How does non-nutritive sucking support infant feeding?

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link ABSTRACTFifty nine premature infants participated in a randomized controlled study to determine the effectiveness of nonnutritive sucking (NNS). It was predicted that NNS would not accelerate the development of full oral feeding or early language skills as sometimes perceived in practice. However, it was predicted that using NNS as a strategy to support parents to identify and respond to early communication and oral readiness signs would increase confidence in infant management and enable quicker discharge home.Infants were aged 26 -35 weeks gestation. Infants with no significant difficulties were randomly assigned to one of three groups; Group 1, NNS pre-tube feeding (n = 19); Group 2, NNS on onset of tube feeding (n = 20) and Group 3, Control (n = 20). Follow -up occurred at 6 months. There were no significant differences with number of days to full oral feeding between the groups receiving NNS and the Control group, ?2 (2, n = 59) = 4.33, p = .115. A significant difference in number of days in hospital between the Control group and the other two groups was found ?2 (2, n = 59) = 7.678, p = .022. Significant changes were noted with the development of more normal sucking patterns in Groups 1 -3. At 6 months, there were no significant differences in receptive (?2 (1, n = 56) = .117, p = .732) or expressive language skills (?2 (1, n = 56) = .000, p = 1.0) between all groups. NNS had no significant impact on the transition to full oral feeding or later language development. There was a significant difference in the number of days in hospital between the Control group and the other two groups which involved parents in identification of early communication signs. Possible reasons for this change and future directions are discussed. Key words: non-nutritive sucking; full oral feeding; oral readiness; early communication HIGHLIGHTS• We examined using non-nutritive sucking (NNS) with premature infants.• We predicted that using NNS would not accelerate the development of full oral feeding.• We predicted that NNS would not accelerate development of early language skills.• We predicted parent training to identify pre-verbal skills using NNS would decrease time in hospital. INTRODUCTIONThis paper considers using non-nutritive sucking (NNS) to support transition to full oral feeding for infants. There are many methods of administering NNS in the literature and these are often a prescribed programme of oral -motor and sensory exercises implemented by a health care professional which do not involve parents (Barlow, Finan & Lee, 2008;Boiron, Da Nobrega & Roux, 2007;Fucile, Gisel & McFarland, 2011;Hwang, Vergana & Lin, 2010;Pimenta, Moreira & Rocha, 2008;Rocha & Lopes Moreira, 2006;Gaebler & Hanzlik, 1996). The focus of this study is from a speech and language therapy and nursing perspective, and it recognises the benefits that NNS can have. It is novel as it concentrates on training ...

The Effect of Non-nutritive Sucking by Mothers on Full Oral Feeding Attainment in Preterm Neonates

“…Although no significant difference was observed between the groups, neonates in the intervention group attained oral feeding very sooner than the controls. In addition, a greater number of neonates were on breastfeeding in the intervention groups than control group at discharge (33).…”

“…According to Lessen (2012), the mean length of hospital stay was 41.8 and 44.4 days in the intervention and control groups, respectively, indicating no statistically significant difference between the groups (P = 0.541) (24). Harding et al (2014) showed a significant difference in the length of hospital stay between two intervention groups and the control group (group 1: 21.74 days; group 2: 31 days; group 3: 36.85 days) (P = 0.022) (33). Kamhawy et al (2014) showed that the intervention neonates were discharged at lower corrected age (36.7 weeks versus 37.3 weeks) (31).…”

Pediatric feeding and swallowing rehabilitation: An overview

“…In the initial phase non-nutritive sucking (on a pacifier) to stimulate sucking and prepare for nutritive sucking is provided [33]. However, it should be noted that non-nutritive sucking does not always enable an infant to achieve full oral feeding more quickly than those infants who do not use non-nutritive sucking [34]. Using non-nutritive sucking is important for helping the infant to achieve the quiet alert state appropriate for feeding, and it can support parent learning on how to interpret differing infant states and therefore support parent-bonding [34].…”

Nutrición intrahospitalaria del prematuro. Recomendaciones de la Rama de Neonatología de la Sociedad Chilena de Pediatría

“…La estimulación orokinésica perioral ayuda a una transición más rápida de sonda a oral. Los niños con más dificultades para adquirir succión madura son los prematuros menores de 28 semanas, los con DBP y los con RCIU, por lo que el trabajo de estimulación debe ser persistente en estos casos 63 . Nutrición intrahospitalaria del prematuro 13…”