Sucking Organization Following an Infant-Directed Developmental Intervention


Paper Presentation


To evaluate sucking organization in premature infants following a multisensory intervention compared with infants assigned to a control group.


Experimental design.


Two community-based neonatal intensive care units.


A convenience sample of 185 healthy premature infants born between 29- and 34-week gestation was recruited.


This randomized trial was used to test the Impacts of Hospital-Home Transition: Optimizing Prematures’ Environment (H-HOPE). The intervention included infant remediation using a multisensory approach (the auditory, tactile, visual, and vestibular intervention) and maternal redefinition and re-education, using maternal participatory guidance. Sucking organization was measured at baseline (prior to random assignment to the experimental or control groups) followed by weekly assessments during the infant's hospital stay. Sucking organization was measured by the number of sucks, number of sucks per burst, and sucking pressure. A sucking maturity index was constructed from these three variables.


At baseline, there were no significant differences between the H-HOPE and control groups for number of sucks, number of sucks per burst, and sucking pressure. During the course of the infants’ hospitalization, significant increases in the number of sucks (p < .05), number of sucks per burst (p < .03), sucking pressure (p < .10), and the sucking maturity index (p < .01) were identified between the two groups. Several infant characteristics were related to measures of sucking organization.

Conclusion/Implications for Nursing Practice

Inefficient oral feeding resulting from immature behavioral organization requires substantial energy expenditure and delays hospital progression, thus increasing costs. Failure to coordinate breathing, sucking, and swallowing predisposes the premature infant to apneic events, bradycardia and oxygen desaturation, and fatigue during feeding. Slight arousal prior to feeding helps infants achieve an active awake state, which is conducive to nipple feeding. H-HOPE infants exhibited improved sucking organization over the course of hospitalization, suggestive that this intervention improves oral feeding.