A Cochrane review [Abstract] 1 included 12 studies with a total of 746 preterm infants. The intervention of non-nutritive sucking (NNS) was via a pacifier in all but one study, which used a gloved finger. Meta-analysis showed a significant effect of NNS on transition from gavage to full oral feeding (MD −5.51 days, 95% CI −8.20 to −2.82; N = 87), transition from start of oral feeding to full oral feeding (MD −2.15 days, 95% CI −3.12 to −1.17; N = 100), and the length of hospital stay (MD −4.59 days, 95% CI −8.07 to −1.11; N = 501). There was no significant effect on weight gain. One study found that the NNS group had a significantly shorter intestinal transit time during gavage feeding compared to the control group (MD −10.50 h, 95% CI −13.74 to −7.26; N = 30). Other individual studies demonstrated no clear positive effect of NNS on age of infant at full oral feeds, days from birth to full breastfeeding, rates and proportion of infants fully breastfeeding at discharge, episodes of bradycardia, or episodes of oxygen desaturation. No negative outcomes were reported in any of the studies.
Comment: The quality of evidence is downgraded by study quality (lack of blinding) and by imprecise results (few patients).
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