Sucking disorders in neurologically impaired infants: assessment and facilitation of breastfeeding.

Neurologically impaired infants have immature, damaged, or abnormally developed nervous systems that may cause abnormalities of sucking and swallowing, among other problems. Sucking abnormalities usually present as absence of the sucking response, weakness or incoordination of sucking and swallowing, or some combination of these problems. More investigation of the responses of these infants to various stimuli and training techniques is greatly needed. Although training neurologically impaired infants to breastfeed may present a challenge to even the most experienced neonatal nurse, physician, or therapist, most infants improve and can learn to suckle at the breast. If a mother has intended to nurse her infant, she should be encouraged to do so, even when the infant has abnormalities of sucking, except in the rare and most severely affected infants who remain dependent on gavage or gastrostomy feedings. Various techniques of stimulating, positioning, and progressive weaning to the breast can be helpful in teaching mother and infant to breastfeed. Encouraging support should be provided by all professionals involved with the mother and infant, as well as by a team experienced in helping with such problems. Most importantly, mother and staff must be patient, because the rewards for both the infant and mother are worth the effort.