BEHAVIORAL AND PHYSIOLOGICAL-EFFECTS OF NONNUTRITIVE SUCKING DURING GAVAGE FEEDING IN PRETERM INFANTS

Behavioral and physiologic responsivity to nasogastric gavage feeding was assessed in 36 preterm infants on 2 consecutive d. On one of these days, a pacifier was provided during and after the gavage segment of the standardized protocol. The protocol was divided into segments that included baseline, preparatory handling, pregavage, gavage, and postg avage periods. Patterns of cardiac (heart period and vagal tone), oxyg en saturation, behavioral state, and defensive behavioral responses to gavage were quantified. These stable preterm infants responded to han dling and gavage feeding with reductions in heart period, vagal tone, and oxygen saturation. These responses were not altered by provision o f a pacifier, although there was a tendency for fewer episodes of brad ycardia and oxygen desaturation. Conversely, behavioral state was affe cted significantly by nonnutritive sucking: when provided with a pacif ier, infants exhibited less behavioral distress, spent less time in fu ssy and active awake states during and after feeding, and returned to a sleep state significantly faster. There is converging evidence to su ggest that nonnutritive sucking lessens behavioral distress to iatroge nic stressors but does not alter physiologic responsiveness.