Abstract:
A heating system for warming nutritional liquid fed to a neonate or preterm infant may comprise a control module and a heater. The heating system is portable so that the heating system is not connected to a syringe pump or other device used to feed the neonate. The heater of the heating system is mounted to the tube that is used to feed the neonate. The heater is positioned along the tube in close proximity to the neonate so that a temperature drop of the nutritional liquid after the nutritional liquid exits the heater and reaches the neonate is negligible. The heater raises the temperature of the nutritional liquid to a target desired temperature (e.g., body temperature of the mother and neonate or to a temperature above the temperature of the mother and neonate) so that the neonate may consume warm nutritional fluid. Once the nutritional liquid reaches the neonate, the nutritional liquid is at about the body temperature of the mother or neonate or at least above room temperature.

Description:
BACKGROUND 
       [0001]    The embodiments disclosed herein relate to a heater for warming nutritional liquid fed to a pre-term infant. 
         [0002]    Nutritional delivery to a preterm infant or enteral feeding is an important part of caring for the preterm infant in neonate-natal intensive care units. Typically, the preterm infant is fed with a feeding tube that delivers breast milk or neonatal formula directly into the stomach of the preterm infant. The feeding tube is generally introduced either through the nose (i.e., nasally) or through the mouth (i.e., gastrically). Previously, the breast milk or neonatal formula was fed to the neonate while the breast milk or neonate formula was at room temperature (i.e., below body temperature). However, studies have shown that preterm infants respond favorably when the nutritional liquid (e.g., breast milk or neonatal formula) coincides with the body temperature of a person (i.e., 98.6° F.). When the nutritional liquid is provided to the preterm infant at a temperature closer to the body temperature of a person, the preterm infant was found to digest more of the nutritional liquid. Moreover, other studies have found that the lower the body temperature of the preterm infant, the higher the likelihood of mortality of the preterm infant. As such, it is important to preserve the preterm infant&#39;s energy so that the preterm infant does not need to divert energy away from heating and growth to generate heat. If the nutritional liquid is fed to the preterm infant at room temperature, the preterm infant must divert energy that could be used for healing and growth to heat him or herself due to digestion of the cold nutritional liquid. Accordingly, it would be beneficial to feed preterm infants with nutritional liquid raised to the body temperature of a person to reduce the amount of energy diverted away from healing and growth to digestion and heat generation. 
         [0003]    In response, prior art devices have been introduced for warming nutritional liquid (e.g., breast milk or neonate formula) provided to pre-term infants. Typically, the nutritional liquid is warmed in a neonate feeding syringe or warm nutritional liquid is poured into the syringe and then fed to the neonate. Unfortunately, even if the nutritional liquid is pre-warmed to body temperature, the temperature of the nutritional liquid in the feeding syringe decreases to room temperature during feeding due to the long feeding time. The average feeding time is about 30 minutes to 4 hours. Heat is lost through the neonate feeding syringe. Also, heat is lost through a tube routed to the stomach of the neonate. In particular, as the nutritional liquid flows from the feeding syringe to the neonate through the tube, significant heat loss is experienced through the tubing since the nutritional liquid travels through the tubing at a relatively slow rate. Accordingly, even if the nutritional liquid in the neonate feeding syringe is raised to the body temperature of the mother, such warming is rendered ineffective since there is a significant temperature drop as the nutritional liquid flows through the tube. 
         [0004]    Accordingly, there is a need in the art for an improved method and device for heating nutritional liquid fed to the pre-term infant. 
       BRIEF SUMMARY 
       [0005]    The embodiments discussed herein address the needs discussed above, discussed below and those that are known in the art. 
         [0006]    A heating system that includes a heater and a control module is disclosed herein. The control module controls operation of the heater. The heater is used to warm the nutritional liquid (e.g., breast milk or neonate formula) being fed to the neonate. In particular, the heater of the heating system is placed in close proximity to the neonate along a length of a tube being used to feed the neonate. Since the heater is in close proximity to the neonate on the tube, the temperature drop due to heat loss through the tube after the nutritional liquid is heated and travels to the neonate is minimal. Moreover, any heat loss from the syringe to the heater is inconsequential since the heater raises the temperature of the nutritional liquid to the desired target temperature immediately before the nutritional liquid reaches the neonate. 
         [0007]    More particularly, a heating system for heating neonate nutritional liquid so that a temperature of the nutritional liquid is greater than room temperature when providing warmed nutritional liquid to the neonate during feeding is disclosed. The heater system may comprise a heater including a first heating portion having a first groove for receiving a tube; a first handle fixed to the first heating portion; a second portion disposable over the first groove; and a second handle fixed to the second portion. 
         [0008]    The first heating portion and handle may be pivotally traverseable to the second portion and handle between open and closed positions. In the open position, the neonate feeding tube may be inserted or removed from the first groove. In the closed position, the second portion covers the first groove and the first heating portion warms the neonate nutritional liquid that flows through the tube. 
         [0009]    The second portion may have a heating portion and a second groove for receiving the tube. The first and second grooves may collectively have a snug fit around the tube for transferring heat through the neonate feeding tube to the neonate nutritional liquid flowing through the neonate feeding tube. The first heating portion may comprise a first heater and a first heat conductor. The first groove may be formed in the first heat conductor. The second heating portion comprises a second heater and a second heat conductor. The second groove may be formed in the second heat conductor. 
         [0010]    The first and second grooves may be straight and have matching semi-circular cross sectional configurations. 
         [0011]    The first and second portions may be pivotally biased to the closed position. A spring may bias the first and second portions to the closed position. 
         [0012]    The heating system may further comprise a control module including a rechargeable battery pack for providing electricity to the heater and a means for controlling the heater. The control module may include a readout for providing a temperature of the heater. The control module may also include a battery strength indicator. The control module and the heater may be in electrical communication with each other through a wire. The control module may be integrated into a body of the heater. 
         [0013]    Additionally, a system for providing warm nutritional liquid to a neonate is disclosed. The system may comprise a neonate feeding syringe fillable with the nutritional liquid; a tube connected to the syringe and in fluid communication with a stomach of the neonate; a syringe pump wherein the syringe is mountable to the syringe pump which forces the nutritional liquid from the syringe through the tube to the neonate; a heater mounted about the tube and positioned closer to the neonate than the syringe pump along a length of the tube wherein the heater transfers heat through the tube and to the nutritional liquid flowing through the tube to minimize heat loss from the nutritional liquid after the nutritional liquid exits the heater and flows toward the neonate so that the nutritional liquid is provided to the neonate above room temperature. 
         [0014]    The tube may be an extension tube and the heater may be positioned immediately adjacent to a distal end of the extension tube. The heater may abut the distal end of the extension tube. 
         [0015]    The system may further comprise a feeding tube in fluid communication with the extension tube and the heater further. The heater may comprise a first heating portion having a first groove for receiving the extension tube; a first handle fixed to the first heating portion; a second portion disposable over the first groove; a second handle fixed to the second portion. 
         [0016]    The first heating portion and handle may be pivotally traversable to the second portion and handle between open and closed positions. In the open position, the feeding tube or extension tube may be inserted or removed from the first groove. In the closed position, the second portion covers the first groove and the first heating portion warms the neonate nutritional liquid that flows through the extension tube or the neonate feeding tube. 
         [0017]    Additionally, a system for providing warm nutritional liquid to a neonate is disclosed. The system may comprise a gravity feeding syringe fillable with the nutritional liquid; a tube connected to the syringe and in fluid communication with a stomach of the neonate; a stand for hanging the gravity feeding syringe above the neonate to flow the nutritional liquid from the syringe through the tube to the neonate; a heater mounted about the tube and positioned closer to the neonate than the syringe pump along a length of the tube. The heater transfers heat through the tube and to the nutritional liquid flowing through the tube to provide warm nutritional liquid to the neonate to minimize heat loss from the nutritional liquid after the nutritional liquid exits the heater and flows toward the neonate so that the nutritional liquid is provided to the neonate above room temperature. 
         [0018]    The tube may be a feeding tube and the heater may be positioned immediately adjacent to the neonate so that a temperature of the nutritional liquid is above room temperature when the nutritional liquid reaches the neonate. 
         [0019]    Additionally, a method of feeding a neonate with warm nutritional liquid is disclosed. The method may comprise the steps of filling a neonate feeding syringe with nutritional liquid; connecting a tube to the neonate feeding syringe; placing the tube in fluid communication with a stomach of the neonate; placing a heater on the tube for heating the nutritional fluid flowing through the tube, the heater being positioned on the tube closer to the neonate than the neonate feeding syringe along a length of the tube; flowing the nutritional liquid from the neonate feeding syringe, through the tube and to the neonate; and heating the nutritional liquid flowing through the tube with the heater so that a temperature of the nutritional liquid is above room temperature when the nutritional liquid reaches the neonate to facilitate digestion of the warm nutritional liquid by the neonate. 
         [0020]    The flowing step may be accomplished with a syringe pump. The flowing step may also comprise elevating the neonate feeding syringe above the neonate to gravity feed the neonate. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0021]    These and other features and advantages of the various embodiments disclosed herein will be better understood with respect to the following description and drawings, in which like numbers refer to like parts throughout, and in which: 
           [0022]      FIG. 1  illustrates a neonate being fed with a syringe pump or alternatively with a gravity syringe and a heating system disposed as close to the neonate so that the neonate is fed with nutritional liquid above room temperature and preferably at normal body temperature of a person; 
           [0023]      FIG. 2  illustrates the heating system having a heater and a control module; 
           [0024]      FIG. 3  is a side view of the heater shown in  FIG. 2 ; 
           [0025]      FIG. 4  is an exploded perspective view of the heater shown in  FIGS. 1-3 ; 
           [0026]      FIG. 5  is an illustration of a second embodiment of the heating system with the control module integrated into the heater; and 
           [0027]      FIG. 6  is a side view of the second embodiment of the heating system shown in  FIG. 5 . 
       
    
    
     DETAILED DESCRIPTION 
       [0028]    Referring now to the drawings, an in-line neonatal fluid tubing heater  10 ,  10   a  is shown. A syringe  12 ,  12   a  is filled with a nutritional liquid (e.g., breast milk or neonate formula). From the syringe  12 ,  12   a,  the nutritional liquid flows through extension tube  18  and feeding tube  14  or feeding tube  14   a.  The heater  10  is mounted to the extension tube  18  or the feeding tube  14   a  to warm up the nutritional liquid flowing through the feeding tube  14 ,  14   a  above room temperature and preferably to about the body temperature of a person (i.e. between about 95° F. and about 99° F.). Feeding warm nutritional liquid to the neonate  16  facilitates digestion of the nutritional liquid and preserves the neonate&#39;s energy for healing and growth. The heater  10 ,  10   a  may be placed on the extension tube  18  or the tube  14   a  as close to the neonate  16  as possible to minimize a reduction in the temperature of the nutritional fluid as the nutritional liquid exits the heater  10 ,  10   a  on its way to the neonate  16 . As the nutritional liquid flows through the heater  10 , the heater  10  increases the temperature of the nutritional liquid to a temperature above room temperature and preferably to a temperature about the body temperature of the neonate  16 . 
         [0029]    As shown in  FIG. 1 , the neonate  16  may be fed nutritional liquid with a syringe  12  and syringe pump  20  or with a gravity syringe  12   a.  In relation to the syringe pump  20 , the heater  10  is shown as being attached to the extension tube  18  instead of the feeding tube  14 . However, it is also contemplated that the heater  10  may be mounted to the feeding tube  14  as close as possible to the neonate  16  in a similar fashion as the heater  10  described in relation to the gravity feeding method. 
         [0030]    A heating system  22  is shown in  FIG. 2 . The heating system  22  may comprise the heater  10  and a control module  24 . The heater  10  is shown in more detail in  FIGS. 3 and 4 . Referring to  FIG. 3 , the heater  10  may be traversed between the open and closed positions. The open position is shown in solid lines in  FIG. 3 . The closed position is shown in dash lines in  FIG. 3 . The first and second handles  26   a, b  and first and second heating portions  28   a, b  may be biased to the closed position as shown in dash lines in  FIG. 3 . The handles  26   a, b  and heating portions  28   a, b  may be biased to the closed position by way of a torsion spring  63  (see  FIG. 4 ) fitted within hinge  30 . From the closed position shown by the dash lines, a person may grip the first and second handles  26   a, b  and apply opposing compressive forces  32   a, b  to overcome the biasing force and open the first and second heating portions  28   a, b.  The feeding tube  14 ,  14   a  or extension tube  18  may be fitted within the heating portions  28   a, b  to heat nutritional liquid that flows through the tubes  14 ,  14   a,    18 . When the tubes  14 ,  14   a,    18  are fitted within the first and second heating portions  28   a, b,  the user may release the first and second handles  26   a, b  to clamp the first and second heating portions  28   a, b  about the tube  14 ,  14   a,    18 . Each of the heating portions  28   a, b  may have a straight elongated groove  34   a, b  that extends along the length  66  of the heating portions  28   a, b  as shown in  FIGS. 2 and 3 . The heating portions  28   a, b  may be sufficiently long so that heat can be transferred into the nutritional liquid as the nutritional liquid flows through the tube  14 ,  14   a,    18  between an entrance  33  and exit  36  (see  FIG. 2 ) of the heating portions  28   a, b.  The heater  10  may also be in electrical communication with the control module  24  through cable  35 . The control module  24  is capable of controlling the heating portions  28   a, b  by way of heater controller  37 . The heater  10  and the control module  24  may be powered by rechargeable batteries  39 . The rechargeable batteries  39  may be recharged by way of a charger connected to a battery recharge port  38 . A readout  40  (e.g., digital readout) provides the temperature of the heating portions  28   a, b.  Battery strength/charging indicator  42  may also be provided on the control module  24 . The control module  24  and the heater  10  may be turned on and off by way of an on/off switch  44 . 
         [0031]    During use, the operator squeezes the handles  26   a, b  together to traverse the heater  10  to the open position as shown in  FIG. 3 . With the heater  10  in the open position, the operator inserts the tube  14 ,  14   a,    18  into the first and second grooves  34   a, b.  In particular, the tube  14 ,  14   a,    18  is inserted into one of the grooves  34   a,    34   b.  Once the tube  14 ,  14   a,    18  is placed in the groove  34   a  or  34   b,  the operator releases the first and second handles  26   a, b  to traverse the heater portions  28   a, b  to the closed position. In the closed position, the tube  14 ,  14   a,    18  is nested within the grooves  34   a, b.  Preferably , the heater portions  28   a, b  contact and press against tube  14 ,  14   a  and  18  to provide as much heat to the nutritional liquid flowing through the tube  14 ,  14   a,    18 . 
         [0032]    Referring now to  FIG. 2 , once the tube  14 ,  14   a,    18  is placed in the heater  10 , the operator turns on the control module  24  by toggling switch  44  to the on position. The user adjusts the temperature at which the heater  10  will heat the nutritional liquid by manipulating buttons of the heater controller  37 . The operator either increases or decreases the maximum temperature of the heater  10 . The maximum temperature is shown on the readout  40 . The heater  10  and the control module  24  have a feedback loop which allows the control module  24  to control the maximum temperature of the heater  10 . Additional toggle buttons and/or readouts  40  may be mounted to the control module  24  so that the readouts  40  can also provide the current temperature of the heater  10 . Additional temperature sensors may be mounted to the heater  10 ,  10   a  to sense a temperature of the nutritional fluid flowing through the tube  14 ,  14   a,    18 . The control module  24  and the heater  10  are portable in that the control module  24  and the heater  10  may be powered by a battery pack  39 . The remaining power in the battery pack  39  may be indicated by indicator  42 . Also, the battery pack  39  may be recharged by connecting the battery pack  39  to a battery charger by way of recharge port  38 . 
         [0033]    Referring now to  FIG. 4 , an exploded view of the heater  10  is shown. The first and second heating portions  28   a, b  may have first and second thermistor thermocouples  46   a, b.  The first and second heating portions  28   a, b  may additionally have first and second heaters  48   a, b.  The first and second thermocouples  46   a, b  and heaters  48   a, b  may be in electrical communication with the control module  24 . When the operator turns on the control module  24 , the control module  24  may send power to the heaters  48   a, b  to increase the temperature of the heating portions  50   a, b.  The thermocouples  46   a, b  take the reading of the temperature of the heating portions  50   a, b  and send that information to the control module  24 . The temperature of the heating portions  50   a, b  may be displayed on the readout  40 . If the thermocouple  46   a, b  indicates that the heating portions  50   a, b  have reached the maximum temperature set by the operator, then the control module  24  modulates the power supplied to the heaters  48   a, b  so that the temperature of the heating portions  50   a, b  is maintained at about the maximum temperature set by the operator. 
         [0034]    Optionally, a temperature sensor  68  may be located adjacent the exit  36  of the heater  10 ,  10   a.  The sensor  68  may sense a temperature of the nutritional fluid flowing through the tube  14 ,  14   a,    18  as the nutritional fluid flows out of the heater  10 ,  10   a.  The temperature sensor  68  may send a signal to the control module  24  which may be programmed to modulate power to the heater  10 ,  10   a  based on the sensed temperature of the nutritional liquid instead of the sensed temperature of the heating element  50   a, b.    
         [0035]    First and second insulators  52   a, b  may be disposed between the thermocouples  46   a, b  and the heating portions  50   a, b.  The heating portions  50   a, b  may be a Kapton (i.e., polyimide) heater. The heating portions  50   a, b  may have a curved semi-cylindrical configuration as shown in  FIG. 4 . Heat sinks  54   a, b  may be disposed on the inside of the heating portions  50   a, b.  The heat sinks  54   a, b  may define the straight grooves  34   a, b  of the first and second heating portions  28   a, b.  The straight grooves  34   a, b  may have a semi-circular cross sectional configuration so as to receive the tube  14 ,  14   a  and  18  which preferably has a cylindrical cross section. The back side  56   a, b  may have a curved configuration and receive the heating portions  50   a, b.  The heating portions  50   a, b  may be mounted to the back sides  56   a, b  of the heating portions  50   a, b  through methods known in the art or developed in the future. 
         [0036]    The heaters  48   a, b,  the heat sinks  54   a, b,  the insulation  52   a, b  and the thermocouples  46   a, b  may all be mounted within respective outer cases  58   a, b.  The outer cases  58   a, b  may have first and second hinge elements  60   a, b.  The hinge elements  60   a, b  may be nested together and held together by pin  62 . A torsion spring  63  may be mounted to the hinge elements  60   a, b  to bias the heating portions  28   a, b  to the closed position. The outer cases  58   a, b  may additionally have support members  64   a, b  that are received into the first and second handles  26   a, b  for mounting the outer cases  50   a, b  to the handles  26   a, b.    
         [0037]    Referring now to  FIGS. 5 and 6 , a second embodiment of the heating system  22   a  is shown. The heating system  22   a  has a heater  10   a  and a control module  24   a  which are integrated to each other. As shown in  FIG. 6 , the control module  24   a  may be integrated into one or both of the heating portions  28   a, b.  The control module  24   a  may have the readout  40 , indicator  42  and on/off switch  44  integrated into the first heating portion  28   a.  Battery pack  39  may be integrated into the second heating portion  28   b.  The electronics for the readout  40 , indicator  42  and the on/off switch  44  may be in electrical communication with the battery pack  39 . Moreover, the battery pack  39  may be in electrical communication with the heater  48   a,  b and the thermocouple  46   a, b  mounted within the outer cases  58   a, b  of the first and second heating portions  28   a, b.  The heating system  22   a  may operate in substantially the same manner as that described in relation to heating system  22  except that the control module  24  is integrated into the heater  10   a.    
         [0038]    The heater  10 ,  10   a  discussed herein may be placed as close to the neonate  16  as possible. This does not mean that the heater  10 ,  10   a  is placed on the tube  14 ,  14 ,  18  away from the neonate and the tube  14 ,  14   a,    18  is bent so that the heater  10 ,  10   a  is located closely adjacent to the heater  10 ,  10   a.  Instead, this means that the distance that the nutritional liquid fluid flows from the heater  10 ,  10   a  to the neonate  16  through the tube  14 ,  14   a,    18  is minimized by placing the heater  10 ,  10   a  as close to the neonate along a length of the tube  14 ,  14   a,    18 . The extension tube  18 , feeding tube  14 ,  14   a  have a linear length. The heater  10 ,  10   a  may be placed on the tube  14 ,  14   a,    18  at any position along the length of the tube  14 ,  14   a,    18 . However, as discussed herein it is advantageous that the heater  10 ,  10   a  be placed near the neonate  16  along the length of the tube  14 ,  14   a,    18 . By placing the heater  10 ,  10   a  closer to the neonate  16  the distance that the nutritional liquid travels to reach the neonate  16  after the nutritional liquid exits the heater  10 ,  10   a  is minimized so that heat loss through the tube is neglible. For example, after the nutritional liquid exits the heater  10 ,  10   a  the heat in the nutritional liquid begins to be transferred to the environment thereby cooling the nutritional liquid. By the time the nutritional liquid reaches the neonate  16 , the nutritional liquid has a lower temperature than when the nutritional liquid exited the heater  10 ,  10   a.  Nonetheless, the nutritional liquid is above room temperature and is preferably about equal to the body temperature of. If the temperature drop from the heater  10 ,  10   a  to the neonate  16  is significant, it is contemplated that the heater  10 ,  10   a  may raise the temperature of the nutritional liquid to a temperature above the body temperature of a human. In this manner, as the nutritional liquid flows from the heater  10 ,  10   a  towards the neonate  16 , the temperature of the nutritional liquid cools down to about the body temperature of a person. 
         [0039]    The heater  10 ,  10   a  may be sufficiently long so that the nutritional liquid can be heated to the target temperature of the neonate. The heater  10 ,  10   a  has a particular length  66 ,  66   a  as shown in  FIGS. 2 and 5 . The nutritional liquid flows into the heater  10 ,  10   a  from the entrance  33 , 33   a  and leaves out of exit  36 ,  36   a.  However, the actual heating portions have a length  68  (see  FIG. 4 ) which is shorter than the length  66  of the heater  10 ,  10   a.  The heater  10 ,  10   a  is mounted to a heat conductor  54   a, b.  The heat conductors  54   a, b  heat up the nutritional liquid flowing through the tube  14 ,  14   a,    18 . A length  70  of the heat conductor  54   a, b  defines a heating region which heats up the nutritional liquid flowing through the tube  14 ,  14   a,    18 . The heating region may be sufficiently long to gradually raise the temperature of the nutritional liquid. If the length  70  of the heating region is too short, then the temperature of the nutritional liquid must be raised at a rapid rate which may require the heating portions  50   a, b  to be set at a high temperature. In this case, the nutritional liquid may be exposed to excessively high temperatures that may destroy immunological properties of the nutritional liquid. Accordingly, the length  70  of the heating region is sufficiently long so that the maximum temperature of the heating portions  50   a, b  may be reduced to a temperature which is safe for the nutritional liquid and can still raise the temperature of the nutritional liquid to the target temperature (e.g., body temperature, temperature above body temperature) at a reasonable rate. 
         [0040]    As discussed herein the grooves  34   a, b  of the heating portions  28   a, b  that receive the tube  14 ,  14   a,    18  may be straight. However, other shapes are also contemplated. By way of example, other shapes include but is not limited to Z shaped, L shaped, U shaped. 
         [0041]    The above description is given by way of example, and not limitation. Given the above disclosure, one skilled in the art could devise variations that are within the scope and spirit of the invention disclosed herein, including various ways of flow nutritional fluid through the tube  14 ,  14   a,    18 . Further, the various features of the embodiments disclosed herein can be used alone, or in varying combinations with each other and are not intended to be limited to the specific combination described herein. Thus, the scope of the claims is not to be limited by the illustrated embodiments.