Related Experiment Video
Updated: Aug 22, 2026
Non-Nutritive Suck Parameters Measurements Using a Custom Pressure Transducer System
Published on: April 19, 2024
Early evolution of oral feeding skills in very preterm infants: impact of an oral stimulation protocol assessed by
Jean-Charles Picaud1,2, Pierre Pradat3, Thierry Pébayle4
1Department of Neonatology, Hôpital de La Croix-Rousse, 69677, Hospices Civils de Lyon, Lyon, France. jean-charles.picaud@chu-lyon.fr.
Insights
Assessing sucking maturation in very preterm infants using a novel cot-side suckometer is feasible. Oral stimulation improved sucking performance, preventing early decline and enhancing development, suggesting benefits for feeding outcomes.
Area of Science:
- Neonatal development
- Pediatric feeding disorders
- Clinical quality improvement
Background:
- Delayed oral feeding acquisition is common in very preterm infants, impacting discharge and long-term feeding skills.
- Existing evidence on oral stimulation interventions is inconsistent, lacking objective longitudinal assessments.
- Immature suck-swallow-breathe coordination contributes to feeding difficulties in preterm neonates.
Purpose of the Study:
- To assess the feasibility of cot-side non-nutritive sucking (suckometry) for evaluating sucking maturation in very preterm infants.
- To characterize early sucking performance before and after implementing a structured oral stimulation protocol.
- To provide objective data on sucking development for preterm infants.
Main Methods:
- A prospective, pre-post, uncontrolled pilot study in a level III neonatal unit.
- Inclusion of infants born at 27-32 weeks' gestational age.
- Weekly cot-side suckometry measurements from the first postnatal week until oral feeding autonomy.
Main Results:
- Cot-side suckometry was feasible from the first postnatal days.
- Non-stimulated infants showed an average 40% decline in sucking performance.
- Stimulated infants demonstrated a progressive 120% increase in sucking performance.
- Seventeen infants (11 pre-protocol, 6 post-protocol) were included; groups were comparable.
Conclusions:
- Cot-side suckometry offers a feasible and objective method for assessing sucking maturation in very preterm infants.
- Oral stimulation interventions appear associated with improved sucking development.
- Further investigation in larger trials is warranted to confirm the benefits of oral stimulation.
Abstract:
Oral feeding acquisition is frequently delayed in very preterm infants, potentially affecting hospital discharge timing and longer-term feeding competence. Evidence supporting oral stimulation interventions remains heterogeneous, with few objective longitudinal assessments available. We aimed to evaluate the feasibility of cot-side assessment of non-nutritive sucking (suckometry) for assessing sucking maturation and to characterise early sucking performances before and after implementation of a structured oral stimulation protocol. We conducted a prospective quality improvement (QI) pre-post uncontrolled pilot study in a single-centre level III neonatal unit among infants born at 27-32 weeks' gestational age. Sucking performance was measured weekly from the first postnatal week until full oral feeding autonomy using a novel cot-side suckometer. Clinical characteristics and sucking performances were compared before and after protocol implementation. Seventeen infants were included (11 before, 6 after protocol). Median gestational age was 29.7 weeks and birth weight 1320 g (comparable between groups). Cot-side suckometry proved feasible from the first postnatal days. Approximately 73% of non-stimulated infants exhibited an early decline in sucking performance (a ~ 40% reduction, primarily affecting suction and compression bursts), whereas stimulated infants demonstrated progressive improvement (an approximately 120% increase). Conclusion: Cot-side suckometry provides feasible objective assessment of sucking maturation in very preterm infants. Oral stimulation was associated with more favourable sucking development, warranting further evaluation in larger trials. What is Known: • Very preterm infants commonly experience delayed transition to oral feeding due to immature suck-swallow-breathe coordination • Oral stimulation and non-nutritive sucking interventions are widely employed, but systematic reviews highlight inconsistent evidence regarding optimal protocols and clinical benefits What is New: • A novel cot-side suckometer enables reliable objective assessment of sucking maturation from the earliest postnatal days in very preterm infants • Implementation of oral stimulation was associated with prevention of early performance decline and progressive sucking enhancement Trial registration: NCT07632066 (06/02/2026).
