| Background Medical technology advances have greatly increased survival rates of infants born preterm. Yet, approximately90%of them need to be admitted in a neonatal intensive care unit (NICU) because of a variety of medical and developmental complications. Oral feeding difficulty is one of the most common care issues. Oral feeding problems have significant negative consequences for children’s growth and development as well as their family’s well-being. Currently there are several strategies to facilitate oral feeding, NNS has been studied in domestic but limited to the biochemical index,the foreign researchers have investigated the effectiveness of oral stimulation and the combination of NNS and oral stimulation, However, to our knowledge until now the combined use of NNS and OS has never been compared with either of these modalities alone. Therefore, the objective of the present study is to compare and to evaluate the efficacy of NNS and OS, either applied alone or in combination, to improve the oral feeding in the preterm infants.Objective To introduce a oral motor intervention and compare the effectiveness of different interventions on the oral feeding progression, oral feeding performances, weight gain and length of hospital stay in the preterm infants.Method Preterm infants (n=122) born between29and34weeks gestational age were randomly assigned to one of three intervention groups (NNS n=28; OS n=29; NNS+OS n=33) or a control group (n=32). The NNS group received non-nutritive sucking by a pacifier, the OS group received stroking of the oral structure, and the combined group received both. The control group received standard care without oral motor interventions. The outcomes were time from introduction of nipple feeding to independent oral feeding (in days), rate of milk transfer (ml/min), proficiency (intake in the first5minutes,%), volume transfer (%), and length of hospital stay (in days).Results①Transition time was significantly reduced in the three intervention groups compared to the control group (p<0.05);②There was no significant difference in the postmenstrual age(PMA) and days of life between the four groups at the stage when the infants initiated the oral feeding, while the NNS group and the NNS+OS group had lower PMA and days of life compared to the control group when the infants reached to the independent oral feeding (p<0.05);③More preterm infants in the OS group and NNS+OS group had reached to the independent oral feeding at10days after the initiation of oral feeding when compared to the control group (p<0.05) while there was no difference between the NNS group and the control group (P>0.05);④There was no difference in the postmenstrual age distribution among the four groups (P>0.05);⑤The milk transfer rate in the three intervention groups was significantly greater than that in the control group (p<0.05), Proficiency and volume transfer in the NNS+OS group was greater than in the control group at the stage when the infants initiated the oral feeding(p<0.05);⑥There was a significant increase in the rate of transfer, proficiency, volume transfer noted over time in the every study group(p<0.05);⑦here were no significant differences in the days reached to the birth weight,the discharge weight and the average weight gain between the four groups (P>0.05),there were no difference in the weight when the infants at the stage of initiation of oral feeding between the four groups (P>0.05),while the OS group and the NNS+OS group had lower weight when they reached to the independent oral feeding compared to the control group(p<0.05);⑧length of hospital stay did not significantly differ among the four groups (P>0.05)Conclusion Non-nutritive sucking and oral stimulation reduced the transition time from introduction to independent oral feeding and the combined intervention have an additive beneficial effect on proficiency and volume transfer,oral motor intervention is beneficial to the oral feeding in preterm infants. |
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