The Effect of Breast Milk Odor on Transition Time From Gavage to Oral Feeding and Hospital Stay in Premature Infants

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

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Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0282 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Qiong Le ◽

Sheng-hua Zheng ◽

Lan Zhang ◽

Li-fen Wu ◽

Feng-juan Zhou ◽

...

Keyword(s):

Clinical Trial ◽

Breast Milk ◽

Premature Infant ◽

Preterm Infants ◽

Oral Feeding ◽

Transition Time ◽

Control Group ◽

Oral Motor ◽

Oral Stimulation ◽

Nutritive Sucking

Abstract Objectives This study was performed to evaluate the effect of oral stimulation with breast milk for preterm infants. Methods A total of 68 subjects form neonatal intensive care unit were randomly assigned into control group (n=20), premature infant oral motor intervention (PIOMI) group (n=25) and premature infant oral motor intervention with breast milk (BM-PIOMI) group (n=23). Results BM-PIOMI group had significant shorter initiation of oral feeding (IOF) time compared to PIOMI group (2.95 days, 95% CI [0.42–5.48]) or control group (9.79 days, 95% CI [7.07–12.51]). BM-PIOMI group had significant sooner transition time from IOF to full oral feeding (FOF) compared to control group (6.68 days, 95% CI [2.2–11.16]), but not to PIOMI group (2.09 days, 95% CI [−2.07 to 6.25]). Length of hospital stay (LOS) did not show statistical different between three groups (control 38.85 ± 14.40 vs. PIOMI 38.48 ± 11.76 vs. BM-PIOMI 38.04 ± 12.2). Growth mixture model identified improvement in non-nutritive sucking (NNS) score in BM-PIOMI group compared to control and PIOMI group (0.8293, p<0.0001, and 0.8296, p<0.0001, respectively). Conclusions Oral stimulation with breast milk can better promotes the oral feeding process of premature infants than the simple oral stimulation, by shorten IOF time and improve early NNS score, but does not shorten transition time from IOF to FOF and LOS. Trial registration The trial identification number is ChiCTR1800019134 (Chinese Clinical Trial Registry http://www.who.int/ictrp/network/chictr2/en/)

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The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01355-0 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Xian-Rong Yu ◽

Shu-Ting Huang ◽

Ning Xu ◽

Li-Wen Wang ◽

Zeng-Chun Wang ◽

...

Keyword(s):

Cardiac Surgery ◽

Breast Milk ◽

Hospital Stay ◽

Physiological Saline ◽

Oral Feeding ◽

Control Group ◽

Oral Nutrition ◽

Congenital Cardiac Surgery ◽

Oral Stimulation ◽

Stimulation Group

Abstract Objective To investigate the effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery. Methods Infants with congenital heart disease were randomly divided into the breast milk oral stimulation group (n = 23), physiological saline oral stimulation group (n = 23) and control group (n = 23). Debra Beckman’s oral exercise program was used with breast milk and physiological saline in the breast milk oral stimulation group and the physiological saline oral stimulation group, respectively. The time oral feeding and total oral nutrition were started, the length of intensive care unit (ICU) stay and hospital stay, weight and the complications at discharge were recorded for each group and statistically analyzed. Results The time oral feeding and total oral nutrition were started and the length of ICU stay and hospital stay were significantly less in the breast milk oral stimulation group and physiological saline oral stimulation group than in the control group (P < 0.05). There were no significant differences in other indicators between the breast milk oral stimulation group and the physiological saline oral stimulation group, except for the time total oral nutrition began (P < 0.05). However, there were no significant differences in weight or complications at discharge among the three groups (P > 0.05). Conclusion Early oral stimulation exercises with breast milk can help infant patients quickly recover total oral nutrition and reduce the length of ICU and hospital stay after cardiac surgery.

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The effect of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in premature infants: A single-blind randomized–clinical trial

Journal of Pediatric Rehabilitation Medicine ◽

10.3233/prm-190651 ◽

2021 ◽

Vol 14 (3) ◽

pp. 379-387

Author(s):

Alireza Alidad ◽

Maryam Tarameshlu ◽

Leila Ghelichi ◽

Hamid Haghani

Keyword(s):

Hospital Stay ◽

Premature Infants ◽

Length Of Hospital Stay ◽

Oral Feeding ◽

Feeding Problems ◽

Feeding Performance ◽

Oral Motor ◽

Nutritive Sucking ◽

Combined Intervention ◽

Single Blind

PURPOSE: Feeding problems are common in premature infants (PIs) and may lead to negative consequences such as malnutrition, dehydration, excessive weight loss, as well as developmental and psychological deficits. Moreover, they are associated with increased length of hospital stay/cost. There is not enough evidence on how feeding problems should be treated in PIs. The goal of this study was to investigate the effects of non-nutritive sucking combined with oral motor stimulation and oral support on feeding performance in PIs. METHODS: A single-blind randomized clinical trial was performed on 44 PIs with feeding problems. Patients were randomly categorized into two groups: (1) combined intervention (CI) and (2) non-nutritive sucking (NNS). The CI group received NNS, oral motor stimulation and oral support simultaneously. Infants in both groups received 14 treatment sessions for 14 consecutive days. The Preterm Oral Feeding Readiness Assessment Scale (POFRAS) was used as the primary outcome measure. Weight, volume of milk intake, time to achieve full oral feeding, and length of hospital stay were secondary outcome measures. All measures were assessed before treatment, after the 7th session, after the 14th session, and after 7 days after the end of treatment. RESULTS: Both groups improved in all outcome measures across time (P < 0.001). The improvements in the POFRAS, volume of milk intake, and time to achieve full oral feeding were significantly greater in the CI group than the NNS group (P < 0.001). The improvements attained in weight and length of hospital stay were not significantly different between the CI and NNS groups (P > 0.05). Large effect sizes were found for POFRAS score in both CI (d = 3.98) and NNS (d = 2.19) groups. CONCLUSION: The current study showed that the combined intervention including NNS, oral motor stimulation, and oral support significantly improved the feeding performance in PIs.

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Preterm newborn readiness for oral feeding: systematic review and meta-analysis

CoDAS ◽

10.1590/2317-1782/20152014104 ◽

2015 ◽

Vol 27 (1) ◽

pp. 101-107 ◽

Cited By ~ 11

Author(s):

Ana Henriques Lima ◽

Marcela Guimarães Côrtes ◽

Maria Cândida Ferrarez Bouzada ◽

Amélia Augusta de Lima Friche

Keyword(s):

Hospital Stay ◽

Preterm Infants ◽

Rating Scales ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Research Strategy ◽

Oral Feeding ◽

Transition Time ◽

Sensory Motor ◽

Stimulation Of

PURPOSE: To identify and systematize the main studies on the transition from enteral to oral feeding in preterm infants. RESEARCH STRATEGY: Articles that describe the transition from oral to enteral feeding in preterm infants were located in MEDLINE, LILACS, and SciELO databases. SELECTION CRITERIA: Original studies, with available abstract, published in the last 10 years were included. DATA ANALYSIS: Analysis of the methodology and the main results of the studies, and meta-analysis of the effects of sensory-motor-oral stimulation at the time of transition to full oral feeding and duration of hospitalization were conducted. RESULTS: Twenty-nine national and international publications were considered. Most studies were clinical trials (44.8%) and did not use rating scales to start the transition process (82.7%). In the meta-analysis, positive effect of stimulation of the sensory-motor-oral system was observed with respect to the transition time to oral diet (p=0.0000), but not in relation to the length of hospital stay (p=0.09). However, heterogeneity between studies was found both in the analysis of the transition time to full oral feeding (I2=93.98) and in the length of hospital stay (I2=82.30). CONCLUSION: The transition to oral feeding is an important moment, and various physical and clinical characteristics of preterm infants have been used to describe this process. Despite the impossibility of generalizing the results due to the heterogeneity of the studies, we have noted the importance of strategies for stimulation of sensory-motor-oral system to decrease the period of transition to full oral feeding system.

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THE BREAST MILK BANK AS A COMMUNITY PROJECT

PEDIATRICS ◽

10.1542/peds.16.2.264 ◽

1955 ◽

Vol 16 (2) ◽

pp. 264-269

Author(s):

E. Robbins Kimball ◽

Elizabeth Jones ◽

Myrtle E. Lewis ◽

Ethel R. Kolb

Keyword(s):

Breast Milk ◽

Hospital Stay ◽

Breast Feeding ◽

Premature Infants ◽

Length Of Hospital Stay ◽

Community Project ◽

Milk Bank

1. The management of breast feeding is outlined. 2. The organization of our breast milk bank as operated by Evanston Hospital and Junior League volunteers is described. 3. The establishment of a breast milk bank has enabled us to increase the number of premature infants fed breast milk threefold. Their weights and length of hospital stay are presented.

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Anemia of Prematurity and Oral Feeding Milestones in Premature Infants

American Journal of Perinatology ◽

10.1055/s-0039-1700488 ◽

2019 ◽

Author(s):

Sreekanth Viswanathan ◽

Sudarshan Jadcherla

Keyword(s):

Hospital Stay ◽

Study Design ◽

Premature Infants ◽

Intraventricular Hemorrhage ◽

Supplemental Oxygen ◽

Oral Feeding ◽

Feeding Problems ◽

Anemia Of Prematurity ◽

Postmenstrual Age ◽

Per Oral

Abstract Objective Anemia of prematurity (AOP) and oral feeding problems are common in premature infants. This study aimed to determine the influence of AOP on aerodigestive outcomes and the duration to full Per Oral (PO). Study Design Prospectively collected data on premature infants who initiated oral feeds at ≤ 34 weeks' postmenstrual age were examined. Infants were categorized into “AOP+” and “AOP−” based on hematocrit at initial PO, that is, < 29 or ≥ 29%. Results Forty-four infants in AOP+ compared with 74 in AOP−. AOP+ infants had lower birth gestation and weight (p < 0.001). The anthropometrics at initial PO were similar. AOP+ had lower mean hematocrit and higher oxygen need at initial PO, and at full PO (p < 0.05). AOP+ reached full PO at a later gestation and took longer days from initial PO to full PO (p < 0.01). BPD, intraventricular hemorrhage (IVH ≤ 2), and hospital stay were greater in the AOP+ (p < 0.05). After adjusting for covariates, initial PO hematocrit was not predictive of time to full PO [hazard ratio 1.3 (CI 0.88–2.0), p = 0.18]. Conclusion AOP is not independently associated with the duration to full PO. Supplemental oxygen for associated comorbidities may have compensated for the underlying anemia.

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Premature: growth and its relation to oral skills

CoDAS ◽

10.1590/2317-1782/20152014179 ◽

2015 ◽

Vol 27 (4) ◽

pp. 378-383

Author(s):

Camila Lehnhart Vargas ◽

Luana Cristina Berwig ◽

Eduardo Matias dos Santos Steidl ◽

Leila Sauer Prade ◽

Geovana Bolzan ◽

...

Keyword(s):

Hospital Stay ◽

Premature Infant ◽

Premature Infants ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Tube Feeding ◽

Oral Feeding ◽

Feeding Performance ◽

Time Of Feeding ◽

Oral Skills

OBJECTIVE: To evaluate the influence of oral motor skills of premature infants on their oral feeding performance and growth, during neonatal hospitalization.METHODS: Fifty-one newborns hospitalized in the neonatal intensive care unit of a hospital in Southern Brazil, between July 2012 and March 2013, were evaluated. The evaluation of oral feeding skills, according to Lau and Smith, was applied after prescription for starting oral feeding. The oral feeding performance was analyzed using the following variables: days taken to start independent oral feeding and hospital discharge. Growth was measured by weight, length, and head circumference, using the curves of Fenton, at birth, first and independent oral feeding, and hospital discharge.RESULTS: At birth, 71% preterm infants were proper for gestational age, most of them were males (53%), with average of 33.6 (±1.5) weeks of gestational age. The gestational age in the assessment did not influence the oral feeding performance of the premature infant and did not differ between levels. Time of transition from tube feeding to oral feeding and hospital stay was shorter when the oral skills were higher. At birth, there was a tendency of low weight and low oral feeding performance. Level IV premature infants in the release of oral feeding presented higher weights.CONCLUSION: The level of oral skills of the premature infant interfered positively on time of feeding transition from tube to independent oral feeding and hospital stay. Growth, represented by weight gain, was not affected by the level of oral skill.

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