The Effect Of Oral Motor Stimulation And Nonnutritive Sucking To The Time Of Transition To Oral Nutrition In Preterm
Oral feeding difficulty is one of the problems that preterm infants frequently experience due to poorly developed oral musculature. Sucking and swallowing are present in early fetal life, but sucking-swallowing and swallowing-respiratory coordination are respectively occurs after the 32 and 33-34 gestational week (GA). For this reason, although there are sucking movements in preterm babies with gestational weeks of 31 and below, oral feeding is difficult because adequate coordination cannot be achieved during sucking-swallowing and breathing. Until these structures develop, preterm babies are fed by gavage (nasogastric/orogastric route) in intensive care units. Gavage feeding causes many negativities such as preventing the advantages of oral nutrition and creating an entry route for infectious agents, and the discharge is also delayed. Thus, infants are exposed to adverse intensive care conditions for a longer period of time. For this reason, it is important to ensure the transition to full oral nutrition as soon as possible.
There are various methods that facilitate the transition of infants to oral feeding. Pacifier and oral stimulation applications are some of them. Oral stimulation was first applied by Fucile et al (2002). It is a method consisting of a total of 15 minutes, in which therapeutic touches are made for 12 minutes before feeding, and in the last few minutes, non-nutritive sucking is applied. Later, Lessen thought that this intervention was longer than the fragile preterm babies with a small oral cavity and shortened the duration of the intervention and reformatted it. This intervention, called "Premature Infant Oral Motor Intervention (PIOMI)" (Preterm Infant Oral Motor Intervention), is a 5-minute application consisting of 3 minutes of massage and 2 minutes of non-nutritive sucking. In the literature review, a study comparing oral motor stimulation and pacifier method was reached. However, in this study, unlike our study, a pacifier was applied to one of the groups, a 12-minute stimulation to the second, and a 12-minute stimulation and pacifier to the third. In our study, there are 3 groups. one of the groups a pacifier will be applied to one group and a 5-minute oral stimulation program will be applied to the other group. The third group is the control group.
The aim of the study is to evaluate the effect of pacifier and oral stimulation applied to preterm infants on the transition time to oral feeding.
Study Overview
Status
Intervention / Treatment
Detailed Description
The infant hospitalized in the intensive care unit will be evaluated primarily in terms of inclusion criteria in the sample group. The baby meeting the criteria will be evaluated by the neonatologist physician and, if appropriate, interviewed with the parents. Parents will be informed about the study and their written consent will be obtained. The group that the baby will be included in will be determined by the randomization method.
"Preterm Baby Information Form" created by the researcher will fill to all infants in the before the intervention. Then, body weight, height and head circumference will be measured and recorded in order to fill in the 1st day anthropometric measurements information in the Preterm baby follow-up form. Then, "Early Nutrition Skills Assessment Tool (EFS-Turkish)" will be applied to evaluate pre-intervention nutrition skills. Then, intervention will be started. Infants in the PIOMI group will receive a 5-minute PIOMI 30 minutes before feeding time. Infants in the non-nutritive sucking group will receive pacifier 3 minutes before 1 hour any feeding time and, 2 minutes before 10 minutes. PIOMI and non-nutritive sucking will be applied once daily for 14 days. only feeding follow-up will be done in the infants in the control group.
"Early Feeding Skills Assessment Tool (EFS-Turkish)" will be re-administered to all babies at the end of the fourteenth day. Nutritional follow-up will be done until the babies are discharged.
In nutritional follow-up will be evaluated time to transition to full oral feeding and how many cc it takes per minute.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Eskisehir, Turkey
- Eskisehir Osmangazi University
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- gestational age of 29-34 weeks
- Vital signs in balance for at least 24 hours,
- 1st and 5th minute APGAR score of 4 and above,
- postnatal 2-5 days
- Babies with written and verbal consent from their parents
Exclusion Criteria:
- Congenital anomaly
- Necrotizing enterocolitis
- Intraventricular Bleeding
- Babies receiving respiratory support other than high-flow nasal cannula
- Babies who developed any complications during the follow-up period after being included in the study group and whose balance status deteriorated
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: PIOMI group
Infants in the PIOMI group will receive a 5-minute PIOMI 30 minutes before feeding time.
PIOMI will be applied once daily for 14 days.
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PIOMI group; The first three minutes of the five minutes include massages aimed at strengthening the cheeks, lips, gums and tongue; the last two minutes consist of non-feeding suction application. Infants in the Non-nutritive sucking group will receive pacifier 3 minutes before 1 hour any feeding time and, 2 minutes before 10 minutes. |
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Experimental: Non-nutritive sucking group
Infants in the non-nutritive sucking group will receive pacifier 3 minutes before 1 hour any feeding time and, 2 minutes before 10 minutes.
Non-nutritive sucking will be applied once daily for 14 days.
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PIOMI group; The first three minutes of the five minutes include massages aimed at strengthening the cheeks, lips, gums and tongue; the last two minutes consist of non-feeding suction application. Infants in the Non-nutritive sucking group will receive pacifier 3 minutes before 1 hour any feeding time and, 2 minutes before 10 minutes. |
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No Intervention: control group
only feeding follow-up will be done in the infants in the control group.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Early Nutrition Skills Assessment Tool (The Early Feeding Skills (EFS) Assessment-Turkish)
Time Frame: first day
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It will be used to assess infants' oral feeding skills and readiness during the transition to oral feeding.
Infants will be evaluated on the 1st and 14th days using this scale.A low score indicates that she has no nutritional skills, while a high score indicates that she has nutritional skills.
|
first day
|
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Early Nutrition Skills Assessment Tool (The Early Feeding Skills (EFS) Assessment-Turkish)
Time Frame: 14th day
|
It will be used to assess infants' oral feeding skills and readiness during the transition to oral feeding.
Infants will be evaluated on the 1st and 14th days using this scale.A low score indicates that she has no nutritional skills, while a high score indicates that she has nutritional skills.
|
14th day
|
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Nutritional follow-up
Time Frame: average of 1 month
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Nutritional follow-up will be carried out from the day of starting the study until discharge. Feeding at 12am and 12pm will be taken into account in the nutrition follow-up. At these feeding times; - How many cc it oral takes per minute will be recorded. |
average of 1 month
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Nutritional follow-up
Time Frame: average of 1 month
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Feeding babies with only a bottle or breast 8 times in 48 hours indicates that they are on full oral feeding.
Dates when infants transition to full oral feeding will be recorded.
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average of 1 month
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
rate of body weight gain
Time Frame: first day
|
birth weight and weight on the day of started study will be note.
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first day
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rate of body weight gain
Time Frame: 7th day
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Weight on the 7th day will be note.
|
7th day
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rate of body weight gain
Time Frame: 14th day
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Weight on the 14th day will be note.
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14th day
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rate of body weight gain
Time Frame: one day
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weight on the day of discharge will be note.
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one day
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discharge time
Time Frame: average of 1 month
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The date of infants admission to the intensive care unit and the date of her discharge will be noted.
|
average of 1 month
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Merve Cakirli, Eskisehir Osmangazi University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- EskisehirOU-cakirli-1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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