Open AccessPatterned frequency-modulated oral stimulation in preterm infants: A multicenter randomized controlled trial
Author(s) -
Dongli Song,
Priya Jegatheesan,
Suhas Nafday,
Kaashif A. Ahmad,
Jonathan Nedrelow,
Mary E Wearden,
Sheri L. Nemerofsky,
Sunshine Pooley,
Diane Thompson,
Daniel Vail,
Tania Cornejo,
Zahava Cohen,
Balaji Govindaswami
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0212675
Subject(s) - pacifier , medicine , randomized controlled trial , stimulation , gestational age , pulsatile flow , clinical endpoint , multicenter trial , gestation , external cephalic version , anesthesia , pediatrics , multicenter study , pregnancy , breastfeeding , biology , genetics , breech presentation
Objective To evaluate the effect of patterned, frequency-modulated oro-somatosensory stimulation on time to full oral feeds in preterm infants born 26–30 weeks gestation. Study design This is a multicenter randomized controlled trial. The experimental group (n = 109) received patterned, frequency-modulated oral stimulation via the NTrainer system through a pulsatile pacifier and the control group (n = 101) received a non-pulsatile pacifier. Intent-to-treat analysis (n = 210) was performed to compare the experimental and control groups and the outcomes were analyzed using generalized estimating equations. Time-to-event analyses for time to reach full oral feeds and length of hospital stay were conducted using Cox proportional hazards models. Results The experimental group had reduction in time to full oral feeds compared to the control group (-4.1 days, HR 1.37 (1.03, 1.82) p = 0.03). In the 29–30 weeks subgroup, infants in the experimental group had a significant reduction in time to discharge (-10 days, HR 1.87 (1.23, 2.84) p < 0.01). This difference was not observed in the 26–28 weeks subgroup. There was no difference in growth, mortality or morbidities between the two groups. Conclusions Patterned, frequency-modulated oro-somatosensory stimulation improves feeding development in premature infants and reduces their length of hospitalization. Trial registration ClinicalTrials.gov NCT01158391