This study aims to improve the breastfeeding skills of premature or sick term infants with non-invasive, transcutaneous vagus nerve stimulation (taVNS). taVNS is microcurrent stimulation to the ear, which targets a vagus nerve branch. Pairing taVNS with motor activity, such as breast feeding, may help with motor learning in infants as it does in adults with stroke. Ten premature infants older than or equal to 35 weeks gestational age, or convalescing sick term infants whose mothers want to breastfeed will participate in this study with parental consent. Infants will receive 1 taVNS treatment paired with breastfeeding per day for up to 14 days. Before each treatment, the researcher will determine how much electrical stimulation is needed for the infant to feel a slight tingle without discomfort. This level of electrical stimulation will be delivered by a TENS unit (Transcutaneous elecrical nerve stimulation) and neonatal electrodes applied just in front of the ear and our custom made carbon electrode used in the BabyStrong studies (#10881, #67997). Stimulation will be timed with latching and sucking for the duration of the feed and will be on with sucking and off with rest. Pre- and post-feed weights, the length of time for each feed, and observations of latch, suck, and swallow efficiency will be recorded. Parental satisfaction will be assessed by questionnaires at the beginning, after 1 and 2 weeks, and 3 months after the end of treatment to assess infants' progress in and maintenance of breastfeeding abilities.
If pairing breastfeeding with taVNS is able to improve effective breastfeeding in infants in the neonatal intensive care units, it might help premature and sick term infants to successfully breastfeed at the time of discharge and maintain breast feeding at home after discharge. Premature infants may benefit from longer time receiving maternal breastmilk.

This study is designed to improve how body image distress is identified among adult survivors of head and neck cancer during routine clinic visits. Participants will complete questionnaires about body image concerns either on paper or electronically (in clinic or remotely through a secure link). The study will evaluate how well a brief screening questionnaire (IMAGE-HN SF) identifies patients experiencing meaningful body image distress compared with the longer, full IMAGE-HN survey. In addition to assessing how accurately the short form performs, we will ask patients how they prefer the screening to be delivered, including the timing, format, and method of completion in routine care. A subset of participants will be invited to complete a short interview to share additional thoughts about how this type of screening should be implemented. Findings from this study will help guide the use of efficient and patient-centered body image screening in head and neck cancer clinics.