Parent-Administered Oral Stimulation in Preterm Infants: A Randomized, Controlled, Open-Label Pilot Study

Reducing the Duration to Reach Full Enteral and Oral Feeding Volumes for Very Preterm and Extremely Preterm Infants: A Quality Improvement Project

BACKGROUND

Enteral and oral feeding are crucial for infants with a gestational age <32 weeks during hospitalization, with potential for improved outcomes through optimized feeding practices.

PURPOSE

To shorten the time to achieve full enteral and oral feeding volumes in infants with a gestational age <32 weeks.

METHODS

This pre-post-intervention study focused on patients with a gestational age <32 weeks in Shenzhen City, 44 bed NICU. Quality improvement interventions included workflow enhancements, breastfeeding education, and oral motor strategies. Analysis of feeding times and hospital stays was conducted using SPSS software, alongside a provider survey to project feasibility.

RESULTS

Statistical significant improvements were seen in full enteral feeding time for infants under 28 weeks gestation and full oral feeding time for those between 28 and 30 weeks. Length of stay did not show significant differences between period. Providers unanimously found the intervention feasible and acceptable.

IMPLICATIONS

Quality improvement interventions can expedite achievement of full feeding volumes in preterm infants, with potential for enhanced feeding outcomes.

Effect of premature infant oral motor intervention [PIOMI] combined with music therapy on feeding progression of preterm infants: a randomized control trial

Prematurity may produce long-term complications in the physical and cognitive development of infants. There is a need for interventions that can improve feeding and reduce the length of NICU stay and separation time between the infant and mother. This study aimed to explore the clinical effect of premature infant oral motor intervention [PIOMI] combined with music therapy [MT] on feeding progression in premature infants.Premature infants with gestational ages between 26 and 30 weeks were included in the study. Fifty-two participants were randomly divided into intervention and control groups. All infants received PIOMI, and the intervention group received additional MT. The participants of the two groups were compared based on weight gain, feeding progression, Preterm Oral Feeding Readiness Scale [POFRAS], milk volume, and length of hospitalization. The data were analyzed using independent sample t-tests, covariance tests, and repeated measure ANOVA used to compare three group means.The intervention group reached independent oral feeding 8 days earlier [P = .018] than the control group. Length of hospitalization was 6 days shorter [P = .224] for the intervention group, and the mean volume of milk on the 10th day was 215.38 ± 56.4 in the intervention group and 155.69 ± 68.9 in the control group, respectively [P = .001]. The mean score of the POFRAS scale on the 10th day was 28.65 ± 3.0 in the intervention groups and 20.96 ± 3.3 in the control groups, retrospectively [P = .001]. There was no difference in weight gain between the two groups [P = .522].Conclusion: PIOMI combined with MT was effective for the feeding progression of premature infants, and infants who received both these interventions were discharged sooner than control infants. Thus, MT should be considered part of feeding interventions for preterm infants with gestational ages between 26 and 30 weeks.Trial registration: Clinical trial registration number: IRCT20210502051155N1 on 18/9/2021 What is Known -- What is New: • There is numerous study about the eff ect of music therapy or oral motor interventi on. However, premature Infants havenot been yet studied to determine whether music therapy and oral motor interventi ons may synergize to aid their feedingprogression.

Pre-feeding premature infant oral motor intervention (PIOMI) for transition from gavage to oral feeding: A randomised controlled trial

PURPOSE

To assess the performance of premature infant oral motor intervention for transition from gavage to full spoon feeding in preterm infants.

METHODS

Preterm neonates born between 28 + 0-32 + 6 weeks gestation (n = 32) were randomised into an intervention group (premature infant oral motor intervention) for five minutes twice a day along with routine care (n = 16) and a control group (routine care, n = 16) once they reached a feed volume of at least 150 ml/kg/day administered by gavage method. The primary outcome measure was time (in days) to transition from gavage to full spoon feeds.

RESULTS

The mean (SD) time to transition from gavage to full spoon feeds was attained significantly earlier in the intervention group than the control group (9.93 [5.83] vs 16.43 [10.46] days; mean difference, -6.5 days; 95% CI, -12.58 to -0.41). There was no significant difference between the two groups in terms of the duration of hospital stay, rates of physiological stability, and culture positive sepsis.

CONCLUSION

Premature infant oral motor intervention, as used in this specific population, significantly reduces the time to transition to full spoon feeds without increasing culture positive sepsis and physiological instability.