Originally published on Aug. 12, 2018.

If your baby is not yet ready to start oral feeds, it can be a frustrating time. Learning to feed orally is a barrier to being discharged in some units, though not all.

This post looks at one of the things you can do with your baby to support their path towards oral feeding: Non-nutritive sucking (NNS).

NNS is any sucking that doesn't involve actually taking milk. Non-nutritive sucking may be from an 'empty' breast (after you have expressed), on a dummy (pacifier) or a finger.

Non-nutritive sucking has been associated with earlier discharge from hospital. It uses a different part of the brain to nutritive sucking (sucking for feeding), and so practising NNS does not necessarily mean that a child will be a successful oral feeder, since this is a much more complex skill. It also does not imply that a child can swallow effectively.

However, there is evidence that NNS can support physiological stability and be supportive of a child's capacity to stay in or move into a 'calm alert' state, both of which are associated with better feeding outcomes.

As we have talked about in previous posts, premature babies need a good grounding of physiological stability in order to start feeding. This means, for example, that they are able to regulate temperature, or tolerate being handled without desaturating.

A common recommendation is that your baby is offered the opportunity for NNS at the begining of a tube feed, so that they can start to learn an association between feeding and sucking. We may also suggest that you offer a 'dummy dip'- a dummy dipped in your baby's milk.

NNS is a recommendation that is fairly common in units, but every baby is different, especially if they are unwell in addition to being premature. A Speech and Language Therapist will help you to understand whether NNS is the right choice for your baby, and when to start.

Many of the things that are suggested for you to do to encourage your child's feeding may seem like very small, even insignificant things. It is so important that we value the opportunities we have to support our babies. Aside from the potential impact on feeding, taking opportunites such as supporting your baby with NNS will help you to learn to watch them closely and learn their individual signs, and to bond.

Posts from Find the Key Speech Therapy are intended for information. They are not intended to, and cannot take the place of advice from an appropriately qualified Speech and Language therapist who knows your child. Find the Key Speech Therapy does not take responsibility for the use of any advice without appropriate professional guidance.