For developmental care, as part of the research work, in neonatal departments of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of Ministry of Health of Russian Federation we used an adapted oral stimulation program based on the methods of D. Beckman, S. Fucile et al., and B. Lessen Knoll [1–3].
The Beckman Oral Motor Intervention (BOMI) is a 15-minute oral intervention for term newborns, children, and adults with developmental delays and feeding difficulties. The oral stimulation program based on the protocol, according to S. Fucile et al., 2002, has shown its effectiveness in reducing the time for the transition from feeding through a gastric tube to oral feeding in preterm infants of 26–29 weeks of gestation [2].
B. Lessen (2008) modified the technique specifically for very premature babies. It is possible to start the stimulation at an earlier age, even before the formation of the sucking reflex and before the first trial of oral feeding, taking into account the small size of the oral cavity, and a shorter duration of stimulation. This technique was called Premature Infant Oral Motor Intervention (PIOMI) [3]. The original 11 steps of BOMI were decreased to 8 steps, and 15 minutes were shortened to 5 minutes to increase the tolerability of the procedure in preterm patients. The model of prehabilitation exploits the possibilities of early neuroplasticity of the neonatal brain during the period when fundamental neural connections for feeding skills, the formation of a sucking pattern, and coordination of swallowing with breathing are developing. Correct positioning was taken into account to ensure adequate neck flexion and head support for the premature baby that improves tolerance of parameters characteristics of the physiological and behavioral signals of the premature baby.
In our investigation [4], to study the effect of oral stimulation in isolation from non-nutritive sucking, the described programs were combined and adapted while maintaining the basic steps of the extended basic version, consisting of stimulation of the cheeks (outside and inside), lips, gums, tongue and palate with the operator’s fingers. Useful model of a manipulator device has proposed to optimize the procedure and improve the method.
Thus, the technique described in the last issue is an interpretation (not the original program) of PIOMI by B. Lessen adapted for research purposes, which was chosen as the most relevant and improved [3] and, in part, the program of S. Fucile et al. [2].
Comparison of various methods of oral stimulation, in combination with other methods of stimulation, is the subject of further research.
Sincerely, collective of authors
References
1. Beckman D. Oral motor assessment and intervention. In: Oral Motor Assessment and Intervention. Dallas (TX), 1998.
2. Fucile S., Gisel E., Lau C. Oral stimulation accelerates the transition from tube to oral feeding in preterm infants. J Pediatr. 2002; 141 (2): 230–6.
3. Lessen B. Effect of the premature infant oral motor intervention on feeding progression and length of stay in preterm infants. Adv Neonatal Care. 2011; 2 (11): 129–41.
4. Kukhartseva M.V., Bobrova A.M., Ryumina I.I., Narogan M.V. Oral stimulation as a part of developmental care in the practice of a neonatologist. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2023; 11 (2): 30–8. DOI: https://doi.org/10.33029/2308-2402-2023-11-2-30-38 (in Russian)