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Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants

An Evidence-Based Systematic Review

Rhooms, Latisha, MSc; Dow, Kimberly, MD; Brandon, Cara, MSc; Zhao, Grace, MSc; Fucile, Sandra, PhD, OT

doi: 10.1097/ANC.0000000000000546
Oral Feeding Strategies: Special Series

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.

Department of Paediatrics (Drs Dow and Fucile) and School of Rehabilitation Therapy, (Mss Rhooms, Brandon, and Zhao and Dr Fucile), Queen's University, Kingston, Ontario, Canada.

Correspondence: Sandra Fucile, PhD, OT, Department of Paediatrics, Queen's University, 76 Stuart St, Kingston, ON K7L 2V7, Canada (

The authors alone are responsible for the content and writing of this article.

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses