THE IMPROVED OXYGENATION OF PRETERM INFANTS DURING NON-NUTRITIVE SUCKING DEPENDS ON POSTCONCEPTIONAL AGE

Abstract

Non-nutritive sucking (NNS) has been reported to stabilize transcutaneous (tc) PO₂ in preterm infants during both gavage feeding and assisted ventilation. To evaluate the effect of NNS in the resting preterm infant, we measured TcPO₂, heart rate (HR) and resp. rate in 14 healthy, sleeping infants (G.A. at birth 26-33 wk, B.Wt 710-1450g). Each study was begun in active sleep, and comprised 15 min. of data collection divided into 3 equal periods: preNNS, NNS and postNNS. Sucking was recorded with a pacifier adapted to measure sucking pressure, and respiration was detected with a nasal thermistor. Subjects were studied at two weekly intervals until discharge and divided into 4 groups based on postconceptional age.

During NNS, TcPO₂ increased 2.3±0.9 mmHg at 32-33 wk (p<.01) and 4.0±1.5 mmHg at 34-35 wk (p<.05). In contrast, TcPO₂ did not increase during NNS at either 36-37 or 38-39 wk. HR increased during NNS in all 4 groups although this was only significant at 34-35 wk (p<.01) and 36-37 wk (p<.02), while resp. rate never changed. Time spent in active sleep during the 5 min. epochs did not differ between the 3 periods and ranged from 61% to 96%. Thus the increase in TcPO₂ during NNS is dependent on the infant's postconceptional age and does not appear to be due to a change in resp. rate or sleep state. These data suggest that providing an opportunity for NNS may be a beneficial intervention in the care of healthy preterm infants between 32 and 35 wk postconceptional age.

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