Introduction: The purpose of this study was to investigate the effects of Beckman oral stimulation program on the time to achieve independent oral feeding in preterm infants.Materials and Methods: In this randomized clinical trial study, 21 preterm infants, whose gestational ages ranged from 26 to 32 weeks and were hospitalized in Kamali Hospital NICU (Karaj- Iran), were chosen according to inclusionary and exclusionary criteria. They were randomly assigned either to a control group or Beckman prefeeding oral stimulation program. Considering the high importance of continued practice in this prefeeding oral stimulation program, the researcher individually implemented this program for each infant allocated to the experimental group for 10 successive days. The subjects in experimental and control groups were compared on these variables: 1- chronological and gestational age at various oral feeding times and at discharge from NICU; 2- weight gained during the first and the second postnatal weeks; and 3- the discharge time from NICU.Results: Average chronological age at 8 oral feeding times was 18.2±9.1 days (mean±SD) in Beckman group and 24.27±10.42 days in control group. Therefore, the subjects in experimental group reached to the criteria 6.07 days sooner than the other group. The difference can be considered as a clinically important achievement. The mean chronological age at discharge time from hospital in Beckman group and control groups were 27.6±12.57 and 33.45±13.46 days respectively. That is, the experimental group discharged 5.85 days sooner from hospital, which is a clinically important benefit.Conclusion: The results of this pilot study implicate the need for more investigation on the efficacy of Beckman prefeeding oral stimulation program. Meanwhile, the program seems to increase oral feeding skills and decrease the length of hospitalization in NICU.

Background and purpose: Problems in oral feeding are common in infants, especially in preterm infants. Therefore, assessment of infants feeding could be of great help in making appropriate diagnosis for rehabilitation of swallowing. Therefore, comprehensive and accurate assessment tools are needed. The aim of this study was to review assessment tools used for infants oral feeding. Materials and methods: Electronic databases including Google scholar, Pubmed, Scopus, Science Direct, and Medline were searched using the following keywords: Infant OR Preterm infant OR Premature infant, Evaluation or Assessment tool, Dysphagia OR Oral motor feeding or Swallowing or Feeding behavior. Articles published between 2000 and 2018 were reviewed and information including the manufacturer's name and country, purpose of the test, population, age, feeding method, examiner, psychometric properties, scoring criteria, and number of test items was collected. Results: In studies reviewed, 14 tools were used. Among the tools, two were used for assessment of bottle and breast feeding, 10 evaluated only breast feeding and only one tool was used for bottle feeding. There was also one tool that assessed the pre-feeding skills. Conclusion: Speech therapists usually use the tools that could accurately evaluate breast feeding or bottle feeding at a shorter time. Current review suggests Early Feeding Skills Assessment (EFS) and Neonatal Oral-motor Assessment scale (NOMAS) as the tools that have the features desired, and also have suitable psychometric properties and could be used in this group of infants.

Objective: To assess whether an oral stimulation program, enhances the oral feeding performance of preterm infants which born between 26-32 weeks gestational age.Materials & Methods: Preterm infants (n=20) were randomized into two experimental and control groups. The experiment group received an oral stimulation program consisting of stimulation of the oral structures for 15 minutes. Infant in the control group did not receive stimulation. Both were administered once a day for 10 consecutive days.Results: Independent oral feeding was attained significantly earlier in the experimental group than the control group, 13±4 days (means) versus 26±4 days, respectively (P<0.001). Length of hospital stay significantly was shorter in the experimental group than the control group, 32±6 days versus 38±2 days, respectively (P=0.021).Conclusion: An early oral stimulation program accelerates the transition to full oral feeding in preterm infants. This was associated with shorter time of hospital stay.

Background and Aim: One of the biggest problems of premature babies is oral feeding problems and delay in reaching independent oral feeding. The aim of the present study is to investigate the effect of non-oral stimulation with massage on the time of starting and achieving independent oral feeding and weighing in premature infants. Materials and Methods: Randomized clinical trial, 60 premature babies of 28-32 weeks in the NICU department of Ommolbanin Hospital, Mashhad met the criteria for entering the study, were selected and placed in two groups of field massage and control by simple random allocation. In the intervention group, infants received field massage (twice a day) for 15 minutes for 7 days, and the control group received the usual care. The two groups were compared with each other in variables of starting oral feeding, achieving independent oral feeding, and weight gain rate with statistical tests (T test, Manvitny & Covariance). A significance level of 0.05 was considered. Results: The mean and standard deviation of the gestational age of the infants in the intervention group was 29.0±1.1 and in the control group was 29.1±1.0 weeks. The results showed that the intervention group compared to the control group had a statistically significant difference in the beginning of oral feeding (p = 0.01) and the weight difference on the first and seventh days (p = 0.001), but even though nutritional progress to eight times of oral feeding in the intervention group was two days faster than the control group, but this difference was not significant (p = 0.17). Conclusion: Since non-oral stimulation with field massage can be effective in speeding up the time of oral feeding and weight gain of premature infants; it is recommended to be used by nurses in neonatal intensive care units to improve the quality of nursing care.

Introduction & Objective: Complications of adenotonsillectomy such as pain, nausea and vomiting, fever, inadequate oral intake, dehydration and bleeding are common and important. In addition of unpleasant feeling for patient, post operative nausea and vomiting will lead to more prolonged hospitalization and intravenous hydration. The purpose of this study was to determine whether a single dose of dexamethasone (0.5mg/kg) administered before surgery could decrease postoperative vomiting and improves oral intake in the first 24-hours after adenotonsillectomy procedures.Materials & Methods: In this double-blinded, placebo controlled study, 100 patients age 5-15 years, with ASA physical status I and 11were enrolled and iney were randomly allocated to receive either dexamethasone (n=50) 0.5 mg/kg IV (maximum dose 8 mg) or an equivalent volume of saline (n=50) preoperatively. The anesthetic regimen and surgical procedures were standardized for all patients. The incidence of early and late vomiting, the first time oral intake. oral intake adequacy, and duration oflV hydration were compared in both groups.Results:Data from 100 patients were analyzed. The overall incidence of early as well as late vomiting was significantly less in dexamethasone as compared to control group (P=0.001).The time to first oral intake, oral intake adequacy, and duration of IV hydration showed significant difference in both groups (P=0.01).Conclusion: A single dose of dexamethasone was not associated with adverse effects.Dexamethasone significantly decreased the incidence of postoperative vomiting during the first 24 hour. Shortened the time to the first oral intake, oral intake adequacy, and duration of IV hydration.

Objective: The purpose of this study was to investigate the effects of nonnutritive sucking on the time needed for achievement of independent oral feeding and weight gaining in 26-32 week gestational ages preterm infants in kamali NICU hospital.Materials & Methods: Randomized clinical trial design was used. The population of study was 22 preterm infant with 26-32 weeks gestational ages, that were admitted in kamali’s NICU. After choosing infants based on inclusion and exclusion criteria, the researcher divided them into two groups (control and nonnutritive sucking program) randomly.The researcher implemented this program in 10 consecutive days for each infant during first 5 minutes of gavage feeding (3 times in a day) in experimental group. Infants in control group did not receive any stimulation except routine nursing care. The testers were investigated for gestational age during various oral feeding times and discharge time from NICU and also their weight measured during first, second week after birth and discharge time from NICU and then the results of two groups, were compared.Results: In nonnutritive sucking group, mean of gestational age at discharge times, was 33.97±0.69 weeks (mean ±SD) and in control group was 34.32±1.33 weeks, which is not statistically significant (P=0.4).In NNS group Average weight at discharge time was 1654.54±133.29 grams and in control group was a 1472.72±94.34 gram. In NNS group, weight at discharge from NICU was significantly more than the control group (P=0.001).Conclusion: Use of NNS, significantly increased weight gain.Although there was no statistically significant effect on oral feeding criterion, but clinically improved oral feeding in preterm infants and decreased hospitalization time in NICU, were seen.

Introduction: Early feeding improves the outcome of patients with trauma and burns, although, few studies have examined its use after gastrointestinal (GI) anastomosis. A randomized controlled trail that compared an early regular diet with the conventional postoperative dietary management to determine GI complications and mortality after major GI anastomosis was conducted. The secondary purpose of this trial was to evaluate the incidence of postoperative ileus after major GI anastomosis with early feeding in comparison with the conventional diet. The purpose of this study was to compare early feeding with traditional postoperative dietary management for improvement of postoperative gastrointestinal (GI) symptoms.Materials and Methods: We conducted a prospective randomized controlled study. This was a study of 80 patients who were randomly allocated to early feeding beginning with liquid diet, 3 days postoperative, whereas those in the traditional feeding group were given a regular diet with normal bowel sounds.Results: The incidence of postoperative ileus did not differ between the two groups. However, there was no significant difference in the rate of intraoperative complications such as, leakage of anastomosis, mesenteric embolus, wound infection, and wound dehiscence between the groups. Also, there was no Considerable Variation in mortality between the two groups. There was noticeable contracts in time of bedridden between the two groups (p<0.001).Conclusion: Early feeding in GI anastomosis seems to be safe, well tolerated, and was not associated with increased postoperative GI complaints including ileus and postoperative complications such as wound dehiscence, infection, leakage, anastomosis, and mortality.