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Sucking Behavior of Preterm Neonates As a Predictor of Developmental Outcomes

Medoff-Cooper, Barbara PhD, FAAN*†; Shults, Justine PhD; Kaplan, Joel PhD§

Journal of Developmental & Behavioral Pediatrics: February 2009 - Volume 30 - Issue 1 - p 16-22
doi: 10.1097/DBP.0b013e318196b0a8
Original Article

Objectives: The relationship between the pattern of sucking behavior of preterm infants during the early weeks of life and neurodevelopmental outcomes during the first year of life was evaluated.

Methods: The study sample consisted of 105 preterm infants (postmenstrual age [PMA] at birth = 30.5 ± 2.8 weeks [mean ± SD]; birth weight = 1476 ± 460 g; mean length of hospital stay = 41.6 ± 31.4 days). All infants received a 5-minute sucking test at 34 and at 40 weeks PMA, with outcomes evaluated at 6 and/or 12 months corrected gestational age via the Bayley Scales of Infant Development.

Results: As expected, 6- and 12-month values for the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development were significantly below the normative levels established for infants delivered at term. A significant association between neonatal sucking pattern at 40 weeks PMA and developmental outcome at 12 months corrected gestational age was obtained. Each of the 3 simple sucking parameters evaluated (number of sucks, mean number of sucks per bursts and mean sucking pressure peaks), as well as a composite parameter (average of the respective parameter z-scores), was significantly related to both PDI and MDI at 12 months.

Conclusions: Multivariable models, adjusting for PMA at birth, length of hospital stay, and other predictors, affirmed that sucking performance at 40 weeks PMA was a significant, independent predictor of developmental status 1 year later. Standardization of an instrument for neonatal sucking assessment may offer a cost-effective early screening strategy for preterm infants at greatest risk for developmental delay.

From the *Children’s Hospital of Philadelphia; and the School of Nursing, the Center for Clinical Epidemiology and Biostatistics, and §the Department of Psychology, University of Pennsylvania, Philadelphia, PA.

Received July 2008; accepted November 2008.

This work was supported by Grant R01-NR02093 from NIH/NINR.

Address for reprints: Barbara Medoff-Cooper, Ph.D., F.A.A.N., School of Nursing, University of Pennsylvania, Ruth M Colket Professor of Pediatric Nursing, Children’s Hospital of Philadelphia, 420 Guardian Dr., Philadelphia, PA 19004-6096; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.