Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates
BackgroundOral motor stimulation interventions improve oral feeding readiness and earlier full oral feeding in preterm neonates. However, using a structured method may improve the transition time to full oral feeds and feeding efficiency with respect to weight gain and exclusive breastfeeding when c...
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1296863/full |
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| author | Pari Singh Nandini Malshe Aditya Kallimath Reema Garegrat Arjun Verma Nandini Nagar Rajesh Maheshwari Pradeep Suryawanshi |
| author_facet | Pari Singh Nandini Malshe Aditya Kallimath Reema Garegrat Arjun Verma Nandini Nagar Rajesh Maheshwari Pradeep Suryawanshi |
| author_sort | Pari Singh |
| collection | DOAJ |
| description | BackgroundOral motor stimulation interventions improve oral feeding readiness and earlier full oral feeding in preterm neonates. However, using a structured method may improve the transition time to full oral feeds and feeding efficiency with respect to weight gain and exclusive breastfeeding when compared to an unstructured intervention.ObjectiveTo compare the effect of Premature Infant Oral Motor Intervention (PIOMI) and routine oromotor stimulation (OMS) on oral feeding readiness.MethodsRandomised controlled trial conducted in a neonatal intensive care unit between June-December 2022. Preterm neonates, 29+0–33+6 weeks corrected gestational age, were studied. The intervention group received PIOMI and the control group received OMS. Primary outcome: time to oral feeding readiness by Premature Oral Feeding Readiness Assessment Scale (POFRAS) score ≥30. Secondary outcomes: time to full oral feeds, duration of hospitalisation, weight gain, and exclusive breastfeeding rates.ResultsA total of 84 neonates were included and were randomised 42 each in PIOMI and OMS groups. The mean chronological age and time to oral feeding readiness were lower by 4.6 and 2.7 days, respectively, for PIOMI. The transition time to full oral feeds was 2 days lower for PIOMI and the duration of hospitalisation was 8 days lower. The average weight gain was 4.9 g/kg/day more and the exclusive breastfeeding rates at 1 month and 3 months post-discharge were higher by 24.5% and 27%, respectively, for the PIOMI group. The subgroup analysis of study outcomes based on sex and weight for gestational age showed significant weight gain on oral feeds in neonates receiving PIOMI. Similarly, the subgroup analysis based on gestational age favoured the PIOMI group with significantly earlier transition time and weight gain on oral feeds for the neonates >28 weeks of gestational age. The odds of achieving oral feeding readiness by 30 days [OR 1.558 (0.548–4.426)], full oral feeds by 45 days [OR 1.275 (0.449–3.620)], and exclusive breastfeeding at 1 month [OR 6.364 (1.262–32.079)] and 3 months [3.889 (1.186–12.749)] after discharge were higher with PIOMI.ConclusionPIOMI is a more effective oromotor stimulation method for earlier and improved oral feeding in preterm neonates.
Clinical trial registrationhttps://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=70054&EncHid=34792.72281&modid=1&compid=19','70054det', identifier, CTRI/2022/06/043048. |
| first_indexed | 2024-03-11T09:20:47Z |
| format | Article |
| id | doaj.art-12c51396368b42d4910aa1b033f10969 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T09:20:47Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-12c51396368b42d4910aa1b033f109692023-11-16T18:21:03ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-11-011110.3389/fped.2023.12968631296863Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonatesPari Singh0Nandini Malshe1Aditya Kallimath2Reema Garegrat3Arjun Verma4Nandini Nagar5Rajesh Maheshwari6Pradeep Suryawanshi7Department of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaDepartment of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaDepartment of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaDepartment of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaDepartment of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaDepartment of Neonatology, Cloudnine Hospital, Bengaluru, IndiaDepartment of Neonatology, Westmead Hospital, Westmead, NSW, AustraliaDepartment of Neonatology, Bharati Vidyapeeth Deemed University, Pune, IndiaBackgroundOral motor stimulation interventions improve oral feeding readiness and earlier full oral feeding in preterm neonates. However, using a structured method may improve the transition time to full oral feeds and feeding efficiency with respect to weight gain and exclusive breastfeeding when compared to an unstructured intervention.ObjectiveTo compare the effect of Premature Infant Oral Motor Intervention (PIOMI) and routine oromotor stimulation (OMS) on oral feeding readiness.MethodsRandomised controlled trial conducted in a neonatal intensive care unit between June-December 2022. Preterm neonates, 29+0–33+6 weeks corrected gestational age, were studied. The intervention group received PIOMI and the control group received OMS. Primary outcome: time to oral feeding readiness by Premature Oral Feeding Readiness Assessment Scale (POFRAS) score ≥30. Secondary outcomes: time to full oral feeds, duration of hospitalisation, weight gain, and exclusive breastfeeding rates.ResultsA total of 84 neonates were included and were randomised 42 each in PIOMI and OMS groups. The mean chronological age and time to oral feeding readiness were lower by 4.6 and 2.7 days, respectively, for PIOMI. The transition time to full oral feeds was 2 days lower for PIOMI and the duration of hospitalisation was 8 days lower. The average weight gain was 4.9 g/kg/day more and the exclusive breastfeeding rates at 1 month and 3 months post-discharge were higher by 24.5% and 27%, respectively, for the PIOMI group. The subgroup analysis of study outcomes based on sex and weight for gestational age showed significant weight gain on oral feeds in neonates receiving PIOMI. Similarly, the subgroup analysis based on gestational age favoured the PIOMI group with significantly earlier transition time and weight gain on oral feeds for the neonates >28 weeks of gestational age. The odds of achieving oral feeding readiness by 30 days [OR 1.558 (0.548–4.426)], full oral feeds by 45 days [OR 1.275 (0.449–3.620)], and exclusive breastfeeding at 1 month [OR 6.364 (1.262–32.079)] and 3 months [3.889 (1.186–12.749)] after discharge were higher with PIOMI.ConclusionPIOMI is a more effective oromotor stimulation method for earlier and improved oral feeding in preterm neonates. Clinical trial registrationhttps://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=70054&EncHid=34792.72281&modid=1&compid=19','70054det', identifier, CTRI/2022/06/043048.https://www.frontiersin.org/articles/10.3389/fped.2023.1296863/fullneonateoral motor stimulationprematurityoral feeding readinessexclusive breastfeeding |
| spellingShingle | Pari Singh Nandini Malshe Aditya Kallimath Reema Garegrat Arjun Verma Nandini Nagar Rajesh Maheshwari Pradeep Suryawanshi Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates Frontiers in Pediatrics neonate oral motor stimulation prematurity oral feeding readiness exclusive breastfeeding |
| title | Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates |
| title_full | Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates |
| title_fullStr | Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates |
| title_full_unstemmed | Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates |
| title_short | Randomised controlled trial to compare the effect of PIOMI (structured) and routine oromotor (unstructured) stimulation in improving readiness for oral feeding in preterm neonates |
| title_sort | randomised controlled trial to compare the effect of piomi structured and routine oromotor unstructured stimulation in improving readiness for oral feeding in preterm neonates |
| topic | neonate oral motor stimulation prematurity oral feeding readiness exclusive breastfeeding |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1296863/full |
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