Effects of an Oral Stimulation Program on Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-Analysis

Abstract

Aims

To review the literature on the effects of unimodal sensorimotor stimulation protocols on feeding outcomes in very preterm and moderate to late preterm infants (PIs).

Methods

Five databases were searched up to April 2022. Studies comparing unimodal sensorimotor stimulation protocols based on the combination of manual oral stimulation with NNS against usual care in PIs, on-time transition to full oral feeding (FOF), feeding efficacy, length of hospital stay, and/or body weight gain.

Results

Eleven studies were included. Compared to usual care, unimodal sensorimotor stimulation protocols based on manual oral stimulation combined with NNS demonstrated to be more effective in decreasing time transition to FOF (standardized mean difference [95%CI] − 1.08 [−1.74, −0.41]), improving feeding efficacy (2.15 [1.18, 3.13]) and shortening length of hospital stay (−0.35 [−0.68, −0.03]). However, the proposed intervention was not effective in improving weight gain (0.27 [−0.40, 0.95]). There were no significant differences according to gestational age (p > .05).

Conclusions

Based on fair-to-high quality evidence, unimodal sensorimotor stimulation protocols combined with NNS reduce time transition to FOF, improve feeding efficacy, and shorten the length of hospital stay; yet the proposed intervention yielded no significant effects on body weight gain when compared to usual care in PIs.

Keywords:

• Feeding efficacy
• hospital discharge
• meta-analysis
• oral stimulation
• preterm infants

Acknowledgements

To the language translation service of Il·lustre Col·legi Official de Fisioterapeutes de la Comuntat Valenciana.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was partially supported by Grants from the Spanish Government (PID2021-125694OB-I00; co-financed by EU FEDER funds), Generalitat Valenciana, Conselleria d'Innovació, Universitats, Ciència i Societat (CIAICO/2021/215); and from Universitat de València (INV19-01-13-07).

Notes on contributors

Elena Muñoz-Gómez

Dr. Elena Muñoz-Gómez graduated in Physiotherapy in 2014 and completed her PhD in 2021 at the University of Valencia. Her research is focused on the therapeutic approach of musculoskeletal disorders, especially chronic pain.

Marta Inglés

Dr. Marta Inglés is an assistant professor at the Physiotherapy Department of the Universitat de València. Her research is focused on ageing-related conditions, pain, and therapeutic interventions.

Sara Mollà-Casanova

Sara Mollà Casanova, Ph.D. in physiotherapy specialized in neurological disease rehabilitation. She owns a research grant at the Physiotherapy Department of the University of València, in the Research Group Unitat de Recerca en BIomecànica Clínica (UBIC).

Núria Sempere-Rubio

Dr. Núria Sempere-Rubio graduated in physiotherapy in 2005 and performed her PhD in 2019 with Special Distinction at University of Valencia. Her research is focused on women, as well as on the characterization and therapeutic approach of physical condition and pelvic floor.

Pilar Serra-Añó

Dr. Pilar Serra-Añó is a full professor at the Physiotherapy Department of the Universitat de València (Spain). Her field of expertise is focused on Clinical Biomechanics and pain in people with several pathologies and conditions.

Marta Aguilar-Rodríguez

Dr. Marta Aguilar-Rodríguez graduated in Physiotherapy in 1991 with special Distinction, and in Documentation in 2007. She performed her PhD in 2012 at the University of Valencia and her research is focused on the assessment and therapeutic approach of musculoskeletal conditions.