Oromotor intervention for improving oral feed readiness in preterm infants

Objectives: Early oral motor intervention – comprising oral stimulation, oral support and noninvasive nasal suctioning – may enhance oral feeding skills in preterm infants and reduce hospital stay. Preterms typically struggle to initiate oral feeding due to the immature coordination of sucking, swallowing and breathing, typically developed between 32 and 34 weeks of gestation. This study aimed to study the improvement in the Preterm Oral Feeding Readiness Assessment Scale (POFRAS) after 5 days of oro-motor intervention in preterm infants. Material and Methods: This interventional study was conducted in the neonatal intensive care unit (NICU) at AJ Institute of Medical Sciences, Mangalore on neonates with gestational age more than 27 + 6/7 weeks and up to 34 + 6/7 weeks. Newborns were randomly assigned to either the oro-motor intervention group or a control group receiving standard care. All preterm infants were assessed using the POFRAS scale. The intervention was done for 5 min twice a day for 5 consecutive days. Both groups were then reassessed for oral feeding readiness using the POFRAS score after the intervention. Results: A total of 70 infants were enrolled, with 35 in the intervention group and 35 in the control group. Nasogastric (NG) tube feeds were initiated earlier in the intervention group, with 68.6% starting on the 1 st –2 nd day of life as compared to 40% in the control group. Full feeds on the NG tube were achieved earlier in the intervention group. Oral feeds were initiated significantly earlier in the intervention group, with a mean initiation day of 4.7 ± 1.3 days. Newborns in the intervention group achieved full oral feeds earlier, with a mean day of 6.1 ± 1.6 days, while the control group achieved this milestone at 11.1 ± 6.2 days ( P < 0.001). The improvement in POFRAS score from the first to the second assessment was significantly higher in the intervention group (2.0 ± 0.6) compared to the control group (0.7 ± 0.9, P < 0.001). Conclusion: These findings suggest that implementing early oro-motor intervention strategies can be beneficial in improving the clinical outcomes of preterm infants. Incorporating this simple, low-cost strategy into routine NICU care may optimise feeding outcomes and potentially reduce hospital stay.