Development of sucking patterns in preterm infants

The studies reported on in this thesis addressed the development of sucking patterns in preterm newborns. Preterm infants often have problems learning to suckle at the breast or to drink from a bottle. It is unclear whether this is due to their preterm birth or whether it is the consequence of neurological damage. From the literature, as well as from daily practice, we know that there is much variation in the time and in the way children start sucking normally. Factors such as birth weight and gestational age may indeed be risk factors but they do not explain the differences in development. A small spot-check proved that most hospitals in the Netherlands start infants on oral feeding by 34 weeks’ post-menstrual age (pma). By and large the policy is aimed at getting the infant to rely on oral feeding entirely as soon as possible. The underlying rationale is to reduce the stay in hospital, and the idea that prolonged tube-feeding delays or even hampers the development of sucking.
Recent research found a relationship between frequent and serious reductions in oxygen saturation during feeding and behavioural eating problems at a later age. Likewise, not recovering within five minutes from the impact feeding has on the physiological parameters, bears a relationship to eating problems later on. There is no evidence that postponing oral feeding until the infant is ready for it from a physiological point of view has a negative effect on the development of sucking. It is important, therefore, to check carefully whether a preterm infant is ready to start feeding orally. When oral feeding actually commences, it is important to keep a close watch on whether the infant keeps in control of its physiological parameters and recovers rapidly after a feed. Knowledge about the development of sucking patterns in preterm infants and the ability to recognise the risk factors and indicators of abnormalities in this development will provide paediatricians and nurses insight in how they could best set up oral feeding schedules. We studied the development of sucking patterns in preterm infants from the time the infant stated feeding orally until the age of ten weeks postterm. At weekly, or two-weekly intervals we observed sucking, swallowing and respiration with the aid of the Neonatal Oral-Motor Assessment Scale (nomas). The sessions were video-taped for future assessment

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	Curriculum vitae
	Volledige dissertatie

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