Nonnutritive Sucking at the Mother's Breast Facilitates Oral Feeding Skills in Premature Infants

John, Hima B; Suraj, Charis; Padankatti, Sanjeev M.; Sebastian, Tunny; Rajapandian, Earnest

doi:10.1097/anc.0000000000000545

Cited by 13 publications

(22 citation statements)

References 38 publications

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“…In their study in 2019, John et al compared non-nutritive breastfeeding in the intervention group with a non-nutritive finger sucking in the control group during gavage feeding as facilitators of oral feeding skills in preterm infants. The results suggested that the infants in the intervention group showed the faster transition of non-nutritive sucking maturity stages and had more sucks per burst during breastfeeding than the control group [ 21 ]. The findings of the above study are not consistent with the results of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…It means non-nutritive sucking of the mother’s finger group had better oral feeding behaviors compared to the pacifier and control groups. While in John's study, non-nutritive breastfeeding accelerated oral feeding skills in preterm infants rather than non-nutritive finger sucking [ 21 ]. This inconsistency can be due to using different interventions.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial

et al. 2022

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Background Oral feeding problems will cause long-term hospitalization of the infant and increase the cost of hospitalization. This study aimed to compare the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants. Methods This single-blind randomized controlled clinical trial was performed in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. 150 preterm infants with the gestational age of 31 to 33 weeks were selected and were divided into three groups of 50 samples using randomized block method, including non-nutritive sucking on mother’s finger (A), pacifier (B) and control (C). Infants in groups A and B were stimulated with mother’s finger or pacifier three times a day for five minutes before gavage, for ten days exactly. For data collection, demographic characteristics questionnaire and preterm infant breastfeeding behavior scale were used. Results The mean score of breastfeeding behavior in preterm infants in the three groups of A,B,C was 12.34 ± 3.37, 11.00 ± 3.55, 10.40 ± 4.29 respectively, which had a significant difference between the three groups (p = 0.03). The mean rooting score between three groups of A, B, and C was 1.76 ± 0.47, 1.64 ± 0.48, and 1.40 ± 0.90 (p < 0.001) respectively. Also, the mean sucking score in groups of A, B and C was 2.52 ± 0.76, 2.28 ± 0.64 and 2.02 ± 0.74 respectively, which had a significant difference (p = 0.003), but other scales had no significant difference between the three groups (P > 0.05). The mean time to achieve independent oral feeding between the three groups of A, B, C was 22.12 ± 8.15, 22.54 ± 7.54 and 25.86 ± 7.93 days respectively (p = 0.03), and duration of hospitalization was 25.98 ± 6.78, 27.28 ± 6.20, and 29.36 ± 5.97 days (p = 0.02), which had a significant difference. But there was no significant difference between the two groups of A and B in terms of rooting, sucking, the total score of breastfeeding behavior and time of achieving independent oral feeding (P > 0.05). Conclusion Considering the positive effect of these two methods, especially non-nutritive sucking on mother’s finger, on increasing oral feeding behaviors, it is recommended to implement these low-cost methods for preterm infants admitted to neonatal intensive care unit. Trial Registration Trial Registration: IRCT, IRCT20191116045460N1. Registered 11 January 2020- prospective registered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial

et al. 2022

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“…The suck reflex in preterm infants is triggered by approaching the mother, being held by the mother, and latching on the mother's nipple to exercise their sucking ability. Preterm infants suck their empty breasts through early contact with the mother's skin, which not only satisfies the desire to suck and contributes to the development of a more mature sucking pattern, but also improves breast milk secretion and the rate of breastfeeding [59].…”

Section: Discussionmentioning

confidence: 99%

Early skin contact combined with mother’s breastfeeding to shorten the process of premature infants ≤ 30 weeks of gestation to achieve full oral feeding: the study protocol of a randomized controlled trial

Wang

Niu

et al. 2021

Trials

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Background Most hospitalized preterm infants experience difficulties in transitioning from tube feeding to full oral feeding. Interventions to promote full oral feeding in preterm infants in the neonatal intensive care unit (NICU) are limited to pacifier use or bottle-feeding exercises. Skin contact has been shown to be beneficial to start and maintain lactation and provide preterm infants with the opportunity to suck on the mother’s breast, which may promote further development of the preterm infant’s suckling patterns. The objective of this study is to compare and evaluate the effects of skin contact combined with breastfeeding (suck on the mother’s empty breast) as compared to the routine pacifier suckling training model in achieving full oral feeding for infants whose gestational age are ≤ 30 weeks. Methods This is a single-center, randomized controlled clinical trial conducted in the NICU and designed according to the SPIRIT Statement. The subjects included in the study are premature infants born between April 2020 and July 2021 with a gestational age of ≤30 weeks, birth weight of <1500 g, admission age of <72 h, and absence of congenital malformations. Those with oxygenation indices of >40 and those born to mothers with poor verbal communication skills will be excluded. A sample of 148 infants is needed. The infants will be randomized to the intervention (skin contact combined with mother’s breastfeeding model) or control group (routine pacifier sucking training model). The primary outcome is the time required to achieve full oral feeding. The secondary outcomes are the breastfeeding abilities of preterm infants as assessed by the Preterm Infant Breastfeeding Behavior Scale (PIBBS), breastfeeding rates at 3 and 6 months corrected gestational age, complication rates, duration of oxygen requirement, days of hospital stay, and satisfaction of parents. Discussion This paper describes the first single-center, open-label, randomized clinical trial on this topic and will provide crucial information to support the implementation of skin contact combined with the breastfeeding model in the NICU setting. Trial registration ClinicalTrials.gov NCT 04283682. Registered on 8 February 2020.

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“…However, the possible earliest time to initiate oral feeding is currently unknown. The time and the rate of maturation of oral feeding skills are different [27]. Though the feeding performance of preterm infants reached only the tenth percentile of the healthy term infants at postmenstrual age 34-35 weeks, it matured at postmenstrual age 38-40 weeks by the noninvasive evaluation of swallowing sound [28].…”

Section: Discussionmentioning

confidence: 99%

Development of Swallowing Function in Infants with Oral Feeding Difficulties

Han

Shin

Jeon

2020

International Journal of Pediatrics

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Background. Discharge of preterm infants is often delayed because of their oral feeding difficulties. Independent oral feeding is the last obstacle to pass after managing acute and chronic morbidities. We conducted this study to determine the prevalence, characteristics, and risk factors of swallowing dysfunction and suggest proper interventions to reduce aspiration and chronic lung injury. Methods. Infants admitted to the neonatal intensive care unit (January 2016 to December 2018) who were performed modified barium swallow study due to oral feeding difficulties were enrolled. Modified barium swallow study was done≥postmenstrual age 37 weeks to limit radiation exposure. Clinical data were collected retrospectively. Swallowing dysfunction was defined as inadequate epiglottic closure, laryngeal penetration, or tracheal aspiration according to result of the modified barium swallow study. Results. Among a total of 54 infants enrolled, nine (16.7%) were term infants, 13 (24.1%) were late preterm infants (gestational age, 34-36 weeks), and 32 (59.3%) were early preterm infants (gestational age<34 weeks). Gestational age and birth weight were smaller in infants with swallowing dysfunction. Total duration of mechanical ventilation and duration of invasive ventilation were longer in infants with swallowing dysfunction. The risk of swallowing dysfunction increased by 11.2 times for infants with gestational age<29 weeks compared to infants with gestational age≥29 weeks. Swallowing dysfunction was improved in most infants after they became matured. They showed different time and rate of maturation with the help of rehabilitation through swallow therapy and dietary modification with thickened formula. Conclusion. Preterm infants with gestational age<29 weeks or with longer ventilation duration are at a higher risk of aspiration. Rehabilitation of swallow therapy and dietary modification with thickened formula can be helpful interventions to prevent aspiration and chronic lung injury and reassure parents until independent oral feeding is possible.

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Nonnutritive Sucking at the Mother's Breast Facilitates Oral Feeding Skills in Premature Infants

Abstract: Nonnutritive sucking at the mother's breast can be explored as an intervention, with a larger sample, to facilitate exclusive breastfeeding and to establish intervention fidelity.

Cited by 13 publications

References 38 publications

Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial

Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial

Early skin contact combined with mother’s breastfeeding to shorten the process of premature infants ≤ 30 weeks of gestation to achieve full oral feeding: the study protocol of a randomized controlled trial

Development of Swallowing Function in Infants with Oral Feeding Difficulties

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