PEDIATRICS Vol. 83 No. 5 May 1989, pp. 706-716
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Lack of Improved Growth Outcome Related to Nonnutritive Sucking in Very Low Birth Weight Premature Infants Fed a Controlled Nutrient Intake: A Randomized Prospective Study

Judith A. Ernst RD, DMSc1, Karyl A. Rickard RD, PhD1, Patricia R. Neal MD1, Pao-Lo Yu PhD1, Tjien O. Oei MD1, and James A. Lemons MD1

1 The Departments of Nutrition and Dietetics, Medical Genetics, and Pathology, Section of Neonatal-Perinatal Medicine, Indiana University School of Medicine, and the James Whitcomb Riley Hospital for Children, Indianapolis

The effect of nonnutritive sucking during gavage feeding on nutritional outcome and gastrointestinal transit time was evaluated in 18 premature appropriate for gestational age infants whose birth weights were \g=le\1,400 g and gestational ages were \g=le\30 weeks. Infants were randomized to a treatment (nonnutritive sucking infants received a pacifier for 30 minutes with each feeding, 12 times per day until they reached a weight of 1,500 g, eight times per day thereafter) or control (no pacifier) group. The nine nonnutritive sucking (five girls, four boys) and nine control (five girls, four boys) infants were treated for 14 days. Infants were without medical complications and were fed a single premature formula by intermittent gastric gavage at exactly 120 kcal/kg/d throughout the study period. Weight gain, linear growth, subscapular and triceps skinfold, and arm circumference accretions were assessed weekly. Serum proteins (albumin, prealbumin, retinol-binding protein, and transferrin) were measured weekly. Gastrointestinal transit times were measured weekly using carmine red markers. In contrast to previous studies, these data indicate no apparent effect of nonnutritive sucking on growth outcome, serum proteins, or gastrointestinal transit time in growing, very low birth weight infants when nutrient intake was controlled. In a subgroup of eight boys (four nonnutritive sucking, four control), energy and fat excretions were determined from 72-hour fecal collections and energy expenditure was estimated from six-hour cumulative heart rate measurements. Neither excretion of fat and calories nor estimated energy expenditure was affected significantly by nonnutritive sucking in this subgroup of baby boys. Fat excretion correlated well (r = .987) with energy excretion.

Key Words: nonnutritive sucking • premature infant • growth • gastrointestinal function • energy

Submitted on October 12, 1987
Accepted on May 31, 1988




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