Neonatal Therapy Interventions Supporting Oral Feeding Skills in Preterm Infants: A Systematic Review

To synthesize the existing literature on neonatal therapy interventions and evaluate their impact on oral feeding outcomes among preterm infants in the neonatal intensive care unit. A systematic literature search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Physiotherapy Evidence Database (PEDro) databases for studies published from 2014 to 2023. Included studies were clinical trials evaluating neonatal therapy interventions delivered by neonatal therapists or caregivers trained by therapists, focusing on oral feeding outcomes for infants born at <37 week gestation. Primary outcomes were time to full oral feeding (FOF) and feeding quality. Secondary outcomes were weight gain and length of stay (LOS). Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Fourteen studies were included, identifying three categories of neonatal therapy interventions: oral motor stimulation, swallowing exercises, and sensory-based interventions. Most interventions began between 27 and 33 week postmenstrual age. Interventions generally resulted in improved oral feeding outcomes, notably faster achievement of FOF and improved feeding quality. Results for LOS and weight gain varied. Multidomain interventions demonstrated superior outcomes compared to single-domain approaches. Neonatal therapy interventions can start early and improve oral feeding outcomes in preterm infants, particularly when using multi-domain approaches.