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Updated: Dec 24, 2025
Laboratory Administration of Transcutaneous Auricular Vagus Nerve Stimulation taVNS: Technique, Targeting, and Considerations
Published on: January 7, 2019
Transcutaneous Auricular Vagus Nerve Stimulation-Paired Rehabilitation for Oromotor Feeding Problems in Newborns: An
Bashar W Badran1, Dorothea D Jenkins2, Daniel Cook1
1Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States.
Insights
Transcutaneous auricular vagus nerve stimulation (taVNS) paired with feeding therapy improved oral feeding volumes in infants with feeding dysfunction. This noninvasive approach helped 57% of infants achieve discharge readiness without a gastrostomy tube.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neurorehabilitation
Background:
- Infants born premature or with birth-related brain injury often exhibit oral feeding dysfunction.
- This dysfunction leads to prolonged hospitalizations and the need for gastrostomy tubes (G-tubes).
- Vagus nerve stimulation (VNS), particularly noninvasive transcutaneous auricular VNS (taVNS), shows promise in accelerating functional recovery.
Purpose of the Study:
- To assess the safety and tolerability of taVNS paired with oromotor rehabilitation in infants with feeding difficulties.
- To determine if this combined therapy can improve oral feeding volumes and facilitate motor learning.
- To evaluate the potential of taVNS to help infants avoid G-tube placement.
Main Methods:
- A prospective, open-label study involving 14 infants (11 premature, 3 HIE) requiring G-tubes.
- Daily taVNS applied to the left tragus during bottle-feeding sessions for 2 weeks.
- Primary outcomes included achieving adequate oral feeding volumes and weight gain for discharge, with safety monitored via discomfort and heart rate.
Main Results:
- No adverse events related to taVNS were reported.
- Stimulation-induced heart rate reductions were transient and considered safe, indicating vagal engagement.
- 57% of participants (8/14) achieved adequate feeding volumes for discharge without a G-tube, with a mean treatment duration of 16 days.
- Responders showed significant increases in feeding volume trajectories compared to pre-stimulation levels (p < 0.05).
Conclusions:
- taVNS-paired feeding rehabilitation is safe and well-tolerated in infants with oromotor dyscoordination.
- This noninvasive therapy may enhance oral feeding abilities, potentially increasing the rate of discharge without G-tube placement.
- Larger, controlled trials are warranted to confirm these promising findings.
Abstract:
Neonates born premature or who suffer brain injury at birth often have oral feeding dysfunction and do not meet oral intake requirements needed for discharge. Low oral intake volumes result in extended stays in the hospital (>2 months) and can lead to surgical implant and explant of a gastrostomy tube (G-tube). Prior work suggests pairing vagus nerve stimulation (VNS) with motor activity accelerates functional improvements after stroke, and transcutaneous auricular VNS (taVNS) has emerged as promising noninvasive form of VNS. Pairing taVNS with bottle-feeding rehabilitation may improve oromotor coordination and lead to improved oral intake volumes, ultimately avoiding the need for G-tube placement. We investigated whether taVNS paired with oromotor rehabilitation is tolerable and safe and facilitates motor learning in infants who have failed oral feeding. We enrolled 14 infants [11 premature and 3 hypoxic-ischemic encephalopathy (HIE)] who were slated for G-tube placement in a prospective, open-label study of taVNS-paired rehabilitation to increase feeding volumes. Once-daily taVNS was delivered to the left tragus during bottle feeding for 2 weeks, with optional extension. The primary outcome was attainment of oral feeding volumes and weight gain adequate for discharge without G-tube while also monitoring discomfort and heart rate (HR) as safety outcomes. We observed no adverse events related to stimulation, and stimulation-induced HR reductions were transient and safe and likely confirmed vagal engagement. Eight of 14 participants (57%) achieved adequate feeding volumes for discharge without G-tube (mean treatment length: 16 ± 6 days). We observed significant increases in feeding volume trajectories in responders compared with pre-stimulation (p < 0.05). taVNS-paired feeding rehabilitation appears safe and may improve oral feeding in infants with oromotor dyscoordination, increasing the rate of discharge without G-tube, warranting larger controlled trials.
