Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation

Crowe, Linda; Chang, Anne M.; Wallace, Karen

doi:10.1002/14651858.cd005586.pub3

Cited by 39 publications

(22 citation statements)

References 59 publications

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“…A number of management plans, oral feeding skills assessment program and scales, efficacious tools, and interventions have been developed, but their awareness has not been widely recognized and adopted into practice ( 10 , 22 – 24 , 30 – 33 ). Insofar as not all the respondents in our survey used oral motor interventions, the development of a training program that incorporates the current available evidence-based techniques to NICU providers would further advance the care we can offer our high-risk infants in China.…”

Section: Discussionmentioning

confidence: 99%

Management of Oral Feeding Challenges in Neonatal Intensive Care Units (NICUs): A National Survey in China

Lyu

Zhang

et al. 2020

Front. Pediatr.

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Objectives: To investigate the current practices of oral feeding difficulties facing high-risk infants in Chinese NICUs. Methods: A questionnaire to survey infant oral feeding practices was distributed to 100 level II and III Chinese neonatal intensive care units (NICUs). Results: Responses were obtained from 88 NICUs. No Units had any structured guidelines regarding the management of infant oral feeding as they transitioned from tube to independent oral feeding. In 54 (61.4%) NICUs, nurses and physicians made shared decisions on when oral feeding were to be initiated. Fifty-four (61.4%) and 22 (25.0%) NICUs used postmenstrual age (PMA) or weight at PMA as a criterion for initiating oral feedings, respectively. The top three criteria to determine introduction of oral feeding were severity of disease, presence of sucking reflex, and trial feeding success. Adverse events were used by 78 Units as indices of oral feeding difficulty. Twenty (22.7%) and 25 (28.4%) Units had access to occupational therapists or nurses who provided oral motor interventions during feeding, i.e., oral support (chin and cheek support, aid to deglutition), non-nutritive sucking with pacifier, and oral stimulation. Conclusions: The management of oral feeding issues in NICUs vary widely in China in relation to the assessment of readiness to oral feeding, daily oral feeding practices and interventions used by staff. It is proposed that an educational program focused on the physiology of infant oral feeding, available evidence-based tools and interventions would assist NICU caregivers develop structured guidelines to improve infants' safe and efficient attainment of independent oral feeding.

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Section: Discussionmentioning

confidence: 99%

Management of Oral Feeding Challenges in Neonatal Intensive Care Units (NICUs): A National Survey in China

Lyu

Zhang

et al. 2020

Front. Pediatr.

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“…The proper identification of this moment provides the infants with better oral feeding experiences as they wean from tube feeding. Also, it leads to a reduction of the time for obtaining full oral feeding, contributing to a consequent decrease on time of hospitalization and on the financial costs related to it (22)(23)(24)(25) . Additionally, an adequate assessment can indicate the need of therapeutic conducts in order to achieve full oral feeding (12) .…”

Section: Discussionmentioning

confidence: 99%

Avaliação para o início da alimentação oral de recém-nascidos pré-termo

Bolzan

Berwig

Prade

et al. 2016

CoDAS

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RESUMO Objetivo avaliar a acurácia do Preterm Oral Feeding Readiness Scale - POFRAS para iniciar a alimentação oral de recém-nascidos pré-termo e verificar a concordância entre este instrumento e o instrumento de avaliação do Nível de Habilidade Oral. Métodos Foram avaliados 82 recém-nascidos pré-termo quanto à prontidão para o início da alimentação oral através do POFRAS e da avaliação do Nível de Habilidade Oral, durante a primeira alimentação oral. A acurácia do POFRAS foi estimada em relação à variável proficiência, por meio da Curva ROC (Receiver Operating Characteristic Curve). Para a análise da concordância entre os instrumentos, foi utilizado o coeficiente Kappa. Resultados A acurácia global do POFRAS foi de 71,29%. O ponto de corte 29 foi o que apresentou melhor equilíbrio entre sensibilidade e especificidade. O coeficiente Kappa mostrou fraca concordância entre os instrumentos na identificação dos RN aptos e inaptos a mamar por via oral (k=0.281). Conclusão a acurácia do POFRAS para o início da alimentação oral, estimada por meio da variável proficiência, foi semelhante à obtida com a técnica de translactação. Observou-se fraca concordância entre os instrumentos avaliados. Sugere-se, portanto, que estes instrumentos de avaliação sejam usados de forma complementar na prática clínica, uma vez que ambos apresentam aspectos importantes do comportamento alimentar do prematuro, que ao serem analisados conjuntamente permitirão orientar a conduta necessária para propiciar uma transição alimentar mais breve e eficaz para essa população.

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“…Mean gestational age at discharge (weeks) was 36.6±1.6 in GI and 36.8 ±1.6 in GII (p = 0.792), weight at discharge was 2418 ±461 in GI and 2442±519 in GII (p = 0.940). Median length of hospital stay (days) was 20 in GI and 32 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) in GII (p = 0.210), transition time to full oral feeding was 4 (3-11) in GI and 8 (7)(8)(9)(10)(11)(12)(13) in GII (p = 0.003). Full breastfeeding at discharge was 33 (89.2%) in GI and 34 (91.9%) in GII (p = 1.000), with no statistically significant between-group differences in corrected gestational age at baseline assessment-as shown above.…”

Section: Plos Onementioning

confidence: 99%

“…Achievement of oral feeding is one of the most challenging milestones for preterm infants [7]. Successful oral feeding while still in hospital leads to a rapid transition away from tube feedings; minimizes adverse events such as apnea, bradycardia, and desaturation; and can reduce long-term consequences such as food aversion [8].…”

Section: Introductionmentioning

confidence: 99%

Impact of a pre-feeding oral stimulation program on first feed attempt in preterm infants: Double-blind controlled clinical trial

et al. 2020

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Objective To evaluate the effect of an oral stimulation program in preterm on the performance in the first oral feeding, oral feeding skills and transition time from tube to total oral intake. Study designer Double-blind randomized clinical trial including very preterm newborns. Congenital malformations, intracranial hemorrhage grade III or IV, bronchopulmonary dysplasia, and necrotizing enterocolitis were excluded. Intervention group (GI) received an oral stimulation program of tactile extra-, peri-, and intraoral tactile manipulation once a day for 15 minutes, during a 10-day period. Control group (GII) received sham procedure with same duration of time. Feeding ability was assessed by a speech-language pathologist blinded to group assignment. The classification of infants' oral performance was determined by Oral Feeding Skills (OFS). Neonates were monitored until hospital discharge. Results Seventy-four (37 in each group) were randomized. Mean gestational ages and birth weights were 30±1.4 and 30±1.5 weeks, and 1,452±330g and 1,457±353g for intervention and control groups, respectively. Infants in the intervention group had significantly better rates than infants in the control group on: mean proficiency (PRO) (41.5%±18.3 vs. 19.9%±11.6 (p<0.001)), transfer rate (RT) (2.3 mL/min and 1.1 mL/min (p<0.001)) and overall transfer (OT) (57.2%±19.7 and 35.0%±15.7 (p<0.001)). Median transition time from tube to oral feeding was 4 (3-11) and 8 (7-13) days in intervention and control groups, respectively (p = 0.003). Intake of breast milk was found to reduce transition time from tube feeds to exclusive oral feeding (p<0.001, HR 1.01, 95%CI 1.005-1.019), but the impact of the study intervention remained significant (p = 0.007, HR 1.97, 95%CI 1.2-3.2).

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Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalisation

Cited by 39 publications

References 59 publications

Management of Oral Feeding Challenges in Neonatal Intensive Care Units (NICUs): A National Survey in China

Management of Oral Feeding Challenges in Neonatal Intensive Care Units (NICUs): A National Survey in China

Avaliação para o início da alimentação oral de recém-nascidos pré-termo

Impact of a pre-feeding oral stimulation program on first feed attempt in preterm infants: Double-blind controlled clinical trial

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