Comparative study on the effect of oral motor intervention protocols on oral motor skills of preterm infants from tertiary care hospital in metropolitan city: pilot study


  • Shailaja S. Jaywant Department of Occupational Therapy, L. T. M. Medical College and G. H. Sion, Mumbai, Maharashtra, India
  • Jayashri S. Kale Department of Occupational Therapy, Seth G. S. Medical College and K. E. M. H., Parel, Mumbai, Maharashtra, India



Behavioural regulations, Oral motor skills, Premature infant oral motor intervention


Background: Premature infants often have feeding difficulties leading to morbidity or developmental co-morbidities. Premature infant oral motor intervention (PIOMI), has shown the positive effects on feeding progression of the premature infants. PIOMI with the massage technique, may help in improving oral motor activity, weight gain in preterm infants along with better neurobehavioral organization. The study was done to analyse effect of this combined protocol on achieving oral motor control and Neurobehavioral state regulation and evaluate its efficacy against PIOMI.

Methods: A total 72 clinically stable infants admitted in premature care unit, fulfilling inclusion criterion were enrolled. They were allocated in control and experimental group. Infants from control group received PIOMI and experimental group received PIOMI with massage therapy (M technique), for 10 minutes each day. Data was collected for oral motor abilities, behavioural assessment, weight and day of achieving full feeds.

Results: Gestational age at full feeds was 33.65 weeks and 32.89 weeks in control and experimental groups respectively with ‘p’ value 0.002. The number of days of full feed in experimental group was 3.7 days earlier (p=0.04). Infants from experimental group showed higher oral motor score and more weight gain with significant difference The behavioral regulation in infants of both the groups improved after 8 day.

Conclusions: PIOMI with M technique was well tolerated by preterm infants. The modified protocol has resulted in achieving early oral feeds and reducing hospital stay. It has also shown the benefit of behavioural regulation along with better oral motor control.


Harding CM, Law J, Pring T. The use of non-nutritive sucking to promote functional sucking skills in premature infants: an exploratory trial. Infant. 2006;2(6):238-40.

Greene Z, Walshe M, O'Donnell CP. Effects of oral stimulation for oral feeding in preterm infants. Cochrane Database Syst Rev. 2012;3:CD009720.

Gaebler CP, Hanzlik, J. R. The effects of a prefeeding stimulation program on preterm infants. Am J Occupat Ther. 1996;50:184-93.

Medoff-Cooper B, Mcgrath JM, Shults J. Feeding patterns of full-term and preterm infants at forty weeks postconceptional age. J Develop Behav Pediatr. 2002;23(4):231-6.

Lessen BS. Effect of the premature infant oral motor intervention on feeding progression and length of stay in preterm infants. Adv Neonat Care. 2011;11(2):129-39.

Arora K, Goel S, Manerkar S, Konde N, Panchal H, Hegde D, Mondkar J. Prefeeding oromotor stimulation program for improving oromotor function in preterm infants - a randomized controlled trial. Indian Pediatr. 2018;55:675-8.

Smith JR, Raney M, Conner S, Coffelt P, McGrath J, Brotto M, Inder T. Application of the M Technique in hospitalized very preterm infants: a feasibility study. Adv Neonat Care. 2012;12(5S):S10-7.

Smith JR. Impact of a novel relaxation method of touch on neonatal neurobehavioral development among very preterm infants (Doctoral dissertation). 2013. Available at: Accessed on 12th March 2020.

Lau C, Fucile S, Gisel EG. Impact of nonnutritive oral motor stimulation and infant massage therapy on oral feeding skills of preterm infants. J Neonatal-Perinat Med. 2012;5(4):311-7.

Pepino VC. Application of tactile/kinesthetic stimulation in preterm infants: a systematic review. J Pediatics Res. 2015;91(3):213-33.

Bertoncelli N, Cuomo G, Cattani S, Mazzi C, Pugliese M, Coccolini E, et al. Oral feeding competences of healthy preterm infants: a review. Int J Pediatr. 2012;2012.

Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant Behavior Develop. 2010;33(2):115-24.

Harding CM, Law J, Pring T. The use of non-nutritive sucking to promote functional sucking skills in premature infants: an exploratory trial. Infant. 2006;2(6):238-40.

Gonzalez AP, Vasquez-Mendoza G, García-Vela A, Guzmán-Ramirez A, Salazar-Torres M, Romero-Gutierrez G. Weight gain in preterm infants following parent-administered Vimala massage: a randomized controlled trial. Am J Perinatol. 2009;26(04):247-52.

Kulkarni A, Kaushik JS, Gupta P, Sharma H, Agrawal RK. Massage and touch therapy in neonates: the current evidence. Indian Pediatr. 2010;47(9):771-6.

Mathai S, Fernandez A, Mondkar J, Kanbur W. Effects of tactile-kinesthetic stimulation in preterms-a contolled trial. Indian Pediatr. 2001;38(10):1091-8.






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