Patterned orocutaneous therapy improves sucking and oral feeding in preterm infants

Abstract

Aim: To determine whether NTrainer patterned orocutaneous therapy affects preterm infants' non-nutritive suck and/or oral feeding success.

Subjects: Thirty-one preterm infants (mean gestational age 29.3 weeks) who demonstrated minimal non-nutritive suck output and delayed transition to oral feeds at 34 weeks post-menstrual age.

Intervention: NTrainer treatment was provided to 21 infants. The NTrainer promotes non-nutritive suck output by providing patterned orocutaneous stimulation through a silicone pacifier that mimics the temporal organization of suck.

Method: Infants' non-nutritive suck pressure signals were digitized in the NICU before and after NTrainer therapy and compared to matched controls. Non-nutritive suck motor pattern stability was calculated based on infants' time- and amplitude-normalized digital suck pressure signals, producing a single value termed the Non-Nutritive Suck Spatiotemporal Index. Percent oral feeding was the other outcome of interest, and revealed the NTrainer's ability to advance the infant from gavage to oral feeding.

Results: Multilevel regression analyses revealed that treated infants manifest a disproportionate increase in suck pattern stability and percent oral feeding, beyond that attributed to maturational effects alone.

Conclusion: The NTrainer patterned orocutaneous therapy effectively accelerates non-nutritive suck development and oral feeding success in preterm infants who are at risk for oromotor dysfunction.

Figures

Figure 1

(left) Infant is treated with the NTrainer© patterned orocutaneous therapy. (right) The NTrainer© device is wheeled cribside in the Neonatal Intensive Care Unit (NICU).

Figure 2

Steps for Non-Nutritive Suck Spatiotemporal Index calculation for one infant.

Figure 3

PRE and POST suck pressure samples and Non-Nutritive Suck Spatiotemporal Index calculation for a Control and NTrainer-treated infant. Left side of each panel includes non-nutritive suck source pressure signals for five five-peak bursts. Right side of each panel includes the same set of bursts after time- and amplitude-normalization for Non-Nutritive Suck Spatiotemporal Index calculation. Organized non-nutritive suck resulting from NTrainer treatment (Non-Nutritive Suck Spatiotemporal Index = 35) can be seen in the bottom panel.