Fletcher Allen Health Care/University of Vermont, 1 South Prospect, Burlington, VT 05401, USA.
Arch Dis Child Fetal Neonatal Ed. 2010 May;95(3):F194-200. doi: 10.1136/adc.2009.164186. Epub 2009 Nov 29.
The aim of the present work was to assess the value of non-nutritive sucking (NNS) measures as predictors of oral feeding performance in comparison to other putative predictors of feeding skills: respiratory support, post-menstrual age (PMA) at birth and the neonatal oral motor assessment score (NOMAS).
This was a prospective, observational study. Cox proportional hazards and non-parametric rank sum tests were used to assess the relationship between NNS and feeding outcome measures. The setting was neonatal intensive care units (NICU) in rural/academic, urban/tertiary centres in the USA. In all, 51 premature infants born between 25 and 34 weeks' PMA, birth weight 1512.3+/-499.4 g, were included in this study. Interventions were measurement of NNS, standardised feeding advance schedule, performance of NOMAS, and standardised, permissive, oral feeding advance schedule.
were transition time from first to full oral feeding (FOF) and gestational age at FOF.
Higher NNS organisation scores predicted shorter transition to FOF (p<0.05): infants with a more organised suck pattern reached independent oral feeding 3 days earlier (16 vs 13 day transition) than infants with more chaotic patterns of suck bursts. Consistency of the suck waves also corresponded with feeding milestones: infants with more regular suck wave pressure deflections became competent oral feeders approximately 3 days earlier than those with irregular suck pressure waves. PMA at birth was inversely associated with PMA at FOF. NOMAS measures were not associated with outcome measures.
Measures of NNS organisation and suck consistency constitute useful candidate predictors of feeding performance by premature infants. The results accord with previous findings linking PMA at birth with age at independent feeding.
本研究旨在评估非营养性吸吮（NNS）指标预测经口喂养能力的价值，并与其他可能预测喂养技能的指标（呼吸支持、出生后胎龄（PMA）和新生儿口腔运动评估评分（NOMAS））进行比较。
这是一项前瞻性观察性研究。采用 Cox 比例风险和非参数秩和检验评估 NNS 与喂养结局指标之间的关系。研究地点为美国农村/学术型和城市/三级中心的新生儿重症监护病房（NICU）。共纳入 51 例胎龄 25-34 周、出生体重 1512.3+/-499.4g 的早产儿。干预措施包括测量 NNS、标准化喂养推进计划、进行 NOMAS 以及标准化、允许性、经口喂养推进计划。
从首次经口喂养（FOF）到 FOF 的过渡时间和 FOF 时的胎龄。
较高的 NNS 组织评分预示着向 FOF 的过渡时间更短（p<0.05）：吸吮模式更有组织的婴儿比吸吮模式更混乱的婴儿更早达到独立经口喂养（16 天 vs 13 天）。吸吮波的一致性也与喂养里程碑相对应：吸吮波压力挠度更规则的婴儿比吸吮压力波不规则的婴儿更早成为有能力的经口喂养者，约早 3 天。出生时的 PMA 与 FOF 时的 PMA 呈负相关。NOMAS 指标与结局指标无关。
NNS 组织和吸吮一致性的测量是预测早产儿喂养表现的有用候选指标。这些结果与以前的研究结果一致，即出生时的 PMA 与独立喂养的年龄有关。
