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Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants: An
Latisha Rhooms1, Kimberly Dow, Cara Brandon
1Department of Paediatrics (Drs Dow and Fucile) and School of Rehabilitation Therapy, (Mss Rhooms, Brandon, and Zhao and Dr Fucile), Queen's University, Kingston, Ontario, Canada.
Insights
Sensorimotor interventions for preterm infants
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation
Background:
- Preterm infants struggle with transitioning from tube to oral feeding.
- Existing sensorimotor interventions lack standardization and cohesion.
- Optimizing oral feeding is crucial for preterm infant development.
Purpose of the Study:
- To evaluate sensorimotor interventions for preterm infant oral feeding.
- To compare the efficacy of unimodal versus multimodal interventions.
- To identify best practices for improving feeding outcomes.
Main Methods:
- Systematic review of CINAHL, Embase, MEDLINE, and PsycINFO.
- Analysis of 35 studies on sensorimotor interventions.
- Assessment of interventions for oral feeding transition, intake, weight gain, and hospital stay.
Main Results:
- Twenty-six studies used unimodal interventions (primarily oral sensorimotor input).
- Nine studies employed multimodal interventions (e.g., tactile and kinesthetic stimulation).
- Heterogeneity in study methodologies limits firm conclusions on intervention effectiveness.
Conclusions:
- Sensorimotor intervention effectiveness in preterm infants varies significantly.
- Current evidence is insufficient to determine if multimodal approaches outperform unimodal ones.
- Further large-scale, standardized randomized clinical trials are needed.
Background:
Preterm infants often experience difficulty with the transition from tube to oral feeding. While many unimodal and multimodal sensorimotor interventions have been generated to optimize oral feeding skills, there has been little cohesion between interventions.
Purpose:
The aims of this systematic review were to examine the effect of sensorimotor interventions on oral feeding outcomes and to determine whether multimodal interventions lead to better oral feeding performances than unimodal interventions.
Search Strategy:
A systematic search of CINAHL, Embase, MEDLINE, and PsycINFO databases was conducted. Studies were reviewed to assess the types of interventions used to improve transition to full oral feeding, volume intake, weight gain, and length of hospital stay.
Results:
The search identified 35 articles. Twenty-six studies examined a unimodal intervention, with the majority focusing on oral sensorimotor input and the others on tactile, auditory, and olfactory input. Nine studies assessed multimodal interventions, with the combination of tactile and kinesthetic stimulation being most common. Results varied across studies due to large differences in methodology, and caution is warranted when interpreting results across studies. The heterogeneity in the studies made it difficult to make any firm conclusions about the effects of sensorimotor interventions on feeding outcomes. Overall, evidence on whether multimodal approaches can lead to better oral feeding outcomes than a unimodal approach was insufficient.
Implications For Practice:
The use of sensorimotor interventions to optimize feeding outcomes in preterm infants varies based on methods used and modalities. These factors warrant caution by clinicians who use sensorimotor interventions in the neonatal intensive care unit.
Implications For Research:
Large randomized clinical trials using a standardized approach for the administration of sensorimotor input are needed to further establish the effects on feeding outcomes in preterm infants.
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