223 NONNUTRITIVE SUCKING(NNS) ENHANCES MATURATION OF THE SUCKING REFLEX IN PREMATURE INFANTS

Abstract

Coordinated sucking during feeding is rarely achieved until 33 -34 wks. gestation. To define sucking patterns after birth & to determine the influence of pacifier stimulation (NNS) during gavage(NG) feeding, 20 medically stable, NG fed AGA infants (mean gest. age(GA) 32 wks.(range 28-34) were studied. Infants matched for birthwt. & GA were randomized into 2 groups. NNS received a pacifier prior to and during every NG feeding, the control received no pacifier. Intraoral negative(suction) pressure and suck ing patterns were recorded weekly during NG feedings. Both groups at 30-33 wks. gest. had low suction pressure(35-65mmHg); after 33 wks., intraoral pressure increased and sucks were organized into repetitive bursts(>3 rapidly consecutive sucks) with fewer sporadic sucks. However, the NNS group showed greater suction pressures(p<.05) from 34 wks.(89vs.62mmHg) to 39 wks.(120vs.73mmHg). In both groups, burst frequency increased from 7 to 12/2min; however, sucks/burst were greater in NNS(p<.05) from 34wk(8vs5/burst through 39wk(12vs7/burst) with fewer sporadic sucks (avg. 2.5vs. 7.5/2 min, p<.05). Finally, the NNS completed their first bottle feeding more rapidly(6.4±2.1 vs10.4±4.3min/oz avg±SD, p<.05) and made an earlier transition to total PO feeding(10±2.7 vs. 16±6.8 days, p<.02). Conclusion: Following birth, the sucking pattern in prematures is characterized by an increase in intraoral negative pressure and a transition from sporadic sucking to organized bursts; NNS opportunities significantly enhance this pattern and also facilitate an easier transition to bottle feedings.