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PubMed1988

Effect of nonnutritive sucking on infant gastroesophageal reflux.

To evaluate the effect of pacifier use (nonnutritive sucking) on gastroesophageal reflux in infants, 48 infants younger than 6 months of age with pathologic reflux were prospectively evaluated with pH probe. In each infant, parameters of reflux were blindly quantified during paired periods in a cross-over design when pacifier use was either encouraged or prohibited. To determine whether positioning was a factor in the effect of nonnutritive sucking on reflux, 24 of the infants were studied seated and 24 studied prone. Pacifier use significantly affected only the frequency of reflux episodes, increasing it in prone infants from 7.2 +/- 1.1 to 12.8 +/- 2.3 episodes/120 min postprandially (p = 0.040) and decreasing it in seated infants, from 21.1 +/- 3.1 to 14.8 +/- 2.6 postprandially (p = 0.003) and from 17.3 +/- 4.8 to 5.9 +/- 0.9 in the fasting period (p = 0.035). It did not significantly affect the clearance of reflux episodes or the total reflux time. These results suggest that infants with pathologic reflux frequency might best avoid pacifier use while in the beneficial prone position. When seated position is necessary, the pacifying effects of nonnutritive sucking may be useful in decreasing reflux events as well as in reducing crying behavior.

Fasting↗
PubMed1998

Profile of non-nutritive sucking habits in relation to nursing behavior in pre-school children.

Although a number of investigators have studied the prevalence and etiology of non-nutritive sucking habits in children, no consensus exists among dental and medical experts in respect to the contributing factors and preventing behaviors. Furthermore, changes in the rearing practices of children make management of such habits even more complicated. The purpose of the present study was to investigate finger and pacifier sucking habits among pre-school children, and its possible relationship to nursing behavior. Parental attitudes towards sucking habits were also registered. Questionnaires were sent to parents of 600 children, three to five years old, following an oral examination in a private office. Children attended kindergartens that were randomly selected from the area of Athens, Greece. Questions regarding the nursing patterns-breast or bottle feeding-characteristics of finger and pacifier sucking habits, parental attitudes towards sucking habits, as well as recommendations of the pediatricians were included. Three hundred and sixteen questionnaires were returned by parents. Results indicated that pre-school children discontinued a pacifier sucking habit earlier compared to a finger habit. Pacifiers showed a preventive effect against finger sucking, since only 2% of the sample examined practiced both habits. Breast feeding was not clearly associated with sucking habits; however, long bottle feeding periods were related with decreased finger sucking and high figures of pacifier sucking. The majority of pediatricians were not in favor of an intervention in breaking a finger sucking habit of the child.

Attitude to Health↗
PubMed2003

[Estimation of daily oral exposure to phthalates derived from soft polyvinyl chloride baby toys].

Daily oral exposure of babies to phthalate was estimated on the basis of the mouthing time of infants and the oral concentration of diisononyl phthalate (DINP) released from polyvinyl chloride (PVC) toy specimens. Total mouthing time, including the use of pacifiers, ranged widely from 11.4 min to 351.8 min with the mean of 105.3 +/- 72.1 min. The mean of the total mouthing time without pacifiers was 73.9 +/- 32.9 min. The average amount of DINP in saliva was 92.4 +/- 56.8 micrograms/10 cm2/hr, ranging from 13.2 micrograms/10 cm2/hr to 240.4 micrograms/10 cm2/hr. The exposure of phthalate in two different trials was estimated by the method of Monte Carlo simulation, one with the total mouthing time with pacifiers and the other with the total mouthing time without pacifiers. The average exposure in the former trial was 21.4 micrograms/kg/day and the 95th percentile was 65.8 micrograms/kg/day, while in the latter it was 14.8 micrograms/kg/day and the 95th percentile was 35.7 micrograms/kg/day.

Humans↗
PubMed2000

Sucrose for analgesia in newborn infants undergoing painful procedures.

BACKGROUND: Management of pain for neonates is less than optimal. The administration of sucrose with and without non-nutritive sucking (pacifiers) has been the most frequently studied non-pharmacological intervention for relief of procedural pain in neonates. OBJECTIVES: To determine the efficacy, effect of dose, and safety of sucrose for relieving procedural pain as assessed by physiologic and/or behavioural indicators. SEARCH STRATEGY: Standard methods as per the Neonatal Collaborative Review Group. A MEDLINE search was carried out for relevant randomized controlled trials (RCTs) published from January 1966 - November 1, 1997; EMBASE from 1993-1997; Reference Update search on November 11, 1997 and search of the Cochrane Library Issue 4 on November 11, 1997. Key words and (MeSH) terms included, infant/newborn, pain, analgesia and sucrose. Personal files, bibliographies, the most recent relevant neonatal and pain journals and conference proceedings were searched manually. Unpublished studies were not included. Language restrictions were not imposed. SELECTION CRITERIA: RCTs in which term and/or preterm neonates undergoing heel lance, venepuncture or intramuscular injection (immunization) received sucrose or water/placebo or no intervention. DATA COLLECTION AND ANALYSIS: Trial quality was assessed according to the methods of the Neonatal Collaborative Review Group. Quality measures included; blinding of randomization, blinding of intervention, completeness of follow up and blinding of outcome measurement. Data were abstracted and independently checked for accuracy by the two investigators. The inconsistency in outcome measures and differences in the statistical reporting of results made meta-analysis impossible. We were not able to identify two studies in which the same physiologic and/or behavioral outcomes following a noxious stimulus (heel-lance, venepuncture, intramuscular injection) were measured and reported in an identical fashion using means and standard deviations (or standard errors). The results are therefore reported for each accepted study separately. MAIN RESULTS: Fifteen studies were identified for possible inclusion in this systematic review. Five studies were excluded; three RCTs were excluded as in these trials the number of infants randomized to treatment vs. placebo groups were not reported; one study was not an RCT, and in one RCT the neonates did not undergo a painful procedure. Ten RCTs were included in this review. Sucrose in a wide range of dosages was generally found to decrease univariate physiologic (heart rate) and behavioural (the mean percent time crying, total cry duration, duration of first cry, and facial action) pain indicators and multivariate [Premature Infant Pain Profile (PIPP)] pain outcomes in neonates undergoing heelstick or venepuncture. An optimal dose of sucrose to reduce pain associated with procedures in preterm and term neonates could not be identified through this systematic review. REVIEWER'S CONCLUSIONS: Sucrose reduces physiologic and/or behavioral indicators of stress/pain in neonates following procedural pain stimuli (heel lance, venepuncture, immunization). There was inconsistency in the dose of sucrose that was effective and an optimal dose to be used in preterm and/or term infants could not be identified. Considerations for future research are to describe the painful procedure and intervention in detail, to use appropriate sample size to show a statistically significant reduction in pain, to use a multidimensional conceptualization of pain, to select outcome measures that are reliable and valid pain indicators and to account for the variation in the infant's response and context in which the pain is experienced. The use of repeated administrations of sucrose in neonates needs to be investigated. Use of sucrose in neonates that are very low birth weight, unstable and/or ventilated also needs to be addressed. (ABSTRACT TRUNCATED)

Analgesics↗
PubMed1998

The effect of nursing on the brain activity of the newborn.

OBJECTIVE: To determine whether nursing influences brain activity in the newborn and whether there are differences in this respect between breast- or bottle-feeding and pacifier sucking. STUDY DESIGN: Fifty unselected volunteer mothers and their healthy full-term infants, under care in the maternity ward after delivery, served as subjects. Thirty mother-infant pairs were studied in relation to breast-feeding and 20 to bottle-feeding and pacifier sucking. Breast-fed infants were studied between the 1st and 7th day after delivery (mean +/- 2.7 days) and the infants in the bottle-fed group between the 1st and 8th day after delivery (mean +/- 3.3 days). METHODS: Qualitative and quantitative electroencephalogram (EEG), electrooculogram, submental electromyogram, and electrocardiogram were recorded before, during and after breast- and bottle-feeding and pacifier sucking. RESULTS: The amplitude of the EEG increased significantly during breast-feeding in the posterior cortical areas in both hemispheres with a slight predominance on the right. Bottle-feeding caused a similar, but somewhat less marked change. When the breast- and bottle-fed infants were compared, a significant difference was found in only one parameter of the 84 studied. Pacifier sucking had no significant effects on EEG activity. CONCLUSION: Nursing effects a change in the brain activity of the newborn. The cortical response to nursing is most probably a result of activation of the neurohumoral mechanisms related to hunger and satisfaction, including the hypothalamic, limbic, and other brain stem structures, which also regulate the sleep-wake cycle and modulate the level of cortical activity with respect to attention and vigilance.

Bottle Feeding↗
PubMedDate not supplied

Nonnutritive sucking in tube-fed preterm infants: effects on gastric motility and gastric contents of somatostatin.

The present study investigated the way that sucking of a pacifier influences gastric secretory and motor functions in connection with tube feeding. Experiments were performed on eight preterm infants who were tube fed twice--once with and once without sucking of a pacifier. The time for tube feeding was significantly decreased and gastric retention decreased in five of seven infants when sucking a pacifier. Maternal milk was found to contain gastrin-17, somatostatin-14, and a somatostatin-like peptide larger than somatostatin-28. Somatostatin levels were significantly reduced in connection with non-nutritive sucking. Gastrin levels were increased in six of ten experiments 2 h and/or 3 h after bolus feeding, suggesting that these peptides were not only supplied by the milk, but were also released from the gastric mucosa. The presence of gastrin and somatostatin in gastric aspirates was established by use of chromatographic methods. The results indicate that somatostatin and gastrin are released into the gastric lumen in preterm infants and that sucking of a pacifier, in connection with bolus feeding, stimulates the gastric motor functions and facilitates the digestion process, probably via activation of vagal mechanisms.

Enteral Nutrition↗
PubMed1992

Nonnutritive sucking modulates behavioral state for preterm infants before feeding.

Forty-two pre-term infants were studied to determine the effect of nonnutritive sucking pre-feeding on behavioral state. Infants were randomly assigned to pacifier or rest groups. Pacifiers or rest were given for 5 minutes following routine caregiving and before each of the first 16 bottle feedings. A 12-category scale was used to measure state immediately before the 5-minutes and after. Frequencies of states that precede optimal feedings changed for infants given pacifiers versus rest: alert inactivity (+6 vs. -2), quiet awake (+19 vs. -6), and active awake (-24 vs. +12); infants given pacifiers had more sleep and fewer restless states. Group differences were non-significant before nonnutritive sucking (p = 0.16) but significant after (p = 0.00001). When self-regulatory feeding policies based on early hunger cues are not allowed, nonnutritive sucking for 5 minutes pre-feeding is simple, brief, and appropriate for busy intensive care units. These findings confirm those from earlier less conclusive research and indicate that nonnutritive sucking modulates behavioral state.

Feeding Behavior↗
PubMed1997

Beyond dorsal penile nerve block: a more humane circumcision.

OBJECTIVE: To explore techniques that can be utilized in addition to the dorsal penile nerve block (DPNB) to further reduce the neonate's stress and pain from routine circumcision, and thus make the procedure more humane. SETTING: Level 1 nursery at a community hospital. SUBJECTS: Eighty healthy, term, newborn male infants scheduled for routine neonatal circumcision. STUDY DESIGN: Prospective and randomized; double blind and placebo controlled for the study solutions. METHODS: Four statistically similar groups of 20 were studied. The control group included infants circumcised using: a) a rigid plastic restraint board; b) standard DPNB; and c) a pacifier dipped in water to comfort the infant. Each study group differed from the controls in one variable including: 1) using a specially designed, physiologic circumcision restraint chair; 2) pH buffering of lidocaine hydrochloride used for DPNB; and 3) offering a pacifier dipped in a 24% sucrose solution during the DPNB and circumcision. Behavioral observations were recorded and compared for each group starting before the injection of lidocaine hydrochloride and continuing through the completion of the circumcision. Plasma for cortisol levels were collected 30 minutes after the circumcision. RESULTS: Neonates circumcised on the new restraint chair showed a significant decrease in distress scores (>50%) compared with the control group on the rigid molded-plastic restraint. The pacifier dipped in sucrose had a distress-reducing effect during both the post-DPNB injection and circumcision periods. The infants who were injected with the buffered lidocaine showed no differences in distress from the controls. The plasma cortisol levels were not significantly affected by any additional technique and were comparable to the levels previously reported. CONCLUSIONS: When neonatal circumcisions are performed routinely, they should be done as humanely as possible. This study demonstrates that, when used in conjunction with DPNB, a pacifier dipped in 24% sucrose and a more comfortable, padded, and physiologic restraint can be useful in decreasing distress and pain.

Circumcision, Male↗
PubMed2001

Breastfeeding and early weaning practices in northeast Brazil: a longitudinal study.

OBJECTIVES: To describe breastfeeding practices from 0 to 12 months of age in 4 small towns that are representative of urban northeast Brazil and to identify factors associated with introduction of other milk in the first month of life. METHODS: From January to August 1998, 364 mothers were interviewed at delivery to ascertain antenatal care; delivery room practices; and their intentions regarding breastfeeding, pacifiers, and introduction of water, teas, and other milk. Their perceptions of home support and the advantages of breastfeeding also were assessed. Thereafter, daily information about feeding practices was collected at twice-weekly home visits. When other milk was started, a second interview was conducted to ascertain initial and current breastfeeding problems and use of a pacifier. Reasons for starting other milk were investigated using 5-point Likert scales. RESULTS: Mothers were positive toward breastfeeding, and 99% breastfed their new infant. Few intended to breastfeed exclusively, and in the first week 80% gave water/tea and 56% used a pacifier. The median duration of exclusive breastfeeding was 0 days, and the median age for starting other milk was 24 days. The median duration of breastfeeding was 65 days for mothers who started other milk within 1 month and 165 days for other mothers. After adjustment for confounding variables, the main factors associated with introduction of other milk within 1 month were pacifier use in the first week (odds ratio [OR], 4.01; 95% confidence interval [CI]: 2.07-7.78), intention to start other milk in the first month (OR, 3.79; 95% CI: 1.74-8.24), giving water/tea in the first week (OR, 3.07; 95% CI: 1.56-6.03), and leaving the maternity ward before breastfeeding was started (OR, 2.59; 95% CI: 1.34-5.04). CONCLUSION: Although breastfeeding is common in this community, it rarely is exclusive and takes place for a relatively short duration. Identification of risk factors for early introduction of other milk offers potential avenues for future intervention, including improvement of breastfeeding support in antenatal and maternity services.

Brazil↗
PubMed1982

Nonnutritive sucking during tube feedings: effects on preterm neonates in an intensive care unit.

Preterm neonates (mean 32 weeks' gestation, 1,300 gm birth weight) were provided a pacifier for nonnutritive sucking during tube feedings in the intensive care nursery. Their clinical course, subsequent bottle feeding behavior, and performance on the Brazelton Neonatal Behavior Assessment scale were compared with those of control group infants. The infants provided with pacifiers averaged 27 fewer tube feedings, started bottle feeding three days earlier, averaged a greater weight gain per day, and were discharged eight days earlier for an average hospital cost savings of approximately $3,500. Formula intake was similar for the two groups, although nurses appeared to provide more feeding stimulation for the control infants. On the Brazelton scale, the infants provided with pacifiers showed weak reflexes more frequently. Increased restfulness and diminished activity level in these infants may have contributed to the appearance of weak reflexes. The consistency between these findings and those of previous investigators suggests that the provision of a pacifier for nonnutritive sucking during tube feedings may be a cost-effective form of intervention.

Body Weight↗
PubMedDate not supplied

Nutritive and nonnutritive sucking habits: a review.

The habit of sucking is the first coordinated muscular activity of the infant. There are essentially two forms of sucking: the nutritive form which provides essential nutrients, while non-nutritive sucking insures a feeling of warmth and a sense of security. This review gives a description of the anatomy and physiology of sucking together with the influence of breastfeeding and bottle-feeding (conventional or orthodontic nipples) on the dentofacial structures of the infant. Factors involved in the choice of feeding are also discussed. Children who do not have access to unrestricted breastfeeding or bottle-fed children may satisfy their instinctive sucking urge with a pacifier. This paper presents the different types of pacifiers (conventional or orthodontic) along with the beneficial effects provided by pacifiers. Detrimental effects caused by incorrect use of pacifiers or digit-sucking habits are also summarized. Health professionals should inform expectant mothers about the dentofacial advantages of breastfeeding.

Bottle Feeding↗
PubMed2003

Changing determinants of crying termination in 6- to 12-week-old human infants.

Developmental change in human infant crying termination was studied in 60 infants who were 6, 9, and 12 weeks of age. They qualified by spontaneously crying for at least 30 s during the study's first minute. Infants then received either 0.8 ml sucrose (12% w/v) by syringe or sucked a pacifier dipped in the 12% solution for a total of 3.5 min. Crying was substantially reduced by pacifier-sucking at all three ages tested. Sucrose too was effective at 6 and 9 weeks of age but did not reduce crying in 12-week-olds. These data suggest different schedules in the decline of sweet taste and pacifier sucking as agents of crying termination. These differential rates argue for multiple systems that govern crying reduction and argue against a single central target that changes ontogenetically in sensitivity and control. Whether the continuation of sucking effectiveness is sustained by infant sucking experience or reflects a slower rate of decline cannot be determined at present.

Crying↗
PubMedDate not supplied

[Removal of sucking habits and myofunctional therapy: establishing swallowing and tongue rest position].

BACKGROUND: The prolonged habit of pacifier sucking and the prolonged use of feeding bottle may cause myofunctional disorder, such as incorrect swallowing pattern and inadequate tongue rest position. AIM: To study the effect of myofunctional therapy (MFT) associated with the removal of the habit of pacifier sucking and the use of feeding bottle (REM) on the rehabilitation of swallowing and tongue rest position. METHOD: Two groups with ten children, ages ranging from four to four years and eight months, who initially presented a pacifier sucking habit and used the feeding bottle were studied. Children on REM group underwent the process of sucking habits removal using the Modified-Counselling Method, whereas children on MFT group underwent the same procedure associated to myofunctional therapy. Pre-treatment assessments were made, as well as 60 and 180 days post-treatment assessments. Data were analyzed using the statistical tests of Mann-Whitney and Wilcoxon (p < 0.05). RESULTS: Results indicate that children in the MFT group presented adequate swallowing patterns after 60 and 80 days, and presented adequate tongue rest position after 180 days. Children on the REM group, however, presented adequate swallowing pattern only after 180 days and did not present a significant improvement on the tongue rest position during the assessments. CONCLUSION: Myofunctional therapy associated to the removal of sucking habits presented a better and faster improvement of the swallowing pattern and of the tongue rest position.

Bottle Feeding↗
PubMed2006

[Effects of non-nutritive sucking on the physiological and behavioral states of pre-term infants during tube feeding].

PURPOSE: This study was to investigate the effects of non-nutritive sucking on physiological and behavioral state of pre-term infants during tube feeding. METHOD: This nonequivalent, non-synchronized experimental study included 50 pre-term infants. An attempt was made to match gestational age and birth weight of infants in each group. Infants in the experimental group were given a pacifier 2 minutes before, during, and for 2 minutes after tube feeding. Infants in the control group did not get a pacifier. Both groups were tested at three stages for changes in the physiologic state and behavioral state--2 minutes before, during, and 2 minutes after feeding. Date was analyzed with SPSS WIN 10.0 using an Chi2-test, t-test, and repeated measures ANOVA. RESULT: Heart rates and oxygen saturation levels of the two groups were significantly different(P=.001, P=.000). The behavioral states of the two groups were significantly different during and post feeding(P=.000, P=.000). CONCLUSION: This result suggests non-nutritive sucking by using a pacifier is an effective intervention for pre-term infants during tube feeding.

Enteral Nutrition↗
PubMed2004

Sucrose for analgesia in newborn infants undergoing painful procedures.

BACKGROUND: Management of pain for neonates is less than optimal. The administration of sucrose with and without non-nutritive sucking (pacifiers) has been the most frequently studied non-pharmacological intervention for relief of procedural pain in neonates. OBJECTIVES: To determine the efficacy, effect of dose, and safety of sucrose for relieving procedural pain as assessed by validated individual pain indicators and composite pain scores. SEARCH STRATEGY: Standard methods as per the Neonatal Collaborative Review Group. A MEDLINE search was carried out for relevant randomized controlled trials (RCTs) published from January 1966 - March 2004, EMBASE from 1980-2004 and search of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2004). Key words and (MeSH) terms included infant/newborn, pain, analgesia and sucrose. Language restrictions were not imposed. Bibliographies, personal files, the most recent relevant neonatal and pain journals and recent major pediatric pain conference proceedings were searched manually. Unpublished studies, or studies reported only as abstracts, were not included. Additional information from published studies was obtained. SELECTION CRITERIA: RCTs in which term and/or preterm neonates (postnatal age maximum of 28 days after reaching 40 weeks corrected gestational age) received sucrose via oral syringe, NG-tube, dropper or pacifier for procedural pain from heel lance or venepuncture. In the control group, water, pacifier or positioning/containing were used. Studies in which the painful stimulus was circumcision were excluded. DATA COLLECTION AND ANALYSIS: Trial quality was assessed according to the methods of the Neonatal Collaborative Review Group. Quality measures included blinding of randomization, blinding of intervention, completeness of follow up and blinding of outcome measurement. Data were abstracted and independently checked for accuracy by the three investigators. STATISTICAL ANALYSIS: The statistical package (RevMan 4.2) of the Cochrane Collaboration was used. For meta-analysis, a weighted mean difference (WMD) with 95% confidence intervals (CI) using the fixed effects model was reported for continuous outcome measures. MAIN RESULTS: Forty-four studies were identified for possible inclusion in this review. Seven studies reported only as abstracts, and sixteen additional studies were excluded, leaving 21 studies (1,616 infants) included in this review. Sucrose in a wide variety of dosages was generally found to decrease physiologic (heart rate) and behavioural (the mean percent time crying, total cry duration, duration of first cry, and facial action) pain indicators and composite pain scores in neonates undergoing heel stick or venepuncture. When pain scores (Premature Infant Pain Profiles) were pooled across 3 studies (Gibbins 2001; Johnston 1999a; Stevens 1999), they were significantly reduced in infants who were given sucrose (dose range 0.012 g to 0.12 g) compared to the control group, [WMD -1.64 (95% CI -2.47,- 0.81); p = 0.0001] at 30 seconds and [WMD -2.05, (95% CI -3.08, -1.02); p = 0.00010] at 60 seconds after heel lance. When results for change in heart rate were pooled for two studies (Haouari 1995, Isik 2000), there were no significant differences between changes in heart rate for infants given sucrose (dose range 0.5 g to 0.6 g) compared to the control group, [WMD 0.90 (95% CI -5.81, 7.61); p = 0.8] at one minute and [WMD -6.20 (95% CI -15.27, 2.88); p = 0.18] at three minutes after heel lance. REVIEWERS' CONCLUSIONS: Sucrose is safe and effective for reducing procedural pain from single painful events (heel lance, venepuncture). There was inconsistency in the dose of sucrose that was effective (dose range of 0.012 g to 0.12 g), and therefore an optimal dose to be used in preterm and/or term infants could not be identified. The use of repeated administrations of sucrose in neonates needs to be investigated as does the use of sucrose in combination with other behavioural (e.g., facilitated tucking, kangaroo care) and pharmacologic (e.g., morphine, fentanyl) interventions. Use of sucrose in neonates who are of very low birth weight, unstable and/or ventilated also needs to be addressed.

Analgesics↗
PubMed2002

Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition.

The purpose of this study was to determine the association between the duration of nutritive and nonnutritive sucking behaviors and various occlusal characteristics in the primary dentition. Sucking behavior data were collected on 372 children followed longitudinally from birth by using periodic questionnaires completed by parents. Study models were obtained from the children at 4 to 5 years of age and assessed for posterior crossbite, anterior open bite, and overjet. Dental arch parameters including arch widths, arch lengths, and arch depths were measured directly from the models. The subjects were grouped according to type of habit (pacifier or digit) and duration of nonnutritive sucking behaviors (less than 12, 12 to 24, 24 to 36, 36 to 48, and more than 48 months). Children with nonnutritive sucking of less than 12 months were further grouped according to the duration of breast-feeding. The dental arch and the occlusal characteristics were then compared among these groups. The results indicated no relationship between duration of breast-feeding during the first year of life and any dental arch or occlusal parameters. The study found that prolonged pacifier habits resulted in changes to the dental arches and the occlusal parameters that were different from the effects of digit sucking. In addition, some changes in the dental arch parameters and occlusal characteristics (eg, prevalence of posterior crossbite and increased amount of overjet) persisted well beyond the cessation of the pacifier or digit habit. Although further study is needed to determine the effects of nonnutritive sucking behavior in the mixed dentition, the results suggest that current recommendations for discontinuing these habits may not be optimal in preventing habit-related malocclusions.

Analysis of Variance↗
PubMed1996

Effects of sweet taste stimulation on growth and sucking in preterm infants.

OBJECTIVE: To evaluate the effect of sweet taste stimulation in augmenting the reported growth-enhancing effects of nonnutritive sucking in preterm infants who are gavage-fed. DESIGN: Random assignment of preterm infants to receive stimulation by one of three methods during each feeding until totally orally fed. SETTING: Hospital intensive-care and infant transitional units. PATIENTS: Eligibility criteria included body weight greater than or equal to 1,250 g, gestational age younger than 34 weeks, growth parameters appropriate for gestational age, tolerating at least 100 kcals/kg/day by gavage feeding with evidence of weight gain, and no clinical evidence of health complications. Data are presented for 42 infants who completed 14 days of treatment. INTERVENTIONS: Exposure to a sweet pacifier, a latex pacifier, or maternal heartbeat sounds during gavage feedings. MAIN OUTCOME MEASURES: Growth, time to total oral feeding, and sucking responses. RESULTS: No significant differences in sucking measures were noted among treatment groups. Differences in progression time to total oral feedings and weight gain favored the sweet-pacifier group but were not statistically significant. CONCLUSIONS: Oral stimulation of gavage-fed, preterm infants during a 2-week hospitalization was not sufficient to elicit a significant improvement in growth efficiency, progression to total oral feedings, or sucking maturation. Additional studies may show a beneficial effect of chemosensory stimulation in preterm infants.

Child Development↗
PubMedDate not supplied

Nonnutritive sucking in high-risk infants: benign intervention or legitimate therapy?

OBJECTIVE: To review the available research evidence on the effects of nonnutritive sucking (NNS) in high-risk full-term and preterm infants in neonatal nurseries. DATA SOURCES: Electronic searches of MEDLINE (1976-2001) and CINAHL (1982-2001) databases, as well as the Cochrane Library. Reference lists of all relevant articles were also reviewed. STUDY SELECTION: Experimental and quasi-experimental studies that included hospitalized full-term and preterm infants, where NNS by pacifier was compared to no pacifier. DATA EXTRACTION: Results of studies were reviewed by two of the authors. DATA SYNTHESIS: As an intervention to promote behavioral outcomes and gastrointestinal function or feeding, there is little evidence to support the use of NNS in preterm and high-risk full-term infants. NNS has been linked to reduced length of hospital stay and improved pain management. CONCLUSIONS: Although harmful effects have not been specifically studied, NNS in preterm and high-risk full-term infants does not appear to have any short-term negative effects. No long-term data on the effects of NNS in high-risk full-term and preterm infants are presently available. Based on the results of this review, it would seem reasonable for nurses to utilize pacifiers for pain management in high-risk full-term and preterm infants.

Evidence-Based Medicine↗