The Effects of Multimodal Sensory Interventions on the Behavioral States and Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-analysis.

Abstract

Background: Multimodal sensory interventions generally facilitate oral feeding in preterm infants. However, variability exists in forms of interventions, leading to inconsistent effects.

Purpose: The aim is to evaluate the effectiveness of multimodal sensory interventions on behavioral states and feeding outcomes in preterm infants.

Data sources: Five databases were reviewed from inception of databases to April 2025.

Study selection: Randomized controlled trials of multimodal sensory interventions examining feeding outcomes and behavioral states were enrolled. Multimodal interventions were defined as combinations of different unimodal sensory stimuli.

Data extraction: Two independent reviewers evaluated the risk of bias and extracted relevant data.

Results: Thirty studies involving 4 multimodal intervention groups were identified: tactile-kinesthetic stimulation (TKS), TKS combined with oral stimulation, auditory-tactile-visual-vestibular intervention (ATVV), and a combined oral and another unimodal stimulation. TKS increased weight gain and decreased length of stay compared to standard care, but showed no advantage over uni-tactile stimulation. Combined oral with another unimodal stimulation accelerated transition time and increased feeding volume. ATVV and a combined tactile-kinesthetic and oral stimulation showed no significant effects on oral feeding outcomes. Effects on behavioral states were unclear. Frequency, duration, and caregiver quality also impacted effects.

Implications for practice and research: TKS and a combined oral and another unimodal stimulation may enhance feeding outcomes, including weight gain, feeding volume, length of stay, and transition time. The potential effects on behavioral states remain unclear. More high-quality studies are necessary to further validate the effects of variable forms of interventions on behavioral states and feeding outcomes.