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DOI: 10.1055/s-0038-1667289
Non-Nutritive Sucking in the Preterm Infant
Funding This project was supported by NIH R24 (5R24HD065688-05), awarded to the Boston Rehabilitation Outcomes Center, and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number U54 HD087011 to the Intellectual and Developmental Disabilities Research Center at Washington University.Publication History
25 April 2018
15 June 2018
Publication Date:
06 August 2018 (online)
![](https://www.thieme-connect.de/media/ajp/201903/lookinside/thumbnails/10-1055-s-0038-1667289_180222-1.jpg)
Abstract
Objective To identify the progression of non-nutritive sucking (NNS) across postmenstrual age (PMA) and to investigate the relationship of NNS with medical and social factors and oral feeding.
Study Design Fifty preterm infants born at ≤32 weeks gestation had NNS assessed weekly starting at 32 weeks PMA with the NTrainer System. Oral feeding was assessed at 38 weeks PMA.
Results There were increases in NNS bursts per minute (p = 0.005), NNS per minute (p < 0.0001), NNS per burst (p < 0.001), and peak pressure (p = 0.0003) with advancing PMA. Level of immaturity and medical complications were related to NNS measures (p < 0.05). NNS measures were not related to Neonatal Oral Motor Assessment Scale scores. Smaller weekly change in NNS peak pressure (p = 0.03; β = –1.4) was related to feeding success at 38 weeks PMA.
Conclusion Infants demonstrated NNS early in gestation. Variability in NNS scores could reflect medical complications and immaturity. More stable sucking pressure across time was related to feeding success at 38 weeks PMA.
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References
- 1 Nijhuis JG. Fetal behavior. Neurobiol Aging 2003; 24 (Suppl. 01) S41-S46
- 2 Lau C. Development of suck and swallow mechanisms in infants. Ann Nutr Metab 2015; 66 (Suppl. 05) 7-14
- 3 Weber F, Woolridge MW, Baum JD. An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. Dev Med Child Neurol 1986; 28 (01) 19-24
- 4 Sohn M, Ahn Y, Lee S. Assessment of primitive reflexes in high-risk newborns. J Clin Med Res 2011; 3 (06) 285-290
- 5 Medoff-Cooper B, McGrath JM, Shults J. Feeding patterns of full-term and preterm infants at forty weeks postconceptional age. J Dev Behav Pediatr 2002; 23 (04) 231-236
- 6 Hafström M, Kjellmer I. Non-nutritive sucking in the healthy pre-term infant. Early Hum Dev 2000; 60 (01) 13-24
- 7 Wolff PH. The serial organization of sucking in the young infant. Pediatrics 1968; 42 (06) 943-956
- 8 McCain GC. An evidence-based guideline for introducing oral feeding to healthy preterm infants. Neonatal Netw 2003; 22 (05) 45-50
- 9 Bingham PM, Ashikaga T, Abbasi S. Prospective study of non-nutritive sucking and feeding skills in premature infants. Arch Dis Child Fetal Neonatal Ed 2010; 95 (03) F194-F200
- 10 Eishima K. The analysis of sucking behaviour in newborn infants. Early Hum Dev 1991; 27 (03) 163-173
- 11 Rogers B, Arvedson J. Assessment of infant oral sensorimotor and swallowing function. Ment Retard Dev Disabil Res Rev 2005; 11 (01) 74-82
- 12 Volpe J. Hypoxic-ischemic encephalopathy: clinical aspects. In: Neurology of the Newborn. 5th ed. Philadelphia, PA: Saunders and Elsevier; 2008: 400-401
- 13 Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008; 371 (9608): 261-269
- 14 Crapnell TL, Rogers CE, Neil JJ, Inder TE, Woodward LJ, Pineda RG. Factors associated with feeding difficulties in the very preterm infant. Acta Paediatr 2013; 102 (12) e539-e545
- 15 Pickler RH, Best AM, Reyna BA, Gutcher G, Wetzel PA. Predictors of nutritive sucking in preterm infants. J Perinatol 2006; 26 (11) 693-699
- 16 Barlow SM, Finan DS, Lee J, Chu S. Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck. J Perinatol 2008; 28 (08) 541-548
- 17 Brazelton TB, Nugent JK. Neonatal Behavioral Assessment Scale. Cambridge: Cambridge University Press; 1995
- 18 Howe TH, Sheu CF, Hsieh YW, Hsieh CL. Psychometric characteristics of the Neonatal Oral-Motor Assessment Scale in healthy preterm infants. Dev Med Child Neurol 2007; 49 (12) 915-919
- 19 Palmer MM, Crawley K, Blanco IA. Neonatal Oral-Motor Assessment scale: a reliability study. J Perinatol 1993; 13 (01) 28-35
- 20 Zarem C, Kidokoro H, Neil J, Wallendorf M, Inder T, Pineda R. Psychometrics of the Neonatal Oral Motor Assessment Scale. Dev Med Child Neurol 2013; 55 (12) 1115-1120
- 21 van Woerden EE, van Geijn HP, Caron FJ, van der Valk AW, Swartjes JM, Arts NF. Fetal mouth movements during behavioural states 1F and 2F. Eur J Obstet Gynecol Reprod Biol 1988; 29 (02) 97-105
- 22 Lau C, Alagugurusamy R, Schanler RJ, Smith EO, Shulman RJ. Characterization of the developmental stages of sucking in preterm infants during bottle feeding. Acta Paediatr 2000; 89 (07) 846-852
- 23 Medoff-Cooper B, McGrath JM, Bilker W. Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term. MCN Am J Matern Child Nurs 2000; 25 (02) 64-70
- 24 Prechtl HF. The behavioural states of the newborn infant (a review). Brain Res 1974; 76 (02) 185-212
- 25 Estep M, Barlow SM, Vantipalli R, Finan D, Lee J. Non-nutritive suck parameters in preterm infants with RDS. J Neonatal Nurs 2008; 14 (01) 28-34
- 26 Slattery J, Morgan A, Douglas J. Early sucking and swallowing problems as predictors of neurodevelopmental outcome in children with neonatal brain injury: a systematic review. Dev Med Child Neurol 2012; 54 (09) 796-806
- 27 Poore M, Barlow SM, Wang J, Estep M, Lee J. Respiratory treatment history predicts suck pattern stability in preterm infants. J Neonatal Nurs 2008; 14 (06) 185-192