Oral stimulation as a therapeutic strategy to improve sucking and swallowing reflexes in preterm infants: A NICU-based study from South India

Background: Preterm infants often exhibit immature sucking and swallowing reflexes due to underdeveloped neuromuscular systems, delaying oral feeding readiness and extending NICU stays. Oral stimulation techniques have shown promise in enhancing these reflexes, yet few studies have directly measured reflex improvement and its association with clinical variables.Materials and Methods: This quasi-experimental pre-test/post-test control group study evaluated the effectiveness of oral stimulation on sucking and swallowing reflexes in 50 preterm infants (32–37 weeks gestation) admitted to a tertiary care NICU in South India. The experimental group received structured oral stimulation, gentle massage of oral structures for 15 minutes, three times daily over five days while the control group received routine care. Reflexes were assessed using the Preterm Infant Breastfeeding Behaviour Scale. Associations with demographic and clinical variables were also examined.Results: At baseline, no significant difference was found between groups (p = 0.43), indicating homogeneity. Post-intervention, the experimental group showed a statistically significant improvement in sucking and swallowing reflex scores (mean increase from 5.60 to 12.04; p < 0.001), whereas the control group had a non-significant change (mean increase from 5.28 to 5.68; p = 0.09). Significant associations were observed between improved reflexes and maternal age, obstetric history, birth order, birth weight, and APGAR score at 5 minutes.Conclusion: Oral stimulation is an effective, low-cost intervention for enhancing feeding reflexes in preterm infants. Incorporating such protocols into routine NICU care may facilitate earlier feeding readiness and improve neonatal outcomes.