Original Article
Journal of Perinatology (2008) 28, 541–548; doi:10.1038/jp.2008.57; published online 12 June 2008
Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck
S M Barlow1,2, D S Finan3,4, J Lee5 and S Chu1
- 1Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
- 2Programs in Neuroscience, Human Biology and Bioengineering, University of Kansas, Lawrence, KS, USA
- 3Department of Speech-Language-Hearing Science, University of Colorado, Boulder, CO, USA
- 4Program in Neural Science, University of Colorado, Boulder, CO, USA
- 5Center Biobehavioral Neuroscience Communicative Disorders, University of Kansas, Lawrence, KS, USA
Correspondence: Dr SM Barlow, SPLH-Neuroscience, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas 66045, USA. E-mail: smbarlow@ku.edu
Received 23 October 2007; Revised 3 March 2008; Accepted 7 April 2008; Published online 12 June 2008.
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.
Keywords:
suck central pattern generator, sensory experience, orofacial, non-nutritive suck, oral feed
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