Evidence-Based Systematic Review: Effects of Oral Motor Interventions on Feeding and Swallowing in Preterm Infants

Author:

Arvedson Joan1,Clark Heather2,Lazarus Cathy3,Schooling Tracy4,Frymark Tobi4

Affiliation:

1. Children’s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee

2. Appalachian State University, Boone, NC

3. NYU Langone Medical Center, New York, NY

4. American Speech-Language-Hearing Association, Rockville, MD

Abstract

Purpose To conduct an evidence-based systematic review and provide an estimate of the effects of oral motor interventions (OMIs) on feeding/swallowing outcomes (both physiological and functional) and pulmonary health in preterm infants. Method A systematic search of the literature published from 1960 to 2007 was conducted. Articles meeting the selection criteria were appraised by 2 reviewers and vetted by a 3rd for methodological quality. Results Twelve studies were included and focused on 3 OMIs—nonnutritive sucking (NNS), oral/perioral stimulation, and NNS plus oral/perioral stimulation. Six studies addressed the effects of OMI on the feeding/swallowing physiology outcomes of feeding efficiency or sucking pressures. Ten studies addressed the functional feeding/swallowing outcomes of oral feeding or weight gain/growth. No studies reported data on pulmonary health. Methodological quality varied greatly. NNS alone and with oral/perioral stimulation showed strong positive findings for improvement in some feeding/swallowing physiology variables and for reducing transition time to oral feeding. Prefeeding stimulation showed equivocal results across the targeted outcomes. None of the OMIs provided consistent positive results on weight gain/growth. Conclusions Although some OMIs show promise for enhancing feeding/swallowing in preterm infants, methodological limitations and variations in results across studies warrant careful consideration of their clinical use.

Publisher

American Speech Language Hearing Association

Subject

Speech and Hearing,Linguistics and Language,Developmental and Educational Psychology,Otorhinolaryngology

Reference85 articles.

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3. Hospital discharge of the high-risk neonate—proposed guidelines;American Academy of Pediatrics;Pediatrics,1998

4. American Speech-Language-Hearing Association. (2004). Roles of speech-language pathologists in the neonatal intensive care unit: Position statement [Position statement]. Available from www.asha.org/policy

5. Cerebral palsy among very preterm children in relation to gestational age and neonatal ultrasound abnormalities: EPIPAGE cohort study;Ancel P. Y.;Pediatrics,2006

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