Comparative study on the effect of oral motor intervention protocols on oral motor skills of preterm infants from tertiary care hospital in metropolitan city: pilot study

Abstract

Background: Premature infants often have feeding difficulties leading to morbidity or developmental co-morbidities. Premature infant oral motor intervention (PIOMI), has shown the positive effects on feeding progression of the premature infants. PIOMI with the massage technique, may help in improving oral motor activity, weight gain in preterm infants along with better neurobehavioral organization. The study was done to analyse effect of this combined protocol on achieving oral motor control and Neurobehavioral state regulation and evaluate its efficacy against PIOMI.Methods: A total 72 clinically stable infants admitted in premature care unit, fulfilling inclusion criterion were enrolled. They were allocated in control and experimental group. Infants from control group received PIOMI and experimental group received PIOMI with massage therapy (M technique), for 10 minutes each day. Data was collected for oral motor abilities, behavioural assessment, weight and day of achieving full feeds.Results: Gestational age at full feeds was 33.65 weeks and 32.89 weeks in control and experimental groups respectively with ‘p’ value 0.002. The number of days of full feed in experimental group was 3.7 days earlier (p=0.04). Infants from experimental group showed higher oral motor score and more weight gain with significant difference The behavioral regulation in infants of both the groups improved after 8 day.Conclusions: PIOMI with M technique was well tolerated by preterm infants. The modified protocol has resulted in achieving early oral feeds and reducing hospital stay. It has also shown the benefit of behavioural regulation along with better oral motor control.

Effect of premature infant oral motor intervention(PIOMI) combined with music therapy on feeding progression of premature infants: a randomized control trial

“…Jaywant & Kale (2020) found that adding infant massage to PIOMI decreased time to full oral feedings compared to PIOMI alone (24,25). Chailangka et al (2018) and Le et al (2021) found that adding expressed breastmilk to the NNS step of PIOMI resulted in higher feeding e ciency than PIOMI alone (23).…”

“…Because the premature infants have little control on oral movement, which is associated with lower muscle tone around the mouth, less sensation, and lower tongue strength, PIOMI was selected as oral stimulation in this study because it designed speci cally for premature infants and has demonstrated overwhelming evidence of effectiveness (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

Effect of the Premature Infant Oral Motor Intervention on Sucking Capacity in Preterm Infants in Turkey

“…7,12,24,[27][28][29][30][31][32][33][34][35][36][37][38] which often results in decreased LOS. Other RCTs have shown PIOMI's positive effect on NNS scores, 37 behavioral state, 30 and higher scores on the Infant Neurological International Battery (INFANIB) even sustained at 3 and 6 months after discharge. 26 However, there are no studies that have quantitatively tested PIOMI specifically on sucking capacity using pressure manometry.…”

“…26 However, there are no studies that have quantitatively tested PIOMI specifically on sucking capacity using pressure manometry. In addition, although most oral motor studies include the outcome of weight, results vary with some studies demonstrating increased weight gain with PIOMI 28,30,33 while others have not shown this effect. 26,38 No studies were found that measured PIOMI's effect on head circumference.…”

“…[18][19][20] Nonnutritive sucking alone and combined with oral stimulation has been found to mature the oral motor-sensory system and improve not only bottle feeding but also breast/chest feeding. 21 Many RCTs have shown PIOMI to improve oral feeding outcomes such as readiness to feed, [22][23][24][25][26][27][28] oral motor function, 24,[28][29][30][31] breast/chest feeding, 31,32 and a faster transition to full oral feeding. 7,12,24,[27][28][29][30][31][32][33][34][35][36][37][38] which often results in decreased LOS.…”