Judita Dovydėnaitė, Nijolė Drazdienė
The attainment of sucking skill can be very challenging in preterm infant. Early stimulation, which encourages sucking and formation of other necessary feeding skills, can ease the transition to oral feeding, thus have a positive impact on the development of feeding skills. The aim of study: to assess the impact of oral stimulation on feeding skills development in preterm infants. Materials and methods: Clinical study took place at Vilnius University hospital, Children’s hospital, Neonatology centre, department of preterm infants. 32 preterm infants were included in study, 12 of them in experimental group, and 20 in control group. 10 interventions of oral stimulation were provided for infants in experimental group. Infant’s oxygen saturation and pulse were monitored during every stimulation intervention, also the signs of stress were assessed. Infants in the control group got the routine unite care. Infants in both groups were fed while using the infant – driven and individualized protocol of the infant feeding. Specific oral feeding skills were assessed during the transition to oral feeding period: amount of milk taken during 5 minutes of feeding, feeding proficiency, volume transfer, feeding duration, rate of transfer. Infants were assessed three times, while taking 1-2, 3-5 and 8 breast feedings or bottle feedings per day. SPSS package 17 and MS Excel program were used for data analyses. We used parametric paired and unpaired Stjudent t-test and nonparametric Mann-Whitney U and Wilcoxson test for analyses of difference between two groups, p value of 0.05 was used as level of significance. Results. Significant differences in both groups were found in the changes between all observations, in these feeding skills: the amount of milk taken within the first 5 minutes of feeding, feeding efficiency. Volume transfer significantly increased in both groups, between first and second observation, however the singnificant difference between second and third observation was only in control group. Feeding duration increased significantly in both groups between first and second observation and decreased in control group between second and third observation. Oral stimulation significantly decresed the feeding duration and increased rate of transfer on second observation. 67 percent of the experimental group and only 40 percent in the control group of infants were partially breastfed. In the experimental group transition to oral feeding period lasted an average of 8.5 days and in the control group – 10.8 days (p = 0.195). Conclusions. Oral feeding skills improved during transition to oral feeding period in preterm infants. Significant improvement of feeding skills shows that oral muscle strength and endurance increase and the coordination of sucking-breathing-swalloving refines during the transition period. Oral stimulation improved feeding efficiency and decreased feeding duration during second observation. Oral stimulation didn’t improved any other feeding skills. Oral stimulation improved breast feeding rates in preterm infants. Oral stimulation didn’t have impact on start of oral feedings. Transition period was shorter by 2 days in experimental group, although the difference between groups wasn’t significant.
Keyword(s): preterm infants; oral stimulation; feeding skills.
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