Document Detail


Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck.
MedLine Citation:
PMID:  18548084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prematurity can disrupt the development of a specialized neural circuit known as suck central pattern generator (sCPG), which often leads to poor feeding skills. The extent to which suck can be entrained using a synthetically patterned orocutaneous input to promote its development in preterm infants who lack a functional suck is unknown.
OBJECTIVE: To evaluate the effects of a new motorized 'pulsating' pacifier capable of entraining the sCPG in tube-fed premature infants who lack a functional suck and exhibit feeding disorders.
METHODS: Prospective cohort study of 31 preterm infants assigned to either the oral patterned entrainment intervention (study) or non-treated (controls) group, matched by gestational age, birth weight, oxygen supplementation history and oral feed status. Study infants received a daily regimen of orocutaneous pulse trains through a pneumatically controlled silicone pacifier concurrent with gavage feeds.
RESULTS: The patterned orocutaneous stimulus was highly effective in accelerating the development of non-nutritive suck (NNS) in preterm infants. A repeated-measure multivariate analysis of covariance revealed significant increases in minute rates for total oral compressions, NNS bursts, and NNS cycles, suck cycles per burst, and the ratiometric measure of NNS cycles as a percentage of total ororhythmic output. Moreover, study infants also manifest significantly greater success at achieving oral feeds, surpassing their control counterparts by a factor of 3.1 x (72.8% daily oral feed versus 23.3% daily oral feed, respectively).
CONCLUSION: Functional expression of the sCPG among preterm infants who lack an organized suck can be induced through the delivery of synthetically patterned orocutaneous pulse trains. The rapid emergence of NNS in treated infants is accompanied by a significant increase in the proportion of nutrient taken orally.
Authors:
S M Barlow; D S Finan; J Lee; S Chu
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2008-06-12
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  28     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-31     Completed Date:  2008-10-23     Revised Date:  2013-08-02    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  541-8     Citation Subset:  IM    
Affiliation:
Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS 66045, USA. smbarlow@ku.edu
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Enteral Nutrition
Female
Humans
Infant, Newborn
Infant, Premature / physiology*
Male
Pacifiers*
Physical Stimulation
Physical Therapy Modalities / instrumentation*
Prospective Studies
Sucking Behavior / physiology*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 DC005803/DC/NIDCD NIH HHS; P30 DC005803/DC/NIDCD NIH HHS; P30 HD002528/HD/NICHD NIH HHS; P30 HD02528/HD/NICHD NIH HHS; R01 DC003311/DC/NIDCD NIH HHS; R01 DC003311-06/DC/NIDCD NIH HHS
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