Phoniatrics Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
Neonatology Unit, Pediatric Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
BMC Pediatr. 2024 Jul 15;24(1):453. doi: 10.1186/s12887-024-04909-6.
Oral feeding is a complex sensorimotor process influenced by many variables, making it challenging for healthcare providers to introduce and manage it. Feeding practice guided by tradition or a trial-and-error approach may be inconsistent and potentially delay the progression of oral feeding skills.
To apply a new feeding approach that assesses early oral feeding independence skills of preterm infants in the neonatal intensive care unit (NICU). To prove its effectiveness, compare two approaches of oral feeding progression based on clinical outcomes in preterm infants, the traditional approach used in the NICU of Mansoura University Children Hospital (MUCH) versus the newly applied approach.
A quasi-experimental, exploratory, and analytical design was employed using two groups, control and intervention groups, with 40 infants for the first group and 41 infants for the second one. The first group (the control) was done first and included observation of the standard practice in the NICU of MUCH for preterm oral feeding, in which oral feeding was dependent on post-menstrual age (PMA) and weight for four months. The second group (the intervention) included early progression to oral feeding depending on early assessment of Oral Feeding Skills (OFS) and early supportive intervention and/or feeding therapy if needed using the newly developed scoring system, the Mansoura Early Feeding Skills Assessment "MEFSA" for the other four months. Infants in both groups were studied from the day of admission till discharge.
In addition to age and weight criteria, other indicators for oral feeding readiness and oral motor skills were respected, such as oral feeding readiness cues, feeding practice, feeding maintenance, and feeding techniques. By following this approach, preterm infants achieved earlier start oral feeding (SOF) and full oral feeding (FOF) and were discharged with shorter periods of tube feeding. Infants gained weight without increasing their workload to the NICU team.
The newly applied approach proved to be a successful bedside scoring system scale for assessing preterm infants' early oral feeding independence skills in the NICU. It offers an early individualized experience of oral feeding without clinical complications.
口腔喂养是一个复杂的感觉运动过程，受许多变量影响，这使得医疗保健提供者难以引入和管理它。基于传统或试错方法的喂养实践可能不一致，并且可能延迟口腔喂养技能的进展。
应用一种新的喂养方法，评估新生儿重症监护病房（NICU）中早产儿的早期口腔喂养独立性技能。通过比较两种基于早产儿临床结果的口腔喂养进展方法来证明其有效性，一种是曼苏拉大学儿童医院（MUCH）NICU 中使用的传统方法，另一种是新应用的方法。
使用准实验、探索性和分析设计，将 40 名婴儿分为对照组和干预组，第一组为 41 名婴儿。第一组（对照组）首先进行，观察 MUCH NICU 中早产儿口腔喂养的标准实践，其中口腔喂养依赖于胎龄（PMA）和体重四个月。第二组（干预组）包括根据早期口腔喂养技能（OFS）评估和早期支持性干预以及/或需要时使用新开发的评分系统（曼苏拉早期喂养技能评估“MEFSA”）早期进展到口腔喂养，在另外四个月内。两组婴儿均从入院日至出院日进行研究。
除了年龄和体重标准外，还尊重了其他口腔喂养准备和口腔运动技能的指标，例如口腔喂养准备线索、喂养实践、喂养维持和喂养技术。通过遵循这种方法，早产儿更早开始口腔喂养（SOF）和完全口腔喂养（FOF），并在较短的时间内通过管饲喂养出院。婴儿体重增加而不会增加 NICU 团队的工作量。
新应用的方法被证明是一种成功的床边评分系统，用于评估 NICU 中早产儿的早期口腔喂养独立性技能。它提供了一种早期的个体化口腔喂养体验，没有临床并发症。
