Oral Motor Interventions Used to Support the Development of Oral Feeding Skills in Preterm Infants: An Integrative Review
Early Human Development
Ibrahim, C., Chavez, P., et al. (2024).
Early Human Development, 198, 106125.
<div>This systematic review explores the effects of oral motor treatments on oral feeding in preterm infants.</div>
Not stated
2002 to 2022
<div>Randomized controlled trials, quasi-experimental designs, crossover or single-group repeated measures studies</div>
40
<div>The Fucile protocol, a 15-minute oral motor intervention, was associated with decreased time to full oral feeding, increased weight gain, and reduced length of stay (LoS) in preterm infants when compared to no treatment controls.</div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
<div> </div>
<div>Use of the Premature Infant Oral Motor Intervention (PIOMI) protocol, an intervention that incorporates oral stimulation and nonnutritive sucking (NNS), was associated with decreased time to full oral feeding, reduced LoS, and improved quality of feeding in premature infants when compared to no treatment controls.</div>
<div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
</div>
<div>NNS led to mixed outcomes for premature infants when compared to controls, as follows:</div>
<div>
<ul>
<li><strong>NNS with a pacifier: </strong>Five studies demonstrated improved feeding efficiency (i.e., ingested volume per minute), improved time to full oral feeding, or reduced LoS. Three studies found no significant differences for these outcomes.</li>
<li><strong>NNS with an emptied breast: </strong>One study demonstrated higher rates of exclusive breastfeeding at hospital discharge, however no significant effects were seen for time to full oral feeding or hospital LoS. </li>
<li><strong>NNS with mother's finger: </strong>Three studies demonstrated improved time to full oral feeding and decreased LoS. </li>
</ul>
<div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
</div>
</div>
<div>Oral motor swallowing exercises with small volume boluses were associated with decreased time to full oral feeding, increased feeding performance, and increased feeding efficiency across two studies.</div>
<div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
</div>
<div>The Ntrainer, which is a pacifier that provides patterned oral somatosensory stimulation, was associated with reduced LoS, decreased time to full oral feeding, and increased daily percent of oral feeding compared to controls across four studies. </div>
<div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
</div>
<div>
<div>In one study, use of the Fucile protocol plus oral motor swallowing exercises was associated with reduced time to full oral feeding compared to controls.</div>
<div> </div>
<div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
</div>
</div>
<div>Compared to controls, NNS plus oral motor swallowing exercises was associated with an improvement in the number of children requiring tube feeding at discharge (one study). NNS plus swallowing exercises did not improve time to oral feeding, time to full oral feeding, LoS, or time from start of oral feed to time to full oral feeding when compared to NNS alone (one study). </div>
<div> </div>
<div>Limitations to this review include a reduced number of studies for each intervention investigated, heterogeneity in outcome measures, risk of bias, and a lack of investigation into potential adverse events. Additional research is indicated. </div>
