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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT02508571
Other study ID # 1401139552
Secondary ID
Status Active, not recruiting
Phase N/A
First received
Last updated
Start date July 2015
Est. completion date June 2026

Study information

Verified date December 2023
Source Seoul National University Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is randomized controlled trial investigating the effects of direct swallowing training and oral sensorimotor stimulation in preterm infants on oral feeding performance.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 189
Est. completion date June 2026
Est. primary completion date September 2020
Accepts healthy volunteers No
Gender All
Age group 22 Weeks to 31 Weeks
Eligibility Inclusion Criteria: - Preterm infants : before 32+0 weeks gestation - Infants who are receiving full tube feeding (more than 120 ml/kg/day) - Infants who discontinue of nasal continuous positive airway pressure before postmenstrual age 33+0 weeks - 'Feeders and growers' - The parents of the subject voluntarily sign the informed consent Exclusion Criteria: - Major congenital anomalies : face, central nervous system, gastrointestine, heart, etc - Gastrointestinal complications - Chronic medical complications : Intraventricular hemorrhage = Grade III, periventricular leukomalacia, surgical necrotizing enterocolitis

Study Design


Intervention

Other:
Direct swallowing training (DST)
The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.
Oral sensorimotor stimulation (OSMS)
The OSMS consists of a 15-minute stimulation program, whereby the first 12 minutes involve stroking the cheeks, lips, gums, and tongue, and the final 3 minutes consist of sucking on a pacifier. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.
Sham intervention
The sham intervention consisted of the therapists placing his/her hands into the incubator or bassinet for 15 minutes without touching the infants. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Locations

Country Name City State
Korea, Republic of Seoul National University Hospital Seoul

Sponsors (1)

Lead Sponsor Collaborator
Seoul National University Hospital

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (2)

Fucile S, Gisel E, Lau C. Oral stimulation accelerates the transition from tube to oral feeding in preterm infants. J Pediatr. 2002 Aug;141(2):230-6. doi: 10.1067/mpd.2002.125731. Erratum In: J Pediatr 2002 Nov;141(5):743. — View Citation

Lau C, Smith EO. Interventions to improve the oral feeding performance of preterm infants. Acta Paediatr. 2012 Jul;101(7):e269-74. doi: 10.1111/j.1651-2227.2012.02662.x. Epub 2012 Apr 5. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Days from start to independent oral feeding Days from start to independent oral feeding (independent oral feeding, 2 days in a row with no adverse events that do not self-resolve - The first successful day) From date of starting oral feeding until the date of independent, full oral feeding, an expected average of 3 weeks
Secondary Days from start to first full oral feeding first full oral feeding : The first day that attain the full oral feeding regardless of feeding side effects From date of starting oral feeding until the date of first full oral feeding, an expected average of 2 weeks
Secondary Days from start to complete full oral feeding complete full oral feeding : 2 days in a row without any adverse events The first successful day) From date of starting oral feeding until the date of complete oral full feeding, an expected average of 3-4weeks
Secondary Overall transfer % volume taken/volume prescribed Total number of assessment : 3 times ( 1. starting oral feeding, 2. volume of oral feeding/total feeding volume x 100 = 50%, 3. volume of oral feeding/total feeding volume) x 100 = 100%
Secondary Proficiency % volume taken at 5 min/volume prescribed Total number of assessment : 3 times ( 1. starting oral feeding, 2. volume of oral feeding/total feeding volume x 100 = 50%, 3. volume of oral feeding/total feeding volume) x 100 = 100%
Secondary Rate of transfer mL/min volume of milk consumed relative to the duration of the oral Feeding session Total number of assessment : 3 times ( 1. starting oral feeding, 2. volume of oral feeding/total feeding volume x 100 = 50%, 3. volume of oral feeding/total feeding volume) x 100 = 100%
Secondary Volume loss % volume of milk spilled from the lips as a percentage of the total milk transferred Total number of assessment : 3 times ( 1. starting oral feeding, 2. volume of oral feeding/total feeding volume x 100 = 50%, 3. volume of oral feeding/total feeding volume) x 100 = 100%
Secondary Neonatal Oral Motor Assessment Scale (NOMAS) comprehensive description of the infant's feeding patterns
identify normal oral-motor patterns and to differentiate disorganized from dysfunctional patterns
Total number of assessment : 2 times ( 1. 3-5 days after starting oral feeding, 2. within 3 days after stopping intervention)
Secondary Length of hospital stay Length of hospital stay From date of admission until the date of discharge, through study completion, expected average days of 3 month
Secondary Bayley Scales of Infant and Toddler Development, Third Edition an individually administered instrument designed to assess the developmental functioning of infants, toddlers, and young children.
cognitive scale, motor scale (gross motor, fine motor), language scale (receptive communication, expressive communication)
subtest total raw scores & scaled scores / composite scores /percentile ranks/ confidence intervals
Total raw score range (min~max) : cognitive (0~91), receptive communication (0~49), expressive communication (0~48), fine motor (0~66), gross motor (0~72)
Higher scores mean better outcomes
Corrected age 18-24 months
Secondary Korean version of MacArthur-Bates Communicative Development Inventories (K M-B CDI) -a simple screening test for language development postnatal age 36±2 months
Secondary Korean-Wechsler Preschool and Primary Scale of Intelligence (K-WPPSI)-Fourth edition. An innovative measure of cognitive development and an intelligence test for preschoolers and young children
Primary index scales> verbal comprehension, visual spatial, fluid reasoning, working memory, processing speed ==> Full scale IQ
Ancillary index scales > vocabulary acquisition
scaled score, composite score, percentile rank, CI
Range of Full scale IQ : min (40) ~ max (160)
Higher scores mean better outcomes.
aged 4:00~4:11 years
Secondary Korean Developmental Screening Test A fill-up questionnaire to be answered by parents so as to determine who experience developmental problems
Domains: gross motor, fine motor, language, cognition, sociality, self-care
Score range of each domain : min (0) ~ max (24)
Higher scores mean better outcomes.
postnatal age 48±3 months
Secondary Strengths and Difficulties Questionnaire a brief behavioural screening questionnaire
5 subscales: Emotional problems scale, Conduct problems scale, Hyperactivity scale, Peer problems scale, Prosocial scale (score range of each scale : 0-10)
total difficulties score : summing scores from all the scales except the prosocial scale (score range : 0-40)
Lower scores mean better outcomes for the all scales except the prosocial scale
postnatal age 48±3 months
Secondary Behavioral Pediatrics Feeding Assessment Scale (BPFAS) A comprehensive and widely used measure of behavioral and skill-based feeding problems
It consists of 35 questions: 25 related to child eating, and 10 related to parent feeding behaviors.
Parents answer each question on a five-point Likert scale, then indicate whether they perceive that behavior to be problematic or not.
Child an parent frequency scores : from the Likert scales (score range : min 35 ~ max 175)
Child and parent problem scores : from the yes/no questions
postnatal age 48±3 months
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