Oral and non‐oral sensorimotor interventions enhance oral feeding performance in preterm infants

Abstract

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.

Premature: growth and its relation to oral skills

“…The obtained results show the effectiveness of the intervention associated with lower time of hospital discharge (17) . The oral-sensorimotor stimulation has been approached in literature as a positive measure regarding the PTI development, improving the S/D/R coordination, fastening the transition from tube to oral feeding, decreasing hospitalization time, and favoring early weight gain and breast-feeding (18)(19)(20)(21) . The PTI classified as levels I, II, and III (low skill and/or low resistance) received the speech language pathology and audiology intervention, whether by oral-sensorimotor stimulation or by resistance training, in this study.…”

Estimulação sensoriomotora intra e extra-oral em neonatos prematuros: revisão bibliográfica

“…Fucile et al 30 developed an experimental study with 75 PTNB, based on speech intervention with stimulation techniques of OSS and body tactilekinesthetic stimulation. The OSS stimulation consisted in caress cheeks, lips, gums and tongue, while the tactile stimulation was developed by touching head, neck, arms and legs.…”

How does non-nutritive sucking support infant feeding?

“…There are many methods of administering NNS in the literature and these are often a prescribed programme of oral -motor and sensory exercises implemented by a health care professional which do not involve parents (Barlow, Finan & Lee, 2008;Boiron, Da Nobrega & Roux, 2007;Fucile, Gisel & McFarland, 2011;Hwang, Vergana & Lin, 2010;Pimenta, Moreira & Rocha, 2008;Rocha & Lopes Moreira, 2006;Gaebler & Hanzlik, 1996). The focus of this study is from a speech and language therapy and nursing perspective, and it recognises the benefits that NNS can have.…”

“…This approach fits well within the Developmental Care model of interpreting the infant's needs (Als, 1986). Some of the literature published about NNS suggests that it can hasten oral feeding skills, and also have benefits in overall oral-motor development (Barlow, Finan & Lee, 2008;Boiron, Da Nobrega & Roux, 2007;Fucile, Gisel & McFarland, 2011;Hwang, Vergana & Lin, 2010;Pimenta, Moreira & Rocha, 2008;Rocha & Lopes Moreira, 2006;Gaebler & Hanzlik, 1996). Indeed, Boiron, Da Nobrega & Roux (2007) state that "Non-nutritive sucking promotes the coordination of sucking and swallowing, accelerates the maturation of the sucking reflex….…”