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IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015

Development of a Wireless Oral-Feeding

Monitoring System for Preterm Infants
Yu-Lin Wang, Jing-Sheng Hung, Lin-Yu Wang, Mei-Ju Ko, Willy Chou, Hsing-Chien Kuo,
and Bor-Shyh Lin, Member, IEEE

AbstractOral-feeding disorder is common in preterm infants.

It not only shows the adverse effect for growth and neurodevelopment in clinical but also becomes one of the important indicators
of high-risk group for neurodevelopment delay in preterm infants.
Preterm infants must coordinate the motor patterns of sucking,
swallowing, and respiration skillfully to avoid choking, aspiration,
oxygen desaturation, bradycardia, or apnea episodes. However,
up to now, the judgment and classification severity in preterm infants are mostly subjective and phasic evaluations. Directly monitoring the coordination of suckingswallowingbreathing during
oral feeding simultaneously is difficult for preterm infants. In this
study, we proposed a wireless oral-feeding monitoring system for
preterm infants to quantitatively monitor the sucking pressure
via a designed sucking pressure sensing device, swallowing activity via a microphone to detect swallowing sound, and diaphragmatic breathing movement via surface electromyogram. Moreover,
a suckingswallowingbreathing detection algorithm is also proposed to evaluate the events of suckingswallowingbreathing activities. Furthermore, verification of the accuracy and rationality
of oral-feeding parameters with clinical findings including sucking,
swallowing, and breathing in term and preterm infants had proved
the practicality and value of the proposed system.
Index TermsCoordination of suckingswallowingbreathing,
oral-feeding disorder, preterm infants.

I. INTRODUCTION
RAL-FEEDING disorder is common in preterm infants.
According to the report of National Health Insurance,
Taiwan, there are about two hundred thousand newborns annual
in Taiwan, and the incidence rate of preterm infants is about
7.8%. Although the survival rate of preterm infants has been

Manuscript received January 14, 2014; revised May 26, 2014; accepted June
30, 2014. Date of publication July 8, 2014; date of current version May 7, 2015.
This work was supported by the National Science Council, China for the support
of the research through contracts in NSC 102-2221-E-009-065.
Y.-L. Wang and M.-J. Ko are with the Department of Rehabilitation, Chi
Mei Medical Center, Tainan 710, Taiwan, and also with the Center of General
Education, Chia Nan University of Pharmacy and Science, Tainan 710, Taiwan.
L.-Y. Wang is with the Pediatric Department, Chi Mei Medical Center, Tainan
710, Taiwan, and also with the Center of General Education, Chia Nan University
of Pharmacy and Science, Tainan 710, Taiwan.
W. Chou is with the Department of Rehabilitation, Chi Mei Medical Center,
Tainan 710, Taiwan, and also with the Department of Recreation and Health
Care Management, Chia Nan University of Pharmacy and Science, Tainan 710,
Taiwan.
* B.-S. Lin, J.-S. Hung, and H.-C. Kuo are with the Institute of Imaging
and Biomedical Photonics and the Biomedical Electronics Translational Research Center, National Chiao Tung University, Hsinchu 300, Taiwan (* e-mail:
borshyhlin@gmail.com).
Color versions of one or more of the figures in this paper are available online
at http://ieeexplore.ieee.org.
Digital Object Identifier 10.1109/JBHI.2014.2335742

improved in recent years, but meanwhile, the sequelae increased

corresponsively.
Oral-feeding disorder interferes with the nutritive absorption
and reduces the sensation interaction between care-givers, environment, and preterm infants directly [1]. And there also exists
the adverse effect for growth and neurodevelopment during clinical follow up. Oral-feeding disorder becomes one of the important indicators of high-risk group for neurodevelopment delay
in preterm infants [2], [3]. Preterm infants must coordinate the
motor patterns of sucking, swallowing, and breathing skillfully,
which ensure milk flowing into the oral cavity effectively, triggering swallowing reflex and completing ventilation, as well as
avoid chocking, aspiration, oxygen desaturation, bradycardia,
or apnea episodes [4].
Recently, the ability of oral feeding in the infants has been investigated by some neonatal oral feeding studies. Van der Meer
et al. showed that swallowing happens before the onset of the
next sucking and between breathing out and breathing in. When
the coordination collapses, infants cannot maintain ventilation
while sucking and swallowing [5]. Goldfield et al. proposed
that swallowing is not random distribution during feeding and
takes place at particular locations in a space. They also compared the relationship between coordination and oxygen saturation during breast-feeding and bottle-feeding [6]. Macas and
Meneses reported that nutritive sucking can be divided into three
phases of expression/suction, swallowing, and breathing. Nutritive sucking is a changing process which contains continuous,
intermittent, and with pauses [7]. However, in the aforementioned studies, there is no quantitative monitoring system of
oral feeding in preterm infants available for current clinical
practice.
Several methods have been proposed to monitor swallowing
or breathing activities [8][11]. The deformation of a foam-filled
capsule taped to the abdomen in the subxiphisternal position [8],
and the electrical impedance change of the chest due to the chest
expansion [9] have been used to monitor the breathing activity.
They are not suitable for infants due to the small chest movement
of infants under breathing. Several studies attempted to detect
the swallowing activity by using accelerometers or surface EMG
[10], [11]. However, the above approaches are easily interfered
by the cervical movement, and the accelerometer is not suitable
for monitoring the unobvious muscle movement of infants under swallowing. Moreover, there is still lack of sensing devices
to monitor the sucking pressure directly during oral feeding,
because the electrical-sensing device is easily affected by milk.
Therefore, the judgment and classification severity, even the
rehabilitation effect of oral motor stimulation, or training of

2168-2194 2014 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.
See http://www.ieee.org/publications standards/publications/rights/index.html for more information.

WANG et al.: DEVELOPMENT OF A WIRELESS ORAL-FEEDING MONITORING SYSTEM FOR PRETERM INFANTS

867

Fig. 1. Basic scheme of the proposed wireless oral-feeding monitoring system

for preterm infant.

oral-feeding problems in preterm infants are mostly subjective

and phasic evaluations.
In this study, a wireless oral-feeding monitoring system for
preterm infants is proposed to quantitatively monitor sucking
swallowingbreathing activities and investigate the coordination
of the oral-feeding activity in preterm infants. The proposed system assesses the coordination of suckingswallowingbreathing
function by the real-time measuring sucking pressure via a designed sucking pressure sensing device, swallowing activity
via a microphone to detect swallowing sound, and diaphragmatic breathing movement via surface electromyogram (EMG).
A suckingswallowingbreathing detection algorithm was also
proposed to detect the events of suckingswallowingbreathing
automatically. By quantifying the coordination of the sucking
swallowingbreathing function, the care-givers can more objectively monitor the progress of oral feeding, and may be applied
in early detecting the episodes of chocking, aspiration, or apnea
during oral feeding in preterm infants in the future.
II. MATERIALS AND METHODS
A. Design of the Wireless Oral-Feeding Monitoring System
Fig. 1 illustrates the basic scheme of the proposed wireless
oral-feeding monitoring system for a preterm infant. The proposed system mainly consists of a sucking pressure sensing
device, a wireless multichannel biosignal acquisition module,
and a host system. Here, the sucking pressure sensing device
is designed to measure the pressure of sucking for newborns.
The wireless multichannel biosignal acquisition module is designed for acquiring the sucking pressure, swallowing sound,
and breathing EMG signals simultaneously. First, the sucking
pressure sensing device is placed in the users mouth, a small
microphone is placed on the neck in front of the cricoid cartilage [12] and a pair of electrodes is placed on the location
between the sixth intercostal region (along the nipple line) and
seventh intercostal region (along the anterior axillary line) [13],
to acquire the sucking pressure, swallowing sound, and breathing EMG signals, respectively. Next, the acquired signals will
be amplified and filtered, and then be transmitted to the host
system wirelessly by the wireless multichannel biosignal acquisition module. Next, the oral-feeding monitoring program
built in the host system will continuously monitor and store the

Fig. 2. (a) Illustration of the sucking pressure sensing device, (b) block diagrams, and (c) photograph of the wireless multichannel biosignal acquisition
module.

various kinds of biosignals, and detect the events of sucking,

swallowing, and breathing activities.
In the proposed system, only the teat of the milk bottle, electrodes, and the microphone will touch the infant under measurement. The wireless module was packaged by an acrylic box, and
was placed near the infant, but did not touch him/her directly.
The power consumption of the whole system is less than 85 mW,
and this can also effectively reduce the influence of the heat dissipation problem.
1) Sucking Pressure Sensing Device: The design of the sucking pressure sensing device is shown in Fig. 2(a). Here, a
polypropylene bottle with a general caliber of 3.5-cm and capacity volume of 120 ml was used as the container for milk.
And a 15-cm transparent rubber tube with a caliber of 0.6-cm
was used to connect with the polypropylene bottle and a pressure sensor. Here, a pressure sensor (SSC-SNBN400MD-AA3,
Honey Well), which contains two pressure inputs P1(+) and
P2(-), and provides the output signal of the pressure difference
between P1 and P2, was used for monitoring the change in the
sucking pressure. The terminal of the transparent rubber tube
was inserted into the upside of the polypropylene bottle which is
close to the pacifier. The inputs P1 and P2 of the pressure sensor
were connected with the other terminal of the transparent rubber
tube and the air, respectively, to measure the pressure difference
between the general atmospheric pressure and the inner pressure of the polypropylene bottle. The output will become less
than zero at the moment of sucking because the inner pressure
of the bottle is less than the general atmospheric pressure, and
the output will increase when the newborn aspirates.
2) Wireless Multichannel Biosignal Acquisition Module: The
basic block diagram of the proposed wireless multichannel
biosignal acquisition module is shown in Fig. 2(b). It mainly

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contains several parts: front-end amplifier circuits, an analogto-digital converter (ADC), a microprocessor, and a wireless
transmission circuit. The front-end amplifier circuits consist of
preamplifiers and bandpass filters, and are designed to amplify
and filter the acquired biosignals. The total gains of the front-end
amplifier circuits were set to 900 and 4000 times for swallowing sound, and breathing EMG, respectively. And the frequency
bands of the front-end amplifier circuits were set to 0.5500 Hz
for the sucking pressure and breathing EMG, respectively. Besides, a high-pass filter with the cutoff frequency of 160 Hz was
used for the swallowing sound. Then, the amplified biosignals
will be digitized by a 12-bit ADC, built in the microprocessor,
with sampling rate of 1024 Hz. The microprocessor is used to
control the ADC to obtain preprocess, and send data to the wireless transmission circuit. Here, the wireless transmission circuit
contains a printed circuit board antenna and a Bluetooth module which is fully compliant with the Bluetooth v2.0+ EDR
specification. The size of the wireless multichannel biosignal
acquisition module is about 8.3 5.2 2 cm3 . This module
operates at 27.8 mA with 3-V dc power supply, and can continuously operate over 9 h with a commercial 250-mAh Li-ion
battery. Fig. 2(c) shows the photograph of the sucking pressure
sensing device and the wireless multichannel biosignal acquisition module.
3) Host System: In this study, a commercial laptop was used
as the platform of the host system. Here, Windows 7 was used
as the operation system, and Microsoft C# was used to develop
the oral-feeding monitoring program. The software architecture
of the oral-feeding monitoring program mainly contains three
parts: GUI, BUFFER, and THREAD. GUI is used to design
a graphical user interface, and the form and panel extended
from the GUI provide the ability to precisely control the location and display of the GUI elements. BUFFER is a link-list
container used to store the raw data and the system parameters. THREAD denotes the execution thread in the program,
and the oral-feeding monitoring program contains three independent threads: BT API, RECEIVE, and ANALYSIS. Here,
BT API is one of Bluetooth application packages used to set
connection between the wireless multichannel biosignal acquisition module and the host system. The thread of RECEIVE is
used to receive raw data obtained from the wireless multichannel biosignal acquisition module, and store them into BUFFER.
The thread of ANALYSIS is designed based on the proposed
suckingswallowingbreathing detection algorithm to detect the
events of sucking, swallowing, and breathing activities.
The operation procedure of the oral-feeding monitoring program is shown in Fig. 3(a). First, the program builds GUI which
displays the user interface and allows the user to set program
parameters. Next, the program will call the function of BluetoothDeviceInfo in BT API to search the wireless multichannel
biosignal acquisition module. When the wireless multichannel
biosignal acquisition module is found, the serial port profile protocol service will be registered to communicate with the wireless multichannel biosignal acquisition module. Next, the thread
of RECEIVE will receive and display the raw data, and store
them in BUFFER. Finally, the thread of ANALYSIS will evaluate the event frequency of sucking, swallowing, and breathing

Fig. 3. (a) Operation procedure and (b) screenshot of the oral feeding monitoring program. Here, yellow, blue, and red lines in GUI denote the raw signals
of sucking pressure, swallowing sound, and breathing EMG, respectively.

activities from the received data. The screenshot of the oralfeeding monitoring program is shown in Fig. 3(b).
B. SuckingSwallowingBreathing Detection Algorithm
In the previous studies, the wavelet technique has been used
for extracting or detecting the events of EMG and swallowing
sounds [14], [15]. However, the wavelet technique requires a
higher computational complexity. In this study, the techniques
of the adaptive filter [16] and fractal dimension (FD) [17]
[20], that require a lower computational complexity, were used
to extract clean breathing EMG and the features of breathing
EMG and swallowing sounds, respectively. Moreover, the first
derivative (FDI) approach [21] with a dynamic threshold was
used to estimate the events of suckingswallowingbreathing
activities. By using the dynamic threshold, the influence of the
feature variation from subject-to-subject or session-to-session
can be reduced effectively.
The procedure of the proposed suckingswallowing
breathing detection algorithm was shown in Fig. 4. The raw
swallowing sounds and breathing EMG were first preprocessed
by different filters. Here, a high-pass filter with the cutoff frequency of 180 Hz was applied in swallowing sounds to remove
60-Hz power line interference and other lower frequency noise.
Because the electrodes used to measure breathing EMG were
placed near the heart and the frequency band of breathing EMG
is overlapped with that of electrocardiogram (ECG), breathing
EMG is seriously interfered by ECG and cannot be filtered
directly. In this study, an adaptive noise cancellation [16], as
shown in Fig. 5, was used to separate ECG and clean breathing
EMG from raw breathing EMG. Here, a low-pass filter with the
cutoff frequency of 30 Hz was first used to extract the signal

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869

can be calculated by
FD =

log(ns )
.
[log(ns ) + log( dl )]

(1)

Here, ns is the number of steps and is given by

ns =

Fig. 4.

Procedure of the suckingswallowingbreathing detection algorithm.

l
.
a

(2)

The parameter a is the average distance between each successive points, l is the total length of the curve (i.e., the sum of
distances between each successive points), and the parameter
d denotes the distance between the beginning and the farthest
points of the sequence. When the value of FD increases, the
complexity increases and can be viewed as the occurrence of
swallowing and breathing activities.
Finally, all positive peaks of the sucking pressure, and the
FD values of swallowing sounds and breathing EMG were detected to estimate the events of suckingswallowingbreathing
activities. Here, the FDI [21], proposed by Friesen et al.,
was used to detect the positive peaks of these signals. Let
x(k), k = 1, 2, 3, . . . be a input signal sequence of the sucking pressure, or the FD value of swallowing sound or breathing
EMG, and then the FDI approach will first calculate the slope
y(k) of x(k) which can be given by


W /2

y(k) =

l x(k + l)

(3)

l=W /2

Fig. 5.

Procedure of preprocessing for raw breathing EMG.

related to R-wave of ECG from raw breathing EMG. Next, the

extracted R-wave signal was used as the reference signal of a
30-order adaptive noise cancellation. By using adaptive noise
cancellation, the interference of ECG can be estimated adaptively, and clean breathing EMG can be effectively extracted
from raw breathing EMG.
Next, the FD values of the swallowing sounds and breathing
EMG were calculated to extract information related to swallowing and breathing activities. FD is a ratio providing a statistical
index of complexity, and is usually used for estimating the feature of biomedical signals [17][20]. It is sensitive for transient
detection and insensitive to the influence of noise, and contains
the advantage of fast calculation. The value of FD for Katz [20]

where W is the length of sliding window, and was set to 512

in this study. When the slope changes from the positive value
to the negative value, i.e., y(t 1) < 0 and y(t + 1) > 0, then
x(t) is a local maximum value. If the local maximum value
is larger than the dynamic threshold, then it can be viewed as
an activity event. Here, the first 30-s averaged value of the
physiological signal after oral feeding was used as the dynamic threshold. Therefore, the dynamic threshold will be automatically adjusted according to the subject or the measurement condition. Therefore, the influence of the feature variation
from subject-to-subject or session-to-session can be effectively
reduced.
C. Subjects
In this study, 30 Asian infants were evaluated from sick baby
room at Chi-Mei medical center, Taiwan. The full-term infants
(five boys, five girls) were born more than 37 weeks of postmenstrual age (mean 38.3 0.9 weeks), and their weight on date of
assessment ranged from 3800 to 4000 gm. The preterm infants
(ten boys, ten girls) were born between 34 and 36 weeks of
postmenstrual age (mean 35.5 0.73 weeks), and their weight
on date of assessment ranged from 2900 to 3100 gm. The characteristics of the full-term and preterm infants are listed in Table I. The clinical experiment was approved by the Institutional
Review Board, Chi-Mei medical center, Taiwan, and informed
consent was obtained from their parents.

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TABLE I
CHARACTERISTICS OF FULL-TERM AND PRETERM INFANTS
Characteristics
Male/Female
Postmenstrual age (week) #
Weight on date of assessment (g)#
#

Full-term (N = 10)

Preterm (N = 20)

5/5
38.3 0.9
3700 260

10/10
35.5 0.73
2600 430

Mean Standard deviation.

D. Clinical Experiments
Before the oral feeding, the data were recorded for 30 s,
as the baseline. Depending on the feeding situation of each
infant, each experiment was recorded about 25 min. All term
infants were fed with Baochyi silicone S-size round-hole nipple
(Taiwan) and preterm infants were fed with Pigeon isoprene
rubber S-size round-hole nipple (Japan). On the feeding period,
the infants were held in the semiupright supine position and fed
by or the formula or breast milk.
E. Statistical Analysis
The study analyzed the sucking, swallowing, and breathing
frequency during the continuous sucking phase (infants suck
continuously at least 30 s). Analysis of variance (ANOVA) was
used to assess the difference between full-term and preterm
infants. As P < 0.05, the data were considered significant
differences.

Fig. 6. Signals and estimated events of sucking pressure, swallowing sound,

and breathing EMG.

III. RESULTS
A. Performance of the SuckingSwallowingBreathing
Detection Algorithm
In this section, the performance of the suckingswallowing
breathing detection algorithm was first evaluated. Fig. 6 shows
one of the results for the signals and estimated events of sucking
swallowingbreathing activities. From the experimental result,
it shows that the events of sucking, swallowing, and breathing
can be effectively detected by using the proposed sucking
swallowingbreathing detection algorithm. Next, the binary
classification test was used to evaluate the performance of the
proposed algorithm. Here, several parameters of binary classification test were first defined as follows: true positive indicates
that the activity event can be correctly detected as an activity
event. False positive indicates that no activity event is wrongly
detected as an activity event. True negative (TN) indicates that
no activity event can be correctly detected as nothing. And false
negative indicates that the activity event was wrongly detected
as nothing. A total of 809, 843, and 788 events of sucking, swallowing, and breathing EMG, extracted from ten preterm infants,
respectively, are used for analysis. The sensitivity and positive predictive value (PPV) for detecting sucking activities are
97.94 % and 95.74%, respectively. The sensitivity and PPV for
detecting swallowing activities are 93.15% and 95.36%, respectively. The sensitivity and PPV for detecting breathing EMG
are 97.52% and 88.94%, respectively. From the above experimental results, the proposed algorithm exactly provides a good

Fig. 7.

Sucking, swallowing, and breathing signals in a term infant.

performance for detecting the events of sucking, swallowing,

and breathing activities.
B. Oral-Feeding Evaluation in Preterm Infants
Fig. 7 shows the result of monitoring the sucking, swallowing, and breathing signals for a term infant. It contains the
continuous sucking phase that infants suck continuously for at
least 30 s, and the intermittent sucking phase that the sucking
burst alternated with periods of no sucking or a pause. The
difference between continuous and intermittent phase depends
on the hunger state of the infant [7]. In the continuous phase,
the oral reflex activity is vigorous and the sucking activity is
stable. In the intermittent phase, the sucking and swallowing
activities will be accompanied by a 35-s pause due to the

WANG et al.: DEVELOPMENT OF A WIRELESS ORAL-FEEDING MONITORING SYSTEM FOR PRETERM INFANTS

TABLE II
RESPIRATORY RATE DURING BASELINE (NORMAL STATUS) AND CONTINUOUS
PHASE

Full-term
36 weeks
35 weeks
34 weeks

Baseline

Continuous

41.5 3.89
42.3 4.51
46.5 6.89
48.8 7.71

31.2 2.82
27.2 5.99
27.8 5.54
26.1 6.08

All value are expressed as mean standard

deviation.

Fig. 8. Event frequencies of suckingswallowingbreathing activities during

the continuous phase of feeding for term infants and preterm infants. Here,
denotes the difference between activity event numbers of two groups is
significant.

reduction of the infants hunger state. Table II shows the respiratory rate during normal status of oral feeding and continuous phase of oral feeding. The breathing activities reveal more
slower and variable frequency during the continuous phase of
feeding for preterm infants less than 36-weeks postmenstrual
age.
The difference between the event frequencies corresponding to different postmenstrual age was analyzed by using the
ANOVA method. Fig. 8 shows the results of the event frequencies of sucking, swallowing, and breathing activities for
different infant ages, and the significance between the event
frequencies of two groups. The null and alternative hypotheses
are that the difference of the event frequencies of two groups is
not significant and is significant, respectively. Here, the significance is defined as P < 0.05. From the experimental result, it
can be seen that within 3436 weeks, the sucking and swallowing of infants can be slightly improved with age. In particular,
after 36 weeks, the sucking and swallowing of infants can be
improved significantly and the coordination of sucking, swallowing, and breathing activities will be more close to a 1:1:1
ratio [22].

871

IV. DISCUSSION
From the experimental results, the proposed system successfully measures the sucking pressure, swallowing sound, and
breathing EMG signal to detect suckingswallowingbreathing
activities. Although raw breathing EMG is seriously affected
by ECG, using the proposed algorithm can effectively reduce
to the influence of ECG. Moreover, a sucking pressure sensing
device was also designed to measure the continuous sucking
pressure under oral feeding. The special mechanical design of
the sucking pressure sensing device can avoid the influence of
milk on the electrical pressure sensor. From the experimental
results, the event frequency of suckingswallowingbreathing
activities can be effectively and noninvasively detected by using
the proposed system.
From the concept of cross-systems interactions, central pattern generators in the medulla integrate and coordinate the motor neurons of sucking, swallowing, and respiration for infant
safe feedings [23]. For well term infants, coordination of suck
swallowrespiration usually manifests with a consistent suck
swallow ratio (1:1 or 2:1) and a safe swallowrespiration index location (start of inspiration or start of expiration) [24].
For preterm infants with gradual maturation, the sucking and
swallowing events becomes more rapid and coordinated but the
integration of respiration into suckswallow activities is still
highly variable. Our experimental results show that within 34
36 weeks, the event frequencies of sucking and swallowing
can be slightly improved with age. After 36 weeks, the event
frequencies of sucking and swallowing can be improved significantly during the continuous phase of oral feeding, and the
suckswallow ratio ranges from 1:1 to 2:1 for term infants and
1:1 to 3:1 for preterm infants which are compatible with the
sucking and swallowing clinical physiologic findings. During
the continuous phase of feeding, the respiratory rate usually
drops to 3035 breaths/min for term infants [25] and drops to
2631 breaths/min for preterm infants [26]. For preterm infants
less than 36-weeks postmenstrual age, the breathing activities
reveal more slower and variable frequency during the continuous
phase of feeding, which may result from more apnea episodes.

V. CONCLUSION
In this study, a wireless oral-feeding monitoring system
for preterm infants was developed to monitor the sucking
swallowingbreathing function noninvasively and continuously.
And a suckingswallowingbreathing detection algorithm was
also successfully developed to detect the events of sucking
swallowingbreathing activities. Depending on different postmenstrual age, the sucking, swallowing, and breathing events
were analyzed in the continuous phase. From the experimental
results of oral feeding, it shows that the breathing activity reveals more slower and variable frequency during the continuous
phase of feeding due to neurological immaturity. And the ability
of sucking and swallowing can be slightly improved with age.
According to the above results, the coordination of sucking,
swallowing, and breathing will be close to a 1:1:1 ratio because
of that infants mature with age.

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Yu-Lin Wang received the M.D. degree from Kaohsiung Medical University, Kaohsiung, Taiwan, in
1992.
Since 1996, he has been a Visiting Staff and a Lecturer at the Rehabilitation Department, Kaohsiung
Medical University Hospital and Chi Mei Medical
Center, Tainan, Taiwan. His current research interests include sonograms image processing and electrophysiological signal processing.

Jing-Sheng Hung received the M.S. degree from the

Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Hsinchu City, Taiwan,
in 2013.
He is now performing military service. His current
research interests include biomedical system design
and embedded system design.

Lin-Yu Wang received the M.D. degree from the National Taiwan University College of Medicine, Taipei,
Taiwan, in 1992, and the Masters degree from the
Institute of Clinical Medicine, National Cheng Kung
University, Tainan, Taiwan, in 2011.
She is currently the Physician with the Pediatric
Department, Chi Mei Medical Center, Tainan, Taiwan. Her current research interests include development of preterm infants.

Mei-Ju Ko received the M.S. degree from the Hearing and Speech Language Therapy Institute, National
Kaohsiung Normal University, Kaohsiung, Taiwan,
in 2012.
She is currently the Speech-Language Therapist
at the Chi-Mei Medical Center, Tainan, Taiwan. Her
specialty is in adults and children dysphagia.

Willy Chou received the B.S. degree in medicine

from National Taiwan University, Taipei, Taiwan, in
1989, the M.S. degree in human resource management from National Sun Yat-Sen University, Kaohsiung, Taiwan, in 2003.
He is currently the Assistant Professor in the Department of Leisure Management, Chia Nan Pharmacy and Science University, Tainan, Taiwan. He
is also the Director of the Physical Medicine and
Rehabilitation Department, the Chief of the Human
Resource Department, and the Secretary of Medical
Affair of the Chi Mei Medical Center, Taiwan. His research interests are in the
areas of biomedical assistive devices and rehabilitation medicine.

WANG et al.: DEVELOPMENT OF A WIRELESS ORAL-FEEDING MONITORING SYSTEM FOR PRETERM INFANTS

Hsing-Chien Kuo is currently working toward the

Masters degree at the Institute of Imaging and
Biomedical Photonics, National Chiao Tung University, Hsinchu City, Taiwan.
His research interests are in the areas of biomedical system design.

873

Bor-Shyh Lin (M02) received the B.S. degree from

National Chiao Tung University (NCTU), Hsinchu
City, Taiwan, in 1997, and the M.S. and Ph.D. degrees in electrical engineering from National Taiwan
University, Taipei, Taiwan, in 1999 and 2006, respectively.
He is currently the Associate Professor at the Institute of Imaging and Biomedical Photonics, NCTU.
His research interests are in the areas of biomedical
circuits and systems, biomedical signal processing,
and biosensor.