Targeted developmental oral stimulation with the NTrainer system™ in infants with bronchopulmonary dysplasia reduces time to achieve oral feeding success.

Abstract

Infants with bronchopulmonary dysplasia (BPD) are prohibited from oral feeding attempts during essential developmental windows due to their respiratory support, resulting in delayed oral feeding and prolonged length-of-stay (LOS). The NTrainer system™ (Cardinal Health) is an FDA approved device which provides patterned frequency-modulated oral stimulation, matures non-nutritive suck and shortens time to oral feeding. Our objective was to use this device to improve oral feeding competency and shorten the duration to achieve full oral feeding in these infants.MethodsBPD infants received therapy between 32 and 35.5 weeks post-menstrual age (PMA). The primary outcome was PMA at full oral feedings. A contemporary, retrospective cohort of infants with BPD served as controls.ResultsInfants provided therapy achieved oral feeding at 38.5 weeks versus 39.6 weeks PMA in the control group (p = 0.03). Kaplan-Meier analyses revealed days-to-full-oral-feed was achieved earlier for the NTrainer™ group compared to controls (40 vs 61 days; log-rank test p = 0.08). With a hazard ratio of 1.57 (95% CI 0.93-2.65), the NTrainer™ group was 57% more likely to reach full oral feeds at an earlier PMA. LOS was not significantly different between groups.ConclusionsProviding NTrainer™ therapy to infants with BPD during essential developmental windows shortens time to oral feeding success. Although not statistically significant, any reduced LOS potentially has clinical and economic implications for both the family and health care systems.