The effects of body positioning on sucking behaviour in sick neonates

Some infants show better oxygenation in the prone position compared to the supine position while they are bottle-fed; however, the reason for this phenomenon is not clear. The purpose of this study was to obtain a better understanding of the effects of body position on the oral feeding performance, i.e. the sucking pressure, frequency, efficiency, and ventilation. A total of 14 infants (12 full-term, 2 preterm), who often showed O-2 desaturation (SpO(2) < 40) during oral feeding, were enrolled in the study. The infants were fed either in the supine position or in the prone position throughout feeding. Oxygen saturation was recorded with a pulse oxymeter. The sucking pressure was measured with a 1 mm I.D. silicone tube inserted into the artificial nipple. The ventilation volume during bottle feeding was measured with a pneumotachograph. The prone position resulted in better oxygenation (97.2 +/- 0.6% prone, 92.5 +/- 0.9% supine, P < 0.05) and larger tidal volume (6.4 +/- 0.8 ml/kg prone and 4.9 +/- 0.6 ml/kg supine, P < 0.05), although the minute ventilation during bottle-feeding was not different from that in the supine position. In the prone position, the sucking pressure and frequency were higher and the duration of each suck was shorter. Conclusion Sucking in the prone position may to some extent reduce disadvantages of oral feeding on ventilation.