Abstract
The nonnutritive suck (NNS) is an observable and accessible motor behavior which is often used to make inference about brain development and pre-feeding skill in preterm and term infants. The purpose of this study was to model NNS burst compression pressure dynamics in the frequency and time domain among two groups of preterm infants, including those with respiratory distress syndrome (RDS, N = 15) and 17 healthy controls. Digitized samples of NNS compression pressure waveforms recorded at a 1-week interval were collected 15 minutes prior to a scheduled feed. Regression analysis and ANOVA revealed that healthy preterm infants produced longer NNS bursts and the mean burst initiation cycle frequencies were higher when compared to the RDS group. Moreover, the initial 5 cycles of the NNS burst manifest a frequency modulated (FM) segment which is a significant feature of the suck central pattern generator (sCPG), and differentially expressed in healthy and RDS infants. The NNS burst structure revealed significantly lower spatiotemporal index values for control versus RDS preterm infants during FM, and provides additional information on the microstructure of the sCPG which may be used to gauge the developmental status and progression of oromotor control systems among these fragile infants.
Highlights
This stable pattern of frequency modulated (FM) modulation exhibited among the 17 healthy preterm controls at 34.11 wks postmenstrual age (PMA) was markedly different for preterm RDS infants who endured more than a month of O2 supplementation therapy
Healthy preterm infants manifest a significantly longer nonnutritive suck (NNS) burst structure when compared to infants with RDS
Healthy preterm infants suck at a higher frequency at the onset of the suck burst when compared with the RDS infants
Summary
The mammalian suck is the earliest-appearing somatic motor rhythm and is primarily controlled by a neural network known as the suck central pattern generator (sCPG). Suck appears in utero between 15 and 18 of weeks gestational age (GA) and the nonnutritive suck (NNS) is remarkably stable and well patterned by 32 weeks postmenstrual age (PMA) among healthy preterm infants [1]. The presence of a coordinated NNS is a good index of sucking skills, but not necessarily of an infant’s readiness to orally feed [2]. Coordinated nutritive suckswallow-breathe (bottle feeding) is usually not attained until 34 weeks PMA [2,3,4]
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