Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck

Steven M Barlow, D. S. Finan, J. Lee, S. Chu

Research output: Contribution to journalArticle

66 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)541-548
Number of pages8
JournalJournal of Perinatology
Volume28
Issue number8
DOIs
StatePublished - Aug 1 2008

Fingerprint

Premature Infants
Central Pattern Generators
Pacifiers
Silicones
Birth Weight
Gestational Age
Cohort Studies
Multivariate Analysis
Prospective Studies
Interviews
Oxygen
Food
Control Groups

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck. / Barlow, Steven M; Finan, D. S.; Lee, J.; Chu, S.

In: Journal of Perinatology, Vol. 28, No. 8, 01.08.2008, p. 541-548.

Research output: Contribution to journalArticle

@article{f11d7340818b4df5816cbb53c205bce6,
title = "Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck",
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.",
author = "Barlow, {Steven M} and Finan, {D. S.} and J. Lee and S. Chu",
year = "2008",
month = "8",
day = "1",
doi = "10.1038/jp.2008.57",
language = "English (US)",
volume = "28",
pages = "541--548",
journal = "Journal of Perinatology",
issn = "0743-8346",
publisher = "Nature Publishing Group",
number = "8",

}

TY - JOUR

T1 - Synthetic orocutaneous stimulation entrains preterm infants with feeding difficulties to suck

AU - Barlow, Steven M

AU - Finan, D. S.

AU - Lee, J.

AU - Chu, S.

PY - 2008/8/1

Y1 - 2008/8/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=48749104266&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48749104266&partnerID=8YFLogxK

U2 - 10.1038/jp.2008.57

DO - 10.1038/jp.2008.57

M3 - Article

VL - 28

SP - 541

EP - 548

JO - Journal of Perinatology

JF - Journal of Perinatology

SN - 0743-8346

IS - 8

ER -