Tactile/kinesthetic Stimulus Program

The Effect of the Tactile/kinesthetic Stimulus Program on the Maturation of Sucking Ability in Preterm Infants

The study will be carried out as a prospective randomized controlled clinical study to determine the effect of tactile/kinesthetic stimulus program on preterm infants on transition time to full sucking, sucking success and hospital stay.

Study Overview

• Status: Recruiting
• Conditions: Enteral Feeding; Breast Feeding, Exclusive; Hospital Stay
• Intervention / Treatment: Other: Tactile/kinesthetic Group

Detailed Description

Application of the Research Tactile/kinesthetic Group After the stability in the general health status of the babies and the oral feeding decision are made, for 14 days, 2 times a day, just before feeding; There will be a 15-minute tactile/kinesthetic application. Complications that may develop during the tactile/kinesthetic application in infants will be monitored by evaluating the physical findings of the preterm infant and on the bedside monitor. In cases such as decreased oxygen saturation, apnea and bradycardia during the tactile/kinesthetic intervention, the procedure will not be performed or will be delayed until the baby regains stability.

Note: The application will be carried out by showing the necessary sensitivity for the preterm baby (not shaking the baby, not moving the baby suddenly, the temperature of the hands being close to the baby's body temperature, etc.) and by the researcher nurses experienced in NICU.

Control Group Tactile/kinesthetic applications will not be applied to the control group and these babies will be followed up for 14 days and at discharge after the stability of the general health status of the babies is ensured and the oral feeding decision is made.

In both groups; Baby scales and tape measure will be used for anthropometric measurement of body weight before and after breastfeeding. Other data will be obtained from the patient file and observations made during the hospitalization of the preterm infant.

The LATCH Breastfeeding Diagnosis Form (during the first mother's breastfeeding) will be filled in by observation, by the researcher and an observer nurse, as it is an observation-based form. The researcher will train the observer on the use of the LATCH Breastfeeding Diagnostic Form. The researcher and observer will simultaneously and independently evaluate each preterm infant by scoring the LATCH Breastfeeding Diagnostic Form during the breastfeeding period. In order to evaluate the agreement among the observers, the agreement will be evaluated by looking at Cohen's Kappa coefficient. The LATCH second measurement will be made on Day 5.

The amount of food taken during breastfeeding within 14 days (1st, 5th, 9th, 13th, and on the day of discharge) will be determined by measuring body weight before and after feeding. Body weight will be weighed before and after feeding at discharge. The times of full enteral feeding and full oral feeding will be recorded in the groups.

Hypotheses H0 hypothesis: Tactile/kinesthetic stimulus interventions have no effect on transition time to full oral feeding in preterm infants.

Hypothesis H1: In preterm infants, interventions with tactile/kinesthetic stimuli have an effect on transition time to full oral feeding.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: GONCA K KARATAS BARAN, PHD; Phone Number: 05426058161; Email: goncabaran@gmail.com

Study Locations

• Turkey
  • Eyalet/Yerleşke
    • Ankara, Eyalet/Yerleşke, Turkey, 06290
      • Recruiting
      • Etlık Zubeyde Hanım Kadın Hastalıkları Eğitim Ve Araştırma Hastanesi
      • Contact: GONCA KARATAS BARAN, PHD; Phone Number: 05426058161; Email: goncabaran@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 7 months (Child)
• Accepts Healthy Volunteers: Yes

Description

Inclusion criteria

• Born between 28-32 weeks of gestation,
• Stable vital signs,
• 1st and 5th minute APGAR score between 6-10,
• Babies who have received mechanical ventilator or continuous positive air pressure (CPAP) or both support after 48 hours have passed after stabilization,
• Does not have an anomaly that will prevent feeding,
• Oral feeding decision has been made,
• Babies of mothers who are willing to breastfeed their babies,
• Babies of parents who volunteered to participate in the study will be taken.

Exclusion criteria

• IUGG,
• Infants with severe asphyxia,
• Babies born with low birth weight according to their gestational week,
• Having an anomaly that will prevent her from feeding,
• Babies with unstable vital signs,
• Babies with congenital anomalies or serious complications
• Infants with intraventricular bleeding.

Dismissal Criteria

• Babies whose oral feeding process is interrupted for more than 1 day due to neonatal problems.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tactile/kinesthetic Group; After the stability of the general health status of the babies is ensured and the oral feeding decision is made, tactile / kinesthetic application will be made for 14 days, 2 times a day, for 15 minutes just before feeding.	Other: Tactile/kinesthetic Group; Tactile/kinesthetic stimulation is performed in three stages. In the first stage; for tactile stimulation; The baby is placed in the prone (prone) position in the incubator. Light massage was applied in the head, shoulder, back, legs and arms of the infants. Each massage is applied 12 times for 1 minute. Massage was performed for 5 seconds. In the second stage Kinesthetic stimulation, including elbow flexion-extension movement, palm massages, flexion-extension of the knees and legs and plantar massages, was applied while the neonate was in supine position. Each kinesthetic stimulation was performed for 5 seconds. Each movement was repeated six times, with a total duration of 5 minutes. Tactile stimulation was repeated once after kinesthetic stimulation. The total duration of TKS was 15 minutes which was performed three times daily preferably between breastfeeding or bottle feeding for 14 consecutive days.; Other Names: Case
No Intervention: Control Group; Tactile / kinesthetic applications will not be applied to the control group and these babies will be followed for 14 days and at discharge after the stability of the general health status of the babies is ensured and the oral feeding decision is made.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
transition time (day) to full oral feeding	This is the data on which day full oral feeding is started after admission to the neonatal intensive care unit.	within the first 30 days of birth
transition time(day) to oral feeding trials	This is the data on which day oral feeding trials were performed after admission to the neonatal intensive care unit. intensive care unit.	within the first 30 days of birth
transition time (day) to full enteral feeding	This is the data on which day full enteral feeding is started after admission to the neonatal intensive care unit.	within the first 30 days of birth
transition time (day) to enteral feeding trials	This is the data on which day full enteral feeding is started after admission to the neonatal intensive care unit.	within the first 30 days of birth
time (day) to first breastfeeding	This is the data on which day breastfeeding feeding is started after admission to the neonatal intensive care unit.	within the first 30 days of birth
latch score (first day of breastfeeding)	Using LATCH Scale. The minimum LATCH score is 0 and the maximum is 10.	first breastfeeding process (20 minutes)
latch score (fifth day of breastfeeding)	Using LATCH Scale. The minimum LATCH score is 0 and the maximum is 10.	fifth day breastfeeding process (20 minutes)
length of hospital stay (days)	length of hospital stay (days)	the date of at discharge (up to 40 weeks)
change in weight before and after feeding	babies will be weighed before and after feeding on the first, fifth, ninth, thirteenth day and at discharge	the date of at discharge (up to 40 weeks)

Collaborators and Investigators

• Sponsor: Gonca Karatas Baran
• Investigators: Study Director: GONCA K KARATAS BARAN, Etlik Zubeyde Hanım Women's Health Care, Training and Research Hospital

Publications and helpful links

General Publications

• Burklow KA, McGrath AM, Kaul A. Management and prevention of feeding problems in young children with prematurity and very low birth weight. Inf Young Children. 2002; 14(4):19-30.
• Fuccile S. Pre-feeding Sensorimotor Stimulation as an Early Intervention Strategy to Enhance Oral Feeding Skills in Preterm Infants. Health Sciences - Occupational Health and Therapy, doctoral thesis, McGill University, QC, Canada, 2008
• Jaywant SS, Kale JS.The effect of pre-feeding protocol with andwithout tactile and kinaesthetic stimulation onoral motor ability & physiological stability inpreterm infants. Int J Health Sci Res. 2021;11(1):38-4
• Mathai S, Fernandez A, Mondkar J, Kanbur W. Effects of tactilekinesthetic stimulation in preterms: a controlled trial. Indian Pediatr. 2001; 38(10),:1091-1098. • McGrath JM, Braescu AV. State of the science: feeding readiness in the preterm infant. J Perinat Neonatal Nur. 2004;18(4):353-368
• Bache M, Pizon E, Jacobs J, Vaillant M, Lecomte A. Effects of pre-feeding oral stimulation on oral feeding in preterm infants: a randomized clinical trial. Early Hum Dev. 2014 Mar;90(3):125-9. doi: 10.1016/j.earlhumdev.2013.12.011. Epub 2014 Jan 23.
• Bond C. Positive touch and massage in the neonatal unit: a British approach. Semin Neonatol. 2002; 7(6):477-486.
• Clark GF, Avery-Smith W, Wolf L. S, Anthony P, Holm SE, Hertfelder SD, et al. Specialized knowledge and skills in eating and feeding for occupational therapy practice. Am J Occup Ther, 2003:57(6),:660-678.
• Diego MA, Field T, Hernandez-Reif M. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr. 2005; 147(1):50-55.
• ucile S, Gisel E, Lau C. Oral stimulation accelerates the transition from tube to oral feeding in preterm infants, The Journal of Pediatrics, 2002;141(2):230-236
• Gewolb IH, Vice FL. Abnormalities in the coordination of respiration and swallow in preterm infants with bronchopulmonary dysplasia. Dev Med Child Neurol, 2006;48(7):595-599

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2022
• Primary Completion (Estimated): August 1, 2025
• Study Completion (Estimated): August 1, 2025

Study Registration Dates

• First Submitted: July 29, 2022
• First Submitted That Met QC Criteria: August 2, 2022
• First Posted (Actual): August 3, 2022

Study Record Updates

• Last Update Posted (Estimated): November 22, 2024
• Last Update Submitted That Met QC Criteria: November 20, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: enteral feeding; breasfeeding; tactile/kinesthetic intervention
• Other Study ID Numbers: NEONATAL CARE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No