Effects of Pacifier Use on Transition Time From Gavage to Breastfeeding in Preterm Infants: A Randomized Controlled Trial

Breastfeed Med. Jul/Aug 2018;13(6):433-437. doi: 10.1089/bfm.2018.0031. Epub 2018 Jun 18.


Background: Nonnutritive sucking (NNS) has been identified as having many benefits for preterm infants. NNS may improve the efficacy of oral feeding, reduce the length of time spent in orogastric (OG) tube feeding, and shorten the length of hospital stays for preterm infants.

Aim: This study aimed to assess the effect of pacifiers on preterm infants in the transition from gavage to oral feeding, their time to discharge, weight gain, and time for transition to full breastfeeding.

Methods: A prospective, randomized controlled trial was conducted in our center. Ninety infants were randomized into two groups: a pacifier group (PG) (n = 45) and a control group (n = 45). Eligibility criteria included body weight less than or equal to 1,500 g, gestational age (GA) younger than 32 weeks, tolerating at least 100 kcals/kg/day by OG feeding, growth parameters appropriate for GA, and a stable clinical condition.

Results: Mean GAs were 29.2 ± 1.86 versus 28.4 ± 1.84 weeks (p = 0.46), and birth weights were 1,188.2 ± 272 versus 1,112.8 ± 267 g (p = 0.72) in the PG and CG groups, respectively. The time for transition to full oral feeding (38 ± 19.2 days), time to transition to full breastfeeding (38.1 ± 20 days), and time to discharge (48.4 ± 19.2 days) in the PG were significantly shorter compared with the control group (49.8 ± 23.6, 49.1 ± 22, 65.3 ± 30.6 days, respectively) (p < 0.05). For preterm infants with gastrointestinal motility disturbance, similar symptoms (regurgitation, vomiting, abdominal distension) (n = 6, 22%) in the PG were significantly lower than the control group (n = 21, 77.8%) (p < 0.05).

Conclusion: In this study, we determined that the method of giving pacifiers to preterm infants during gavage feeding reduced the infants' transition period to oral feeding and the duration of hospital stay. In addition, the pacifiers could be used during gavage feeding and in the transition from gavage to oral/breastfeeding in preterm infants to encourage the development of sucking ability.

Keywords: breastfeeding; pacifier; preterm infants.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Body Weight
  • Breast Feeding*
  • Enteral Nutrition*
  • Female
  • Gestational Age
  • Humans
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Male
  • Mother-Child Relations
  • Pacifiers*
  • Patient Discharge
  • Prospective Studies
  • Sucking Behavior*
  • Time Factors
  • Turkey