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Nonnutritive sucking in high-risk infants: benign intervention or legitimate therapy?
Janet Pinelli1, Amanda Symington, Donna Ciliska
1Department of Pediatrics, School of Nursing, McMaster University, Hamilton, Ontario, Canada. pinellij@mcmaster.ca
Insights
Nonnutritive sucking (NNS) shows little evidence for improving feeding or GI function in high-risk infants. However, NNS may reduce hospital stays and improve pain management for preterm and full-term infants.
Area of Science:
- Neonatal care
- Infant development
- Evidence-based practice
Background:
- Nonnutritive sucking (NNS) is common in neonatal nurseries.
- Its benefits and risks for high-risk infants require evaluation.
Purpose of the Study:
- To review research on NNS effects in high-risk full-term and preterm infants.
- To assess NNS for behavioral outcomes, GI function, and pain management.
Main Methods:
- Systematic review of MEDLINE, CINAHL, and Cochrane Library (1976-2001).
- Included experimental and quasi-experimental studies comparing pacifier use to no pacifier.
- Two authors reviewed study results.
Main Results:
- Limited evidence supports NNS for behavioral outcomes or feeding in high-risk infants.
- NNS is associated with shorter hospital stays and improved pain management.
- No short-term negative effects were identified.
Conclusions:
- NNS appears safe in the short term for high-risk infants.
- Further research is needed on long-term effects.
- Nurses may consider pacifiers for pain management in these infants.
Objective:
To review the available research evidence on the effects of nonnutritive sucking (NNS) in high-risk full-term and preterm infants in neonatal nurseries.
Data Sources:
Electronic searches of MEDLINE (1976-2001) and CINAHL (1982-2001) databases, as well as the Cochrane Library. Reference lists of all relevant articles were also reviewed.
Study Selection:
Experimental and quasi-experimental studies that included hospitalized full-term and preterm infants, where NNS by pacifier was compared to no pacifier.
Data Extraction:
Results of studies were reviewed by two of the authors.
Data Synthesis:
As an intervention to promote behavioral outcomes and gastrointestinal function or feeding, there is little evidence to support the use of NNS in preterm and high-risk full-term infants. NNS has been linked to reduced length of hospital stay and improved pain management.
Conclusions:
Although harmful effects have not been specifically studied, NNS in preterm and high-risk full-term infants does not appear to have any short-term negative effects. No long-term data on the effects of NNS in high-risk full-term and preterm infants are presently available. Based on the results of this review, it would seem reasonable for nurses to utilize pacifiers for pain management in high-risk full-term and preterm infants.