Relationship of behavioral state and tube-feeding to non-nutritive sucking in premature infants

PurposeNon-nutritive sucking (NNS) has developmental benefits for premature infants, yet little is known about how behavior state or feeding conditions affect this behavior. We examined how NNS varies in amount and organization in relation to (1) behavioral state and (2) tube-feeding conditions.DesignTen-minute observations of NNS together with behavioral state assessment, prior to and during tube-feeding. Analyze quantitative and qualitative NNS measures from digital records in relation to behavioral and feeding conditions via repeated measures ANOVA.SamplePremature infants (n = 56), 30.7 ± 2.1 weeks gestational age at birth, 32–34 weeks postmenstrual age when studied.ResultsIncreased arousal correlated with increased, more mature patterns of NNS activity. Surprisingly, tube-feeding was associated with reduced amount, and simpler patterns, of NNS activity, although burst length, and the quality of suck waves, were maintained. These results inform continuing efforts in the NICU to assess and encourage NNS.