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Published on: February 5, 2019
[Effectiveness of 2 interventions for independent oral feeding in pre-terms]
María Fernanda Hernández Gutiérrez1, N Marta Díaz-Gómez2, Alejandro Jiménez Sosa3
1Servicio de Rehabilitación y Fisioterapia, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España.
Insights
A combined tactile, kinesthetic, and oral stimulation program significantly speeds up independent oral feeding in preterm newborns. This approach is more effective than oral stimulation alone for improving feeding outcomes.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Clinical Nutrition
Context:
- Preterm newborns (PTNB) often experience feeding difficulties due to immaturity and illness.
- These challenges can lead to extended hospital stays.
- Effective feeding strategies are crucial for PTNB development and discharge planning.
Purpose:
- To evaluate the efficacy of a combined tactile, kinesthetic, and oral stimulation (T+K+OS) program.
- To compare T+K+OS with an exclusively oral stimulation (OS) program.
- To determine the impact on time to achieve independent oral feeding and hospital discharge.
Summary:
- A randomized clinical study involved 42 PTNB (27-32 weeks gestation, >900g birth weight) in two groups: OS and T+K+OS.
- The T+K+OS group achieved independent oral feeding significantly earlier (24.9 days) than the OS group (34.1 days) (P=.02).
- While the T+K+OS group showed earlier hospital discharge, the difference was not statistically significant (P=.21).
Impact:
- Combined T+K+OS therapy demonstrates superior effectiveness in establishing independent oral feeding in PTNB compared to OS alone.
- This finding supports the integration of multi-sensory stimulation in neonatal feeding protocols.
- Optimizing feeding in PTNB can potentially reduce hospital length of stay and improve developmental trajectories.
Introduction:
Oral feeding of pre-term newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T+K+OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge.
Patients And Methods:
A clinical study of 2 randomized groups (OS vs. T+K+OS) was carried out on 42 PTNB with gestational age between 27-32 weeks and birth weight>900g. The stimulation programs were carried out in sessions of 15min, for 10 days.
Results:
The PTNBs in the T+K+OS group achieved independent oral feeding earlier, compared to the OS group (24.9±10.1 vs. 34.1±15.6 days, P=.02). An analysis of covariance was performed, which confirmed that the birth weight and gestational age covariates had significant effects on time to reach suction feeding (birth weight: F[1, 38]=5.79; P=.021; gestational age: F[1, 38]=14.12; P=.001) and that once its effect was controlled, the intervention continued to have a significant effect (F[1, 38]=6.07; P=.018). The T+K+OS group, compared to the OS group, achieved an earlier hospital discharge (39±15 vs. 45±18 days), although the differences were not significant (P=.21).
Conclusions:
Combined therapies that include T+K+OS are more effective than OS alone, in order to achieve independent oral feeding in PTNBs.
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