Nonnutritive sucking in high-risk infants: benign intervention or legitimate therapy?

Objective: To review the available research evidence on the effects of nonnutritive sucking (NNS) in high-risk full-term and preterm infants in neonatal nurseries.

Data Sources: Electronic searches of MEDLINE (1976-2001) and CINAHL (1982-2001) databases, as well as the Cochrane Library. Reference lists of all relevant articles were also reviewed.

Study Selection: Experimental and quasi-experimental studies that included hospitalized full-term and preterm infants, where NNS by pacifier was compared to no pacifier.

Data Extraction: Results of studies were reviewed by two of the authors.

Data Synthesis: As an intervention to promote behavioral outcomes and gastrointestinal function or feeding, there is little evidence to support the use of NNS in preterm and high-risk full-term infants. NNS has been linked to reduced length of hospital stay and improved pain management.

Conclusions: Although harmful effects have not been specifically studied, NNS in preterm and high-risk full-term infants does not appear to have any short-term negative effects. No long-term data on the effects of NNS in high-risk full-term and preterm infants are presently available. Based on the results of this review, it would seem reasonable for nurses to utilize pacifiers for pain management in high-risk full-term and preterm infants.