Direct swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial. Issue 2 (19th July 2021)

• Record Type: Journal Article
• Authors: Heo, Ju Sun; Kim, Ee-Kyung; Kim, Sae Yun; Song, In Gyu; Yoon, Young Mi; Cho, Hannah; Lee, Eun Sun; Shin, Seung Han; Oh, Byung-Mo; Shin, Hyung-Ik; Kim, Han-Suk
• Is Part Of: Archives of disease in childhood. Volume 107:Issue 2(2022)
• Page Start: 166
• Page End: 173
• Publication Date: 2021-07-19
• Subjects: neonatology -- rehabilitation; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2021-321945
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: To evaluate the effects of direct swallowing training (DST) alone and combined with oral sensorimotor stimulation (OSMS) on oral feeding ability in very preterm infants. Design: Blinded, parallel group, randomised controlled trial (1:1:1). Setting: Neonatal intensive care unit of a South Korean tertiary hospital. Participants: Preterm infants born at <32 weeks of gestation who achieved full tube feeding. Interventions: Two sessions per day were provided according to the randomly assigned groups (control: two times per day sham intervention; DST: DST and sham interventions, each once a day; DST+OSMS: DST and OSMS interventions, each once a day). Primary outcome: Time from start to independent oral feeding (IOF). Results: Analyses were conducted in 186 participants based on modified intention-to-treat (63 control; 63 DST; 60 DST+OSMS). The mean time from start to IOF differed significantly between the control, DST and DST+OSMS groups (21.1, 17.2 and 14.8 days, respectively, p=0.02). Compared with non-intervention, DST+OSMS significantly shortened the time from start to IOF (effect size: −0.49; 95% CI: −0.86 to –0.14; p=0.02), whereas DST did not. The proportion of feeding volume taken during the initial 5 min, an index of infants' actual feeding ability when fatigue is minimal, increased earlier in the DST+OSMS than in the DST. Conclusions: In very preterm infants, DST+OSMS led to the accelerated attainment of IOF compared with non-intervention, whereas DST alone did not. The effect of DST+OSMS on oral feeding ability appeared earlier than that of DST alone. Trial registration number: ClinicalTrials.gov Registry (NCT02508571 ). Abstract : This single centre, masked RCT enrolling 186 infants <32 weeks gestation found that direct swallowing training combined with oral sensorimotor stimulation significantly shortened the time to independent oral feeding compared with no intervention.