Effectiveness of Occupational Therapy Approaches for Feeding in Early Intervention: A Rapid Systematic Review

Abstract

Objective Newborns are admitted to the NICU for multiple reasons that require services. Feeding difficulties is an aspect of care that many NICU babies present with that require care from a multidisciplinary team. The objective of this study was to evaluate the effectiveness of numerous OT feeding interventions on the infants’ ability to feed independently compared to one that does not receive OT services.

Study design The study was conducted as a RSR using a software called Covidence. There were 3,189 articles uploaded to screen in Covidence and one additional article individually uploaded. From those articles a full text review was completed including 50 articles which then resulted in 24 articles which were included in the RSR from the initial search. Total, there were 25 articles included: 24 from Covidence and one individually uploaded.

Results This study aimed at examining numerous feeding interventions approaches to increase independence in feedings. Multisensory stimulation was found to have a significant increase in weight gain compared to groups receiving a different approach. Infants exposed to a soothing noise while feeding had an increase in sucking rates compared to infants that were not exposed to sound. Infants that received an odor-based intervention approach of being exposed to a food related scent were shown to have a decreased length in time until full feedings and shorter hospital stays. Infants who received skin to skin contact 60 minutes after birth had no difference shown but ones that received skin to skin contact immediately after had a higher breastfeeding and sucking scores. Parents that received caregiver education on feeding and positioning were shown to have less feeding difficulties, appropriate positioning of the baby during feedings, and improved bonding relationships with infants. Adaptive equipment such as nipples for feeding were analyzed and showed moderate improvement of feeding performance. Studies that used various approaches of oral motor stimulation showed a decreased hospital stay, improved feedings, and weight gain.

Conclusion Numerous approaches of intervention to improve feeding performance on infants were reviewed in the RSR. Studies concluded an improvement in one or more outcomes measure of weight gain, improved performance, sucking ability, relationship, and decreased hospital stay. Further research could be conducted to enhance reliability of the intervention approaches due to limited population sizes, geographical differences, and wider age range evaluated.