Preemies’ feeding improved when mothers act naturally

Premature infants’ feeding ability was improved when mothers used voice, moderate touch massage, eye-to-eye contact and rocking to approximate the stimulation that full-term infants receive.

In a study published in the journal Advances in Neonatal Care, researchers at the University of Illinois at Chicago College of Nursing compared two groups of healthy but premature babies to see if a new developmental intervention could improve the preemies’ sucking habits to help them gain weight.

Nearly half a million babies — one out of every eight — are born prematurely in the U.S. each year. Premature babies are less alert, which causes difficulty in feeding by mouth, interacting socially, and gaining weight. Their mothers often struggle to understand and respond appropriately to their infants’ subtle behaviors and lack of alertness.

“Feeding is critical, since it is the primary factor of infant growth,” said Rosemary White-Traut, professor emerita at UIC and director of nursing research at Children’s Hospital of Wisconsin, who developed the Auditory, Tactile, Visual and Vestibular (ATVV) intervention used in the study.

“Failure to coordinate breathing, sucking and swallowing can cause babies to experience feeding-related disorders such as apnea, a slow beating heart, oxygen desaturation and tiredness during feeding.”

All of the 183 babies in the study were born at 29-34 weeks gestation to low-income mothers who had additional socio-economic disadvantages.

While their babies were still in the hospital, half the mothers learned the ATVV intervention and used it during feeding. For the first 10 minutes, the mothers made eye contact with their babies while talking and stroking or massaging them, followed by five minutes of rocking.

Mothers in the other group only received educational materials on premature infant care, such as proper bathing, sleep position and habits, how to hold the baby, use of safe infant-care equipment, and car safety.

Each infant’s sucking during feeding was digitally recorded using a controlled-flow baby feeder.  Data were collected prior to the study and then every seven days until the baby was discharged from the hospital.

By the seventh day of the study, the number of times the baby sucked, the number of times the baby sucked during each sucking burst, and a composite score indicating the infants’ sucking maturity all increased significantly faster for the infants in the ATVV intervention group, White-Traut said. By the 14th day of the study, the pressure exerted on the nipple was higher for the infants assigned to the ATVV group.

“We believe the ATVV intervention contributed to earlier achievement of sucking skills at day seven and more mature sucking patterns as indicated by a composite score of the sucking maturity index,” White-Traut said. Further studies to see how earlier attainment of feeding skills leads to improved health and development in preterm infants is planned.

The study was conducted at Mercy Hospital and Medical Center and Mount Sinai Hospital in Chicago.

Co-authors of the study are Barbara Medoff-Cooper of the University of Pennsylvania and Kristin Rankin, Zhuoying Li and Li Liu of UIC. The study was funded by two of the National Institutes of Health — the National Institute of Child Health and Human Development and the National Institute of Nursing Research — and by the Irving Harris Foundation.