Table 1 Study characteristics
Author, year | Study design and setting | Participants (sample size, age and condition) | Type of respiratory support, flow/pressure | Details of oral feeding | Main outcomes |
|---|---|---|---|---|---|
Bapat 2019 [23] | Quality improvement project (non-contemporary cohort comparison study); NICU | 279 infants < 32 + 6 weeks GA (198 had BPD); baseline group 92 infants (63 had BPD); SIMPLE group 187 infants (135 had BPD) | CPAP (H2O not reported) | Oral feeding on CPAP; Guideline for feeding strategies on respiratory support; once a day oral feeding by occupational therapist, intensive cautious early feeding opportunities. | Days to full enteral feeding; days to first oral feeding; days to full oral feeding; ventilation duration; growth milestones; discharge milestones including LOS |
Dalgleish 2016 [10] | Quality improvement project (non-contemporary cohort comparison study); NICU | 196 infants born < 32 weeks with respiratory morbidity | CPAP (cmH2O not reported) HFNC> 1.5 L/min | Cohort 1: No oral feeding on NIV = 91; Cohort 2: Oral feeding on NIV = 105; Oral feeding on nCPAP as per novel algorithm ‘Eating in SINC: Safe Individualised Nipple-Feeding Competence’ | GA at first oral feed; days of respiratory support; respiratory support at first NF; LOS; safety |
Dumpa 2020 [24] | Retrospective cohort study; NICU | 99 infants < 32 weeks GA | CPAP 5-8cmH2O | Group 1 (oral feeding commenced on CPAP) = 39; Group 2 (oral feeding commenced when off CPAP); objective oral feeding assessment developed by NICU staff. | Duration to achieve full oral feeding; LOS; respiratory morbidities |
Ferrara 2017 [14] | Prospective cohort study; NICU | 7 infants with a PMA > 34 weeks 6 preterm, 1 term (34.1–43.2 weeks CGA) | CPAP 5cmH2O LFNC 1 L/min | Oral feeding on CPAP; Infant swaddled positioned in a sitting position in a tumbleform infant seat, bottle offered for 90 s by a single feeding and swallowing specialize. | Incidence of mild and deep laryngeal penetration, aspiration and nasopharyngeal reflux on VFSS |
Glackin 2017 [25] | Randomised control trial; NICU | 44 infants born before 30 weeks nCPAP = 22; HFNC = 22 | nCPAP (cmH2O not reported, stated ‘current setting’); HFNC commencing at 7 L/min | Oral feeding on CPAP and HFNC; Oral feeds offered in both groups at least once every 72 h and additional feeds offered when infants demonstrated feeding cues. | Duration to first oral feed; duration to full oral feeds; duration of resp. support; CNLD; LOS; episodes of apnoea |
Hanin 2015 [26] | Retrospective cohort study; NICU | 53 infants with BPD 37-42wks PMA; | nCPAP 6-8cmH2O | Orally fed on nCPAP = 26; Gavage fed on nCPAP =27; All oral feedings were done by a trained neonatal OT; clinical assessment completed prior to initiation of feeding therapy; based of SOFFI method; oral feeding session no more than 30mins, one session per day, 3–5 times per week. | Duration to full oral feeds; LOS; duration of nCPAP; safety metrics; readmission rate |
Jadcherla 2016 [27] | Prospective case control study; NICU | 38 infants with BPD 28 + 0.7wks GA; 39-43wks CGA at evaluation; nCPAP = 9; NC = 19; RA = 10 | nCPAP 6-8 cm H2O; NC 0.1–2.0 L/min | Graded sterile water infusions via syringe of 0.1, 0.3 and 0.5 mL to the pharynx for infnats on CPAP. | Effects of pharyngeal stimulation on the initial and terminal pharyngoesophageal and respiratory responses |
La Tuga 2019 | Retrospective case control study; NICU | 243 infants < 32 weeks GA who required CPAP at 32 weeks PCA | CPAP (cmH2O not reported) | No CPAP first oral feed GA 27 (24–32) wks; CPAP first oral feed GA 26 (23–32) wks 31% (n = 76) received first oral feed on CPAP; Oral feeding defined as any feeding taken by mouth > 5 mL | Length of stay; duration of resp. support; age at first oral feed; age at full oral feeds; duration to full oral feed; aspiration pneumonia |
Leder 2015 | Prospective cohort study; NICU & adult ICU | 100 participants: 50 neonates (CGA range 33w7d-49w3d) & 50 adults | HFO2-NC 2-3 L/min | Oral feeding on HFNC. 17 neonates had oral feeding. Decisions to initiate oral feeding made jointly by neonatology and nursing using criteria. | Successful initiation of oral feeding; age at initiation of oral feeds |
Leibel 2020 [33] | Randomised control pilot study; NICU | 25 infants born < 28 weeks GA, 34 weeks PMA, requiring CPAP or HFNC’; CPAP n = 12; HHHFNC n = 13 | CPAP >5cmH2O; HHHFNC > 5 L/min | Infants on CPAP were placed on LFNC (up to 2 L/min) for oral feeding, infants on HHFNC had flow reduced to 2 L/min for oral feeding | Days to full oral feed; weight gain; feeding type; feeding intolerance; NIV support at end of trial; incidence of CLD; PMA at conclusion of trial |
Leroue 2017 [28] | Retrospective cohort study; PICU | 562 children older than 30 days to > 10 years (median age 2 yrs) requiring NIPPV, majority had a primary diagnosis of bronchiolitis or viral pneumonia | NIPPV = HHFNC, CPAP, BiPAP, AVAPS; CPAP or bilevel support 6-8cmH2O; HHFNC (flow rate/s not reported) | Oral feeding on NIPPV. 305 (54%) had oral intake. | Early EN; time to goal EN rate; adequacy of EN; frequency of EN interruptions > 6 h; AEs |
Shadman 2019 [29] | Retrospective cohort study; intensive and general care units, children’s hospital | 123 children aged 1 to 24 months with bronchiolitis treated with HFNC | HFNC (flow rate/s not reported) | Oral feeding on HFNC. 78 (63%) were fed: 50 (41%) were exclusively orally fed and 28 (23%) had mixed oral and tube feeding. | Time to discharge after HFNC cessation; aspiration; intubation after HFNC; seven-day readmission |
Shetty 2016 [8] | Retrospective cohort comparison study; NICU | 116 infants with BPD (24-32wks GA); nCPAP =72; nCPAP/HHFNC =44 | CPAP 4-6cmH2O; HHFNC 2-8 L/min | Oral feeding on HFNC (no oral feeding on CPAP); Infants on HFNC were referred to SLT service from 34 weeks GA to assess readiness to cope with oral feeding. | Age at first oral feed; age at full oral feeds; duration and type of resp. support; LOS |
Shimizu 2019 [30] | Retrospective case control study; NICU | 45 infants (< 34 weeks PMA; GA 23.1–39.6 weeks GA) with very low birth weight and chronic lung disease | HFNC 2 L/kg/min | Oral feeding on HFNC n = 11 (GA 27.4; 23.1–32.0 weeks); oral feeding without HFNC n = 34 (31.2; 23.7–39.6 weeks); Oral feedings offered to infants with stable breathing after 34 weeks PMA, after oral feeding skill evaluation by physical therapists. | Duration to first oral feed; duration to full oral feeds; clinically significant aspiration pneumonia |
Slain 2017 [9] | Retrospective cohort study; PICU | 70 children < 24 months (median age of 5 months) with bronchiolitis | HFNC 2-4 L/min; 5-6 L/min; > 7 L/min | Oral feeding on HFNC; 89% fed orally. | Incidence of feeding-related AEs; LOS; duration of HFNC |
Sochet 2017 [31] | Prospective cohort study; PICU | 132 children (1 month to 2 yrs) with bronchiolitis | HFNC 4-13 L/min (0.3–1.9 L/kg/min) | Oral feeding on HFNC; 97% fed orally. | Incidence of aspiration-related respiratory failure |