title: Evidence-based systematic review: effects of oral motor interventions on feeding and swallowing in preterm infants.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Arvedson
authors.forename: Heather
authors.initials: H
authors.lastname: Clark
authors.forename: Cathy
authors.initials: C
authors.lastname: Lazarus
authors.forename: Tracy
authors.initials: T
authors.lastname: Schooling
authors.forename: Tobi
authors.initials: T
authors.lastname: Frymark
mesh_terms: D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology / Q000628:therapy*; D055317:Evidence-Based Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology*; D041361:Pacifiers; D013391:Sucking Behavior / Q000502:physiology*