[OES-2-5] Effectiveness of a Prefeeding Oral Stimulation Program on Preterm Infants: A Case Study
Background
The feeding performance of the preterms is a critical issue in the neonatal intensive care unit. Their feeding problems include decreased cheek and tongue muscle strength, less lip sealing, and poor sucking. Past studies have shown that the prefeeding oral intervention is effective for the preterms at or below 34 weeks of postmenstrual age (PMA). However, there is a lack of studies working on those with larger PMA (over 34 weeks PMA). The purpose of this study is to investigate whether the prefeeding oral stimulation program benefits the feeding performance of older preterms with feeding difficulties.
Methods
Preterms aged at 35 weeks of PMA or more and referred to occupational therapy (OT) due to feeding difficulties were included. A 5-min prefeeding oral stimulation program included 3-min peri- and intra-oral stimulation followed by 2-min sucking on a pacifier. The program was administered to the preterms just before feeding once a day for five days continuously. The outcome variables included (1) Oral intake in the first 10 minutes of the feeding after the intervention, (2) The percentage of prescribed milk volume in the first 10 minutes of the feeding, (3) Average oral intake of two daytime feedings, (4)The physiological data (heart rate, oxygen saturation, and respiratory rate) in the 3 minutes before and during the intervention.
Results:
A female preterm infant was born at 34+6 wks of gestation. Her age at the time of the study was 36 wks of PMA. She was referred to OT due to less than half of the prescribed amount of milk orally for continuous three feedings. After the intervention, the first 10-min oral intake improved from 20 ml (Day 1) to 40 ml (Day 3 and 5), the total prescribed volume. The average oral intake improved from 25 ml (Day 1) to 40 ml (Day 3). The percentage of prescribed milk volume in the first 10-min feeding was from 50% (Day 1) to 100% (Day 3, and 5).
The physiological status during intervention appeared stable and the physiological value differences decreased. The cardiopulmonary function worked well while feeding. First, from day 1 to 5 the mean heart rate during the intervention was 168, 165.4, 185.2, 172.4, and 160.2. The difference between her resting heart rate versus feeding was 3.2, 6.7, 19.8, 31.7, and 49.1. Second, the mean oxygen saturation during the intervention was 98.8, 94.8,91.6, 99, and 96.4. The difference between her resting oxygen saturation versus feeding was 1.1, 2, 1.1, 0.1, and -9.7. Lastly, the mean respiratory rate during the intervention was 43.2, 59.2, 53.4, 37, and 59. The difference between her resting respiratory rate versus feeding was 3.8, 8.2, 1.5, -0.1, and -8.5.
Conclusions:
The prefeeding oral stimulation program seems to benefit the feeding function of the current preterm infant. Furthermore, the physiological results show it is a safe intervention for this stable infant aged at 35 wks of PMA. Future research with the design of randomized control trials is needed.
The feeding performance of the preterms is a critical issue in the neonatal intensive care unit. Their feeding problems include decreased cheek and tongue muscle strength, less lip sealing, and poor sucking. Past studies have shown that the prefeeding oral intervention is effective for the preterms at or below 34 weeks of postmenstrual age (PMA). However, there is a lack of studies working on those with larger PMA (over 34 weeks PMA). The purpose of this study is to investigate whether the prefeeding oral stimulation program benefits the feeding performance of older preterms with feeding difficulties.
Methods
Preterms aged at 35 weeks of PMA or more and referred to occupational therapy (OT) due to feeding difficulties were included. A 5-min prefeeding oral stimulation program included 3-min peri- and intra-oral stimulation followed by 2-min sucking on a pacifier. The program was administered to the preterms just before feeding once a day for five days continuously. The outcome variables included (1) Oral intake in the first 10 minutes of the feeding after the intervention, (2) The percentage of prescribed milk volume in the first 10 minutes of the feeding, (3) Average oral intake of two daytime feedings, (4)The physiological data (heart rate, oxygen saturation, and respiratory rate) in the 3 minutes before and during the intervention.
Results:
A female preterm infant was born at 34+6 wks of gestation. Her age at the time of the study was 36 wks of PMA. She was referred to OT due to less than half of the prescribed amount of milk orally for continuous three feedings. After the intervention, the first 10-min oral intake improved from 20 ml (Day 1) to 40 ml (Day 3 and 5), the total prescribed volume. The average oral intake improved from 25 ml (Day 1) to 40 ml (Day 3). The percentage of prescribed milk volume in the first 10-min feeding was from 50% (Day 1) to 100% (Day 3, and 5).
The physiological status during intervention appeared stable and the physiological value differences decreased. The cardiopulmonary function worked well while feeding. First, from day 1 to 5 the mean heart rate during the intervention was 168, 165.4, 185.2, 172.4, and 160.2. The difference between her resting heart rate versus feeding was 3.2, 6.7, 19.8, 31.7, and 49.1. Second, the mean oxygen saturation during the intervention was 98.8, 94.8,91.6, 99, and 96.4. The difference between her resting oxygen saturation versus feeding was 1.1, 2, 1.1, 0.1, and -9.7. Lastly, the mean respiratory rate during the intervention was 43.2, 59.2, 53.4, 37, and 59. The difference between her resting respiratory rate versus feeding was 3.8, 8.2, 1.5, -0.1, and -8.5.
Conclusions:
The prefeeding oral stimulation program seems to benefit the feeding function of the current preterm infant. Furthermore, the physiological results show it is a safe intervention for this stable infant aged at 35 wks of PMA. Future research with the design of randomized control trials is needed.