Nonnutritive sucking during tube feedings: effects on preterm neonates in an intensive care unit.

Preterm neonates (mean 32 weeks' gestation, 1,300 gm birth weight) were provided a pacifier for nonnutritive sucking during tube feedings in the intensive care nursery. Their clinical course, subsequent bottle feeding behavior, and performance on the Brazelton Neonatal Behavior Assessment scale were compared with those of control group infants. The infants provided with pacifiers averaged 27 fewer tube feedings, started bottle feeding three days earlier, averaged a greater weight gain per day, and were discharged eight days earlier for an average hospital cost savings of approximately $3,500. Formula intake was similar for the two groups, although nurses appeared to provide more feeding stimulation for the control infants. On the Brazelton scale, the infants provided with pacifiers showed weak reflexes more frequently. Increased restfulness and diminished activity level in these infants may have contributed to the appearance of weak reflexes. The consistency between these findings and those of previous investigators suggests that the provision of a pacifier for nonnutritive sucking during tube feedings may be a cost-effective form of intervention.

Teenage, lower-class, black mothers and their preterm infants: an intervention and developmental follow-up.

To assess the combined risks of being born preterm and to a teenage mother, and to evaluate the effects of an early intervention, preterm infants born to lower-class, black, teenage mothers were provided a home-based, parent-training intervention, and their development was then compared with that of nonintervention controls, of term infants of teenage mothers, and of term and preterm infants of adult mothers. Despite equivalence on prenatal care, factors which placed the preterm infant of the teenage mother at greater risk at birth were the small-for-date size of the infant and the less realistic developmental milestones and child rearing attitudes expressed by the mother. The preterm infants of teenage mothers who received intervention showed more optimal growth, Denver scores, and face-to-face interactions at 4 months. Their mothers rated their infants' temperaments more optimally, expressed more realistic developmental milestones and child-rearing attitudes, and received higher ratings on face-to-face interactions. At 8 months, the intervention group received superior Bayley mental, Caldwell, and infant temperament scores.