Non-nutritive Sucking Research Articles

Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures.

Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented. To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice. This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented. Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needle-related procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist. There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.

Effect of Non-Pharmacological Methods in the Reduction of Neonatal Pain: Systematic Review and Meta-Analysis.

In neonatology, neonates have traditionally been considered incapable of feeling pain, due to the immaturity of their nervous system. Currently, there is sufficient information on the perception of pain in neonates; however, this treatment at this crucial stage for development requires a better approach. For this reason, the aim of this study was to analyse the efficacy of non-pharmacological analgesia interventions during heel prick, and to assess their effects on heart rate (HR), premature infant pain profile (PIPP) and O2 saturation. A systematic review and meta-analysis was performed following the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA), and the Cochrane collaboration handbook. The databases PubMed, Cochrane Library, Web of Science, Scopus, CINAHL and Science Direct were searched until the end of January 2022. The DerSimonian and Laird methods were used to estimate the effect size with a 95% confidence interval (CI95%). Effect size estimates were 0.05 (95% CI: -0.19, 0.29) for HR, -0.02 (95% CI: -0.24, 0.21) for PIPP scale, and -0.12 (95% CI: -0.29, 0.05) for O2 saturation. The non-pharmacological interventions analysed (breastfeeding, kangaroo-mother care method, oral sucrose and non-nutritive sucking) were not statistically significant in reducing neonatal pain, but did influence the decrease in pain score and a faster stabilisation of vital signs.

Effect of Non-nutritive Sucking during Heel-stick Procedure in Pain Management of Term Infants in the Neonatal Intensive Care Unit: A Systematic Review and Meta-analysis.

This study aimed to evaluate the efficacy of non-nutritive sucking for analgesia in term infants undergoing heel-stick procedures. Randomized controlled trials and non-randomized studies based on the PICO framework were included in the study. Review articles, commentary, pilot, and non-English articles were excluded. Databases, such as PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane, were searched until January 31st, 2021, using the keywords "Pain management", 'Non-nutritive sucking", and "Heel stick". All studies were reviewed and retrieved by two authors independently using a standardized form according to the inclusion criteria, and any disagreements were examined by a third scholar. Quality assessment was evaluated by using the ROB-2 tool. Data were analyzed using Stata version 12.0 software, and a random-effects model was used for analysis. A total of 5,629 articles were retrieved from all databases, and after the screening, finally, 6 relevant articles were included in the analysis. The tools used to control pain in infants in the articles included PIPP, NFCS, NIPS, and NPASS. The results showed that the pain scores were significantly lower in the NNS group compared to the control group (MD, -1.05; 95% CI, -1.53 to -0.57) and NNS had a significant effect on oxygen saturation (O2 Sat) increasing in newborns compared to the control group, but no significant reduction in the heart rate (HR) between two groups was observed. NNS effectively provides analgesia in full-term neonates undergoing heel-stick procedures; however, its effects on the long-term outcomes of infants are unclear. The results showed that NNS was effective in improving heel-stick pain in infants.

Methods and problems in the transition of premature infants to oral feeding: A review of the literature

Introduction: Preterm infants are necessary to acquire safe and effective feeding skills as they are born without developed suck-swallow-respiration coordination skills. Various methods are used in premature infants in order to improve sucking skills and transit from gavage feeding to full oral feeding or breastfeeding safer and faster. Aim: To research and evaluate all methods by which a premature infant will transit to oral feeding, as well as to report problems that is going to happen during the transition. Methodology: A review of the literature was conducted in PubMed database from January 2022 to March 2022. The criteria for entering the review were the following: primary research studies, the language should be either English or Greek, the article should be published between 01/01/2012 to 31/12/2021 and studies that refer to preterm infants. The sort was done using the PRISMA 2009 method. Results: A search in electronic database PubMed, applying specific eligibility criteria, resulted in 159 articles. Through identification, screening and eligibility procedures, resulted in 20 articles. The methods that identified were nonnutritive sucking with either a pacifier, the mother’s breast, or a pacifier connected to a music player that heard the mother’s voice, oro-motor stimulation, a combination of nonnutritive sucking oro-motor stimulation, responsive feeding to neonatal signs, cup and probiotics. Conclusions: All these methods lead to earlier full oral feeding, reduce the length of hospital stay, and cause fewer side effects.

Evaluation of the Effect of Oral Motor Stimulation Exercises on Feeding Skills in Premature Infants.

Oral feeding in preterm infants is a complex and dynamic process involving oral motor development and interaction between the neurological, cardiorespiratory, and gastrointestinal systems. Oral motor stimulation (OMS) is defined as stimulating the oropharyngeal components such as the lips, jaw, tongue, and soft palate with fingers in preterm infants to increase their feeding skills. In this study, we aimed to evaluate the effect of OMS exercises on the sucking and swallowing skills of preterm infants and demonstrate the utility of objective scales to evaluate infants' readiness for oral feeding. This single-center, prospective cohort study was conducted between June 1st and December 31st, 2020, which included preterm infants born at ≤34 weeks of gestation and admitted to the neonatal intensive care unit of our hospital. All procedures of the OMS program were performed once a day, 5 times a week by a language and speech therapist who is an expert in oral feeding skills (OFS) staging and non-nutritive sucking (NNS) scoring. All infants were followed up until discharge with a weekly evaluation of OFS staging and NNS scoring. A total of 50 infants were included in this prospective cohort study. The mean birth weight was 1376.9±372 g, and the median gestational age was 30 weeks (interquartile range: 25-34). The comparison of OFS stages on day 5 and day 10 of OMS revealed a significant increase (p<0.001). Similarly, there was a significant improvement in the NNS scores on days 5 and 10 compared to the baseline. In preterm infants, OMS during the transition from gavage feeding to oral feeding improves feeding skills.

Effect of oral stimulation in improving feeding performance of pre-term infants in NICU: A systematic review

Aim: The Aim of this systematic review is to evaluate the effectiveness of oral stimulation techniques in improving feeding performance among pre-term infants in neonatal intensive care units (NICUs). Method: We conducted a comprehensive literature search of electronic databases, including PubMed, CINAHL, and Cochrane Library, from 2010-2021. Studies were included if they investigated the effect of oral stimulation on feeding performance outcomes such as time to full enteral feeding, weight gain, and length of hospital stay. Two reviewers independently assessed the quality of the studies using the Cochrane risk-of-bias tool and extracted data using a standardized data extraction form, and data were synthesized using a narrative approach due to heterogeneity in study design and outcome measures. Result: Our search identified 10 studies that met the inclusion criteria, consisting of randomized controlled trials, quasi-experimental studies, and case series. Eight studies reported significant improvements in feeding performance outcomes with the use of oral stimulation interventions compared to standard care or placebo. The remaining two studies reported mixed findings or no significant differences between groups. Overall, the quality of evidence was low to moderate due to methodological limitations and inconsistency in outcome reporting. Our findings suggest that oral stimulation techniques such as non-nutritive sucking, pacifier-activated device, and oral motor exercises are effective in improving feeding performance among pre-term infants in NICUs. These techniques were associated with reduced time to achieve full oral feeds, shortened hospital stay, and improved weight gain compared to control groups. Conclusion: The results of this systematic review suggest that oral stimulation may be an effective intervention for improving feeding performance in pre-term infants in NICUs. However, further research is needed to establish the optimal timing, frequency, and duration of oral stimulation interventions, as well as their long-term effects on growth and development. Future studies should also address methodological limitations, such as small sample sizes and lack of blinding, to improve the quality of evidence in this field. Significance of the study: Oral feeding is a difficult job for premature infants those who are admitted to NICU. Because of poor muscle tone, underdeveloped oral motor skills and reduced suck-swallow-breathe synchronization, they are unable to commence feeds from the bottle and breast immediately after birth, unlike full-term infants. As long as oral feeding is not developed, a number of non-oral feeding methods are employed which feeding methods can cause severe side effects 1. The primary barrier to oral feeding in infants with gestational age less than 34 weeks is the lack of coordination in sucking, swallowing, and breathing. Oral feeding in these infants can cause apnoea, decreased pulse oximetry, transient bradycardia, and aspiration. Therefore, in neonates those who do not reach the gestational age of 34 weeks for them bottle or breastfeeding are not considered, and developmental transition from gavage to oral feeding in a 28-week-old infant may take 6 weeks or longer. Several studies have shown that oral motor intervention on infants less than 34 weeks results in decreased transition time from gavage to oral feeding 2.

Characterization of feeding skills and clinical markers of preterm newborns with gastroschisis in a neonatal therapy unit.

To describe the clinical and feeding findings of premature infants with gastroschisis (GTQ) in a neonatal intensive care unit and compare them to preterm infants (NBs) without congenital anomalies. A retrospective case-control study was conducted with 50 premature NBs (25 with GTQ and 25 without comorbidities - control group). The NBs were compared regarding demographic and clinical data: risk of mortality and speech-language assessment (nonnutritive and nutritive sucking). Subsequently, a multiple logistic regression model was applied to determine the variables associated with the negative speech therapy outcome (speech therapy discharge after more than 7 days considering the first speech therapy evaluation). The results of the first analysis indicated that there was a difference between the GTQ and the CG for the following variables: total time in days of hospitalization; use of mechanical ventilation (invasive x noninvasive); days of life on the date of the first speech-language assessment; use of alternative feeding route; and the GTQ group had worse results. The results of the multiple logistic regression indicated that the diagnosis of GTQ, the use of invasive mechanical ventilation, and the absence of adequate intraoral pressure during the first speech-language evaluation were risk factors for a negative speech-language outcome. The feeding skills of preterm infants with QTG are related to the severity of the condition (gastrointestinal tract complications), requiring longer hospitalization, use of invasive mechanical ventilation, prolonged use of alternative feeding route and requiring more speech therapy to start oral feeding.

Значение ненутритивного сосания в становлении энтерального вскармливания недоношенного ребенка

Значение ненутритивного сосания в становлении энтерального вскармливания недоношенного ребенка

Breastfeeding and development of malocclusion: A systematic review

Umpteen studies have suggested that breastfeeding can prevent future skeletal and dental malocclusions. However, there is no fair evidence that the duration of breastfeeding affects skeletal or dental malocclusions in pediatric patients. Keeping the facts in mind, the objective of this systematic review was to review available updated articles on the impact of breastfeeding and nonnutritive sucking behaviors in deciduous and mixed dentition on different forms of malocclusions. The electronic databases used PubMed, Web of Science, and Google Scholar to obtain relevant data that met the eligibility criteria. The last 10 years of studies were covered in this narrative review. Out of 254 papers identified, this systematic review focused on 16 articles that met the eligibility criteria. To conclude it has been reviewed that breastfeeding appears to decrease the occurrence of malocclusion in the pediatric population. Furthermore, there appears to be a favorable correlation between the duration of breastfeeding and the reduction in the risk of developing malocclusion. More longitudinal studies are warranted to reduce bias, with data collected prospectively on the duration of exclusive breastfeeding and nonnutritive sucking behaviors, using specific survey questions, and subsequent clinical investigation of the occlusal status at the deciduous, mixed, and permanent teeth stages.

Prontidão para via oral, aleitamento materno e diabetes mellitus gestacional: estudo caso-controle

ABSTRACT Purpose to verify the readiness for oral feeding and breastfeeding in newborns of mothers diagnosed with gestational diabetes mellitus (GDM). Methods observational, analytical, quantitative case-control study. For the evaluation of non-nutritive sucking, the PROFAS protocol was used and for the evaluation of performance at the mother's breast, the protocol of Speech Therapy - Breastfeeding. The sample was stratified into two groups, the experimental group, composed of newborns of mothers diagnosed with GDM, and the control group, with newborns of healthy mothers. For statistical analysis, the Mann-Whitney, Shapiro Wilk and Student's t tests were used. Results the total sample consisted of 46 newborns, 21 from the experimental group and 25 from the control group. P&lt;0.05 was observed in the comparison between the groups in the variables: oscillation in the state of consciousness, global hypotonia, weak search reflex, less than five suctions per pause in the assessment of non-nutritive sucking, holding on to the breast, falling asleep after starting suction and mother-infant positioning. Conclusion newborns of mothers diagnosed with GDM had greater difficulty in readiness for oral feeding and in the practice of breastfeeding in the first 72 hours of life, compared to children of healthy mothers.

Predictors associated with malocclusion in children with and without sleep disorders: a cross-sectional study.

The aim of the present study was to investigate predictors of malocclusion in Brazilian schoolchildren eight to ten years of age based on a causal directed acyclic graph model. A cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians provided information on sleep disorders of the child (Sleep Disturbance Scale for Children) and family characteristics (Family Adaptability and Cohesion Evaluation Scale). The diagnosis of malocclusion was performed by four trained examiners using the Dental Aesthetic Index. Control variables were selected using a directed acyclic graph. Descriptive analysis was performed, followed by robust logistic regression analysis for complex samples (α = 5%). The following variables were associated with malocclusion in the final model: sleep disorders (OR = 2.61; 95%CI: 2.43-2.86), mouth breathing (OR = 1.04; 95%CI: 1.02-1.99), non-nutritive sucking habits (OR = 2.45; 95%CI: 2.37-4.85), and obesity (OR = 1.54; 95%CI: 1.02-2.33). Sociodemographic characteristics, family functioning, and premature tooth loss did not remain associated with malocclusion. Sleep disorders, mouth breathing, sucking habits, and obesity are predictors of malocclusion in schoolchildren eight to ten years of age.

Associations between biomarkers of prenatal metals exposure and non-nutritive suckamong infants from the PROTECT birth cohort in Puerto Rico.

Infant non-nutritive suck (NNS) has been used as an early marker of neonatal brain function. Although there is an established relationship between prenatal exposure to certain metals and brain development, the association between metal exposure and NNS has not been explored. Therefore, in this study we assessed associations between maternal urinary metal(loid) concentrations and NNS measurements among infants from the Puerto Rico PROTECT birth cohort. We hypothesized that maternal urinary metal(loid) concentrations are significantly associated with infant NNS measures in a sex-dependent manner. We measured urinary concentrations of 14 metal(loid)s in pregnant women at up to three time points in pregnancy. The geometric mean of each metal(loid) for each pregnant woman was calculated and used as an exposure measurement across gestation. NNS measurements (duration, frequency, amplitude, bursts/min, cycles/burst, cycles/min) were collected from infants between 4 and 6 (±2 weeks) weeks of age using our custom research pacifier. Linear regression was used to estimate associations between urinary metal(loid) concentrations across pregnancy and continuous NNS variables. Sex-specific effects were estimated using interaction terms between NNS variables and infant sex. We observed significant positive associations between mercury, manganese, and tin with NNS duration (mercury: %Δ = 1.08, 95% CI: 0.42, 1.74; manganese: %Δ = 0.67, 95% CI: 0.15, 1.20; tin: %Δ = 0.83, 95% CI: 0.17, 1.49) and NNS cycles/burst (mercury: %Δ = 1.85, 95% CI: 0.58, 3.11; manganese: (%Δ = 1.37, 95% CI: 0.40, 2.34; tin: %Δ = 1.68, 95% CI: 0.46, 2.91). Furthermore, the association between NNS cycles/min with cadmium (%Δ = 8.06, 95% CI: 3.33, 12.78), manganese (%Δ = 4.44, 95% CI: 1.40, 7.47), and tin (%Δ = 4.50, 95% CI: 0.81, 8.18) were in the opposite direction from its association with zinc (%Δ = -9.30, 95% CI: -14.71, -3.89), as well as with copper (%Δ = -6.58, 95% CI: -12.06, -1.10). For the sex-stratified analysis, the negative associations between metal(loid)s and NNS duration were predominantly driven by male infants; however, the negative associations between metal(loid)s and NNS bursts/min were mainly driven by female infants. We observed significant associations between prenatal metal(loid) exposure and NNS measurements among infants from the ongoing Puerto Rico PROTECT cohort. Similar to previous studies that have demonstrated associations between NNS and subsequent neurodevelopment, this study highlights the potential of NNS as a quantitative index to measure altered neurodevelopment from prenatal metal(loid) exposures. We believe this study will inform future efforts aimed at reducing health risks related to early life metal exposures, such as developing early identification of metal-induced adverse outcomes in child neurodevelopment.

Evolution of swallowing and feeding abilities of neonates with hypoxic-ischaemic encephalopathy during hospitalisation: A case series

Purpose To describe the evolution of swallowing and feeding abilities of neonates with hypoxic-ischaemic encephalopathy (HIE) during hospitalisation. Method A longitudinal cohort study was used. Twenty-nine participants (median age 39.0 weeks [IQR = 2.0 weeks]) with mild (n = 7), moderate (n = 19) and severe (n = 3) HIE were included. Clinical swallowing and feeding assessments were conducted at introduction of oral feeds and at discharge using the Neonatal Feeding Assessment Scale (NFAS). Videofluoroscopic swallow studies (VFSS) supplemented the NFAS before discharge. Result Approximately two thirds of participants showed symptoms of oropharyngeal dysphagia (OPD) during initial NFAS and VFSS. Significantly fewer OPD symptoms occurred at discharge NFAS (p = 0.004). Endurance during non-nutritive sucking (p < 0.001) and nutritive sucking (p < 0.001) significantly improved. Nine participants (31.0%) demonstrated penetration or aspiration. Most aspiration events were silent (60%). Instrumental assessment identified pharyngeal phase dysphagia more effectively than bedside evaluation. High proportions of participants displayed OPD symptoms regardless of HIE severity. The correlation between OPD severity and the length of hospitalisation (p = 0.052) was not significant. Conclusion All grades of HIE should be considered for early intervention by speech-language pathologists before discharge. Findings may be valuable to neonatal feeding teams.

Efficacy of 2 Nonpharmaceutical (Non-nutritive Sucking and Human Care Contact) Pain Relief Measures for Idiopathic Clubfoot Casted Using Ponseti Technique.

This study aimed at exploring the pain and physiological responses exhibited during Ponseti manipulation and casting in clubfoot infants. In addition, we compared the efficacy of 2 nonpharmaceutical techniques (non-nutritive sucking and human care contact) for tackling these responses. The study included children with unilateral and bilateral idiopathic clubfeet between 15 days to 6 months of age. For comparisons, children were divided into control group without any intervention (group A), non-nutritive sucking group (group B), and human care contact group (group C). Pain score (Neonatal Infant Pain Score), heart rate (HR), and oxygen saturation (SpO2) was assessed before, during and 1 minute after casting. These measurements were compared using statistical methods. There were 16 children (11 bilateral) in group A, 17 (10 bilateral) in group B, and 18 (8 bilateral) in group C. Before casting, the baseline parameters (Neonatal Infant Pain Score, HR, and SpO2) of the 3 groups were comparable. Groups B and C had a significant reduction in pain score at casting and in postcasting period when compared with group A (P<0.05). Group B (at casting-mean: 174.1/min, postcasting-mean: 168.2/min) had the lowest HR both during and after cast application. Group B had the highest SpO2 among all the 3 groups, both during casting (mean: 95.7%) and after casting (mean: 97.4%) (P<0.05). Infants exhibit moderate pain response and altered physiological responses during and after Ponseti casting. Non-nutritive sucking emerged as a better method to lessen these parameters when compared with the conventional technique and human care contact. Level II.

Influence of Nonnutritive Sucking Habits on the Oral Carriage of Escherichia coli.

This study aimed to evaluate the impact of nonnutritive sucking habits on the presence of oral Escherichia coli. One hundred and twenty children aged 3-5 years old were enrolled in the present case-control study, as follows: 60 children with continuous pacifier and thumb sucking habits (study group) and 60 children without any sucking habits (control group). The children in the two groups were matched in terms of age and gender. Information was gathered from the parents concerning their children using a special sheet. Sterile swabs were taken from both groups and cultured on agar plates. Then, they were subjected to further biochemical tests to identify E. coli species. The mean of the E. coli count was determined for each child. Descriptive, independent t-test and chi-square test statistics were used. The level of significance was set at p < 0.05. The presence of nonnutritive sucking habits was related to a higher carriage of E. coli among children. Nonnutritive sucking habits may act as a predisposing factor that enhances the colonization of oral E. coli.

Prefeeding interventions improve oral feeding in preterm infants.

To assess whether oral stimulation (OS), nonnutritive sucking (NNS) and combined tactile/kinesthetic (T/K) interventions can improve the effects of oral feeding in preterm infants. A retrospective review was performed from 2014 to 2016, in which one hundred thirty preterm infants were separated into two intervention groups (the OS+NNS group and the OS+NNS+T/K group) and one control group. Infants in the two intervention groups received 30min of interventions a day. All interventions started 48h after stopping nasal continuous positive airway pressure until participants reached complete oral feeding. The transition times of the OS+NNS, OS+NNS+T/K, and control groups from the introduction of oral feeding to independent oral feeding were 9.03±0.58, 7.20±0.28, and 12.17±0.64 days, respectively (P<0.05). The infants' weights at full oral feeding in the OS+NNS, OS+NNS+T/K, and control groups were 1834.58±47.96, 1999.17±92.62, and 1725.87±40.34g, respectively (P=0.007). Further post hoc analyses indicated that the weight gain at full oral feeding in the OS+NNS and OS+NNS+T/K groups were more significant than the control group (P= 0.012 and P= 0.036, respectively)Conclusion: OS+NNS and OS+NNS+T/K interventions could shorten the transition time from tube feeding to independent oral feeding; OS+NNS and OS+NNS+T/K interventions improved weight gain compared to the control group. Furthermore, the OS+NNS+T/K group was superior to the OS+NNS group regarding transition time and weight gain.

The seven points of developmental care for preterm neonates: Nurses’ knowledge and attitudes in the NICU Room

Preterm neonates (premature infants) are born with various risks that require them to be admitted to the Neonatal Intensive Care Unit (NICU) which is full of stressors. The impact of stressors in the NICU on infants can be minimized by the provision of seven points of developmental care. Unfortunately, the NICU nurses’ knowledge and attitude in implementing the seven points of developmental care was still lacking, that not all nurses did. This study aims to identify the effect of education on the seven points of developmental care in increasing the NICU nurses’ knowledge and attitude. The pre-experimental research design of one group pretest-posttest was chosen, involving 28 NICU nurses who were selected by using simple random sampling technique. The inclusion criteria of respondents included nurses with more than 1 year of work experience. Education was given 3 times with a duration of 2 hours through online videos. Data were analyzed using the Wilcoxon test. There was a significant increase in knowledge and attitudes on the aspects of stress cues (p= 0.025), principles of cooperation with family (p=0.003), Standard Operating Procedure (SOP) of Cooperation with family (p= 0.012), Infant Positioning Assessment Tool (p= 0.003), minimizing pain by touching (p=0.002), route of providing nutrition (p= &lt;0.001), and non-nutritive sucking p= 0.004). Education on the seven points of developmental care is able to increase the NICU nurses’ knowledge and attitudes in implementing interventions for preterm neonates. The provision of education is required regularly in order to refresh and update information for the NICU nurses so that they are able to provide appropriate, optimal, and up-to-date care for preterm neonates.

Non-nutritive sucking milestones of preterm infants in Indonesia: a descriptive study

Background Non-nutritive sucking (NNS) maturity has been used as one of the markers of oral feeding readiness in infants. Prematurity may hinder the attainment of NNS milestones. Depending on gestational age (GA) at birth, preterm infants may display various degrees of immaturity, potentially affecting the strength, coordination, and efficiency of skills required for NNS.&#x0D; Objective To identify the progression of NNS patterns across gestational age groups of preterm infants in Indonesia by comparing NNS parameters between moderate-to-late preterm and very preterm infants.&#x0D; Methods NNS evaluation was conducted in 120 preterm infants born at 28-34 weeks gestational age in five tertiary hospitals in Jakarta, Indonesia. Three aspects of NNS (suction pressure, number of suctions per burst, and time between bursts) were documented and arranged to present a descriptive overview. A suction pressure measurement device was used to record, identify, and analyze NNS parameters. We hypothesize that maturity, as determined by GA, positively affected the attainment of NNS milestones.&#x0D; Results Moderate-to-late preterm infants (GA 32 to &lt;37 weeks), compared to very preterm infants (GA 28 to &lt;32 weeks), had higher mean NNS pressure (-79.8 vs. -72.7 mmHg, respectively, P=0.041) and shorter mean time between bursts (6.63 vs. 7.36 s, respectively, P=0.030). Mean number of suctions per burst were also significantly different between the two GA groups (8.90 vs. 8.99 sucks/burst, respectively, P=0.048).&#x0D; Conclusion Maturity, as reflected by GA, had a positive effect on the attainment of NNS milestones in preterm infants in Indonesia. Significant differences in the three NNS parameters: number of suctions per burst, time between bursts, and suction pressure were found between moderate-to-late preterm and very preterm infants.

ANALGESIC ЕFFECT OF 25% GLUCOSE AND NON-NUTRITIVE SUCKING IN TERM NEWBORNS – COMPATIVE ANALYSIS

Non-nutritive sucking and oral uptake of glucose 25% are often non-pharmacological methods used to manage procedural pain in newborns. Aim: To compare the effect of using non-nutritive suction (NNS) and Sol.Glucosae 25% for reducing/eliminating neonatal pain due to heel prick. Material and methods: Term infants were studied: group (A), NNS, n = 40, and group (B) oral uptake of Sol.Glucosae 25%, n = 40. The severity of procedural pain was assessed using the Neonatal Facial Coding System (NFCS) scale: 30 seconds before the procedure, at the 30th second and at the 5th minute after the procedure. Physiological pain markers were monitored at these intervals: respiratory, heart rate, transcutaneous saturation (tSpO2), arterial blood pressure. Results and Discussion: Newborns in a group (B) had a lower evaluation at the 5th minute compared to those treated with non-nutritive suckling(A). There are significant differences in heart rate, breathing frequency and before the procedure. The intake of Sol. Glucose 25% compared to NNS causes a higher heart rate and a decrease in at the 30th second after the painful procedure. In contrast to the heart rate, for respiratory rate and tSpO2 at 5th min. we reported lower than the norms in both groups A and B. Conclusion: Unlike NNS, glucose intake eliminates pain within 5 minutes after a heel prick. Excluding arterial blood pressure, all other physiological pain markers undergo changes before the procedure but not after it.

Correlation between Pacifier Use in Preterm Neonates and Breastfeeding in Infancy: A Systematic Review.

Background: Breastfeeding is very important for the proper nutrition and growth of the child, as well as, the health of the mother. To start breastfeeding, the neonate must have extensive oral capacities for sucking functions but, premature neonates may not have the muscle strength needed to suck successfully. However, the non-nutritive sucking achieved by using a pacifier, has been identified by previous research as a factor associated with shorter duration and exclusivity of breastfeeding. This study aims to perform a systematic review to investigate the relationship between pacifier use in preterm neonates and breastfeeding in infancy. Methods: We included prospective studies, as well as randomized controlled studies that evaluated the association between pacifier use by preterm neonates and of breastfeeding in infancy. Ten research articles from PubMed/Medline, Google Scholar and Crossref were included in the review from a total of 1455 articles. The results differ depending on the type of study.Most prospective studies have shown a negative correlation between pacifier use and breastfeeding, while the randomized controlled studies found a positive correlation. Conclusions: Pacifier use in preterm infants helps transition from tube to oral feeding, breastfeeding, faster weight gain and earlier discharge from the NICU. However, the relationship between pacifiers and breastfeeding is more complicated, as it appears to be influenced by additional risk factors.