Outcomes of Non-nutritive Sucking (NNS) Program in Preterm Newborns at Naresuan University Hospital

Abstract

        Background: Preterm infants often experience delayed development of coordinated sucking, swallowing, and breathing, which may impair feeding efficiency and postnatal growth. Non-nutritive stimulation (NNS) has been proposed as an intervention to enhance oromotor coordination and feeding readiness. Objective: To examine the effects of a structured NNS program on weight gain, length of stay, and complications related to oral stimulation in preterm neonates. Methods: A retrospective, observational, cross-sectional study was conducted in preterm infants with postconceptual age ≥34 weeks admitted at Naresuan University Hospital who had no facial anomalies, CNS anomalies, chromosomal anomalies, necrotizing enterocolitis (NEC), cleft lip/palate and not on mechanical ventilation. The intervention included an oromotor readiness assessment using the Neonatal Oral-Motor Assessment Scale (NOMAS), followed by oral massage and non-nutritive sucking using an empty pacifier for stimulation. The primary outcomes were body weight at key time points (initiation, completion of the program, and discharge), days of stimulation needed for oral feeding, and incidence of adverse events (e.g., cyanosis or oxygen desaturation) during stimulation. Statistical comparisons were made among three gestational age (GA) groups: <28 weeks, 28–32 weeks, and >32 weeks. Results: Forty-eight preterm infants (28 males, 20 females) were enrolled. Infants in the GA <28 weeks group showed significantly greater weight gain compared to those in the 28–32 weeks and >32 weeks groups (p <0.05). Conclusion: The NNS program appears to support weight gain in preterm neonates. Caution is warranted in infants with GA <28 weeks, who are more susceptible to respiratory complications during stimulation. Close monitoring is essential when implementing such interventions in this population.