Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants

Pinelli, Janet; Symington, Amanda

doi:10.1002/14651858.cd001071

Cited by 129 publications

(116 citation statements)

References 36 publications

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“…Non-nutritive oral opportunities are thought to facilitate oral feeding skills, for example, sucking opportunities for preterm infants, most often via pacifier. [17][18][19] Older children who are not safe to take nutrition orally can be given opportunities to mouth toys or to put their fingers into food and suck on their fingers with a miniscule amount of food on them, and to accept two to three drops of water via a spoon. It is rare that a child cannot take anything orally (nil by mouth).…”

Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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Children with cerebral palsy (CP) are at risk for aspiration with oral feeding with potential pulmonary consequences, and commonly have reduced nutrition/hydration status and prolonged stressful meal times. There is considerable variability in the nature and severity of swallowing problems in these children whose needs change over time. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. This review is focused on dysphagia in children with CP: types of deficits, clinical and instrumental evaluation, management decision making and evidence of effectiveness of interventions.European Journal of Clinical Nutrition (2013) 67, S9-S12; doi:10.1038/ejcn.2013.224Keywords: cerebral palsy; dysphagia; pediatrics; feeding; swallowing INTRODUCTIONChildren with cerebral palsy (CP) commonly have feeding disorders and swallowing problems (dysphagia) that in many instances place them at risk for aspiration with oral feeding, with potential pulmonary consequences. They also commonly have reduced nutrition/hydration status and prolonged stressful meal times. The specific nature and severity of the swallowing problems may differ, at least to some degree, in relation to sensorimotor impairment, gross and fine motor limitations, and cognitive/ communication deficits. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits 1,2 than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. 3 Concerns are multifactorial and include issues of reduced volume of food and liquid consumed orally, nutrition deficits, inadequate hydration and limited range of textures with slow advance of oral skills.Children with moderate-to-severe dysphagia usually are managed most effectively with an interdisciplinary team that allows for multiple factors to be addressed in a coordinated way. These factors include, but are not limited to, gastrointestinal issues, pulmonary status, nutrition/hydration, oral sensorimotor skills, behavioral issues and family interactions. The importance of a structured approach is stressed to handle these multiple problems. 4 It is critical that all decisions for the management of feeding and swallowing problems are made in consideration of the primary needs of the child that is, a stable airway with adequate nutrition and hydration. In addition, any feeding/ swallowing intervention should be pleasurable and non-stressful for patients and care givers. In some instances, tube feeding may be needed either temporarily or long term. [5][6][7][8] It is expected, with rare exceptions, that these children can cope with at least minimal tastes for pleasure, a practice that may have a positive impact on management of saliva/secretions while maintaining oral function and swallowing.This review paper is focused on dysphagia: types of deficit...

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Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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“…It also facilitates the development of sucking behavior, as reflected in the neurobehavioral organization and maturation of preterm infants. [1][2][3] In addition to non-nutritive sucking, oral stimulation programs are used in neonatal wards with the goal of providing opportunities for sucking, resulting in improved oral feeding and promoting physiological stability. 2,3 However, some allege that non-nutritive sucking may have a negative impact on breastfeeding rates.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 However, some allege that non-nutritive sucking may have a negative impact on breastfeeding rates. 1 Maintaining breastfeeding for preterm infants is a major challenge. 4 Breastfeeding and its beneficial effects for the infant's and the mother's health are well-known in scientific literature, but breastfeeding for very low birth weight preterm infants remains low.…”

Section: Introductionmentioning

confidence: 99%

Efeitos da sucção não-nutritiva e da estimulação oral nas taxas de amamentação em recém-nascidos pré-termo de muito baixo peso ao nascer: um ensaio clínico randomizado

Pimenta¹,

Moreira²,

Rocha³

et al. 2008

J. Pediatr. (Rio J.)

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Objective: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight.Methods: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding.Results: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). Conclusion:Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.J Pediatr (Rio J). 2008;84(5):423-427: Preterm infant, breastfeeding, sucking behavior.

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“…177 Systematic reviews of experimental evidence for the practice of non-nutritive sucking have found a beneficial effect on length of stay and response to pain, but did not find consistent benefit involving behavioral states, sucking improvement, gastric emptying or weight gain. [178][179][180] No harmful short-term effects have been demonstrated. 178 Although there have been concerns that the use of a pacifier as an instrument for non-nutritive sucking may result in earlier weaning from the breast, this was not significantly demonstrated in a randomized clinical trial.…”

Section: Role Of Sleep In Brain Developmentmentioning

confidence: 99%

“…[178][179][180] No harmful short-term effects have been demonstrated. 178 Although there have been concerns that the use of a pacifier as an instrument for non-nutritive sucking may result in earlier weaning from the breast, this was not significantly demonstrated in a randomized clinical trial. 181 There are no data on long-term effects of this practice.…”

Section: Role Of Sleep In Brain Developmentmentioning

confidence: 99%

The development of potentially better practices to support the neurodevelopment of infants in the NICU

et al. 2007

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Objective: To review the existing evidence used to identify potentially better care practices that support newborn brain development.Study Design: Literature review.Result: Sixteen potentially better practices are identified and grouped into two operational clinical bundles based upon timing for recommended implementation. Conclusion:Existing evidence supports the implementation of selected care practices that potentially may support newborn brain development.

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Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants

Cited by 129 publications

References 36 publications

Feeding children with cerebral palsy and swallowing difficulties

Feeding children with cerebral palsy and swallowing difficulties

Efeitos da sucção não-nutritiva e da estimulação oral nas taxas de amamentação em recém-nascidos pré-termo de muito baixo peso ao nascer: um ensaio clínico randomizado

The development of potentially better practices to support the neurodevelopment of infants in the NICU

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