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Neonatal Therapy Interventions Supporting Oral Feeding Skills in Preterm Infants: A Systematic Review

Kaela Vetter1,2, Christian Fernandes1,3, Tiana T Nguyen1,4

  • 1Department of Occupational Therapy, Samuel Merritt University, Oakland, CA, USA.

Physical & Occupational Therapy in Pediatrics
|September 29, 2025
PubMed

Insights

Neonatal therapy interventions, including oral motor stimulation and sensory-based approaches, can improve oral feeding outcomes for preterm infants. Early and multi-domain interventions show the most promising results for faster full oral feeding.

Area of Science:

  • Neonatal care
  • Therapeutic interventions
  • Pediatric feeding disorders

Background:

  • Preterm infants in neonatal intensive care units (NICUs) often experience challenges with oral feeding.
  • Early and effective interventions are crucial for improving feeding outcomes and overall development in this vulnerable population.

Purpose of the Study:

  • To systematically review and synthesize the literature on neonatal therapy interventions.
  • To evaluate the impact of these interventions on oral feeding outcomes in preterm infants within the NICU setting.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, CINAHL, Web of Science, PEDro) for studies published between 2014 and 2023.
  • Included were clinical trials focusing on neonatal therapy interventions for preterm infants (<37 weeks gestation) and their effect on oral feeding.
  • Primary outcomes included time to full oral feeding and feeding quality; secondary outcomes were weight gain and length of stay.

Main Results:

  • Fourteen studies identified three intervention categories: oral motor stimulation, swallowing exercises, and sensory-based interventions.
  • Interventions, typically initiated between 27-33 weeks postmenstrual age, generally improved oral feeding, leading to faster full oral feeding and better feeding quality.
  • Multidomain interventions demonstrated superior outcomes compared to single-domain approaches, though results for length of stay and weight gain were variable.

Conclusions:

  • Neonatal therapy interventions can be initiated early in preterm infants to enhance oral feeding.
  • Multi-domain therapeutic approaches are particularly effective in improving oral feeding outcomes for preterm infants in the NICU.
Abstract

Keywords:
Feeding therapyoccupational therapyoral motor developmentphysical therapyspeech-language pathology

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