262 - Effect of Maternal Voice on Proportion of Oral Feeding in Preterm Infants

Poster Number: 262
Publication Number: 262.131

Aditya chhikara, Billings Clinic, Billings, MT, United States; James I. Hagadorn, Connecticut Children's Medical Center, Hartford, CT, United States; Shabnam Lainwala, Connecticut Children's Medical Center, Hartford, CT, United States

Background: Delay in achievement of oral feeding is common in preterm infants and may prolong their hospital stay. Interventions that improve oral feeding may decrease such delays, potentially shortening hospital stay and yielding healthcare savings. It is unclear whether exposure to maternal voice prior to feeds can improve the efficiency of preterm infant oral feeding.

Objective: To determine the impact of maternal voice exposure on oral feeding in preterm infants in the NICU.

Design/Methods: This was a prospective unblinded intervention study of infants born 28 0/7-34 6/7 weeks gestation to English-speaking >18 year old mothers, treated between 6/1/20-9/30/20 at 2 neonatal intensive care units and taking < 50% of enteral feeds orally at the start of intervention. Informed consent was obtained prior to enrollment and CT Children’s IRB approved the study. Infants were exposed twice daily to maternal voice for 20 minutes prior to enteral feeding. Infant feedings were grouped into Baseline feed given 3 hours prior to voice exposure; Intervention feed given immediately after voice exposure; and Follow-up feed 3 hours after exposure. Maternal and infant demographics, infant morbidities and feeding data were collected. Feeding readiness scores provided an objective measure of infant readiness to feed orally for each feed. Mixed-level multivariable analyses were performed to examine the effect of maternal voice exposure on proportion of feeding taken orally and on feeding readiness scores.

Results: 25 infants completed 684 maternal voice exposures and 2049 feedings with median (IQR) [range] 15 (7, 27) [1-62] feeding groups per infant. (Figure 1) Compared to the preceding Baseline, Intervention feeds had an adjusted 7.1 percentage-point increase in oral intake (0.071, 95% CI 0.012, 0.131, p = 0.036) (Table 1) and were associated with a 71% increased likelihood of having the highest feeding readiness score (aOR 1.71, 95% CI 1.19, 2.45, p = 0.003) (Table 2)Conclusion(s): Our 2-center study showed that exposure to maternal voice prior to enteral feeding was associated with significantly improved feeding readiness and oral feeding proportions in preterm infants. Prospective studies to evaluate the effect of maternal voice on achievement of full oral feeds, length of hospital stay and long term outcomes are warranted.
Figure 1: 3-level hierarchical structure of data
Table 1: Factors associated with difference between Intervention and Baseline feeds, multivariable mixed-level model