Background The therapeutic management of gastroesophageal reflux (GER) in preterm infants still represents a controversial issue among neonatologists. To date, different non-pharmacological strategies, such as body positioning, milk thickening or changes of feeding modalities, have been proposed. However, the effects of non-nutritive sucking (NNS) on GER features, detected by multiple intraluminal impedance (MII), have not yet been evaluated in preterm newborns symptomatic for GER.

Patients and methods Nineteen preterm newborns (GE ≤ 33 weeks) with GER symptoms underwent a 24-hours pH-MII monitoring. During this period, each infant received eight meals, four followed by NNS, applied by means of pacifier, and four not. Differences in GER features (number of episodes, acidity, duration and height reached) between NNS and non-NNS postprandial periods were evaluated by Wilcoxon signed-rank test.

Results No significant difference in GER features between NNS and non-NNS periods was found. However, postprandial periods without NNS resulted in a slight increase in the mean duration of acid GER episodes (NNS vs. NON-NNS, median values: 51.15 vs. 88.20 sec, p 0.159). Consequently, during NNS periods the time of esophageal acid exposure was reduced (NNS vs. NON-NNS, median values: 3.54 vs. 6.15%, p 0.171).

Conclusions According to our results, NNS administration during postprandial periods seems to have no significant effects on GER features in symptomatic preterm infants. However, during NNS periods we observed a slight, though not significant, reduction in the duration of acid GER, which plays a relevant role in the development of GERD. Further larger evaluations are needed to eventually confirm these preliminary data.