Effect of Olfactory and Gustatory Stimulations on Preterm Neonates’ Feeding Progression and Sniffing Away Feeding Tube

Prematurity is associated with feeding difficulties which remain a challenge for the neonatal nurses. Reaching full enteral feeding and increased weight are eligible criteria for sniffing away feeding tube and discharging from the Neonatal Intensive Care Unit (NICU). So, incorporating innovative olfactory and gustatory stimulations would enhance the preterm neonates’ oral feeding abilities. Consequently, it leads to sniffing away the feeding tube, improve full enteral feeding and weight. Aim: The aim of the present study was to determine the effect of olfactory and gustatory stimulations on preterm neonates' feeding progression and sniffing away feeding tube. Research design: A quasi-experimental design was used. Setting:  The  study  was  conducted  at  the  NICU  of  Damanhour  National  Medical  Institute, Damanhour  City,  Al-Behira  governorate,  Egypt.  Subjects: A convenience sampling of 60 preterm neonates who had hemodynamic and physiological stability and started tube feeding on the first day comprised the study subjects. Those neonates were equally divided into a study group (received olfactory and gustatory stimulations in addition to routine NICU care) and a control group (received NICU routine care without stimulations). Tools: Two tools were used to collect the necessary data namely; characteristics and medical history of the preterm neonates assessment tool and preterm neonates’ feeding progression and sniffing away feeding tube assessment tool. Results: After the application of intervention, the mean time to reach full enteral feeding for the neonates in the study group was 18.77±3.43 in comparison with 25.02±3.95 for those in the control group and the difference was statistically significance (P=0.000 for each). The actual consumed milk relative to the total prescribed milk volume increased to be from 75% to less than 95% per feed for 40% of the neonates in the study group compared to only 16.7% for those in the control group with significant statistical difference (P<0.037). Moreover, the mean neonates’ body weight was 1.926± 0.10 for the neonates in the study group compared to 1.864± 0.10 for the neonates in the control group and the difference was statistically significant (P=0.045). Furthermore, the mean time to sniffing away feeding tube (reach full sucking) was 11.13±2.83 for preterm neonates in the study group compared to 15.49±4.68 for those in the control group with significant statistical difference, where P= 0.000. Conclusion: Preterm neonates who received olfactory and gustatory stimulations exhibited better abilities to organize oral –motor functions and shorter time to reach full enteral feeding. Olfactory and gustatory stimulations were effective in enhancement the volume of consumed milk, feeding tolerance and body weight with decreasing the occurrence of adverse effects during feeding. In addition, those preterm neonates exhibited shorter time to sniffing away feeding tube (reach full sucking). Recommendations: The olfactory and gustatory stimulations should be incorporated in the NICU policies and the written guidelines for caring of the preterm neonates.