Non-nutritive suck as a window into infant development: unraveling the implications of non-nutritive suck through the understanding of 1) typical non-nutritive suck patterning, 2) variations across populations (cleft lip and palate), and 3) connections to neurodevelopmental outcomes

Abstract

Background: Non-nutritive suck (NNS; sucking without nutrient delivery) is one piece of the complex oral feeding process with important connections to clinical outcomes, yet there is paucity on how it develops throughout the first year of life, varies across infant populations, and relates to later developmental outcomes. The central objectives of this dissertation research were to 1) characterize "typical" NNS and how it evolves through the first year of life, 2) characterize NNS and caregiver report of feeding skills in infants with cleft lip and/or palate (CL/P) compared to a control group and 3) add to the growing evidence supporting use of NNS as an early indicator of neurodevelopmental outcomes. We hypothesized that infant NNS would significantly change over the first year of life, that infants with CL/P would have altered NNS patterns compared to a control group and that features of an infant's NNS at 3 months would relate to neurodevelopment at 12 months. Methods: For Chapters 2 and 4, full-term infants were recruited at 3 and 12 months of age. NNS was assessed using a research pacifier attached to a pressure transducer at both timepoints and compared longitudinally (Chapter 2) and to caregiver responses on the Developmental-Profile 3, a screener for neurodevelopment (Chapter 4). In Chapter 3, a cohort of infants with CL/P were recruited and compared to an age matched control group. These infants completed a NNS sample and their caregivers completed the Neonatal Eating Assessment Tool, which indicates problematic feeding behaviors.Results: Between 3 and 12 months, full-term infants significantly increased their NNS amplitude while decreasing their NNS duration, burst number, cycles/burst and cycle number with no significant changes present in NNS frequency. Infant NNS burst duration, cycles/burst, and cycles/minute at 3 months were significantly negatively associated with the Developmental