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Effect of premature oral motor intervention (PIOMI) on oral feeding: A systematic review and meta-analysis
Mozhgan Asadi1, Golnoosh Golmohammadi2, Kowsar Baghban3
1Neuromuscular Rehabilitation Research Center, Research Institute of Neurosciences, Semnan University of Medical Sciences, Semnan, Iran.
Insights
Premature Infant Oral Motor Intervention (PIOMI) speeds up oral feeding in preterm infants and shortens hospital stays. Further research is needed to confirm long-term benefits and optimize PIOMI protocols.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Developmental pediatrics
Background:
- Preterm infants often experience feeding difficulties, impacting their growth and hospital stay.
- Oral motor interventions aim to improve feeding skills in vulnerable infants.
- Optimizing feeding is crucial for preterm infant development and reducing healthcare burdens.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of Premature Infant Oral Motor Intervention (PIOMI) on feeding outcomes in preterm infants.
- To assess PIOMI's impact on time to full oral feeding, hospital stay duration, and infant weight.
- To evaluate the certainty of evidence for PIOMI's effects.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Inclusion of 14 trials with 855 preterm infants.
- Primary outcome: transition time to full oral feeding; Secondary outcomes: hospital stay, weight, milk transfer rate, gavage duration.
Main Results:
- PIOMI significantly reduced time to full oral feeding by 3.91 days and shortened hospital stays.
- Moderate effects on weight at full oral feeding; inconsistent effects on discharge weight and milk transfer.
- Greater efficacy observed in infants with higher gestational age and intervention frequency.
Conclusions:
- PIOMI shows promise in enhancing feeding efficiency and reducing hospitalization for preterm infants.
- Moderate certainty of evidence for improved feeding transition time; low to very low for other outcomes.
- Further high-quality research is recommended to confirm long-term benefits and refine intervention protocols.
Purpose:
This systematic review and meta-analysis assessed effectiveness of Premature Infant Oral Motor Intervention in improving oral feeding outcomes in preterm infants.
Method:
A comprehensive search of electronic databases identified randomised controlled trials evaluating Premature Infant Oral Motor Intervention's impact on feeding-related outcomes. Fourteen randomised control trials involving 855 preterm infants were included. Primary outcome was transition time to full oral feeding. Secondary outcomes included hospital stay length, weight at full oral feeding and discharge, milk transfer rate, and gavage feeding duration. Meta-analysis used a fixed-effects model, and evidence certainty was evaluated via Grading of Recommendations, Assessment, Development and Evaluation framework.
Result:
Premature Infant Oral Motor Intervention significantly reduced transition time to full oral feeding (MD = -3.91 days; 95% CI:-4.19 to -3.62) and shortened hospital stay. Effects on weight at full oral feeding were moderate, while discharge weight and milk transfer rate showed inconsistent effects. Subgroup analyses demonstrated greater efficacy in infants with higher gestational age and intervention frequency. Sensitivity analyses confirmed robustness of findings with minimal publication bias. Evidence certainty was moderate for transition time to full oral feeding but low to very low for secondary outcomes due to heterogeneity and study limitations.
Conclusion:
Premature Infant Oral Motor Intervention may enhance feeding efficiency and reduce hospitalisation in preterm infants. Further high-quality research is needed to confirm long-term benefits and optimise protocols.
