Oral stimulation improves weight gain in premature babies. But what type of stimulation?

There are some disadvantages to being born prematurely. One of the most obvious is the difficulty of correct nutrition when breast feeding. In fact, premature babies present a particular immaturity in their suction-deglution (sucking and swallowing) systems. And on top of that, the primitive reflexes that support suction and swallowing are not sufficiently developed. This problem not only affects premature babies. According to authors about 30% of all babies have nutritional problems.

For some time, it has been observed that oral stimulation has a positive effect on these problems. In fact, it is one of the main practices in therapy for premature babies. In a recent article by Thakkar and group (2018) they confirmed that oral stimulation helped weight gain in premature babies. It also reduced the time spent in hospital. The study was done on babies born between the thirtieth and thirty forth week.

For these authors, “oral motor stimulation is a series of sensorial motor inputs in the cheeks, lips, gums and tongue in order to maintain the archaic motor skills and to improve the tone of the tongue”. This is all to improve normal patterns of oral motor development.

What type of stimulation?

In this study it is not exactly clear what type of stimulation should be applied but we should expect they are referring to archaic patterns. We can build more advanced sensorial motor models on these patterns. 

But beware; oral stimulation is not only rooting and suction. It is much more. It is the same for premature and full term babies. There are many patterns that need stimulating and which we will see in the workshop on lactation in March.

Mechanical stress on children with a traumatic childbirth must not be forgotten. The manual treatment of the base of the skull can be all important. 

As physiotherapists we have the responsibility of joining the midwives in health education for mothers with this type of difficulty.

Lastly, there is an important link between problems of suction-deglutition (sucking and swallowing) and later problems of development, again not only in premature babies. It is vital to evaluate the development of babies with nutritional problems on a scale such as the Alberta Infant Motor Scale.