STIMULATION OF SKILLS INNATE OROFACIAL ATTRICES IN PRETERM CHILDREN

Abstract

 Objective: sucking is an important step in the feeding habits. The newborn has developed this capacity during his life in the uterus and at 34 weeks of postconceptional age, sucking is perfectly coordinated with breathing and swallowing, and it can be used for nutrition. Preterm children born before 34-potconceptional-week have not this capacity still developed, so it is stimulated by several ways: nipples, sensorial stimulation, oral stimulation... Our work objective was to show the efficiency of the stimulation of feeding innate reflexes in decreasing the time needed by the preterm infant to get a nutritive sucking. Methods: research with 20 patients born before 32 postconceptional weeks, fed by catheter due to ineffective nutritive sucking. Two groups have been done: one control and one experimental group, with (children without pathology, children with a neurological pathology and children that have had mechanic ventilation). In the control group, non-nutritive sucking is stimulated with a nipple. In experimental group, feeding innate reflexes are stimulated 2 times/day, during 15', by a physiotherapist with exercises of global and facial relaxation and perioral and intraoral stimulation (movements of cheeks, jaw and tongue). Stimulation begins when the child has a postconceptional age of 32 weeks and lasts since the withdraw of the feeding catheter. Those children with hemodynamic or cardiac-respiratory instability, a grief systemic pathology or with mechanical ventilation are excluded. The variables evaluated are age at birth, weigh, quantity and duration of intake by catheter, time of catheter feeding and time of stay in hospital. Our hypothesis is that stimulation of feeling innate reflexes decreases the time needed by the preterm infant to get a nutritive sucking. We also expect that the groups of children with neurological pathology or those that have had mechanical ventilation previously, need more time to achieve this nutritive sucking, due to central alteration or delayed maturing of the breathing-sucking coordination. Results: the research showed a significant difference (p = 0,036) between the gestational age at birth and the days with catheter (p = 0,012) between the correlation of the weight and the days with catheter and the time with mechanical ventilation. Conclusion: several authors have shown the efficiency of non-nutritive sucking stimulation with an oral stimulation program, but little bibliography is found of the effects of this stimulation in preterm infants with a neurological or respiratory pathology. Further research is needed to check the results in a bigger sample. Some control groups with neurological pathology in preterm children are also necessary. We should also consider the influence of another pathologies or situations in achieving nutritive sucking. In further research we can introduce biomechanical measures in our evaluation.