Preliminary ultrasound observation of lingual movement patterns during nutritive versus non-nutritive sucking in a premature infant

Abstract

Term neonates must suck, swallow, and respire in a coordinated manner during successful oral feeding. When infants are born prematurely, these skills may not be fully mature. To stimulate sucking responses, premature infants are offered pacifiers under the premise that non-nutritive sucking experiences facilitate oral feeding readiness. This case reported examined the lingual-hyoid mechanics of non-nutritive suck (NNS) patterns with a pacifier versus nutritive suck (NS) during a bottle feed in a premature infant using a noninvasive ultrasound imaging technique as a pilot to discern aspects of oral feeding candidacy. Lingual patterns during NS resulted in significantly greater displacements and excursions than NNS (p < 0.0001) in both anterior and posterior regions of the tongue (p < 0.0001). In addition, the angle of hyoid movement during NNS was significantly smaller (p < 0.05) than the angle recorded during NS tasks. Unlike an expected neonatal sucking pattern of horizontal anterior-posterior movements of the tongue body, vertical tongue body excursions occurred as described in the literature of representing a 6-9-month developmental skill level. Through the integration of semiautomatic computerized analyses of tongue surface configurations and hyoid activity, these data may enhance knowledge of oral swallowing function in developing preterm neonates.