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Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck

Journal of Perinatology volume 28, pages 541–548 (2008)Cite this article

Abstract

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 × (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.

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Acknowledgements

This study was supported by grants NIH R01 DC003311-06 (SM Barlow), NIH P30 HD02528 and NIH P30 DC005803. The authors express gratitude to Meredith Estep, Monique Fees, Meredith Poore, Mimi Urish, Emily Zimmerman, Susan Stumm, Lana Seibel, Joy Carlson, Dr Jose Gierbolini, Susan Cannon for support in data collection and patient recruitment, Rajesh Vantipalli and Joan Wang for engineering support, and the families who participated in this project. Gratitude is expressed to Anna Dusick, MD for scientific collaboration, and to the inspiration of Dr Esther Thelen and Dr James Bosma, in memoriam of their contributions to the science of early human development.

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Authors and Affiliations

  1. Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA

    S M Barlow & S Chu

  2. Programs in Neuroscience, Human Biology and Bioengineering, University of Kansas, Lawrence, KS, USA

    S M Barlow

  3. Department of Speech-Language-Hearing Science, University of Colorado, Boulder, CO, USA

    D S Finan

  4. Program in Neural Science, University of Colorado, Boulder, CO, USA

    D S Finan

  5. Center Biobehavioral Neuroscience Communicative Disorders, University of Kansas, Lawrence, KS, USA

    J Lee

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  1. S M Barlow
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  4. S Chu
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Correspondence to S M Barlow.

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Barlow, S., Finan, D., Lee, J. et al. Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck. J Perinatol 28, 541–548 (2008). https://doi.org/10.1038/jp.2008.57

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