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ABSTRACT
Background. Feeding difficulties continue to be a serious problem in newborns with hypoxic-ischemic encephalopathy (FUE) undergoing therapeutic hypothermia (TH). The aim of this study was to investigate the efficacy of oral motor interventions (OMI) on feeding outcomes in neonates with FUE/TH.
Methods. This was a prospective randomised control study conducted between January 2022 and September 2022. Premature Infant Oral Motor Intervention (PIOMI) was used as OMI. Newborns with HIE/TH, who underwent PIOMI, constituted the study group, and newborns, who did not receive any feeding exercise, constituted the control group. Transition time to full oral feeding (EOF) was determined as the time between initiation of tube feeding and full oral breastfeeding or bottle feeding. The day per oral (PO) feeding was started was specified as PO first, the day the infants could take half of the volume of the feedings by mouth was PO half, and the day the infants could take all the feedings by mouth was PO full.
Results. There were 50 neonates in each group. Time to FOF was significantly shorter in the study group than in the control group in all stages of FUE/TH (P= 0.008 for stage 1, and <0.001 for stage 2 and 3 FUE). However, times to PO first, PO half, PO full and discharge were shorter in the study group than in the control group only in the neonates with stage 3 FUE (P= 0.003, 0.014, 0.013, 0.042, respectively).
Conclusions. The PIOMI, which could be named as "FUE-OMI" in our study, is an effective intervention in shortening the transition time to FOF in neonates with all stages of HIE undergoing TH. In addition, "FUE-OMI" shortens the length of hospital stay, and improves feeding outcomes in neonates with severe HIE/TH.
Key words: hypoxic ischemic encephalopathy, feeding outcomes, oral motor interventions, therapeutic hypothermia.
Hypoxic-ischemic encephalopathy (HIE) is an important cause of morbidity and mortality in newborns, and therapeutic hypothermia (TH) is the only proven treatment option that is known to decrease the rates of mortality and neurologic sequelae in neonates who are diagnosed as having moderate and severe HIE.1,2
Before the TH era, it was found that almost 50-90% of the neonates with moderate to severe basal ganglia and thalamic hypoxic-ischemic lesions had oral feeding difficulties, and almost...