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Multisensory Intervention for Preterm Infants Improves Sucking Organization

Medoff-Cooper, Barbara PhD, RN; Rankin, Kristin PhD; Li, Zhuoying MS; Liu, Li PhD; White-Traut, Rosemary PhD, RN

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0000000000000166
Original Research

Background Premature infants are at risk for difficulties in feeding, social interaction, and growth. Many premature infants exhibit a lower capacity for self-regulation, resulting in less behavioral alertness and hypersensitivity to stimulation. Feeding is critically important because it is a primary factor for infant growth and a major concern for both parents and clinicians.

Purpose The aim of this randomized controlled trial was to evaluate sucking organization in premature infants following a preterm infant multisensory intervention, the Auditory, Tactile, Visual, and Vestibular (ATVV) intervention.

Methods: A convenience sample of 183 healthy premature infants born 29-34 weeks postmenstrual age (PMA) enrolled. Sucking organization was measured at baseline, then weekly, during the infant's hospital stay.

Results: A quadratic trend was observed for number of sucks, sucks per burst, and maturity index with the intervention group increasing significantly faster by day 7 (model estimates for group × day: β= 13.69, P < .01; β = 1.16, P < .01; and β= 0.12, P < .05, respectively). Sucking pressure increased linearly over time, with significant between-group differences at day 14 (β= 45.66, P < .01).

Implications for Practice: The ATVV infants exhibited improved sucking organization during hospitalization, suggesting that the ATVV intervention improves maturation of oral feeding.

Implications for Research: Further research that includes 2 or more tests, delivered the same day and/or over consecutive days, will provide researchers and clinicians a more sensitive indicator of maturational changes in feeding behaviors.

Department of Family and Community Health, University of Pennsylvania School of Nursing, and The Children's Hospital of Philadelphia, Philadelphia, PA (Dr Medoff-Cooper); Division of Epidemiology and Biostatistics, School of Public Health (Drs Rankin and Liu), and Children and Family Health Science, College of Nursing (Drs Li and White-Traut), University of Illinois at Chicago; and Children's Hospital of Wisconsin, Milwaukee (Dr White-Traut).

Correspondence: Barbara Medoff-Cooper, PhD, RN, Pediatric Nursing, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Claire Fagin Hall, Philadelphia, PA 19104 (

This work was supported by grants from the National Institutes of Child Health and Human Development, the National Institute of Nursing Research (1 R01 HD050738-01A2) and the Harris Foundation to the University of Illinois at Chicago.

There is no competing financial interest in relation to the work described. The authors have nothing to disclose and declare no conflicts of interest in any way related to this submission.

© 2015 by The National Association of Neonatal Nurses