Effect of the Supplemental Nursing System on the Oral Feeding Skills of Preterm Infants: A Randomized Controlled Study

Abstract

PURPOSE: For most preterm infants, survival depends on support provided in the neonatal intensive care unit (NICU). Oral feeding skills are key criteria for discharge. The Supplemental Nursing System (SNS) is a device designed to assist breastfeeding by delivering human milk to the infant. This study investigated the impact of the SNS on the oral feeding skills of preterm infants in the NICU. METHOD: The study included 60 preterm infants aged 33-37 weeks of postmenstrual age followed in the NICU of a training and research hospital in southeastern Türkiye between August 20, 2022, and August 27, 2023. Once considered ready for oral feeding, infants in the experimental group received three daytime feeds with the SNS; their other five feeds and all feeds in the control group were given by bottle per unit routine. In both groups, three daytime feedings were evaluated in terms of physiological parameters (heart rate, oxygen saturation, and respiratory rate) before, during, and after feeding; Early Feeding Skills score; transition time to full oral feeding; weight change during the first 2 days of oral feeding; feeding efficiency; and average feeding duration. RESULTS: The SNS had no significant effect on weight (p = .684). However, SNS infants transitioned to full oral feeding earlier (2.97 ± 1.00 days vs. 4.23 ± 0.90 days; p ≤ .001) and had higher Early Feeding Skills scores (44.58 ± 2.96; p = .005), shorter feeding duration (13.55 ± 4.99 min; p = .021), higher oral intake ratio (91.25% ± 8.82%; p ≤ .001), and greater feeding efficiency (2.24 ± 0.91 ml/min; p = .003). Heart and respiratory rates during feeding were more stable in the SNS group (135.37 ± 15.35 vs. 153.95 ± 4.51; p < .001). CONCLUSION: The SNS improves oral feeding skills, feeding efficiency, and transition time to oral feeding in preterm infants, offering an effective alternative to bottle-feeding.