Premature infants face many challenges when they are transitioning to oral feeding. Progress with feeding is often a source of stress for the baby’s family, and a major concern of NICU staff. Parents and NICU staff frequently look to therapists for suggestions for supporting an infant during a feeding (positioning, type of nipple, etc.). What is often overlooked, however, is what can be done just before a feeding to optimally prepare the baby for the experience.
In a recently published randomized controlled trial which included 183 healthy preterm infants born between 29-34 weeks postmenstrual age, researchers sought to evaluate the effectiveness of the Auditory, Tactile, Visual, and Vestibular (ATVV) intervention on sucking skills during oral feeding. The ATVV intervention is a multisensory treatment that consists of 10 minutes of auditory stimulation (female voice), moderate touch stroking or massage, and eye to eye stimulation, followed by 5 minutes of horizontal rocking. Stimuli are presented gradually as the baby becomes more alert. In this study, the ATVV intervention was administered to babies in the treatment group 20 minutes prior to a feeding twice a day, five days per week. Mothers and research team members were trained to perform the intervention reliably.
Researchers recorded infant sucking digitally, and this was used to measure number of sucks, sucks per burst, sucking pressure, and sucking maturity index (a combination of the three sucking parameters). Researchers found that infants in the ATVV intervention group demonstrated improved sucking organization; number of sucks, sucks per burst, and maturity index increased significantly faster by day 7, and sucking pressure increased more over time.
This study has several important implications for neonatal therapy:
- The ATVV intervention effectiveness further demonstrates the need for continued emphasis on the interactions that a baby has just prior to feeding, and that these interactions can be strong facilitators.
- Although the ATVV intervention involves engaging the infant for 20 minutes prior to feeding, it has been shown to improve sucking organization, which may lead to less energy expenditure for the baby during feeding.
- The ATVV intervention can be performed by families, empowering them to take an active role in preparing their babies to feed well.
To access the abstract of the study, visit: (or full text if you’re a subscriber) http://journals.lww.com/advancesinneonatalcare/Abstract/2015/04000/Multisensory_Intervention_for_Preterm_Infants.12.aspx
Medoff-Cooper, B., Rankin, K., Li, Z., Liu, L., &White-Traut, R. (2015). Multisensory intervention for preterm infants improves sucking organization. Advances in Neonatal Care, 15(2), 142-149.
