Predictors of nutritive sucking in preterm infants

Abstract

Objective: The purposes of this analysis were to determine how select characteristics of nutritive sucking (number of sucks, sucks/burst, and sucks/minute) change over time and to examine the effect of select factors (morbidity, maturity, prefeeding behavior state, and feeding experience) on those changes.Study design: A longitudinal, non-experimental study was conducted in a Level 3 neonatal intensive care unit using a convenience sample of 88 preterm infants. Statistical analyses were performed using a repeated-measures mixed-model in SAS.Results: Sucking activity (number of sucks, sucks/burst, and sucks/ minute) was predicted by morbidity, maturity, feeding experience and prefeeding behavior state. Experience at oral feeding had the greatest effect on changes in the number of sucks, suck/burst and sucks/minute. Conclusion:Experience at feeding may result in more rapid maturation of sucking characteristics.

Preterm newborn readiness for oral feeding: systematic review and meta-analysis

“…Most excluded articles did not evaluate the moment of transition to oral feeding or the NB participants in the researches had already received oral feeding. The final sample included 29 articles, with 12 articles published between 2003 and 2007 (10,20,21,23,(34)(35)(36)(37)(38)(39)(40)(41) and 17 published between 2008 and 2012 (8,22,(24)(25)(26)(27)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) .…”

Attainment of early feeding milestones in preterm neonates

“…It is often assumed that neonates possess the skills necessary to commence suckle-feeds by 34 weeks gestational age (GA) and will be able to maintain exclusive suckle-feeding before 37 weeks GA. 1 However, to date, few studies have systematically investigated the age at which preterm neonates attain these essential early feeding milestones, 2,3 or the factors that influence this important aspect of neonatal development. 4 To be able to commence suckle-feeds, a neonate needs to demonstrate the ability to suckle, and the ability to coordinate suckling, swallowing and breathing at least over short periods of time. For the attainment of exclusive suckle-feeding, the neonate must demonstrate the skills and endurance to suckle well, and to proficiently coordinate suckling, swallowing, and breathing, over longer time periods (that is, over the duration of an entire feed, for each of the feeds throughout the day).…”

Oral stimulation techniques in preterm infants – International research challenges

“…prolonged intubation, continuous positive airway pressure, nasal cannulation, regular oropharyngeal, nasal or tracheal suction) may compound negative responses by the infant to oral feeding trials (Bingham, 2009;Dougherty and Luther, 2008;Jadcherla et al, 2010). General factors such as prefeeding behavior, state and feeding experience also influence feeding performance in this population (Dodrill et al, 2008a;Pickler et al, 2006). Some intervention that would ameliorate the impact of negative feeding experiences, provide some positive oral motor sensory stimulation and expedite the transition from tube to oral feeding would therefore seem important.…”

“…Empirically derived guidelines for either starting or progressing oral feeds are lacking (Crowe et al, 2012;Pickler et al, 2006). The criteria for making judgments on readiness to feed can vary between centers and seems dependent on a range of factors such as age, weight, oral motor skills, feeding techniques, and feeding experience (Crowe et al, 2012;Dodrill et al, 2008b;Zimmerman and Barlow, 2009).…”

“…The complex skills, required for the development of sucking and feeding in infants, have been well documented (Bingham et al, 2010;Dodrill et al, 2008a;Pickler et al, 2006;Poore and Barlow, 2009). For the preterm infant acquisition of these skills means dealing with many added challenges depending on the extent of the prematurity and the myriad of accompanying co-morbidities and experiences encountered on the journey through the Neonatal Intensive Care Unit (NICU).…”