Letter to the Editor Regarding “Impact of Oromotor Stimulation on Transition from Gavage to Full Oral Feeding in Preterm Neonates: A Randomized Controlled Trial”

Dear Editor:

The recent randomized controlled trial conducted by Kumar et al. examining the effects of Premature Infant Oral Motor Intervention (PIOMI) on the transition from gavage feeding to full oral feeding in preterm neonates is of great interest to the feeding progression and breastfeeding outcome communities, especially in resource-limited regions, since these are important clinical issues. ¹

While this study offers valuable information regarding the potential role of oromotor stimulation on accelerating feeding milestone attainment, there are some methodological considerations that might be worth further discussion. First, although the intervention centered on oromotor stimulation, there was no objective assessment of oromotor function such as sucking coordination, oral motor control, or feeding efficiency. These parameters would have strengthened the causal link between the intervention and the enhanced feeding outcome.^2–4

Second, there was no report of baseline oral motor readiness or readiness-to-feed assessment. Although the demographic and clinical characteristics of the two groups were comparable, differences in baseline oral motor readiness may have contributed to feeding milestones. These reports would have improved the internal validity of the study and ensured comparability between the two groups.

Although the authors stratified the results according to gestational age, several factors are known to influence or delay feeding milestone attainment in preterm infants, including birth weight, respiratory stability, behavioral state, and feeding readiness.^3,4 These factors may have contributed but were not controlled or analyzed in this study.

Ultimately, the study highlighted that an earlier feeding transition may reduce hospital burden but did not report actual length of stay as an outcome. This would have further improved the clinical significance and practical implications of these results.

Despite the limitations of this study, the authors provide significant evidence that structured oromotor intervention provides successful feeding outcomes for premature neonates. Future studies of the clinical impact of PIOMI when objective oromotor assessment, baseline feeding readiness, and other clinical outcomes are included may further define the relevance and clinical usefulness of this form of intervention in neonatal care.

Authors’ Contributions

J.K.: Conceptualization, formal analysis, methodology, validation, and writing—original draft preparation. K.G.: Supervision, writing—review and editing, validation, and correspondence.

Data Availability Statement

No dataset was created or examined for this study, so data sharing is not relevant.