NUTRITIVE VS. NON-NUTRITIVE SUCKING: EFFECTS ON BREATHING PATTERN OF TERM NEONATES

Abstract

Marked inhibition of breathing during the early part of oral feeding is documented in neonatal lambs and preterm infants. This is presumably due to stimuli arising from the upper airway due to presence of liquid or due to repetitive sucking and/or swallowing. Sucking generates negative pressure in the upper airway and negative pressure in the upper airway is known to decrease the breathing frequency. We monitored 12 term healthy newborns (1-3 days old) during non-nutritive and nutritive sucking polygraphically to determine the effect of feeding on the breathing pattern and to separate the effect of sucking per se. Heart rate, sucking pressures, nasal airflow and respiratory efforts were monitored in semi-upright position. During nutritive feeding an initial burst of continuous sucking lasting 20-30 sec. followed by intermittent sucking was seen. Decreased breathing frequency and tidal volume as well as shortening of inspiration were seen during the initial period. A recovery towards control values was seen during intermittent sucking. In contrast, changes in breathing pattern were minimal during nonnutritive sucking. We conclude that stimuli related to either the presence of liquid in the upper airway or repetitive swallowing rather than sucking per se appears to be responsible for the inhibition of breathing seen during oral feeding.1Recipient of NIH Clinical Investigator Award HLO1156.