Effect of an oral stimulation protocol on breastfeeding among preterm infants: a randomised controlled trial

Objectives: The objectives are to assess the effectiveness of a modified and adapted oral sensorimotor intervention (MA-OSMI) protocol for infants in India on the rate and performance of breastfeeding among preterm (PT) infants at discharge. Design: Single-centre randomised control trial. Setting: Level III B neonatal intensive care unit in a quaternary care hospital in South India. Patients: A total of 76 PT infants born between 26 and 33⁺⁶ weeks of gestational age, stratified into <30 weeks and 30-33⁺⁶ weeks, were randomised to intervention group (MA-OSMI) or standard care (SC). Interventions: MA-OSMI in addition to SC versus SC alone. The stimulation included 12 techniques administered by the principal investigator. SC included kangaroo mother care and non-nutritive sucking. Outcome measures: Exclusive breastfeeding (EBF) rate and breastfeeding performance at the time of discharge, assessed using standardised tools by clinician and mothers. Results: Infants in MA-OSMI group (66%) had significantly higher EBF rate compared with the SC group (16%) (OR: 10.25; 95% CI: 3.41 to 30.80). Improved breastfeeding performance was noted as per the clinician's observation. Significantly lower scores for MA-OSMI groups (63.42±36.43) than SC groups (126.61±60.94) on mothers' ratings suggested better feeding skills. Conclusion: Prefeeding oral stimulation contributed significantly to the achievement of EBF among PT infants at discharge. The present findings may benefit speech-language pathologists, paediatricians/neonatologists and nurses in the intervention of oral feeding among neonates.