Neonatal Therapy Interventions Supporting Oral Feeding Skills in Preterm Infants: A Systematic Review.

No meta-analysis was possible because intervention type, frequency, duration and protocols varied too much. The authors also say this variability makes it hard to tell which component of a combined programme is doing the work. Therapists and caregivers could not be blinded to which treatment they were giving or receiving, which the authors list as a source of bias. Every included trial excluded babies with severe complications such as grade III or IV intraventricular haemorrhage, bronchopulmonary dysplasia, necrotising enterocolitis, seizures, congenital malformations, genetic conditions or sepsis, so the findings do not transfer to the sickest preterm infants, who are often the ones with feeding problems. The trials were small (30 to 210 infants), and two of the 14 found no significant difference from control: one measured only suck strength and exclusive breastfeeding rates, the other found no benefit from non-nutritive sucking. Outcomes were measured during the hospital stay only; nothing is reported about feeding after NICU discharge. Only studies published in English were included.

The authors state that no potential conflict of interest was reported. No funding source is stated in the article text.

Do not conclude that combining interventions is proven better than a single one. The authors say no included study directly compared a multi-component programme with a single-component one across all outcomes, so the combination advantage is a pattern across separate trials, not a tested comparison. Do not read this either as evidence that neonatal therapy shortens NICU stay or speeds weight gain, because those results were mixed or unchanged.