Gentle Massage of Preemie's
Mouth Helps Them Eat

NEW YORK (Reuters Health) - Gently stroking the inside and outside of premature babies' mouths before feeding helps them make the transition from a feeding tube to drinking milk from a breast or bottle, new study findings show.

Furthermore, Dr. Chantal Lau of Baylor College of Medicine in Houston, Texas and colleagues found that preemies who received a so-called "oral stimulation program" during their first days of life were able to take in more milk--and more quickly--than those who did not receive the stimulation.

Preterm babies often have trouble taking in food because their early arrival has left them with underdeveloped cardiovascular and respiratory systems, and musculature around the mouth. And as Lau told Reuters Health, in order to feed, babies need to coordinate their swallowing, sucking and breathing.

"You are really asking these babies to do three tasks, if you think about it, that they're not ready for, because they're supposed to be in the womb," she said.

As a result, these infants can have difficulties keeping milk from going into their lungs, and may stop breathing while feeding. Because of this, very premature babies spend the beginning days of their lives using a feeding tube, which delivers nutrients directly to their stomachs.

But in order to leave the hospital, premature babies eventually need to make the transition from tube-feeding to bottle- or breast-feeding.

In a recent issue of The Journal of Pediatrics, Lau and colleagues present the results of an experiment testing an oral stimulation program on 32 preterm babies born after only 26 to 29 weeks in the womb, designed to help them develop their abilities to feed orally. Half of the babies received the program, while the rest were given no intervention.

Around 15 to 30 minutes before the infant received a tube-feeding, an adult would spend 12 minutes stroking the infant's cheeks, lips, gums and tongue, then 3 minutes trying to get the infant to suck on a pacifier. Premature babies received the program once a day for 10 minutes.

The researchers then measured how long it took babies to transition from tube-feeding to breast-feeding, and how much milk they took in during each feeding session, and how quickly could they drank it.

Lau's team reports that babies who received the oral stimulation program were able to make the transition from tube to breast in 11 days, an achievement which took the group who didn't receive the intervention an average of 18 days. Babies given the program also took in more milk more quickly than babies who did not receive any pre-feeding stimulation, the authors add.

Both groups of preterm infants had an equally long hospital stay.

In an interview with Reuters Health, Lau explained that the stimulation program may help babies to feed by showing them that things that touch their mouths do not always hurt. Premature babies are subjected to many tests and tubes early in life, she explained, all of which can make them aversive to contact in and around their mouths--contact that is needed for them to feed from a bottle or breast. Consequently, gently stroking their mouths may help babies "unlearn" their fear that touching around the mouth can hurt, she said.

"And then you try to teach them--if you can, if you believe in learning--that the mouth actually ought to be used for something else," Lau added.

Also, sucking may be like playing sports, she noted--the more you do it, the better you get. "The more he practices sucking and swallowing, maybe the better he gets at it," Lau said.

SOURCE: The Journal of Pediatrics 2002;141:230-236.

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