Training preemies to feed could prevent disability
As if things weren’t tough enough for premature babies who have tubes down their throats and noses to survive, once the tubes are removed, they are often unable to take nourishment orally—that is, suck.
But at Stormont-Vail Regional Medical Center 20 tube-fed preterm infants with respiratory distress syndrome (RDS) treated with the NTrainerTM, a therapeutic instrumented pacifier patented by the University of Kansas, rapidly learned to suck far better and transitioned to bottle feeding faster than a control group of babies with RDS.
RDS is the seventh leading cause of death in infants younger than one year. In some cases, infants with RDS go home with gastric feeding tubes and don’t learn to take nourishment orally for months or even years.
If babies with RDS could be stimulated to suck and then to bottle or breast feed better and earlier, they could go home sooner, potentially saving up to $30,000 a week in medical costs.
But more fundamentally, NTrainer treatment might also prevent and treat developmental problems. It is this possibility that has driven Steven Barlow, professor of speech-language-hearing neuroscience, for much of his career developing and testing the NTrainer and its companion technology, the Actifier.
Barlow hypothesizes that if the NTrainer can stimulate a brain network known as the suck central pattern generator with normal sucking patterns at the right time, development can proceed more normally for RDS infants and those with bronchopulmonary dysplasia, Down syndrome and very low birthweight preemies at risk for neurologic damage.
The NTrainer device powers a SoothieTM silicone pacifier with a computer-controlled air pump to transform the nipple into a dynamically patterned pulsing touch stimulus on the infant’s lips and tongue. Modeled on the burst-pause suck dynamics of healthy preterm infants, the NTrainer teaches babies the correct pattern of “non-nutritive suck”— what babies normally do in the womb beginning as early as the second trimester.
“Some neonatolgoists suggest that non-nutritive suck is a window into the development of the central nervous system,” said
Barlow. “The NTrainer system is the first objective physiologically-based tool that gives the physician and nurse almost instant feedback about the infant’s oromotor system through the assessment of non-nutritive suck.”
Barlow will soon have the chance to further test his theory. A newly funded $2.6 million clinical trial funded by the National Institutes of Health will begin in the fall of 2008 and continue over the next ve years at Stormont-Vail Regional Medical Center and Overland Park Regional Medical Center. is comprehensive study will examine the e ects of early NTrainer intervention on the development of feeding skills, fine motor skills, brain development, and the acquisition of speech and language of 240 premature infants followed longitudinally until 3 years of age.