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

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.

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

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.

Anemia of Prematurity and Oral Feeding Milestones in Premature Infants

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.

scholarly journals Premature: growth and its relation to oral skills

CoDAS ◽  
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.

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

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/)

Dysphagia and Oral Feeding Problems in the Premature Infant

2002 ◽  
Vol 21 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Martha Wilson Jones ◽  
Elaine Morgan ◽  
Jean Shelton
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Term Infant ◽  
Oral Feeding ◽  
Feeding Disorders ◽  
Feeding Problems ◽  
The Past ◽  
Common Problems

FEEDING DISORDERS AND dysphagia are common problems seen in premature infants following their discharge from the NICU. A major factor in the growing incidence of these problems is the number of infants born and surviving between 23 and 25 weeks gestational age, which has increased dramatically over the past decade. These infants experience both a lengthier exposure to noxious oral stimuli and a longer time until they develop the suck/swallow coordination that makes oral feeding safe.1 Oral feeding is generally not offered before 32–34 weeks gestational age, when the preterm infant’s sucking pattern begins to resemble that of a term infant.2,3 Therefore, there may be an 8- to 9-week lag between birth and oral feedings in a 23- or 24-week gestational age infant.

Fast Track Postoperative Management after Elective Colorectal Surgery: A Controlled Trail

2009 ◽  
Vol 75 (12) ◽  
pp. 1247-1251 ◽  
Author(s):  
Carlo V. Feo ◽  
Serena Lanzara ◽  
Davide Sortini ◽  
Riccardo Ragazzi ◽  
Mario De Pinto ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Hospital Stay ◽  
Fast Track ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Control Group ◽  
Intestinal Function ◽  
Elective Colorectal Surgery ◽  
Early Ambulation ◽  
Colorectal Resections

In the attempt to reduce postoperative complications and costs and improve outcomes, the concept of fast track surgery has been proposed. Improvements in anesthesia techniques and a better understanding of the pathophysiologic events occurring during and after surgery have made it possible. A group of patients undergoing colorectal resections with a fast track approach were investigated; specifically, the effects on postoperative morbidity, resumption of intestinal function, and duration of hospitalization. Fifty patients were managed according to a protocol, which included epidural analgesia, early ambulation, and oral feeding (fast track group); they were compared with 50 patients managed with a different protocol: no epidural analgesia, early ambulation, and early oral diet (control group). Primary outcome end-points reported include morbidity, time to passage of flatus and stool, and length of hospital stay. Fourteen complications occurred in the fast track group and 13 in the control group ( P = not significant (NS)). Resumption of intestinal function occurred after 3 days, and length of hospital stay was 5 days in the fast track group compared with 4 and 7 days respectively in control patients ( P = NS, P < 0.01). Patients undergoing elective colorectal resections can be managed safely with fast track protocols reducing hospital stay.

scholarly journals Development of Suck and Swallow Mechanisms in Infants

2015 ◽  
Vol 66 (Suppl. 5) ◽  
pp. 7-14 ◽  
Author(s):  
Chantal Lau
Keyword(s):  
Health Care Professionals ◽  
Oral Feeding ◽  
Assessment Tools ◽  
Therapeutic Interventions ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Functional Maturation ◽  
Nutritive Sucking ◽  
Integrative Level ◽  
Definition Of

Preterm infants' hospital discharge is often delayed due to their inability to feed by mouth safely and competently. No evidence-based supported guidelines are currently available for health-care professionals caring for these infants. Available interventions advocating benefits are not readily acknowledged for lack of rigorous documentation inasmuch as any improvements may ensue from infants' normal maturation. Through research, a growing understanding of the development of nutritive sucking skills has emerged, shedding light on how and why infants may encounter oral feeding difficulties due to the immaturity of specific physiologic functions. Unfortunately, this knowledge has yet to be translated to the clinical practice to improve the diagnoses of oral feeding problems through the development of relevant assessment tools and to enhance infants' oral feeding skills through the development of efficacious preventive and therapeutic interventions. This review focuses on the maturation of the various physiologic functions implicated in the transport of a bolus from the oral cavity to the stomach. Although infants' readiness for oral feeding is deemed attained when suck, swallow, and respiration are coordinated, we do not have a clear definition of what coordination implies. We have learned that each of these functions encompasses a number of elements that mature at different times and rates. Consequently, it would appear that the proper functioning of sucking, the swallow processing, and respiration need to occur at two levels: first, the elements within each function must reach an appropriate functional maturation that can work in synchrony with each other to generate an appropriate suck, swallow process, and respiration; and second, the elements of all these distinct functions, in turn, must be able to do the same at an integrative level to ensure the safe and efficient transport of a bolus from the mouth to the stomach.

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