Experience with a "Feed and Swaddle" program in infants up to six months of age

Acta Anaesthesiol Scand. 2020 Jan;64(1):63-68. doi: 10.1111/aas.13471. Epub 2019 Oct 7.

Abstract

Background: Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia.

Methods: We reviewed the charts of all infants ≤6 months who underwent brain MRI at our institution between 1 January 2013 and 31 March 2016. We recorded and analyzed demographic information, scan indication, scan length, prematurity status, anesthetic technique if used, complications, and diagnostic success or failure.

Results: One hundred and sixty-four term infants underwent brain MRI using a feed and swaddle technique. The success rate in term infants <90 days was 91.1% (113/124) versus 95.0% (38/40) in infants ≥90 days and ≤181 days old. Fifty-three premature infants underwent feed and swaddle for brain MRI with a diagnostic success rate of 92.5% (49/53). No complications were noted in any feed and swaddle patients. Those who received anesthesia had a diagnostic success rate of 100% (70/70) but experienced complications including hypoxemia, 14.3% (10/70); hypothermia, 18.9% (10/53); bradycardia, 10.1% (7/69); and hypotension, 4.2% (3/70).

Conclusion: Given the high rate of success and absence of complications with feed and swaddle in children ≤6 months for brain MRI and the presence of anesthesia-related complications, most infants should undergo a trial of feed and swaddle prior to undergoing brain MRI with anesthesia.

Keywords: general anesthesia; infant; magnetic resonance imaging; pediatrics; premature infant; radiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Bedding and Linens
  • Brain / diagnostic imaging*
  • Feeding Behavior / physiology*
  • Female
  • Humans
  • Infant
  • Infant Formula
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods*
  • Male
  • Milk, Human
  • Restraint, Physical / methods*
  • Retrospective Studies
  • Sleep / physiology*