Exploration of the Association Between Sucking Measures and Ability to Attain Independent Oral Feeds Among Infants Who Are Born Preterm.

IMPORTANCE: Infants who are born preterm often experience difficulty transitioning from full tube to independent oral feeds, which often prolongs their hospital stay. No clinical measures associated with attainment of independent oral feeds are currently available. OBJECTIVE: To identify specific nutritive sucking measures associated with time to attainment of independent oral feeds among infants who are born preterm. DESIGN: An observational cohort pilot study was undertaken. SETTING: A Level 2 to Level 3 neonatal intensive care unit. PARTICIPANTS: Fourteen infants (7 male, 7 female) born at or less than 34 wk gestation were enrolled. OUTCOMES AND MEASURES: The monitored suck measures included average suck strength (millimeters of mercury), average sucking burst duration (seconds), average suck count (number of sucks), and average pause duration (seconds). Time to independent oral feeds (days) and baseline characteristics were also monitored. The nutritive sucking measures were recorded once, during the first 5 min of an oral feed, when infants were taking an average of three to four oral feeds per day using a nipple monitoring device. RESULTS: An inverse relation was found among average suck burst duration (p = .04), gestational age (p = .03), and days to attainment of independent oral feeds. CONCLUSIONS AND RELEVANCE: Study results suggest that average sucking burst duration, during the first 5 min of an oral feed, is associated with time to attain independent oral feeds. Plain-Language Summary: Sucking burst duration is a simple measure that may be used clinically to identify early on infants who may have trouble transitioning from full tube to independent oral feedings. The results of this study suggest that a suck burst duration in the first 5 min of an oral feeding is inversely associated with the length of time to achieve independent oral feeding. The results highlight the importance of considering an infant's nutritive sucking ability when evaluating their potential to achieve independent oral feedings.

Interventions to Enhance Achievement to Independent Oral Feeds in Premature Infants: A Scoping Review.

AIM: To assess the effectiveness of interventions aimed at facilitating the transition from full tube to independent oral feeds in premature infants. METHODS: Scoping review methodology using the Preferred Reporting items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA_ScR). A search of six databases (EMBASE, MEDLINE, CINAHL, Web of Science, COCHRANE, and OT Seeker), using keywords related to oral feeding and premature infants retrieved 11,870 articles. Full-text screening was completed for 36 articles, and 21 articles were included in this review. RESULTS: Review of the 21 articles revealed five intervention types: oral stimulation (n = 14), swallow/gustatory stimulation (n = 3), olfactory stimulation (n = 2), tactile/kinesthetic stimulation (n = 1), and auditory stimulation (n = 1). Oral stimulation had the most studies with consistent evidence supporting its beneficial effect to facilitate achievement to independent oral feeds, swallow/gustatory stimulation appeared to have some benefit, but evidence for olfactory, tactile/kinesthetic, and auditory stimulation was sparse. CONCLUSION: Oral stimulation has the most studies with consistent evidence, and thus is suggested as a suitable early intervention strategy that can be used by health providers to facilitate the achievement to independent oral feeds in premature infants. The alternate forms of stimulation have limited evidence and necessitate further studies to confirm their benefits.

Parental Perceptions of the Impact of NICU Visitation Policies and Restrictions Due to the COVID-19 Pandemic: A Qualitative Study.

BACKGROUND: The COVID-19 pandemic has impacted parents' ability to participate in their infants' care during the neonatal intensive care unit (NICU) stay in unprecedented ways. PURPOSE: The purpose of this study was to explore the lived experience of parents whose infants was in the NICU during the COVID-19 pandemic. METHODS: A qualitative telephone interview survey was conducted. Participants included parents of preterm infants who were born less than 34 weeks' gestation during the first wave of the COVID-19 pandemic (March 2020-August 2020). Telephone surveys were conducted through open-ended questions. A thematic content analysis identifying themes was performed after interviews were completed and transcribed. RESULTS: A total of 8 mothers completed the telephone survey. Key themes from this study include parents experiencing increased stress due to the restricted visitation policies, limited opportunities to care for their infant, lack of support, and inconsistent communication regarding their infant status and COVID-19 protocols. IMPLICATIONS FOR PRACTICE: Suggestions provided to enhance NICU services during the pandemic include increasing parental engagement opportunities to care for their infant in the NICU, enhanced empathy and compassion from the neonatal team, and open and transparent communication. IMPLICATIONS FOR RESEARCH: Further research investigating cultural impact on parents' perspectives, perspectives of fathers, long-term impact of how parents coped after discharge from the NICU, and emotional impact on NICU staff members may be beneficial to aid improvements in NICU service delivery during the ongoing and future pandemic.

Oral Feeding Outcomes in Infants Born With Neonatal Abstinence Syndrome.

OBJECTIVE: Breastfeeding is the optimal source of nutrition for all infants, but there are limited data on feeding outcomes in infants with neonatal abstinence syndrome (NAS) who are admitted in the neonatal intensive care unit (NICU). METHODS: A retrospective cohort study was conducted at a level II/III NICU. Study sample consisted infants with a diagnosis of NAS and those diagnosed with respiratory distress syndrome. The primary outcome was attainment of independent oral feeds, defined as the number of days to transition from full-tube to full oral feeds. Secondary outcomes included length of hospital stay and method (breast or bottle) of oral feeds at the start, at attainment of independent oral feeds, and at hospital discharge. RESULTS: Infants with NAS took significantly longer to attain independent oral feeds than controls (P = .021) and received significantly fewer breastfeeds at the start of oral feeds, at independent oral feeds, and at hospital discharge (P = .000). There was no difference in length of hospital stay between groups. CONCLUSION: These results suggest that infants with NAS can experience difficulties achieving independent oral feeds and are less likely to receive breastfeeds. Additional support is required to enhance oral feeds in infants with NAS in the NICU.

Impact of the Covid-19 Pandemic on Breastfeeding Establishment in Preterm Infants: An Exploratory Study.

Purpose: To evaluate breastfeeding outcomes in preterm infants born during the Covid-19 pandemic. Design: An observational cohort study of 33 infants born ≤34 weeks' gestation was conducted. Sample: The study sample consisted of 33 infants divided into 2 groups: infants born during the Covid-19 pandemic (Covid group, n = 11) and those born prior to the pandemic (pre-Covid group, n = 22). Main Outcome Variable: Breastfeeding at hospital discharge. Results: Fewer infants in the Covid group received breastfeeds at full oral feed (p = .015) and none breastfeeding at hospital discharge (p = .001). In addition, fewer infants in the Covid group received non nutritive sucking (p = .612) and more infants in the Covid group required milk supplementation (p = .032). Study results suggest that breastfeeding establishment at hospital discharge in preterm infants is significantly impacted by the Covid-19 pandemic. There is a critical need, in low-risk disease transmission areas, to enhance parental access and to increase in-hospital lactation supports to help safeguard breastfeeding outcomes in preterm infants.

A Unique Clinical Tool for the Evaluation of Oral Feeding Skills in Infants.

Background. Occupational therapy practice for oral feeding assessment is based on clinical observation of infants' sucking, swallowing, and breathing ability, which is influenced by clinical experience and provides poor evidence on explanatory factors. Purpose. To test the clinical utility and safety of a nipple monitoring device for the quantitative evaluation of oral feeding skills. Method. Sixteen infants, with no severe medical complications, participated in a pre-experimental pilot study. Oral feeding performances (duration, intake volume, and rate of transfer), and occurrence of adverse events (apnea, bradycardia, and oxygen desaturations) were recorded to ensure the tool does not interfere with infant's feeding ability or does not create any adverse effects. Findings. There was no significant difference in duration, intake volume, rate of transfer between the two monitored sessions, and no occurrence in adverse events. Implications. The findings suggest that the nipple monitoring device may be used for quantitative assessment and intervention planning of oral feeding difficulties in infants.

Benefits of a Standardized Enteral Feeding Protocol on the Nutrition and Health Outcomes of Very Low Birth Weight Preterm Infants.

Purpose: To compare nutrition and health outcomes before and after implementing a standardized enteral feeding protocol on nutrition and health outcomes in very low birth weight preterm infants.Methods: A retrospective chart review was performed evaluating preterm infants, born less than 34 weeks gestation and weighing less than 1500 g, before and after the implementation of a standardized enteral feeding protocol. Outcomes included weaning of parenteral nutrition, initiation and advancement of enteral feeds, initiation of human-milk fortifier (HMF), change in weight z-score and neonatal morbidities.Results: Fifty-six infants (30 in pre-group, 26 in post-group) met the inclusion criteria. Infants in the standardized enteral feeding protocol group started enteral feeds earlier (p = 0.039) and received full HMF fortification at lower weights (p = 0.033) than those in the pre-group. Fewer days on continuous positive airway pressure (p = 0.021) and lower rates of bronchopulmonary dysplasia (p = 0.018) were also observed in the post-group. Weaning of parenteral nutrition and weight z-score were not significantly different between groups. There were no differences in other morbidities.Conclusion: Study results suggest that adopting a standardized enteral feeding protocol may promote early initiation of enteral feeds and fortification.

Investigating the Developmental Trajectory of Long-term Oral Feeding Problems in 'Healthy' Preterm Infants.

PURPOSE: To investigate the occurrence of oral feeding problems in preterm infants up to one year after hospital discharge. METHODS: Thirty-six infants born <34 weeks gestation were enrolled in a prospective exploratory longitudinal pilot study prior to hospital discharge. Parents of eligible infants completed telephone questionnaires at 3, 6, and 12 months corrected gestational age. The occurrence and type of feeding problems; medical problems; and rehabilitation services received were collected. RESULTS: A total of 26 (72.2%) parents responded, with 11 (42%) identifying feeding problems that developed within the first year of life. Avoidant behavior (including crying, agitated/fussy, and refusing to eat) was the most common feeding problem that occurred. CONCLUSION: Feeding problems in 'healthy' preterm infants may occur at any point in development within the first year of life. Increased screening after hospitalization is needed for early identification and to make appropriate referrals in a timely manner to prevent and/or reduce the severity of long-term feeding problems.

The Impact of Infant and Maternal Factors on Oral Feeding Performance in Premature Infants.

Aims: To identify infant and maternal factors associated with attainment of full oral feeding (FOF) in premature infants.Method: A retrospective study was performed on 89 premature infants (<34 weeks gestational age) from a tertiary care neonatal intensive care unit (NICU). Infant and maternal factors were concurrently assessed. Infant factors included gestational age, birthweight, continuous positive airway pressure assistance, mechanical ventilation support, and presence of neonatal morbidities including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and intraventricular hemorrhages (IVH). Maternal factors included maternal age, first born, twin birth, and presence of mental health conditions including anxiety, stress, or depression.Results: A total of 89 premature infants were included in the sample. A stepwise linear regression model revealed that infants who received mechanical ventilator support and presence of maternal mental health conditions were significantly associated with time to attain FOF.Conclusions: Results suggest that oral feeding performance is influenced not only by infant's medical severity denoted by need for ventilator assistance, but also by presence of maternal anxiety, stress, and/or depression.

Risk Factors Associated With Long-term Feeding Problems in Preterm Infants: A Scoping Review.

BACKGROUND: Infants who are born preterm are at a high risk of encountering feeding problems. PURPOSE: The aim of this scoping review is to identify risk factors associated with feeding problems that persist beyond infancy in children (aged 1-6 years) who were born preterm (<37 weeks' gestation). METHODS: To perform this scoping review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework was applied. To be included in this study, articles had to be published in peer-reviewed journals, had an empirical study design, examined feeding problems relating to the child's feeding ability or refusal to eat certain texture of foods, and assessed risk factors (age, weight, and medical conditions) associated with long-term feeding problems in children who were born preterm. RESULTS: After abstract and full-text screening, a total of 9 articles meeting the inclusion criteria were included in this study. Findings from this study identified that gestational age and birth weight are significant risk factors and that sex, duration of mechanical ventilation, and length of tube feedings are potential risk factors. IMPLICATIONS FOR PRACTICE: This study confirms that younger and smaller infants are at a high risk of encountering oral feeding difficulties and early interventions services should be focused on these preterm infants. IMPLICATIONS FOR RESEARCH: Evaluation of timing and intensity (dose) of early interventions strategies should be investigated to provide more targeted and effective interventions for younger and smaller preterm infants.

Evaluation of Methods of Breast or Bottle Feeding on Length of Hospitalization of Preterm Infants.

Background: Direct breastfeeding is the optimal method of nourishing preterm infants. Preconceived notions exist among health practitioners that establishment of direct breastfeeding lengthens hospitalization. Thus far, the aforementioned association remains unknown. Research Aim: The objective of this study was to assess the impact of direct breastfeeding establishment on length of hospital stay in preterm infants. Methods: A retrospective chart review on a sample of 101 mother-infant dyads was conducted in the neonatal intensive care unit at Kingston Health Sciences Center (KHSC) in Ontario, Canada. The sample consisted of three groups: (1) modified direct breastfeeding group, defined as infants receiving ≥50% direct breastfeeds during hospitalization, (2) partial breastfeeding group, defined as infants receiving <50% breastfeeds during hospitalization, and (3) bottle feeding group, defined as infants only receiving bottle feeds during hospitalization. A multiple linear regression model was performed to assess the relationship between length of hospitalization and method of oral feeds (modified direct breastfeeds vs. partial breastfeeds vs. bottle feeds) while controlling for infant (gestational age [GA], birth weight, 5 minutes Apgar score, ventilator support) and maternal (age, first-time mother, mental health conditions) factors. Results: GA was inversely associated with length of hospitalization. The number of days on ventilator support was positively associated with length of hospitalization. Method of oral feed, birth weight, 5 minutes Apgar score, maternal age, first-time mother status, and maternal mental health conditions were not associated with duration of hospitalization. Conclusions: Direct breastfeeding establishment does not lengthen hospitalization in preterm infants. This finding may aid health practitioners in increasing direct breastfeeding success in this population.

Enhancing breastfeeding establishment in preterm infants: A randomized clinical trial of two non-nutritive sucking approaches.

BACKGROUND: Preterm infants and their mothers face many barriers to the establishment of exclusive breastfeeding in the neonatal intensive care unit. OBJECTIVE: The objective of this study was to assess and compare the effect of maternally administered non-nutritive sucking (NNS) on an emptied breast versus a pacifier on exclusive breastfeeding establishment at hospital discharge. STUDY DESIGN: A block randomized study design was performed. TRIAL REGISTRATION NUMBER: NCT03434743. METHODS: A total of 33 preterm infants born less than or equal to 34 weeks gestation participated in the study. The NNS on an emptied breast or pacifier interventions were administered by mothers, once a day for 15 min. Outcomes included: exclusive breastfeeding acquisition, described as infants who received greater than or equal to 50% of direct breastfeeds at hospital discharge; time to achieve independent oral feeding, defined as the number of days to transition from complete tube feeds to full oral feeds (full breast, partial breast/bottle, or full bottle); length of hospitalization, described as the number of days from admission to hospital discharge. RESULTS: A significantly greater number of infants in the NNS emptied breast group acquired exclusive breastfeeds at hospital discharge as compared with those in the NNS pacifier group (63% vs. 24%, p = 0.037). There was no difference between groups in time to achieve independent oral feeds (14.4 ± 8.0 vs. 14.4 ± 6.4 days, p = 0.683) and length of hospital stay (48.7 ± 33.7 vs. 53.1 ± 30.6 days, p = 0.595). CONCLUSION: Provision of NNS on an emptied breast is a safe and low-cost infant and mother targeted intervention which can increase exclusive breastfeeding rates and its well-recognized advantages in a highly vulnerable population.

Developmental Outcomes of Children Born with Neonatal Abstinence Syndrome (NAS): A Scoping Review.

AIMS: The purpose of this scoping review is to provide an overview of developmental outcomes of children diagnosed with neonatal abstinence syndrome (NAS). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework was used to guide this scoping review. A comprehensive search of CINAHL, MEDLINE, EMBASE, Web of Science, and PsycINFO was conducted using search terms related to NAS and developmental areas. Full-text screening was completed for 30 articles, and eight studies were included in this review. RESULTS: Cognitive and language development, as well as school performance, social and motor domains, may be areas of concern in children with NAS. CONCLUSIONS: The developmental outcomes of infants with NAS cannot be firmly determined due to inconsistent results across reviewed studies. Future research investigating development across various ages is required for rending more appropriate intervention services to this high-risk population.

A national survey of the enteral feeding practices in Canadian neonatal intensive care units.

AIM: Nutrition affects the growth and neurodevelopmental outcomes of preterm infants, yet controversies exist about the optimal enteral feeding regime. The objective of this study was to compare enteral feeding guidelines in Canadian neonatal intensive care units (NICUs). METHOD: The research team identified key enteral feeding practices of interest. Canadian Neonatal Network site investigators at 30 Level 3 NICUs were contacted to obtain a copy of their 2016 to 2017 feeding guidelines for infants who weighed less than 1,500 g at birth. Each guideline was reviewed to compare recommendations around the selected feeding practices. RESULTS: Five of the 30 NICUs did not have a feeding guideline. The other 25 NICUs used 22 different enteral feeding guidelines. The guidelines in 40% of those NICUs recommend commencing minimal enteral nutrition (MEN) within 24 hours of birth and maintaining that same feeding volume for 24 to 96 hours. In 40% of NICUs, the guideline recommended that MEN be initiated at a volume of 5 to 10 mL/kg/day for infants born at <1,000 g. Guidelines in all 25 NICUs recommend the use of bovine-based human milk fortifier (HMF), and in 56% of NICUs, it is recommended that HMF be initiated at a total fluid intake of 100 mL/kg/day. Guidelines in only 16% of NICUs recommended routine gastric residual checks. Donor milk and probiotics are used in 76% and 72% of the 25 NICUs, respectively. CONCLUSION: This study revealed substantial variability in recommended feeding practices for very low birth weight infants, underscoring the need to establish a national feeding guideline for this vulnerable group.

A two-pronged approach to reduce noise levels in the neonatal intensive care unit.

OBJECTIVES: The aim of this study was to assess the efficacy of a visual noise feedback system and "quiet time" in reducing noise levels in the neonatal intensive care unit (NICU). DESIGN: A prospective cross-sectional study was performed in a combined level II/III NICU at a Canadian tertiary care hospital. Noise levels were recorded continuously for three weeks without and then three weeks with visual noise feedback system. Noise levels were compared after one year of using visual feedback, and subsequently with the addition of two "quiet times." RESULTS: Visual feedback reduced noise levels from 54.2 dB (95% CI 53.8-54.7 dB) to 49.4 dB (95% CI 48.9-49.8 dB; P < 0.0001) and increased the amount of time spent under 45 dB from 0 to 25% (P < 0.0001) after three weeks of use. However, this effect was not sustained at one year of visual feedback, with noise levels at 54.7 dB (95% CI 54.5-55.0 dB, P = 0.55). Quiet Time did not further reduce daily noise in the NICU (average noise levels 54.7, 95% CI 54.4-55.0 dB, P = 0.836). CONCLUSIONS: While visual noise feedback system reduced noise levels in the short term, these effects were not sustainable at one year and could not be remediated with the addition of a Quiet Time initiative. Continuing education regarding the detrimental effects of noise is paramount to ensure persistent noise reduction in the NICU.

Goals of Parents Whose Infant Is in the Neonatal Intensive Care Unit: An Explorative Study.

BACKGROUND: The aim of many neonatal intensive care units (NICU) today is to promote a family-centered practice that addresses parental concerns and needs. However, the specific goals of parents are often unaddressed by the healthcare team. The aim of this study was to understand the goals of parents whose infant was in the NICU to enhance collaboration and communication between parents and health professionals. METHODS: A written questionnaire was disseminated to parents whose infant was in the NICU at the Kingston Health Sciences Centre. A thematic analysis of the goals was completed to identify key emergent themes and their implications. RESULTS: A total of 23 questionnaires were disseminated to parents and 13 (57%) were returned. Returned questionnaires were most often completed by the mother (n = 9, 70%), and a total of 40 goals were recorded. Three key emergent themes were identified, which included feeding and weight gain, eliminating medical equipment, and successful hospital discharge. IMPLICATIONS FOR PRACTICE: Understanding the goals of parents whose infant was in the NICU can enhance communication between parents and their healthcare team, thus aiding the implementation of a family-centered practice. IMPLICATIONS FOR RESEARCH: Future larger sample sizes studies across several NICUs would increase the generalizability of results and garner a larger volume of data to establish significant trends between specific infant and parent demographic data and the associated goals.

Occupational Therapy Management Strategies for Infants With Neonatal Abstinence Syndrome: Scoping Review.

With opioid use in North America rising, there is a growing incidence of neonatal abstinence syndrome (NAS). Infants with NAS experience withdrawal signs that interfere with their occupational performance in activities of daily living. This scoping review aims to identify the non-pharmacologic interventions currently used in the treatment of infants with NAS that fall within the scope of the occupational therapy profession. Searching three databases, articles were independently reviewed by two authors to meet defined inclusion criteria. Forty-five articles were included, and the interventions identified and organized according to the Person-Environment-Occupation Model. The non-pharmacologic interventions identified fall within the scope of the occupational therapy profession. Initiating occupational therapy services in an acute care setting may have the potential to improve occupational performance and engagement for these infants from an early age.

Identification of a Pivotal Period in the Oral Feeding Progression of Preterm Infants.

OBJECTIVE: Preterm infants are at risk of encountering oral feeding difficulties which impede on the transition to independent oral feeds. The objective of this study was to identify a pivotal period where regressions are most likely to occur during their oral feeding progression. STUDY DESIGN: This is a retrospective study on 101 infants born <35 weeks' gestation. The sample was separated into two groups, infants who experienced a regression during their oral feeding progression and those who did not. A pivotal period was defined as a time frame where setbacks (a decrease in oral feed attempts by one) are most likely to occur at the start (1-2 oral feed attempts per day), middle (3-5 oral feed attempts per day), or end (6-8 oral feed attempts per day) of the oral feeding progression. RESULT: Eighty-two percent of infants experienced setbacks; 45% of all setbacks occurred at the middle time frame (p = 0.03). Infants' degree of maturity and enteral tube feeding intolerances were associated with increased occurrence of setbacks (p = 0.04). CONCLUSION: The midpoint in the oral feeding progression is a pivotal period where setbacks are most likely to occur. This time frame can be used by clinicians to evaluate oral-motor skills for earlier provision of interventions to reduce the occurrence of oral feeding difficulties in this high-risk population.

Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants: An Evidence-Based Systematic Review.

BACKGROUND: Preterm infants often experience difficulty with the transition from tube to oral feeding. While many unimodal and multimodal sensorimotor interventions have been generated to optimize oral feeding skills, there has been little cohesion between interventions. PURPOSE: The aims of this systematic review were to examine the effect of sensorimotor interventions on oral feeding outcomes and to determine whether multimodal interventions lead to better oral feeding performances than unimodal interventions. SEARCH STRATEGY: A systematic search of CINAHL, Embase, MEDLINE, and PsycINFO databases was conducted. Studies were reviewed to assess the types of interventions used to improve transition to full oral feeding, volume intake, weight gain, and length of hospital stay. RESULTS: The search identified 35 articles. Twenty-six studies examined a unimodal intervention, with the majority focusing on oral sensorimotor input and the others on tactile, auditory, and olfactory input. Nine studies assessed multimodal interventions, with the combination of tactile and kinesthetic stimulation being most common. Results varied across studies due to large differences in methodology, and caution is warranted when interpreting results across studies. The heterogeneity in the studies made it difficult to make any firm conclusions about the effects of sensorimotor interventions on feeding outcomes. Overall, evidence on whether multimodal approaches can lead to better oral feeding outcomes than a unimodal approach was insufficient. IMPLICATIONS FOR PRACTICE: The use of sensorimotor interventions to optimize feeding outcomes in preterm infants varies based on methods used and modalities. These factors warrant caution by clinicians who use sensorimotor interventions in the neonatal intensive care unit. IMPLICATIONS FOR RESEARCH: Large randomized clinical trials using a standardized approach for the administration of sensorimotor input are needed to further establish the effects on feeding outcomes in preterm infants.

Oral Sensorimotor Intervention Enhances Breastfeeding Establishment in Preterm Infants.

OBJECTIVE: To assess the efficacy of an oral sensorimotor intervention on breastfeeding establishment and maintenance in preterm infants. STUDY DESIGN: Thirty-one preterm infants born ≤34 weeks gestation were randomized into an experimental or control group. The experimental group received a 15-minute program consisting of stroking the peri-oral structures for the first 5 minutes, tongue exercises for the next 5 minutes, followed by non-nutritive sucking for the final 5 minutes. The control group received a sham intervention for the same duration. The interventions were administered once daily for 10 days. The outcomes included: time to attainment of full oral feeding, breastfeeding acquisition (i.e., ≥50% of direct breastfeeding at hospital discharge), breastfeeding skill assessment using the Preterm Infant Breastfeeding Behavior Scale (PIBBS), length of hospitalization, and breastfeeding maintenance at 3 and 6 months posthospitalization. RESULTS: Full oral feeding was attained earlier in the experimental group compared with the control (10.7 ± 2.1 vs. 19.3 ± 3.6 days, p < 0.01). This was associated with a greater number of infants in the intervention group acquiring breastfeeding at hospital discharge compared with the controls (n = 11 vs. 5, p = 0.049). There was no statistical difference in PIBBS score, length of hospitalization, and breastfeeding rates at 3 and 6 months posthospitalization between the two groups (all tests, p > 0.32). CONCLUSIONS: An oral sensorimotor intervention accelerated the achievement of full oral feeding and enhanced direct breastfeeding rates at hospital discharge only. Provision of an oral sensorimotor intervention is a safe and low-cost intervention that may increase breastfeeding rates in a highly vulnerable population.