Preterm and term infants with brain injury frequently have difficulty learning to feed by mouth. Transcutaneous vagus nerve stimulation (taVNS) may be paired with the motor activity of feeding to boost brain circuits involved with feeding. This study will test a taVNS-paired bottle system in a blinded, randomized, controlled trial in infants who have reached term age and failed to learn to feed. Our preliminary data indicates that most infants improve their volume of oral feeds with the BabySTrong system, and 50-70% achieve full oral feeds and avoid placement of a gastrostomy tube (G-tube) or home nasogastric tube. The BabySTrong feeding system may improve oral feeding volumes and help infants and their families avoid a long hospital stay while trying to learn to feed.

Newborns who are born premature or infants who suffer brain injury are at risk for motor problems. The common motor skills of reaching and grasping that infants have to learn can be weaker on one side of the body, depending on the site of the brain injury. These skills are routinely practiced with an occupational therapist once or twice a week, to help the infant strengthen these skills. A high intensity therapy program of constraint induced movement therapy (CIMT) may be available for the infant, but it takes from 40-120 hours total treatment time for most infants to improve their motor skills.
Transcutaneous auricular vagus nerve stimulation (taVNS) stimulates a branch of a major nerve by the ear, called the vagus nerve, that may help improve your child's ability to learn motor skills. CIMT involves placing a soft mitt constraint on the stronger arm and hand while encouraging your child to use the weaker arm and hand during intensive therapy sessions. By using both CIMT and the nerve stimulation together, we hope your child's movement skills will improve more than with therapy alone.
The purpose of this study is to evaluate the safety and effectiveness of taVNS to improve motor skills when paired with the minimal amount of CIMT and whether a measure of the strength of the brain circuit to the arm and hand muscles can tell us how well a child may respond to this therapy.