title: Interventions to improve the oral feeding performance of preterm infants.
abstract: OBJECTIVE
  Preterm infants have difficulty oral feeding. We hypothesized that a specific sucking and swallowing exercises vs. no intervention accelerate the attainment of independent oral feeding through a faster maturation of infants' oral feeding skills (OFS).
  
  
  METHODS
  Very low birthweight infants were randomized to a control, sucking and swallowing groups. Sucking consisted of active sucking on a pacifier, and swallowing of placing a milk bolus (0.05-0.2 mL) on the tongue where the bolus rests prior to entering the pharynx. Primary outcome was days from start to independent oral feeding (SOF-IOF). Secondary outcomes included overall transfer (OT, % volume taken/volume prescribed), proficiency (PRO, % volume taken at 5 min/volume prescribed), rate of transfer (RT, mL/min) over the entire feeding and infants' OFS levels. OFS levels were defined by PRO and RT.
  
  
  RESULTS
  Days from SOF to IOF vs controls (21 ± 2) were similar for the sucking group (19 ± 2) and shorter for the swallowing group (15 ± 2; p = 0.019). Only the latter infants demonstrated more mature OFS levels than controls.
  
  
  CONCLUSIONS
  The swallowing exercise is an efficacious intervention in facilitating the attainment of independent oral feeding, but not the sucking exercise. We speculate that the swallowing benefit resulted from an accelerated maturation of infants' OFS levels.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. clau@bcm.edu
authors.forename: C
authors.initials: C
authors.lastname: Lau
authors.forename: E O
authors.initials: EO
authors.lastname: Smith
mesh_terms: D002657:Child Development; D003679:Deglutition; D004750:Enteral Nutrition / Q000379:methods*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D041943:Infant Formula / Q000008:administration & dosage; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019102:Infant, Very Low Birth Weight; D016014:Linear Models; D008297:Male; D008895:Milk, Human; D041361:Pacifiers; D011446:Prospective Studies; D013391:Sucking Behavior