Identification of Risk Factors for Poor Feeding in Infants with Congenital Heart Disease and a Novel Approach to Improve Oral Feeding.
Gitanjali Indramohan, Tiffany P Pedigo, Nicole Rostoker and 3 others
PMID 28169036WHAT IT FOUND
Oral motor exercises did not improve full oral feeding at discharge beyond chance: 57% versus 45%.
Longer intubation, withheld feeds, reflux, and hypoplastic left heart syndrome were linked to poor feeding.
Key findings
01Full oral feeding at discharge was 57% in the intervention group and 45% in the control group, and the difference was not statistically significant.
02Longer total intubation and more postoperative days without enteral feeds were associated with not reaching full oral feeds by discharge.
03Hypoplastic left heart syndrome and gastroesophageal reflux disease were each associated with greater need for tube feeding at discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Only 23 infants received the intervention, and the study was compared with 40 historical controls, so it may have been too small to detect a real difference. The control group came from an earlier period, so hospital care may have differed in ways that were not measured. Some control infants may have received occupational therapy feeding treatment, which could have made the intervention group look less different. Two infants in the intervention group and nine in the control group were transferred before discharge, so their feeding status at discharge is unknown. The study did not test whether nurses and parents performed the oral motor exercises as instructed. Few parents chose to perform the exercises, and the study did not ask why. Vocal cord palsy was usually assessed in controls only when symptoms appeared, while some intervention infants were screened before symptoms, so the groups were not assessed in the same way. The study did not determine why reflux, longer intubation, delayed feeds, or hypoplastic left heart syndrome are linked to poor oral feeding.
The easy way to misread this
Do not conclude that oral motor intervention improves oral feeding or shortens hospital stay. The main feeding difference was not statistically significant, and the study was too small to rule out a real effect.