Non-nutritive sucking and its effect on the time between tube feeding and breastfeeding in premature babies

Background

Helping premature babies to make the transition to oral feeding is still always a major challenge. Tube feeding often also results in them staying in hospital for longer.¹ Using a pacifier improves their non-nutritive sucking capability because of the oral stimulation. For babies to get the timing right when feeding requires sensory and motor coordination of the sucking action, swallowing and breathing as well as several different muscles which help to establish an observable rhythmic process.² A pacifier helps with the development of this system.

^{¹Fucile S et al. Effect of an oral stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol 2005;47:158-162.}

^{²Rendón-Macias ME et al. Assessment of sensorial oral stimulation in infants with suck feeding disabilities. Indian J Pediatr 1999;66:319-329.}

Methodology

The criteria for inclusion in the trial were:

• Gestational age of between 26 and 32 weeks
• Stable clinical condition
• Exclusively tube fed with a feeding tube in the stomach
• Birth weight: 1500 grams or less

• The time taken to transition from tube feeding to exclusive breastfeeding and full oral feeding
• Time until discharge from hospital
• Daily weight gain

Results

• In the active treatment group, the pacifier was used for the first time on average on the 30th day (day 29.64).
• The median gestational age was on average 29.2 versus 28.4 weeks.
• The birth weight was between 1,188.2 and 1,112.8 grams.
• The time until transition to full oral feeding was on average 38 days for the pacifier group and 49.1 days for the control group.
• The time until exclusive breastfeeding was significantly shorter for the pacifier group than for the control group (38.1 versus 49.1 days; p<0.05).
• The number of premature babies experiencing gastrointestinal motility disorders (regurgitation, vomiting, wind) was significantly lower in the pacifier group than in the control group which did not use pacifiers (p<0.05).
• Sucking on a pacifier strengthens the orofacial muscles, leads to more successful drinking from a bottle and significantly shortens the time spent in hospital.
• Because of these positive effects, premature babies should be given a pacifier at the earliest possible gestational age.

MAM Service