Sniffin' away the feeding tube: The influence of olfactory stimulation on oral food intake in newborns and premature infants

Abstract

Because of their immaturity, many premature infants are fed via nasogastric tube. One objective of the neonatal care is to feed infants orally early. The olfactory function of premature infants is developed before birth and odorants have a significant impact on nutrition in infants. The aim of the study was to test whether odor stimulation has a positive effect on the transition from gavage to oral feeding in infants. Participants were premature infants with gestational age of more than 27 weeks, with full or partial gavage feeding, stable vital parameters and without invasive ventilation. Before each feeding procedure an odorant was presented in front of the infant's nose. Infants were randomized into 1 of 3 groups and received either rose odor (not food-Associated), vanilla odor (food-Associated), or placebo (no odor). The primary outcome of the study was defined as the time until complete oral nutrition. About 150 children born at a postnatal age of 9.5 ± 7.8 days were included in this study. The duration until complete oral nutrition was reached after 11.8 ± 7.7 (vanilla), 12.2 ± 7.7 (rose), and 12.9 ± 8.8 (control) days. A nearly linear relation between odor presentation frequency and effect size was detectable. For infants that received the intervention for more than 66.7% of the time the length of gavage feeding (8 ± 5.4) and hospitalization (11 ± 6.5) was significantly lower in the vanilla group when compared with control (15 ± 7.3 and 21 ± 13.7, respectively). Odor stimulation with vanilla has an impact on oral feeding in premature infants, however the odor has to be presented on regular basis.