title: Non-nutritive sucking for gastro-oesophageal reflux disease in preterm and low birth weight infants.
abstract: BACKGROUND
  Gastro-oesophageal reflux (GOR) is commonly diagnosed in the neonatal population (DiPietro 1994), and generally causes few or no symptoms (Vandenplas 2009). Conversely, gastro-oesophageal reflux disease (GORD) refers to GOR that causes troublesome symptoms with or without complications such as damage to the oesophagus (Vandenplas 2009). Currently there is no evidence to support the range of measures recommended to help alleviate acid reflux experienced by infants. Non-nutritive sucking (NNS) has been used as an intervention to modulate neonatal state behaviours through its pacifying effects such as decrease infant fussiness and crying during feeds (Boiron 2007; Pickler 2004).
  
  
  OBJECTIVE
  To determine if NNS reduces GORD in preterm infants (less than 37 weeks' gestation) and low birth weight (less than 2500 g) infants, three months of age and less, with signs or symptoms suggestive of GORD, or infants with a diagnosis of GORD.
  
  
  METHODS
  We performed computerised searches of the electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 9, 2013), MEDLINE (1966 to September 2013), CINAHL (1982 to September 2013), and EMBASE (1988 to September 2013). We applied no language restrictions.
  
  
  METHODS
  Controlled trials using random or quasi-random allocation of preterm infants (less than 37 weeks' gestation) and low birth weight (less than 2500 g) infants three months of age and less with signs or symptoms suggestive of GORD, or infants with a diagnosis of GORD. We included studies reported only by abstracts, and cluster and cross-over randomised trials.
  
  
  METHODS
  Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data. We identified two studies from the initial search. After further review, we excluded both studies.
  
  
  RESULTS
  We identified no studies examining the effects of NNS for GORD in preterm and low birth weight infants
  
  
  CONCLUSIONS
  There was insufficient evidence to determine the effectiveness of NNS for GORD. Adequately powered RCTs on the effect of NNS in preterm and low birth weight infants diagnosed with GORD are required.
authors.affiliation: CHoRUS Project, Family and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, College of Health and Science, Locked Bag 1797, Penrith South DC, NSW, Australia, 1797.
authors.forename: Kim
authors.initials: K
authors.lastname: Psaila
authors.forename: Jann P
authors.initials: JP
authors.lastname: Foster
authors.forename: Robyn
authors.initials: R
authors.lastname: Richards
authors.forename: Heather E
authors.initials: HE
authors.lastname: Jeffery
mesh_terms: D003448:Crying; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D041361:Pacifiers