Evaluating sucking maturation using two pressure thresholds

Abstract

Background The Medoff-Cooper Nutritive Sucking Apparatus (M-CNSA) has been used to objectively measure sucking maturation in preterm infants. The M-CNSA is able to accurately detect sucking pressures less than 20 mm Hg, however lower pressure thresholds have not previously been used in research. Aims To determine if differences are observed in the number of sucks and maturation in the number of sucks over time when the minimum pressure threshold used to detect a suck is 7 mm Hg compared to 20 mm Hg using the M-CNSA. Study design Descriptive. Subjects A convenience sample of 171 healthy premature infants born between 29 and 34 weeks gestational period who were part of a larger randomized controlled study. Outcome measures The number of sucks detected during weekly five-minute oral feeding observations using 7 mm Hg and 20 mm Hg. Results Significantly more sucks were detected using the 7 mm Hg vs 20 mm Hg threshold at all time points. At both pressure thresholds, the mean number of sucks detected during the five minute feeding observation increased over time. The difference in the number of sucks detected at 7 and 20 mm Hg did not change over time (p = 0.50). Conclusions Using the lower threshold of 7 mm Hg compared to 20 mm Hg resulted in more sucks detected while consistently measuring improvement in sucking over time. Detection of more sucks and sucks at a lower pressure threshold allows clinicians and researchers to more accurately assess oral feeding skills among premature infants.

Multisensory Intervention for Preterm Infants Improves Sucking Organization

“…To standardize the feeding, a member of the research team conducted the feeding for the test sessions. The digital nutritive record was analyzed by Matlab 2007a (Natick, MA: The MathWorks) and a custom Matlab subroutine, Suck_Detect 1.1.12 software 28 for the five minutes that were most representative of the ten minute feeding, according to procedures detailed elsewhere 29 . During this process, portions of the record during which the nipple was removed from the infant's mouth were deleted.…”

“…During this process, portions of the record during which the nipple was removed from the infant's mouth were deleted. 29 Sucking parameters included NOS, NOS per burst and MAMP. The SMI was derived by calculating and averaging the Z-scores for total NOS, MSPB and MAMP across time points.…”

Establishing Breastfeeding with the Late Preterm Infant in the NICU

“…Compared to full‐term infants, LPIs have weaker suction while eating, which leads to a cascade of events. The uncoordination of the LPIs’ suck, swallow, and breathing places them at risk for fatigue and subsequently insufficient caloric intake because they may be mistaken as being satiated (Walker, ; White‐Traut et al., ).…”

“…Compared to full-term infants, LPIs have weaker suction while eating, which leads to a cascade of events. The uncoordination of the LPIs' suck, swallow, and breathing places them at risk for fatigue and subsequently insufficient caloric intake because they may be mistaken as being satiated (Walker, 2008;White-Traut et al, 2013). In addition, LPIs who lack a strong suck during breastfeeding may not transfer enough milk volume to meet their nutritional and hydration needs (Walker, 2008).…”

Preliminary Validation of Infant Sucking Measurement System with Healthy Term Infants

“…Over the past century, multiple methods have been employed to quantitatively evaluate infant sucking behavior. A frequently used method has been a pressure transducer that is coupled with a custom-made bottle/nipple system with and without measurements of milk flow rates to the nipple (4)(5)(6)(7). This method has provided objective measurements of intraoral pressure during bottle-feeding, allowing for evaluation of changes in various sucking parameters as an infant matures or in response to feeding interventions.…”