Effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants: a randomised controlled trial.

AIMS AND OBJECTIVES: To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants.

BACKGROUND: Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences.

DESIGN: A prospective, randomised controlled trial conducted in the Eastern Turkey.

METHODS: Seventy infants were randomised into two groups: a pacifier group (n = 34) and a control group (n = 36). Pacifier use was applied in the preterm infants in the pacifier group, up to switching to full breastfeeding. The infants in the control group did not use pacifiers. Data were collected by a researcher using the Preterm Infant Introductory Information Form, the Preterm Infant Monitoring Form and the LATCH Breastfeeding Assessment Tool. For the study, ethics committee approval, official permission and written informed consents of the families were obtained.

RESULTS: The time to transition to full breastfeeding (123·06 ± 66·56 hours) and the time to discharge (434·50 ± 133·29 hours) in the pacifier group were significantly shorter compared to the control group (167·78 ± 91·77 and 593·63 ± 385·32 hours, respectively) (p < 0·05). The weight at transition to full breastfeeding (1944·12 ± 275·67 g) and the weight of discharge (1956·45 ± 268·04 g) in the pacifier group were significantly lower compared to the control group (2155·58 ± 345·57 and 2159·75 ± 341·22 g, respectively) (p < 0·05). Sucking skills of the infants in the pacifier group at 48 hours after transition to oral feeding and before the discharge was better than in the control group (p < 0·05).

CONCLUSION: Pacifier use improved the sucking skills and shortened the time to transition to full breastfeeding and to discharge in preterm infants receiving complementary feeding.

RELEVANCE TO CLINICAL PRACTICE: Pacifier use may be recommended to accelerate transition to full breastfeeding and to improve the sucking skills in preterm infants who were fed by both oral route and complementary feeding in the neonatal intensive care units.