Non-nutritive sucking

What is non-nutritive sucking?

Allowing a baby to suck without taking milk is known as non-nutritive sucking. Ideally this is at the breast (after milk has been expressed), but when this is not possible, the use of a dummy may be beneficial.

Why do we think dummies can be of use in the NICU?

• Non-nutritive sucking reduces the experience of pain.
  Babies often become upset when they have a blood sample taken or any other test performed. Ways of calming a baby include holding and rocking, skin-to-skin contact or breast feeding; these may not always be possible, and then the use of a dummy can be helpful.
• Non-nutritive sucking encourages sucking and weight gain.
  Sucking is a basic instinct for a newborn baby. A healthy full term baby uses sucking to feeding either at the breast or from a bottle and therefore does not require a dummy. The sick or premature baby however may not be able to suck any or only some of his feeds and may need to have milk given directly into the stomach through a gastric tube (tube feeds). If a baby can be held in skin-to-skin contact near the breast during a tube feed, he learns to associate the breast with food, comfort and a full tummy. When this is not possible offering a dummy during tube feeding helps to encourage the baby to suck and to learn to associate sucking with the feeling of a full tummy. We know that babies who are offered dummies during tube feeds gain weight quicker.
• Non-nutritive sucking helps with breathing
  Babies needing help with breathing (CPAP) are more stable if allowed to suck as this helps maintain good pressure in baby's mouth and breathing passages.

Will giving a dummy interfere with breast feeding?

There is evidence that the use of dummies in healthy, full term babies may interfere with breast feeding. There is no evidence of this in the premature baby, although it is possible that prolonged dummy sucking may interfere with the baby's ability to breast feed on demand. In sick and premature babies careful use of a dummy has advantages for the baby that outweigh any possible disadvantages.

Giving your baby a dummy.

• Your baby's dummy is contained in a pot of sterilising fluid kept near to his incubator or cot. His name will be on the pot along with the date that the sterilising solution was last changed.
• Before giving the dummy to your baby, you may wish to rinse it in sterile water. Your baby's nurse will give you a bottle of sterile water to use.
• When giving your baby a dummy, gently brush the dummy against baby's lips and when he opens his mouth, place the dummy on top of his tongue. You may need to hold it in place until he begins to suck strongly.
• Allow your baby to suck on the dummy for a couple of minutes before and during an uncomfortable procedure, or if unsettled, until he is calm and resting quietly. If non-nutritive sucking is being used to encourage feeding, it should begin for a couple of minutes before and then during and for a short while after the tube feed.
• When your baby no longer needs the dummy, wash it in warm soapy water, rinse with clean water and then place it back into the sterilising fluid.

Your baby's nurse will answer any other questions you may have about non-nutritive sucking. If you do not agree with your baby having a dummy, please let the staff know.