Patterned orocutaneous therapy improves sucking and oral feeding in preterm infants

Abstract

Aim-To determine whether NTrainer patterned orocutaneous therapy affects preterm infants' non-nutritive suck and/or oral feeding success.Subjects-Thirty-one preterm infants (mean gestational age 29.3 weeks) who demonstrated minimal non-nutritive suck output and delayed transition to oral feeds at 34 weeks post-menstrual age.Intervention-NTrainer treatment was provided to 21 infants. The NTrainer promotes nonnutritive suck output by providing patterned orocutaneous stimulation through a silicone pacifier that mimics the temporal organization of suck.Method-Infants' non-nutritive suck pressure signals were digitized in the NICU before and after NTrainer therapy and compared to matched controls. Non-nutritive suck motor pattern stability was calculated based on infants' time-and amplitude-normalized digital suck pressure signals, producing a single value termed the Non-Nutritive Suck Spatiotemporal Index. Percent oral feeding was the other outcome of interest, and revealed the NTrainer's ability to advance the infant from gavage to oral feeding.Results-Multilevel regression analyses revealed that treated infants manifest a disproportionate increase in suck pattern stability and percent oral feeding, beyond that attributed to maturational effects alone. Conclusion-TheNTrainer patterned orocutaneous therapy effectively accelerates non-nutritive suck development and oral feeding success in preterm infants who are at risk for oromotor dysfunction.

Estimulação sensoriomotora intra e extra-oral em neonatos prematuros: revisão bibliográfica

“…They described that the resource reflects in the increase of cerebral skills, organization of the oral dynamic system and non-nutritive pattern (skills that is initial to the complexity that involves oral feeding and the success of other skills as chewing and speaking). The fast advent of NNS in children submitted to NTrainer®therapyaccelerated the transition to OF diet 34,35 . Similar NTrainer®technology was not reported in any national article analyzed.…”

“…Four articles 30,[33][34][35] out pf the six international studies analyzed, used the pacifier as resource for the non-nutritive sucking stimulation. Two articles 31,32 used the non-nutritive sucking in gloved finger.…”

“…Pooreet al 34 and Barlow et al 35 developed trials in order to evaluate the effectiveness of NNS with electronic pacifier (pressured) named NTrainer® in PTNB. According to authors, the NTrainer® is a biomedical device which develop the function of a NNS synthetic, in which pulsing stimulus are sent to pacifier (as a pulsing nipple) attached to an electronic device.…”

“…Poore et al 34 and Barlow et al 35 developed a trial and cohort research, respectively, both with 31 PTNB sample, using NTrainer®as oral motor intervention. The results were satisfactory, since the stimulation was associated to the acceleration of the sucking process, the increasing in the number of blurts, to the enhancing of the oral dynamic system and early hospital discharge.…”

Oral stimulation techniques in preterm infants – International research challenges

“…The developmental stages of sucking in low birth weight preterm infants during bottle feeding have been described (Amaizu et al, 2008;Bingham et al, 2010;Dodrill et al, 2008a;Neiva and Leone, 2007). Varying components of sucking physiology such as sucking amplitude, rate, pressure intensity, timing of sucking cycles, sucking proficiency and efficiency appear to mature over time although at varying rates depending on several motor and sensory factors (Bingham et al, 2010;Poore et al, 2008;Matsubara et al, 2005). Preterm infants frequently remain in hospital for protracted periods as they learn to transition from gavage to oral feeds, mastering these skills.…”