Effect of the Premature Infant Oral Motor Intervention on Sucking Capacity in Preterm Infants in Turkey

Abstract

Background: Preterm infants have oral feeding difficulty that often delays discharge, indicating a need for evidence-based interventions for oral–motor development. Purpose: To test the Premature Infant Oral Motor Intervention (PIOMI) on the development of oral–motor function, feeding, and anthropometric outcomes using sucking manometry. Methods: A single-blind randomized experimental design was conducted with a sample of 60 preterm infants from 2 neonatal intensive care units between May 2019 and March 2020. The experimental group received PIOMI for 5 min/d for 14 consecutive days. Sucking capacity, anthropometrics (weight and head circumference), bottle feeding, breast/chest feeding initiation, and length of hospital stay were measured. The Yakut Sucking Manometer (PCT/TR2019/050678) was developed specifically for this study and tested for the first time. Results: The experimental group had a statistically significant percent increase over controls in sucking power (69%), continuous sucking before releasing the bottle (16%), sucking time (13%), and sucking amount (12%) with partial η2 values of interaction between the groups of 0.692, 0.164, 0.136, and 0.121, respectively. The experimental group had a higher increase in weight (89%) and head circumference (81%) over controls (F = 485.130, P < .001; F = 254.754, P < .001, respectively). The experimental group transitioned to oral feeding 9.9 days earlier than controls (t = −2.822; P = .007), started breast/chest feeding 10.8 days earlier (t = 3.016; P = .004), and were discharged 3.0 days earlier. Implications for Research/Practice: The PIOMI had a significant positive effect on anthropometrics, sucking capacity, readiness to initiate bottle and breast/chest feeding, and a 3-day reduction in length of hospital stay.

Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates

“…Similarly, Arora et al ( 5 ) reported that neonates receiving PIOMI could be discharged earlier as compared to sham intervention (P > 0.05). Some of the other studies have observed a statistically significant reduction in the duration of stay with PIOMI, however, the control groups in these studies had not received any form of oral motor stimulation ( 4 , 6 , 8 , 12 , 14 – 16 ).…”

“…Similarly, Arora et al (5) reported that neonates receiving PIOMI could be discharged earlier as compared to sham intervention (P > 0.05). Some of the other studies have observed a statistically significant reduction in the duration of stay with PIOMI, however, the control groups in these studies had not received any form of oral motor stimulation (4,6,8,12,(14)(15)(16)). Although the difference between the groups for oral feeding readiness, full oral feeding, and duration of hospitalisation was not statistically significant, each day saved in terms of clinical management has a significant implication on the expenditure for the affected family and the healthcare system.…”

Effects of Complete Oral Motor Intervention and Nonnutritive Sucking Alone on the Feeding Performance of Premature Infants: A Systematic Review and Meta-Analysis

“…Third, outcome measures and indices varied across the included studies; therefore, we could only compare the OMI and NNS groups in terms of transition time, hospitalization duration, and weight gain. We did not assess other relevant outcomes, such as the Preterm Oral Feeding Readiness Assessment Scale scores [19,23], sucking power [22], or volume and rate of milk intake [19,22,23]. Finally, the included studies tended to exclude preterm newborns with complications or respiratory, cardiovascular, neurological, and digestive disorders; however, these newborns constitute an important proportion of preterm infants with pediatric feeding disorders.…”

“…Two studies reported that episodes of apnea, bradycardia, or oxygen desaturation during the oral feeding session were recorded. However, there is no specific mention of the frequency of these complications or if there was any significant difference between the intervention and control groups regarding these episodes [22,25]. One study did not specifically mention complications such as apnea, desaturation, or aspiration within this document [20].…”

“…We identified 451 articles in the initial search; of these, 8 RCTs met our inclusion criteria (Figure 1) [18][19][20][21][22][23][24][25]. Table 1 presents the characteristics of these 8 RCTs.…”