week in NNS group were significantly more than those in N-NNS group [(2.26 +/- 0.17) times/d vs (1.79 +/- 0.58) times/d, P < 0.05]. However, there were no significantly differences in WGTT and stool frequencies of the first week between the two groups (P > 0.05).

CONCLUSIONNNS was recommended as a beneficial intervention for premature infants during intermittent nasogastric tube feeding.

Enteral Nutrition ; Female ; Gastrointestinal Motility ; physiology ; Gastrointestinal Tract ; physiology ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Low Birth Weight ; growth & development ; Infant, Newborn ; Infant, Premature ; growth & development ; Infant, Very Low Birth Weight ; growth & development ; Male ; Sucking Behavior