Oropharyngeal colostrum administration in neonates with gastroschisis: a randomized clinical trial.

OBJECTIVE: To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis. METHODS: Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a "sham procedure" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay. RESULTS: The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days. CONCLUSION: The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.

Oropharyngeal colostrum administration in neonates with gastroschisis: a randomized clinical trial / Administração orofaríngea de colostro em recém-nascidos com gastrosquise: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis. Methods: Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a "sham procedure" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay. Results: The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days. Conclusion: The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.

RESUMO Objetivo: Avaliar o efeito da colostroterapia em dias para iniciar a dieta por sucção em recém-nascidos com diagnóstico de gastrosquise simples. Métodos: Ensaio clínico randomizado com recém-nascidos diagnosticados com gastrosquise simples em um hospital federal no Rio de Janeiro que foram randomizados para receber administração orofaríngea de 0,2mL de colostro ou "procedimento simulado", nos primeiros 3 dias de vida. A análise incluiu desfechos clínicos, como dias sem alimentação, dias com alimentação parenteral, dias para iniciar a alimentação enteral, dias para atingir a alimentação completa, sepse e tempo de internação. Resultados: O início da alimentação por via oral (sucção) na gastrosquise simples, em ambos os grupos, ocorreu com mediana de 15 dias. Conclusão: O presente estudo mostrou que não há diferenças significativas no uso de colostroterapia em dias para início de alimentação enteral e dieta por sucção entre grupos de recém-nascidos com gastrosquise simples.

Internação e alta hospitalar do recém-nascido na unidade de cuidado neonatal: identificação das dúvidas dos pais / Hospitalization and discharge of the neonate in the neonatal care unit: identification of parents' doubts / Hospitalización y alta del recién nacido en la unidad de cuidado neonatal: identificación de las dudas de los padres

Objetivo:Identificar as dúvidas dos pais frente aos cuidados dos seus filhos na UTIN no processo de internação e alta hospitalar. Metodologia: estudo de natureza descritiva e abordagem qualitativa. O cenário da pesquisa foi uma unidade neonatal de um hospital terciário, localizado no Estado do Rio de Janeiro. Foram selecionadas, por conveniência, como participantes do estudo as mães e pais dos recém-nascidos internados na UTIN, com internação mínima de 2 semanas, e que estivessem presentes na unidade. A coleta de dados foi realizada através de dados obtidos no prontuário do recém-nascido e um questionário. Foram realizadas também entrevistas abertas com os pais na primeira semana de internação do RN na UTIN e nas semanas subsequentes, até a semana da alta. Nesta pesquisa, a análise de dados foi feita por meio da análise de conteúdo de Bardin. Resultados: Participaram desta pesquisa 10 mães e 02 pais de RNinternados na UTIN. Com a transcrição das entrevistas, emergiram setecategorias que se tratavam das dúvidas que as mães e os pais apresentavam durante o processo de internação, descritas a seguir: Cuidados Básicos; Amamentação/Alimentação; Tratamento; Exames/Cirurgias; Impeditivos para alta; Cuidados pós-cirúrgicos; Tempo de internação. A categoria com o maior número de dúvidas apresentada durante a pesquisa foi sobre Tratamento (25.5%). Conclusão:Foi possível constatarque a internação na UTIN gera nos pais diversas dúvidas. Dúvidas essas relacionadas aos cuidados prestados aos seus filhos, sobre amamentação e alimentação, sobre o tratamento, entre outras.

Objective: To identify the doubts of parents regarding the care of their babies in the NICU in the process of hospitalization and hospital discharge. Methodology: descriptive study and qualitative approach. The research scenario was a neonatal unit of a tertiary hospital, located in the Rio de Janeiro, Brazil. The mothers and fathers of newborns admitted to the NICU, with a minimum stay of 2 weeks, and who were present in the unit, were selected, for convenience, as study participants. Data collection was performed using data obtained from the newborn's medical record and a questionnaire. Open interviews were also carried out with the parents in the first week of the newborn's hospitalization in the NICU and in the subsequent weeks, until the week of discharge. In this research, data analysis was performed using Bardin's content analysis. Results: 10 mothers and 02 fathers of NBadmitted to the NICU participated in this research. With the transcription of the interviews, seven categories emerged that dealt with the doubts that mothers and fathers had during the hospitalization process, described below: Basic Care; Breastfeeding/Feeding; Treatment; Exams/Surgeries; Disadvantages for discharge; Post-surgical care; Hospitalization time. The category with the highest number of doubts presented during the survey was Treatment (25.5%). Conclusion: It was possible to verify that the hospitalization in the NICU generates several doubts in the parents. Doubts related to the care provided to their children, about breastfeeding and feeding, about treatment, among others.

Objetivo: Identificar las dudas de los padres sobre el cuidado de sus hijos en la UCIN en proceso de hospitalización y alta hospitalaria. Metodología: estudio descriptivo y enfoque cualitativo. El escenario de la investigación fue una unidad neonatal de un hospital de tercer nivel, ubicado en el Estado de Río de Janeiro. Las madres y padres de recién nacidos ingresados en la UCIN, con estancia mínima de 2 semanas, y que estuvieran presentes en la unidad, fueron seleccionados, por conveniencia, como participantes del estudio. La recolección de datos se realizó a partir de los datos obtenidos de la historia clínica del recién nacido y de un cuestionario. También se realizaron entrevistas abiertas con los padres en la primera semana de internación del RN en la UCIN y en las semanas posteriores, hasta la semana del alta. En esta investigación, el análisis de datos se realizó mediante el análisis de contenido de Bardin. Resultados: Participaron de esta investigación 10 madres y 02 padres de RN ingresados en la UCIN. Con la transcripción de las entrevistas, surgieron siete categorías que abordaban las dudas que las madres y los padres tenían durante el proceso de hospitalización, descritas a continuación: Atención Básica; Lactancia materna/Alimentación; Tratamiento; Exámenes/Cirugías; Desventajas para la descarga; Atención posquirúrgica; Tiempo de hospitalización. La categoría con mayor número de dudas presentadas durante la encuesta fue Tratamiento (25,5%). Conclusión: Se pudo verificar que la internación en la UCIN genera varias dudas en los padres. Dudas relacionadas con la atención brindada a sus hijos, sobre la lactancia y alimentación, sobre el tratamiento, entre otros.

Bem-vindo ao lar: dificuldades dos cuidadores de bebês nascidos prematuramente após a alta hospitalar / Welcome home: difficulties of caregivers of premature infants after hospital discharge / Bienvenido a casa: dificultades de los cuidadores de bebés prematuros después del alta del hospital

Objetivo: Identificar as dificuldades dos cuidadores após a alta hospitalar da UTI Neonatal. Metodologia: Pesquisa de abordagem quantitativa, tipo transversal de caráter descritivo e exploratório. Desenvolvido no ambulatório de seguimento/ Follow-up de um hospital terciário no Rio de Janeiro.Os voluntáriosda pesquisa foram os pais ou cuidadores de recém-nascidos com idade gestacional menor que 37 semanas e que tiveram o tempo mínimo de quinze dias de internação do filho na UTIN. Os dados foram coletados através de uma entrevista na primeira consulta do RN no follow-up, realizada após uma semana de alta. A análise dos dados foi feita por meio deestatística descritiva. Resultados: Foram incluídos no estudo 15 cuidadores. Dentre as orientações que não foram recebidas destaca-se os sinais de alerta (70,6%), Limpeza da mamadeira (52,9%) e uso da chupeta (52,9%). Ao relacionar o tempo de permanência na UTIN com as orientações recebidas vemos que os cuidadores em que o RN permanece por menor tempo na UTIN são os que acabam tendo menos orientações sobre os cuidados com atemperatura, cuidados com higiene e sinais de alerta. Conclusão: Os resultados aqui apresentados mostraram que a chegada da família ao domicílio com o bebê, representa orompimento com o mundo da internação e gera experiências próprias do contexto domiciliar.

Objective: To identify the difficulties of caregivers after hospital discharge from the Neonatal ICU. Methodology: Research with a quantitative approach, transversal type of descriptive and exploratory character. Developed in the follow-up/Follow-up clinic of a tertiary hospital in Rio de Janeiro. The research volunteers were parents or caregivers of preterm infants with a gestational age of less than 37 weeks and who had at least fifteen days of hospitalization. Data were collected through an interview during first follow-up appointment, carried out after one week of discharge. Data analysis was performed using descriptive statistics. Results: 15 caregivers were included in the study. Among the guidelines that were not received, warning signs (70.6%), bottle cleaning (52.9%) and pacifier use (52.9%) stand out. When relating the length of stay in the NICU with the guidelines received, we see that caregivers whose newborns spend less time in the NICU end up having less guidance on temperature care, hygiene care and warning signs. Conclusion: The results presented here showed that the arrival of the family at home with the baby represents a break with the world of hospitalization and generates experiences specific to the home context.

Objetivo: Identificar las dificultades de los cuidadores después del alta hospitalaria de la UTI Neonatal.Metodología: Investigación con enfoque cuantitativo, de tipo transversal de carácter descriptivo y exploratorio. Desarrollado en el ambulatorio de seguimiento/seguimiento de un hospital de tercer nivel en Río de Janeiro. Los voluntarios de la investigación fueron los padres o cuidadores de recién nacidos con edad gestacional menor de 37 semanas y que tuvieran un tiempo mínimo de quince días de internación del niño en la UCIN. Los datos fueron recolectados a través de una entrevista en la primera visita de seguimiento del RN, realizada después de una semana del alta. El análisis de los datos se realizó mediante estadística descriptiva. Resultados: Quince cuidadores fueron incluidos en el estudio. Entre las orientaciones que no fueron recibidas, se destacan las señales de advertencia (70,6%), limpieza del biberón (52,9%) y uso del chupete (52,9%). Al relacionar el tiempo de permanencia en la UCIN con las orientaciones recibidas, vemos que los cuidadores en los que el RN permanece menos tiempo en la UCIN son los que terminan teniendo menos orientaciones sobre cuidados de temperatura, cuidados de higiene y signos de alarma.Conclusión: Los resultados aquí presentados mostraron que la llegada de la familia a casa con el bebé representa una ruptura con el mundo de la hospitalización y genera vivencias del contexto domiciliario.

Macronutrients of mothers milk of very low birth weight infants: analysis according to gestational age and maternal variables / Macronutrientes do leite materno de recém-nascidos de muito baixo peso: análise segundo idade gestacional e variáveis maternas

ABSTRACT Objective: To analyze the composition of macronutrients present in the milk of mothers of preterm newborn infants (PTNB) - protein, fat, carbohydrate, and calories - by gestational age (GA), chronological age (CA) and maternal variables. Methods: Longitudinal study that analyzed 215 milk samples from the 51 mothers of PTNB admitted in three Neonatal Intensive Care Units of Rio de Janeiro from May/2013-January/2014. Milk collection was performed by pickup pump, on a fixed day of each week until discharge. The spectrophotometric technique with Infrared Analysis (MilkoScan Minor 104) was used for the quantitative analysis. A sample of 7 mL of human milk was taken from the total volume of milk extracted by the mother. The data was grouped by GA (25-27, 28-31, 32-36, 37-40 weeks) and by CA (zero to 4, 5-8, 9-12, 13-16 weeks). Results: Protein, carbohydrate, fat and calories did not show any pattern of change, with no difference among groups of GA. When the macronutrients were analyzed by groups of CA, protein decreased, with significant difference between the first two groups of CA. Carbohydrates, fat and calories presented increasing values in all groups, without significant differences. Weight gain during pregnancy, maternal hypertension and maternal age were associated with changes in fat and calories in the first moment of the analysis of milk. Conclusions: There was a significant decrease in the levels of protein during the first eight weeks after birth. CA may be an important factor in the composition of human milk.

RESUMO Objetivo: Analisar a composição dos macronutrientes presentes no leite de mães de recém-nascidos pré-termo (RNPT) - gorduras, carboidratos e calorias - por idade gestacional (IG), idade cronológica (IC) e variáveis maternos. Métodos: Estudo longitudinal para analisar 215 amostras de leite de 51 mães de RNPT admitidos em três unidades neonatais do Rio de Janeiro de maio/2013 a janeiro/2014. A coleta de leite foi realizada por bomba coletora, em dia fixo a cada semana até a alta. Utilizou-se a técnica espectrofotométrica com análise de infravermelho (MilkoScan Minor 104) para a análise quantitativa. Uma amostra de 7 mL de leite humano foi retirada do volume total de leite extraído pela mãe. Os dados foram agrupados por IG (25-27, 28-31, 32-36 e 37-40 semanas) e por IC (0-4, 5-8, 9-12 e 13-16 semanas). Resultados: Proteínas, carboidratos, gorduras e calorias não apresentaram nenhum padrão de mudança, não havendo diferença entre os grupos de IG. Quando os macronutrientes foram analisados por grupos de IC, a proteína diminuiu, com diferença significante entre os dois primeiros grupos de IC. Carboidratos, gorduras e calorias apresentaram valores crescentes em todos os grupos, sem diferença estatística. O ganho de peso durante a gestação, a presença de hipertensão arterial e a idade materna foram associados a alterações de gordura e calorias no primeiro momento da análise do leite. Conclusões: Observou-se redução estatisticamente significante nos níveis de proteína durante as primeiras oito semanas após o nascimento. A IC pode ser um fator importante na composição do leite humano.

MACRONUTRIENTS OF MOTHERS' MILK OF VERY LOW BIRTH WEIGHT INFANTS: ANALYSIS ACCORDING TO GESTATIONAL AGE AND MATERNAL VARIABLES.

OBJECTIVE: To analyze the composition of macronutrients present in the milk of mothers of preterm newborn infants (PTNB) - protein, fat, carbohydrate, and calories - by gestational age (GA), chronological age (CA) and maternal variables. METHODS: Longitudinal study that analyzed 215 milk samples from the 51 mothers of PTNB admitted in three Neonatal Intensive Care Units of Rio de Janeiro from May/2013-January/2014. Milk collection was performed by pickup pump, on a fixed day of each week until discharge. The spectrophotometric technique with Infrared Analysis (MilkoScan Minor 104) was used for the quantitative analysis. A sample of 7 mL of human milk was taken from the total volume of milk extracted by the mother. The data was grouped by GA (25-27, 28-31, 32-36, 37-40 weeks) and by CA (zero to 4, 5-8, 9-12, 13-16 weeks). RESULTS: Protein, carbohydrate, fat and calories did not show any pattern of change, with no difference among groups of GA. When the macronutrients were analyzed by groups of CA, protein decreased, with significant difference between the first two groups of CA. Carbohydrates, fat and calories presented increasing values in all groups, without significant differences. Weight gain during pregnancy, maternal hypertension and maternal age were associated with changes in fat and calories in the first moment of the analysis of milk. CONCLUSIONS: There was a significant decrease in the levels of protein during the first eight weeks after birth. CA may be an important factor in the composition of human milk.

"Horário do Soninho": uma estratégia para reduzir os níveis de pressão sonora em uma unidade de terapia intensiva neonatal / Quiet time: a strategy to reduce sound pressure levels in a neonatal intensive care unit

Introdução: Estudos mostram que o ambiente muito estimulante, com altos níveis sonoros, interfere negativamente no desenvolvimento e crescimento de recém-nascidos. Objetivo: verificar se o "horário do soninho" é capaz de reduzir os níveis de pressão sonora em uma unidade de cuidados neonatais. Método: Trata-se de uma pesquisa transversal. A medida do nível de pressão sonora foi realizada durante 15 dias não consecutivos, com tempo de avaliação de 30 minutos antes, 1 hora durante e 30 minutos após o "horário do soninho" Resultado: Observamos uma redução dos níveis de pressão sonora durante o "horário do soninho" (p = 0,00). Essa redução permaneceu no período dos 30 minutos subsequentes, com diferença estatisticamente significante quando comparada ao período antes do "horário do soninho" (p = 0,00). Conclusão: O "horário do soninho" é uma ferramenta capaz de reduzir o nível de pressão sonora em uma unidade de terapia intensiva neonatal. (AU)

Objective: Verify if the "quiet time" is able to reduce the sound pressure levels in a neonatal care unit. Method: It is a cross-sectional research. The measurement of the sound pressure level was performed during 15 non-consecutive days with an evaluation time of 30 minutes before, 1 hour during and 30 minutes after the "quiet time" Result: We observed a reduction of the sound pressure levels during the hours of quiet time (p = 0.00). This reduction remained in the period of the subsequent 30 minutes, with a statistically significant difference when compared to the period before sleep time (p = 0.00). Conclusion: The "quiet time is a tool capable of reducing sound pressure level in a neonatal intensive care unit. (AU)

Objectivo: Verificar si el "tiempo de silencio" puede reducir los niveles de presión acústica en una unidad de cuidados neonatales. Método: Investigación transversal. La medición del nivel de presión sonora se realizó durante 15 días no consecutivos con un tiempo de evaluación de 30 minutos antes, 1 hora durante y 30 minutos después del "tiempo de silencio". Resultado: Observamos una reducción de los niveles de presión sonora durante las horas de tiempo de silencio (p = 0.00). Esta reducción se mantuvo en el período de los siguientes 30 minutos, con una diferencia estadísticamente significativa en comparación con el período anterior al tiempo de sueño (p = 0,00). Conclusión: el "tiempo de silencio es una herramienta capaz de reducir el nivel de presión acústica en una unidad de cuidados intensivos neonatales. (AU)

Development of a technique for evaluating temporal parameters of sucking in breastfeeding preterm newborns.

AIMS: The aim of the current study was to developed and test the reliability of a technique for measuring temporal parameters of sucking in breastfeeding infants. METHODS: The technique was developed using a cohort of 11 term and 12 preterm infants, and subsequently evaluated using a cohort of 43 preterm infants. Measurements related to sucking pressure in the term and preterm infants were acquired. The signals were recorded for 5 min, saved on a computer, and stored for analysis. For purposes of analysis, the minute with the highest quality signal was chosen. Signal analysis was performed by two researchers, and inter- and intra-observer agreement was assessed. The newborns in the sample had different gestational ages. RESULTS: A technique was developed for the analysis of temporal parameters of sucking during breastfeeding and evaluated in 43 preterm infants with different gestational ages for the following variables: number of bursts per minute, number of sucks per burst, sucking rate, pause rate, and duration of pauses. The intra-observer agreement was 0.85 and the inter-observer agreement was 0.85. CONCLUSIONS: The technique that was developed and validated proved capable of measuring temporal parameters of sucking in breastfeeding newborns.

Effects of non-nutritive sucking and oral stimulation on breastfeeding rates for preterm, low birth weight infants: a randomized clinical trial.

OBJECTIVE: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.

Efeitos da sucção não-nutritiva e da estimulação oral nas taxas de amamentação em recém-nascidos pré-termo de muito baixo peso ao nascer: um ensaio clínico randomizado / Effects of non-nutritive sucking and oral stimulation on breastfeeding rates for preterm, low birth weight infants: a randomized clinical trial

OBJETIVO: Determinar a influência da sucção não-nutritiva e da estimulação oral nas taxas de amamentação na alta hospitalar, aos 3 meses e 6 meses de idade corrigida em recém-nascidos pré-termo de muito baixo peso ao nascer. MÉTODOS: Foram randomizados 98 recém-nascidos pré-termo de muito baixo peso ao nascer, e 96 permaneceram no estudo até o 6º mês de idade corrigida. Os recém-nascidos foram randomizados em grupo experimental e grupo controle. O grupo experimental recebeu um programa de estimulação (sucção não-nutritiva associado à estimulação sensório-motora-oral), e o grupo controle, um procedimento simulado a partir do momento em que atingiam alimentação plena até a alimentação oral completa. RESULTADOS: Observou-se que 59 (61,5 por cento) recém-nascidos estavam em amamentação na alta, 31 (32,6 por cento) aos 3 meses e apenas 18 (18,75 por cento) aos 6 meses de idade corrigida. Na alta, 47 por cento dos recém-nascidos do grupo controle e 76 por cento do grupo estimulado estavam em amamentação. Aos 3 meses, 18 por cento do grupo controle e 47 por cento do grupo estimulado continuavam em amamentação, e aos 6 meses, 10 por cento do grupo controle e 27 por cento do grupo estimulado. Houve diferença estatística nos três períodos estudados, favorecendo o grupo estimulado (p < 0,05). CONCLUSÃO: O presente estudo demonstra que a sucção não-nutritiva, associada à estimulação oral, pode contribuir para a melhoria das taxas de amamentação em pré-termos de muito baixo peso ao nascer.

OBJECTIVE: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS: Fifty-nine infants (61.5 percent) were breastfeeding at the time of hospital discharge, 31 (36.9 percent) at 3 months, and only 18 (20.5 percent) at 6 months of corrected age. At discharge, 46.9 percent of the control group and 76.5 percent of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76 percent), 3 months (18 vs. 47 percent) and 6 months after discharge (10 vs. 27 percent). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.

A randomized study of the efficacy of sensory-motor-oral stimulation and non-nutritive sucking in very low birthweight infant.

UNLABELLED: To assess if sensory-motor-oral stimulation and non-nutritive sucking gavage feeding enhances the oral feeding performance of preterm infants born between 26 and 32 weeks of gestational age. STUDY DESIGN: Very low birthweight infants (n=98) were randomized into a experimental and control group. Preterm infants in the experimental group received sensory-motor-oral stimulation and non-nutritive sucking and infants in the control group received a sham stimulation program. Both were administered from when they reached enteral diet (100 kcal/kg/day) until the beginning of oral diet. Primary outcome was length of hospital stay. RESULTS: Independent oral feeding was attained significantly earlier in the experimental group than the control group, 38+/-16 days of life (mean+/-S.D.) versus 47+/-17 days of life, respectively (P<0.001) There was significant difference in length of hospital stay between the two groups (41.9+/-17 (mean+/-S.D.) versus 52.3+/-19 days (P<0.01)). CONCLUSION: Sensory-motor-oral stimulation, together with early non-nutritive sucking (as soon as the newborn reaches full diet and is clinically stable) in very low birthweight preterm infants, as long as they are clinically stable, in this study, earlier initiation of oral feeding and earlier hospital discharge.