Nonnutritive sucking during heelstick procedures decreases behavioral distress in the newborn infant.

We investigated if nonnutritive sucking (NNS) during heelstick procedures alleviates behavioral distress in neonates. In our NICU, 26 neonates without severe complications (mean Minde score 0.8, range 0-3), undergoing heelstick procedures at least twice a day, in the first 2 weeks of life, were enrolled in the trial (mean gestational age 33.9 weeks, range 26-39 weeks, mean birth weight 1, 988.5 g, range 1,200-4,010 g, mean Apgar score at the first minute 6. 7, range 4-10, at the fifth minute 8.5, range 6-10). Two heelpricks were performed in each neonate with NNS randomly assigned. Behavioral states, transcutaneous oxygen tension (TcPO(2)), heart rate, and respiratory rate were monitored before, during and after the heelstick procedures. Heelstick procedures lasted for a mean of 109 s (range 50-230 s) with NNS, and a mean of 128.8 s (range 20-420 s) without NNS. Compared with baseline, heart rate and behavioral distress increased and respiratory rate decreased during heelstick and after heelstick. Oxygen tension did not change. Nonnutritive sucking had no effect on respiratory rate or transcutaneous oxygen tension, but reduced the time of crying and the heart rate increase during the procedure. In conclusion, NNS can be recommended to reduce distress in newborns undergoing invasive routine procedures. Further studies are needed to evaluate the effects of NNS on respiratory rate and blood gas levels.

[Assistance procedures and physiologic balance in newborn infants]. / Procedure assistenziali ed equilibrio fisiologico del neonato.

The authors assume that an appropriate sensory input care can improve the conditions of the very-low-birth-weight (VLBW) infant with RDS. The VLBW preterm infant, in the intensive care unit, takes advantage both medically and developmentally of an individualized behavioral care. The authors present their positive experience with the auditory, visual and tactile stimulations of the preterm infant, after the period of intensive care, with the method of Brazelton.

[Non-nutritional sucking in the preterm neonate]. / La suzione nonnutritiva nel neonato pretermine.

The authors briefly review the available data on nonnutritive sucking (NNS) in preterm infants focusing mainly on NNS as a form of intervention and on the relationship of NNS with cardiorespiratory control. The previous studies on the positive effects of NNS on weight gain and oxygenation called for deeper investigation on the mechanism involved. The authors report the main results of their work on this field. The effects of NNS on transcutaneous oxygen tension, heart rate and respiration were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygenation tension increased during NNS in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. A subsequent study however, demonstrated a small and transient increase of respiratory rate during NNS bursts. Although further longitudinal studies will be needed these data offer further support for the beneficial effects of NNS in preterm infants.