I have not found a direct link in research of suctioning to feeding problems. However, routine suctioning is NOT necessary in the first place!
Vain, N. E., E. G. Szyld, et al. (2004). "Oropharyngeal and nasopharyngeal suctioning of meconium-stained neonates before delivery of their shoulders: multicentre, randomised controlled trial." Lancet 364(9434): 597-602.
BACKGROUND: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disorder in infants born through meconium-stained amniotic fluid (MSAF). Although anecdotal data concerning the efficacy of intrapartum oropharyngeal and nasopharyngeal suctioning of MSAF are conflicting, the procedure is widely used. We aimed to assess the effectiveness of intrapartum suctioning for the prevention of MAS. METHODS: We designed a randomised controlled trial in 11 hospitals in Argentina and one in the USA. 2514 patients with MSAF of any consistency, gestational age at least 37 weeks, and cephalic presentation were randomly assigned to suctioning of the oropharynx and nasopharynx (including the hypopharynx) before delivery of the shoulders (n=1263), or no suctioning before delivery (n=1251). Postnatal delivery-room management followed Neonatal Resuscitation Program guidelines. The primary outcome was incidence of MAS. Clinicians diagnosing the syndrome and designating other study outcomes were masked to group assignment. An informed consent waiver was used. Analysis was by intention to treat. FINDINGS: 18 infants in the suction group and 15 in the no suction group did not meet entry criteria after random assignment. 87 in the suction group were not suctioned, and 26 in the no suction group were suctioned. No significant difference between treatment groups was seen in the incidence of MAS (52 [4%] suction vs 47 [4%] no suction; relative risk 0.9, 95% CI 0.6-1.3), need for mechanical ventilation for MAS (24 [2%] vs 18 [1%]; 0.8, 0.4-1.4), mortality (9 [1%] vs 4 [0.3%]; 0.4, 0.1-1.5), or in the duration of ventilation, oxygen treatment, and hospital care. INTERPRETATION: Routine intrapartum oropharyngeal and nasopharyngeal suctioning of term-gestation infants born through MSAF does not prevent MAS. Consideration should be given to revision of present recommendations.
Linda J. Smith, BSE, FACCE, IBCLC, FILCA
Bright Future Lactation Resource Centre Ltd.
6540 Cedarview Ct., Dayton OH 45459-1214
Phone (937) 438-9458 Fax (937)-438-3229
www.BFLRC.com
-----Original Message-----
From: Kelly Smith [mailto:[log in to unmask]]
Sent: Wednesday, February 02, 2011 2:49 PM
Subject: suctioning at birth and bf difficulties
We are currently updating policies at our facility and I have been asked to provide evidence based research concerning suctioning at birth. I have seen in my practice that babies that have had DeLee suctioning or any mechanical suctioning at birth tend to guard their soft palates and latch issues occur. I attended Gold 2010 and thought for sure in my notes I would find some references to support the claim that oralpharyngeal suctioning can cause feeding issues but did not find what I was needing.
I am hoping our friendly lactnetters might have some references that I can use. Please send me any that you know of.
Thank you,
Kelly
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