Pineda, R., Dewey, K., Jacobsen, A., & Smith, J. (2018). Non-Nutritive Sucking in the Preterm Infant. American journal of perinatology.

Objective To identify the progression of non-nutritive sucking (NNS) across postmenstrual age (PMA) and to investigate the relationship of NNS with medical and social factors and oral feeding.

Study Design Fifty preterm infants born at ≤32 weeks gestation had NNS assessed weekly starting at 32 weeks PMA. Oral feeding was assessed at 38 weeks PMA.

Results There were increases in NNS bursts per minute (p = 0.005), NNS per minute (p < 0.0001), NNS per burst (p < 0.001), and peak pressure (p = 0.0003) with advancing PMA. Level of immaturity and medical complications were related to NNS measures (p < 0.05). NNS measures were not related to Neonatal Oral Motor Assessment Scale scores. Smaller weekly change in NNS peak pressure (p = 0.03; β = –1.4) was related to feeding success at 38 weeks PMA.

Conclusion Infants demonstrated NNS early in gestation. Variability in NNS scores could reflect medical complications and immaturity. More stable sucking pressure across time was related to feeding success at 38 weeks PMA.

Commentary from Catherine:  Co-morbidities matter in every facet of the preterm infant’s development and skill progression. The emergence of non-nutritive sucking, its quality, and its interface with swallowing and breathing,  is clearly affected by the nature of and interaction among the infant’s co-morbidities. Take time to carefully consider this in your assessments and ongoing interventions with our  ones in  the NICU. Remember, sucking does not occur in isolation –  it is part of a dynamic interactive system.