Effects of Environmental Comfort and Oral Motor Stimulation on Comfort and Oral Feeding Readiness in Preterm Infants

November 4, 2026 updated by: Marmara University

Effects of Environmental Comfort and Oral Motor Stimulation Interventions on Comfort and Oral Feeding Readiness in Preterm Infants: An Experimental Study

This study aims to evaluate the effects of short-term environmental comfort interventions and oral motor stimulation on comfort and oral feeding readiness in preterm infants. A total of 84 preterm infants who are clinically stable and transitioning to oral feeding will be assigned to one of four groups: massage, white noise, oral stimulation, or routine care (control). Before the intervention, infant comfort and oral feeding readiness will be assessed using the Premature Infant Comfort Scale and the Preterm Oral Feeding Readiness Assessment Scale (POFRAS). Infants in the intervention groups will receive a single 5-minute session of massage, white noise, or oral stimulation before their first oral feeding, while infants in the control group will receive routine care. Comfort and oral feeding readiness will be assessed during the study to compare the effects of the interventions. The study will also examine the relationship between comfort and oral feeding readiness in preterm infants.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This experimental study will be conducted with preterm infants receiving care in the Neonatal Intensive Care Unit of Cerrahpaşa Faculty of Medicine Hospital. The study will include 84 preterm infants born between 28 and 37 weeks of gestation who are clinically stable and in the process of transitioning to oral feeding. Eligible infants will be randomly assigned to one of four study groups: massage, white noise, oral stimulation, or routine care (control). Before the assigned intervention, descriptive and clinical information will be recorded, and the infants will be assessed using the Premature Infant Comfort Scale and the Preterm Oral Feeding Readiness Assessment Scale (POFRAS). In the massage group, infants will receive a 5-minute session consisting of gentle and rhythmic tactile stimulation. In the white noise group, white noise at an intensity of 40-60 dB will be provided for 5 minutes. In the oral stimulation group, infants will receive a 5-minute oral motor stimulation intervention involving gentle stimulation of the lips, cheeks, palate, gums, and tongue, with non-nutritive sucking when appropriate. Infants assigned to the control group will receive routine neonatal care without an additional study intervention. The assigned intervention will be administered once before the infant's first oral feeding. Following the intervention period, the infant's comfort and oral feeding readiness will be evaluated according to the study assessment schedule, and the first oral feeding will be performed when oral feeding has been clinically authorized by the physician. The study will compare comfort and oral feeding readiness among the intervention and control groups and will examine the relationship between comfort and oral feeding readiness in preterm infants.

Study Type

Interventional

Enrollment (Estimated)

84

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 hour to 1 year (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Preterm infants born between 28 and 37 weeks of gestation
  • Clinically stable preterm infants
  • Infants for whom the physician has decided to initiate oral feeding
  • Infants transitioning to oral feeding
  • Written informed consent provided by a parent or legal guardian

Exclusion Criteria:

  • Congenital anomalies or neurological disorders that may affect oral feeding
  • Severe respiratory or cardiac problems that may prevent oral feeding
  • Clinical instability that prevents participation in the study interventions or oral feeding
  • Withdrawal of parental or legal guardian consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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
Experimental: Massage

Infants assigned to this group will receive a single 5-minute massage intervention before their first oral feeding. The intervention will include gentle, rhythmic tactile stimulation of the back and shoulders, followed by gentle stroking and touch.
Behavioral: Massage

A single 5-minute massage session will be administered before the infant's first oral feeding. The intervention will include gentle rhythmic stroking of the back and shoulders, gentle downward stroking of the back, slow rhythmic touch to the shoulder or head area, and gentle hand contact over the abdominal area.
Experimental: White Noise

Infants assigned to this group will be exposed to white noise at an intensity of 40-60 dB for 5 minutes before their first oral feeding. No additional care or procedure will be performed during the white noise intervention.
Behavioral: White Noise

White noise at an intensity of 40-60 dB will be provided for 5 minutes before the infant's first oral feeding. The sound source will be positioned approximately 30-50 cm from the infant's bed. No additional care or procedure will be performed during the intervention.
Experimental: Oral Stimulation

Infants assigned to this group will receive a single 5-minute oral motor stimulation intervention before their first oral feeding. The intervention will include gentle stimulation of the lips, inner cheeks, palate, gums, and tongue, with non-nutritive sucking when appropriate.
Behavioral: Oral Motor Stimulation

A single 5-minute oral motor stimulation session will be administered before the infant's first oral feeding. The intervention will include gentle stimulation of the lips, inner cheeks, palate, gums, and tongue. Non-nutritive sucking using a sterile finger or pacifier may be provided when appropriate.
Active Comparator: Routine Care

Infants assigned to the control group will receive routine neonatal care without an additional study intervention before their first oral feeding.
Other: Routine Care

Infants assigned to the control group will receive routine neonatal care without additional massage, white noise, or oral motor stimulation as part of the study intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Premature Infant Comfort Scale Score
Time Frame: Within 1 minute before the start of the intervention, within 1 minute after the completion of the 5-minute intervention (before the first oral feeding), and within 1 minute after the completion of the first oral feeding.

Developed by Monique and her colleagues, this is an observation-based scale used to assess the comfort level of premature infants. The scale was adapted into Turkish by Dilek Küçük Alemdar and Fatma Güdücü Tüfekçi (2015) in Turkey, and a validity and reliability study was conducted. The scale consists of a total of 7 items: level of alertness, agitation, crying, physical movement, muscle tone, facial expressions, and heart rate. Each item is rated on a scale of 1 to 5, and the total score ranges from 7 to 35. There are no reverse-scored items on the scale. Factor analysis conducted as part of the construct validity assessment determined that the scale exhibits a unifactorial structure, explaining 57.7% of the total variance. The scale's Cronbach's alpha reliability coefficient was reported as 0.88.
Within 1 minute before the start of the intervention, within 1 minute after the completion of the 5-minute intervention (before the first oral feeding), and within 1 minute after the completion of the first oral feeding.
Change in Preterm Oral Feeding Readiness Assessment Scale Score
Time Frame: Within 1 minute before the start of the intervention (initial assessment) and within 1 minute after the completion of the 5-minute intervention (before the start of the first oral feeding).

Developed by Cristina Ide Fujinaga and colleagues (2007) to assess how ready preterm infants are for the transition to oral feeding, the scale underwent a clinical validity study in 2013. The Turkish validity and reliability study of the scale was conducted by Çamur and Çetinkaya (2021). The scale consists of a total of 18 items, each of which is scored on a scale of 0, 1, or 2. The total possible score ranges from 0 to 36. There are no reverse-scored items on the scale. The scale covers areas such as behavioral status, oral-motor posture, reflexes, and sucking behavior; while its subdimensions are not explicitly named, they are clinically grouped under five headings: corrected gestational age, behavioral organization, oral posture, reflex assessment, and non-nutritive sucking. In the Turkish adaptation, the optimal cutoff score for the scale was reported as 29, and the Cronbach's alpha internal consistency coefficient was found to be 0.87.
Within 1 minute before the start of the intervention (initial assessment) and within 1 minute after the completion of the 5-minute intervention (before the start of the first oral feeding).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Initiate Post-intervention Oral Feeding
Time Frame: The time elapsed (in minutes) from the completion of the five-minute intervention until the start of the first oral feeding up to 20 minutes

The time to initiation of the first oral feeding in preterm infants will be defined as the duration from the completion of the 5-minute intervention until the start of the first oral feeding. This duration will be recorded in minutes and compared across groups. The first oral feeding will be administered to infants determined by a physician to be ready for oral feeding.
The time elapsed (in minutes) from the completion of the five-minute intervention until the start of the first oral feeding up to 20 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Marmara University

Investigators

  • Principal Investigator: Aysegul Simsek, PhD, Marmara University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2026

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

January 1, 2027

Study Registration Dates

First Submitted

October 29, 2026

First Submitted That Met QC Criteria

November 4, 2026

First Posted (Actual)

November 5, 2026

Study Record Updates

Last Update Posted (Actual)

November 5, 2026

Last Update Submitted That Met QC Criteria

November 4, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • MU-SBF-2025-173

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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