No abstract

This study assessed the effect of an oral stimulation program on the maturation of sucking skills of preterm infants. Thirty‐two preterm infants (13 males, 19 females), appropriate size for gestational age (gestational age at birth 28 wks, SD 1.2wks; birth weight 1002g, SD 251g), were randomly placed into experimental and control groups. The experimental group received a daily 15‐minute oral stimulation program, consisting of stroking the peri‐ and intra‐oral structures, for 10 days before the start of oral feedings. Sucking measures were monitored with a specially‐designed nipple‐bottle apparatus. Results indicate that the experimental group achieved full oral feedings 7 days sooner than the control group, and demonstrated greater overall intake (%), rate of milk transfer (mL/min), and amplitude of the expression component of sucking (mmHg). There was no difference in sucking stage maturation, sucking frequency, and amplitude of the suction component of sucking. Endurance, defined as ability to sustain the same sucking stage, sucking burst duration, and suction and expression amplitudes throughout a feeding session, was not significantly different between the two groups. The stimulation program enhanced the expression component of sucking, resulting in better oral feeding performance.

Aim The aim of this study was to determine whether oral, tactile/kinaesthetic (T/K), or combined (oral + T/K) interventions enhance oral feeding performance and whether combined (oral + T/K) interventions have an additive/synergistic effect. Method Seventy-five preterm infants (mean gestational age 29wk; standard error of the mean [SEM] 0.3wk; mean birthweight 1340.3g; SEM 52.5g; 49 males and 26 females) were randomly assigned to one of three intervention groups or a control group. The oral group received sensorimotor input to the oral structures, the T/K group received sensorimotor input to the trunk and limbs, and the combined (oral + T/K) group received both. The outcomes were time from introduction of nipple feeding to independent oral feeding (days), proficiency (intake in the first 5min, %), volume transfer (%), rate of transfer (ml/min), volume loss (%), and length of hospital stay (days). Results Infants in the three intervention groups achieved independent oral feeding 9 to 10 days earlier than those in the control group (p<0.001; effect size 1.9–2.1). Proficiency (p≤0.002; effect size 0.7–1.4) at the time of one to two and three to five oral feedings per day, volume transfer (p≤0.001; effect size 0.8–1.1) at one to two, three to five, and six to eight oral feedings per day, and overall rate of transfer (p≤0.018; effect size 0.8–1.1) were greater, and overall volume losses were less (p≤0.007; effect size 0.9–1.1), than in the control group (p≤0.042). The combined (oral + T/K) group attained independent oral feeding at a significantly younger postmenstrual age than controls (p=0.020) and had clinically greater proficiency than the T/K group (p=0.020; effect size 0.7) and oral group (p=0.109; effect size 0.5). Length of hospital stay was not significantly different between groups (p=0.792; effect size 0.02–0.3). Interpretation Oral and T/K interventions accelerated the transition from introduction to independent oral feeding and enhanced oral feeding skills. T/K has beneficial effects beyond the specific targeted system. The combined sensorimotor intervention led to an additive/synergistic effect for proficiency, further benefiting this population.

Background Preterm infants are at high risk of encountering oral feeding difficulties. Early sensorimotor interventions may improve oral feeding skills in preterm infants. Aim To further explore the effects of an oral (O), tactile/kinesthetic (T/K), and combined (O+T/K) sensorimotor intervention on preterm infants’ nutritive sucking, swallowing and their coordination with respiration. Study design Seventy-five infants (29 [0.3, standard error of mean, SEM] weeks gestation, 49 males/26 females) were randomly assigned to an O group involving sensorimotor input to the oral structures; a T/K group involving sensorimotor input to the trunk and limbs; a combined (O+T/K) group; and a control group. Outcome measures Stage of sucking, suction and expression amplitudes (mmHg), suck-swallow ratio, stability of suck-swallow interval, and swallow-respiration patterns. Results The O group had significantly more advanced sucking stages, and greater suction and expression amplitudes than controls [p≤0.035, effect size (ES) >0.6]. The suck-swallow ratio and stability of suck-swallow intervals did not significantly differ among groups (p≥0.181, ES≤0.3). The three interventions led to fewer swallows bracketed by prolonged respiratory pauses compared to controls (pause-swallow-pause, p≤0.044, ES≥0.7). The T/K and combined (O+T/K) groups had greater occurrence of swallows bracketed by expiration than the control and O groups (expiration-swallow-expiration, p≤0.039, ES ≥0.3) Conclusion The O intervention enhanced specific components of nutritive sucking. All three interventions resulted in improved swallow-respiration coordination. Sensorimotor interventions have distributed beneficial effects that go beyond the specific target of input.

This study assessed the effect of an oral stimulation program on the maturation of sucking skills of preterm infants. Thirty-two preterm infants (13 males, 19 females), appropriate size for gestational age (gestational age at birth 28 wks, SD 1.2wks; birthweight 1002g, SD 251g), were randomly placed into experimental and control groups. The experimental group received a daily 15-minute oral stimulation program, consisting of stroking the peri- and intra-oral structures, for 10 days before the start of oral feedings. Sucking measures were monitored with a specially-designed nipple-bottle apparatus. Results indicate that the experimental group achieved full oral feedings 7 days sooner than the control group, and demonstrated greater overall intake (%), rate of milk transfer (mL/min), and amplitude of the expression component of sucking (mmHg). There was no difference in sucking stage maturation, sucking frequency, and amplitude of the suction component of sucking. Endurance, defined as ability to sustain the same sucking stage, sucking burst duration, and suction and expression amplitudes throughout a feeding session, was not significantly different between the two groups. The stimulation program enhanced the expression component of sucking, resulting in better oral feeding performance.