Journal of Neonatal Biology

Feeding and swallowing in preterm babies from intervention perspectives

International Conference and Expo on Neonatology & Perinatology - October 21, 2022 | Webinar

October 21, 2022 | Webinar

Areej Al Abdulrahman

Rehabilitation Department, King Abdul-Aziz Medical City - Saudi Arabia

Scientific Tracks Abstracts: J Neonatal Biol

Abstract:

Prematurity is one of the significant factors for infants’ hospital admission. The oral feeding of preterm neonates concerns healthcare providers and parents. Feeding has a considerable effect on the child’s growth and development. (Pereira et al, 2020) Feeding and swallowing are significant factors for preterm Health and readiness for hospital discharge decisions, as in Figure 1. Many specialties from healthcare providers intervene according to their part in solving the feeding and swallowing problems. Healthcare providers can include nurses, speech therapists, Occupational Therapists, and Physical therapists. Each of these specialties has an intervention, protocols, and guidelines for feeding stimulation and activation. In this review, a summary of the best interventions will be presented. Also, any extra interventions from other specialties, such as the Osteopathic approaches, will be included. Some of the interventions are studied in the literature, such as Oral and Non-Oral sensorimotor stimulation, Oral motor stimulation, multi-stimulation, and positioning for feeding. In addition, many comparisons were made between non-nutritive sucking with a gloved finger, breath interaction, and phase of respiration with swallowing during the non-nutritive sucking. (Moreira et al, 2014) A study tested using the Transcutaneous Auricular vagus nerve stimulation with promotor feeding. (Badran et al., 2020) Others studied the Finger feeding method versus the syringe-feeding approach. (Buldur et al., 2020) Oral Motor Interventions (OMIs) and Oral Sensory-Motor Stimulation (OSMS) were studied as feeding interventions. Arvedson et al. (2010) systematically review the literature for the best effective oral motor interventions for feeding and swallowing in preterm infants. The oral motor interventions (OMIs) are non-nutritive sucking (NNS), verbal/ perioral stimulation, and NNS plus oral/ perioral stimulation. In the review, they concluded that some OMIs show promising effects for enhancing feeding/ swallowing in preterm infants; methodological limitations and variations in results across warrant careful consideration of their clinical use. In Calk P (2019) systematic review of oral motor stimulation to improve oral feeding in preterm infants. His Analysis revealed that the best practice is utilizing four areas of intervention: oral motor stimulation, non-nutritive sucking, oral support, and co-interventions. The review summarizes that immature suck-swallow-breath coordination, absent, delayed, or impaired oral reflexes; abnormal muscle tone; and impaired motor control impact the infants’ safe and successful oral intake of adequate nutrition. Strong evidence in the review supports the use of peri-oral and intraoral stimulation for pre-feeding readiness and preparation to promote successful oral intake, increase the suction, decrease liquid loss, and promote efficient nutrition intake. Sasmalet al. (2020) did another systematic review of the effect of pre-feeding oromotor stimulation on preterm infants. The conclusion was that the practice of pre-feeding oral stimulation has a variety of protocols; thus, results should be comprehended carefully. A systematic review by Gonzalez et al. (2021) to find the effectiveness of oral (OSMS) in premature infants as the second intervention for feeding stimulation in the Neonatal Intensive Care Unit (NICU). Using OSMS led to many improvements in achieving independent feeding, maturation of the sucking pattern, transition to complete feeding, motor function, and length of hospital stay in most studies. They concluded that evidence supports the benefits of using oral sensorimotor stimulation to achieve independent oral feeding in preterm infants, thereby reducing their stay in the NICU. Importance of research: Most systematic reviews and literature contradict their results regarding the best intervention for feeding and swallowing stimulation. This review summarizes the literature on recent approaches used to improve feeding to have better effects on preterm babies. Besides, weight gain and length of stay in the hospital are essential for any discharge decision. (Thakkar et al, 2018) Another critical factor is to judge the readiness of each preterm to start the feeding prerequisites and what prerequisites should be available to initiate this experience. Keywords: Preterm, feeding, swallowing, oral, sensory, motor, intervention.

Biography :

Areej Al Abdulrahman completed her MSc from Liverpool University. The MSc degree was in Clinical Research Administration. She is a clinical supervisor in physiotherapy. She has an experience 21 years of in Pediatric Physical Therapy. The last ten years as Neonatal Physical Therapist. She initiated the Early Intervention Program at King Abdullah Specialized Children’s Hospital. A member of the Bone Health committee in collaboration with the Neonatal Intensive Care Unit to prevent preemies fractures, and the team won a National Safety Award in The Kingdom of Saudi Arabia.