Premature Infant, Sucking Behavior
Conditions
Keywords
Premature infant, sucking, oral stimulation, POFRAS, NICU, feeding, physiotherapy, Rehabilitation, parental involvement
Brief summary
This randomized clinical trial aims to evaluate the effectiveness of an oral stimulation program to improve sucking in preterm neonates hospitalized in the NICU. The study compares two groups: one receiving the intervention from a physiotherapist and the other from trained parents. The stimulation program includes 4 extraoral and 4 intraoral exercises applied once daily for 14 consecutive days. The primary outcome is improvement in the POFRAS score. Secondary outcomes include the time to exclusive oral feeding, nasogastric tube withdrawal, weight at discharge, hospital stay duration, and parental adherence. This study addresses the potential role of parent participation in neonatal rehabilitation in public hospitals with limited human resources.
Detailed description
This single-blind, randomized clinical trial aims to compare the effectiveness of oral rehabilitation performed by trained parents versus physiotherapists to improve sucking in preterm neonates hospitalized in the NICU at the Hospital Civil de Guadalajara "Fray Antonio Alcalde," during the period July-October 2025. Eligible neonates will be randomized into two groups: Group A (Control): Intervention performed daily by a trained physiotherapist. Group B (Experimental): Intervention performed daily by the parents after structured training and supervised implementation. The oral stimulation program consists of 4 extraoral and 4 intraoral exercises designed to promote the development of sucking, swallowing, and breathing coordination. Each session lasts approximately 15 minutes and will be applied once daily for 14 consecutive days or until full oral feeding is achieved. The primary outcome will be improvement in oral feeding readiness, assessed using the validated Spanish version of the POFRAS (Preterm Oral Feeding Readiness Assessment Scale). Secondary outcomes include: achievement of exclusive oral feeding, time to withdrawal of nasogastric tube, weight gain, hospital length of stay, and parent adherence to the protocol. Randomization will use permuted blocks, and the outcome assessor will be blinded to group assignment. This study explores the feasibility and impact of parent-administered interventions in a public hospital setting with limited specialized personnel.
Interventions
BEHAVIORALParental Oral Stimulation Protocol
This intervention consists of a structured oral stimulation protocol composed of 4 extraoral and 4 intraoral exercises designed to improve oral motor function in preterm neonates. Exercises include perioral massage, stimulation of sucking reflex, and non-nutritive sucking using a pacifier. The protocol is administered once daily for 14 consecutive days. In this study arm, the intervention is performed by parents, previously trained and supervised in the neonatal unit.
BEHAVIORALPhysiotherapist-led Oral Stimulation
This intervention consists of a structured oral stimulation protocol composed of 4 extraoral and 4 intraoral exercises designed to improve oral motor function in preterm neonates. Exercises include perioral massage, stimulation of sucking reflex, and non-nutritive sucking using a pacifier. The protocol is administered once daily for 14 consecutive days. In this study arm, the intervention is performed by a licensed physiotherapist.
Sponsors
Hospital Civil de Guadalajara
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
34 Weeks to 36 Weeks
Healthy volunteers
No
Inclusion criteria
* Neonates with corrected gestational age of 34 to 36 weeks * Clinically stable to receive oral stimulation * Informed consent obtained from parents or legal guardians
Exclusion criteria
* Orofacial congenital malformations * Severe neuromuscular disease * Conditions contraindicating oral feeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in POFRAS Score from Day 1 to Day 14 | Baseline and Day 14 of intervention | Change in the total score of the POFRAS scale (0-36 points), which evaluates oral feeding readiness in preterm neonates. A higher score indicates greater readiness for oral feeding. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Exclusive Oral Feeding | From baseline to achievement of full oral feeding (up to 14 days) | Number of days required for the neonate to transition from tube feeding to exclusive oral feeding without need for nasogastric support. |
| Weight at Hospital Discharge | Baseline and Day 14 post-intervention | Body weight in grams recorded at the time of NICU discharge |
| Length of Hospital Stay | From birth until hospital discharge, assessed up to 60 days | Total number of days the neonate remains hospitalized in the neonatal intensive care unit (NICU) until medically cleared for discharge. |
| Parental Satisfaction | At Day 14 or end of intervention | Level of parental satisfaction with the intervention protocol, assessed using a 5-point Likert scale (1 = very dissatisfied; 5 = very satisfied). |
Countries
Mexico
Contacts
CONTACTNelsi Alejandra Gonzalez Gonzalez, subspecialty
CONTACTJose Armando Labra Zepeda, Fellow
Outcome results
None listed