Suck Predicts Neuromotor Integrity and Developmental Outcomes

Abstract

Neonatal motor behavior predicts both current neurological status and future neurodevelopmental outcomes. For speech pathologists, the earliest observable patterned oromotor behavior is suck. Suck production requires effective coordination of an infant's oral sensorimotor system and is subject to a variety of neuromodulatory inputs. Demonstration and practice of coordinated suck serves as a biomarker for oral feeding skills neural integrity and is being assessed for its relation to neurodevelopmental outcomes (speech, cognition, and learning) by research teams in the United States, Europe, Japan, and Brazil. Suck may also serve as an intervention point to prevent feeding disorders and mitigate speech-language delays and disorders.

Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding

“…Though there is little data available on the use of oral motor intervention in infants born at or later than 37 weeks gestation, efficacy of oral motor intervention has been demonstrated in preterm infants. For example, in preterm infants receiving gavage feeds, oral motor intervention has been shown to increase non-nutritive sucking pressure and activity (Barlow, Finan, Lee, & Chu, 2008; Poore & Barlow, 2009). This resulted in decreased time to achieve full oral feeds (Lessen, 2011), higher milk transfer rates, and greater volume taken during oral feeds (Zhang et al, 2014).…”

Early sucking and swallowing problems as predictors of neurodevelopmental outcome in children with neonatal brain injury: a systematic review

“…Sucking and swallowing form critical components of the infant’s motor repertoire and are essential for successful feeding, growth, and development 18 . Sucking and swallowing abnormalities in early infancy have long been viewed as potential markers of neonatal brain injury 17,19,20 . Moreover, it has been suggested that prolonged dysphagia or swallowing difficulties in very preterm infants may represent an early marker of undiagnosed brain injury 20 .…”

“…The neurological controls that support this motor activity are complex and rely upon the integration of cortical, subcortical, brainstem, and cerebellar inputs 20,22,23 . It is generally agreed that neonatal brain injury can damage these neural pathways, with resultant sucking and swallowing problems 19,20,23,24 . However, there is currently limited evidence regarding this concurrent relation, in particular the frequency of occurrence and the specific patterns of early sucking and swallowing abnormalities associated with different types of neonatal brain injury.…”

“…In addition, it is argued that a relation exists between early sucking and swallowing difficulties and later neurodevelopment 19,25 . In a recent review, Poore and Barlow 19 contend that early sucking skills may predict later neurodevelopmental outcomes, particularly in speech and language.…”

Oral stimulation techniques in preterm infants – International research challenges

“…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).…”