Effect of sequential swallow training programme on feeding transition and suck-swallow-breath coordination in preterm infants

Aims: To retrospectively evaluate the effect of a sequential swallow training programme (SSTP) consisting of nonnutritive sucking (NNS), modified feeding posture, oral sensory-motor intervention and breath exercise on the independent oral feeding transition and coordination of suck-swallow-breath (SSB) functions in preterm infants.

Methods: Sixty preterm infants received SSTP intervention and sixty infants receiving NNS were set as control. The feeding performance and SSB coordination were assessed using POFRAS and NOMAS scales.

Results: The transition interval were 8.42 ± 4.49 and 10.27 ± 5.05 days for SSTP and NNS group, respectively (P = 0.022). SSTP group had substantially more weight gains and shorter in-hospital stay than NNS. Two groups had comparable POFRAS and NOMAS scores before interventions, which were significantly increased after treatments in the two groups (P < 0.05). SSTP groups exhibited higher POFRAS scores, and better NOMAS performance reflected by the movement and coordination of jaw and tongue, especially in the normal sucking domain than the NNS group (P < 0.05). Both interventions significantly reduced the episodes of desaturation, apnea, and bradycardia, while no priority was shown for SSTP comparing with NNS. Multivariate linear regression analysis revealed that SSTP intervention was independently associated with decreased full oral feeding transition days, more weight gain during intervention and higher POFRAS score after intervention.

Conclusion: SSTP intervention shorten the transition days to full oral feeding and efficiently improved oral movement and coordination of SSB pattern when feeding.