The oral motor capacity and feeding performance of preterm newborns at the time of transition to oral feeding

Abstract

The objective of the present study was to determine the oral motor capacity and the feeding performance of preterm newborn infants when they were permitted to start oral feeding. This was an observational and prospective study conducted on 43 preterm newborns admitted to the Neonatal Intensive Care Unit of UFSM, RS, Brazil. Exclusion criteria were the presence of head and neck malformations, genetic disease, neonatal asphyxia, intracranial hemorrhage, and kernicterus. When the infants were permitted to start oral feeding, non-nutritive sucking was evaluated by a speech therapist regarding force (strong vs weak), rhythm (rapid vs slow), presence of adaptive oral reflexes (searching, sucking and swallowing) and coordination between sucking, swallowing and respiration. Feeding performance was evaluated on the basis of competence (defined by rate of milk intake, mL/min) and overall transfer (percent ingested volume/total volume ordered). The speech therapist's evaluation showed that 33% of the newborns presented weak sucking, 23% slow rhythm, 30% absence of at least one adaptive oral reflex, and 14% with no coordination between sucking, swallowing and respiration. Mean feeding competence was greater in infants with strong sucking fast rhythm. The presence of sucking-swallowing-respiration coordination decreased the days for an overall transfer of 100%. Evaluation by a speech therapist proved to be a useful tool for the safe indication of the beginning of oral feeding for premature infants.

Desempenho da alimentação oral em recém-nascidos prematuros estimulados pela técnica treino de deglutição

“…Also, weight gain is one of the criteria adopted by neonatologists for the discharge of PTNB, and oral feeding may promote greater weight gain (14) . In the current study, the PTNB presented weight gain when comparing the evaluation and reevaluation phases, confirming findings from the literature and showing that stimulation does not negatively interfere in this parameter, until total OF is reached (14,20) . The term "oral feeding readiness" is best related to the ability of the PTNB to coordinate suctioning, swallowing and breathing, in a safe and efficient way (21) .…”

“…One study published results with a significant increase in OT and TR, within the SG and the CG, from the introduction of OF to the first successful OF (p≤0,03) (25) . Another study found an average feeding competence of 1.7 (±1.3) ml/min (20) . Oral feeding skills are measured by proficiency (PRO) and transfer rate (TR), which reflect, respectively, the minimum fatigue/ability to feed orally in the first five minutes of feeding and the resistance to OF of the prescribed volume.…”

“…In the present study, regarding the performance of oral feeding, the OT average was 27.7%; nine PTNBs presented TR ≥1.5 ml and seven obtained PRO ≥30%. Some studies have used similar parameters for OF performance evaluation (10,20,25,26,27) . One study published results with a significant increase in OT and TR, within the SG and the CG, from the introduction of OF to the first successful OF (p≤0,03) (25) .…”

Preterm newborn readiness for oral feeding: systematic review and meta-analysis

“…Most excluded articles did not evaluate the moment of transition to oral feeding or the NB participants in the researches had already received oral feeding. The final sample included 29 articles, with 12 articles published between 2003 and 2007 (10,20,21,23,(34)(35)(36)(37)(38)(39)(40)(41) and 17 published between 2008 and 2012 (8,22,(24)(25)(26)(27)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) .…”

“…Among the articles selected for screening, 41.2% (20)(21)(22)(23)(24)(25)27,(34)(35)(36)(37)(38)(39)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) of the ones from the MEDLINE research were included in the final analysis, 27.3% (10,26,42) from SciELO, and 18.7% (8,10,48) from LILACS. Of 29 publications, 86.2% were in English (20,21,(23)(24)(25)27,(34)(35)(36)(38)(39)(40)(41)(43)(44)(45)(46)(47)(48)(49)…”