A randomized study of the efficacy of sensory-motor-oral stimulation and non-nutritive sucking in very low birthweight infant☆
Section snippets
Methodology
A double-blind, randomized, clinical trial was performed. The sample size was calculated considering a 20% reduction in length of stay, statistical power of 80% two-tailed type 1 error of 0.05. Randomization was stratified based on gestational age ranges (26–28, 28.1–30, 30.1–32). A total of 98 newborns were admitted to the study, from the neonatal intensive care unit at the Fernandes Figueira Institute, FIOCRUZ, Rio de Janeiro, Brazil. These preterm infants met the following inclusion
Results
Of the 241 very low birthweight infants who were screened for enrollment, 103 (42%) were ineligible (40% succumbing to death; 22% presented with congenital malformations such as esophageal atresia, gastroschisis, omphalocele or another genetic problems; 10% the parents refused or were unavailable; others presented with asphyxia or convulsions). Among the remaining 138 infants, we studied 98. The remaining 40 eligible infants were not enrolled because of sepsis, intraventricular haemorrhage
Discussion
Preterm infants present with significant difficulties during the post-natal period, such as infections, respiratory problems, hypoglycemia, asphyxia and others. In addition, nutritional issues are a major challenge, especially considering nutritional requirements to maintain vital capacity, the growth and development of these infants. The nutritional challenges include the difficulty newborns less than 34 weeks of gestational age have in coordinating sucking, breathing and swallowing. Preterm
Conclusion
Based on our study, sensory-motor-oral stimulation, together with early non-nutritive sucking (as soon as the newborn reaches full diet) in low birthweight infants as long as they are clinically stable, should be implemented to promote earlier initiation of oral feeding and earlier hospital discharge, but we cannot recommend this practice against non-nutritive sucking alone. Further studies are required to address this issue.
Acknowledgments
This study was supported by PAPES III-FIOCRUZ and FAPERJ. Special thanks to Nadia Rodrigues Mallet.
References (20)
- et al.
Intrinsic dynamics and mechanosensory modulation of non-nutritive sucking in human infants
Early Hum Dev
(1998) - et al.
New Ballard Score, expanded to include extremely premature infants
J Pediatr
(1991) - et al.
A United States national reference for fetal growth
Obstet Gynecol
(1996) - et al.
Oral stimulation accelerates the transition from tube to oral feeding in preterm infants
J Pediatr
(2002) - et al.
Physiologic sequelae of prematurity: the nurse practitioner's role: Part V. Feeding difficulties and growth failure
J Pediatr Health Care
(1991) - et al.
Nonnutritive sucking during tube feedings: effect on clinical course in premature infants
J Nurses Assoc Coll Obstet Gynaecol
(1979) The development of sucking behavior in newborn infants
Early Hum Dev
(1991)- et al.
Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infant
Dev Med Child Neurol
(1990) - et al.
Nonnutritive sucking during gavage feeding enhances growth and maturation in premature infants
Pediatrics
(1983) - et al.
Behavior and physiologic effects of nonnutritive sucking during gavage feeding in preterm infants
Pediatr Res
(1994)
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This study was approved by the Fernandes Figueiras Institutional Review Board/Research Ethics Committee and by neonatal unit where the research was conducted. Prior informed consent was obtained from parents/guardians of the newborns for their participation in the study.