The OSMS consists of a 15-minute stimulation program, whereby the first 12 minutes involve stroking the cheeks, lips, gums, and tongue, and the final 3 minutes consist of sucking on a pacifier. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

The sham intervention consisted of the therapists placing his/her hands into the incubator or bassinet for 15 minutes without touching the infants. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

% volume taken/volume prescribed

% volume taken at 5 min/volume prescribed

mL/min volume of milk consumed relative to the duration of the oral Feeding session

% volume of milk spilled from the lips as a percentage of the total milk transferred

• comprehensive description of the infant's feeding patterns
• identify normal oral-motor patterns and to differentiate disorganized from dysfunctional patterns

Length of hospital stay

• an individually administered instrument designed to assess the developmental functioning of infants, toddlers, and young children.
• cognitive scale, motor scale (gross motor, fine motor), language scale (receptive communication, expressive communication)
• subtest total raw scores & scaled scores / composite scores /percentile ranks/ confidence intervals
• Total raw score range (min~max) : cognitive (0~91), receptive communication (0~49), expressive communication (0~48), fine motor (0~66), gross motor (0~72)
• Higher scores mean better outcomes

-a simple screening test for language development

• An innovative measure of cognitive development and an intelligence test for preschoolers and young children
• Primary index scales> verbal comprehension, visual spatial, fluid reasoning, working memory, processing speed ==> Full scale IQ
• Ancillary index scales > vocabulary acquisition
• scaled score, composite score, percentile rank, CI
• Range of Full scale IQ : min (40) ~ max (160)
• Higher scores mean better outcomes.

• A fill-up questionnaire to be answered by parents so as to determine who experience developmental problems
• Domains: gross motor, fine motor, language, cognition, sociality, self-care
• Score range of each domain : min (0) ~ max (24)
• Higher scores mean better outcomes.

• a brief behavioural screening questionnaire
• 5 subscales: Emotional problems scale, Conduct problems scale, Hyperactivity scale, Peer problems scale, Prosocial scale (score range of each scale : 0-10)
• total difficulties score : summing scores from all the scales except the prosocial scale (score range : 0-40)
• Lower scores mean better outcomes for the all scales except the prosocial scale

• A comprehensive and widely used measure of behavioral and skill-based feeding problems
• It consists of 35 questions: 25 related to child eating, and 10 related to parent feeding behaviors.
• Parents answer each question on a five-point Likert scale, then indicate whether they perceive that behavior to be problematic or not.
• Child an parent frequency scores : from the Likert scales (score range : min 35 ~ max 175)
• Child and parent problem scores : from the yes/no questions

One session of DST and the other of sham intervention/day, five days a week

Direct swallowing training (DST): The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Sham intervention: The sham intervention consisted of the therapists placing his/her hands into the incubator or bassinet for 15 minutes without touching the infants. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

One session of DST and the other of OSMS/day, five days a week

Direct swallowing training (DST): The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Oral sensorimotor stimulation (OSMS): The OSMS consists of a 15-minute stimulation program, whereby the first 12 minutes involve stroking the cheeks, lips, gums, and tongue, and the final 3 minutes consist of sucking on a pacifier. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Total of all reporting groups

Race and Ethnicity were not collected from any participant.

One session of DST and the other of OSMS/day, five days a week

Direct swallowing training (DST): The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Oral sensorimotor stimulation (OSMS): The OSMS consists of a 15-minute stimulation program, whereby the first 12 minutes involve stroking the cheeks, lips, gums, and tongue, and the final 3 minutes consist of sucking on a pacifier. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

first full oral feeding : The first day that attain the full oral feeding regardless of feeding side effects

complete full oral feeding : 2 days in a row without any adverse events The first successful day)

% volume taken/volume prescribed

% volume taken at 5 min/volume prescribed

mL/min volume of milk consumed relative to the duration of the oral Feeding session

% volume of milk spilled from the lips as a percentage of the total milk transferred

• comprehensive description of the infant's feeding patterns
• identify normal oral-motor patterns and to differentiate disorganized from dysfunctional patterns

Length of hospital stay

• an individually administered instrument designed to assess the developmental functioning of infants, toddlers, and young children.
• cognitive scale, motor scale (gross motor, fine motor), language scale (receptive communication, expressive communication)
• subtest total raw scores & scaled scores / composite scores /percentile ranks/ confidence intervals
• Total raw score range (min~max) : cognitive (0~91), receptive communication (0~49), expressive communication (0~48), fine motor (0~66), gross motor (0~72)
• Higher scores mean better outcomes

-a simple screening test for language development

• An innovative measure of cognitive development and an intelligence test for preschoolers and young children
• Primary index scales> verbal comprehension, visual spatial, fluid reasoning, working memory, processing speed ==> Full scale IQ
• Ancillary index scales > vocabulary acquisition
• scaled score, composite score, percentile rank, CI
• Range of Full scale IQ : min (40) ~ max (160)
• Higher scores mean better outcomes.

• A fill-up questionnaire to be answered by parents so as to determine who experience developmental problems
• Domains: gross motor, fine motor, language, cognition, sociality, self-care
• Score range of each domain : min (0) ~ max (24)
• Higher scores mean better outcomes.

• a brief behavioural screening questionnaire
• 5 subscales: Emotional problems scale, Conduct problems scale, Hyperactivity scale, Peer problems scale, Prosocial scale (score range of each scale : 0-10)
• total difficulties score : summing scores from all the scales except the prosocial scale (score range : 0-40)
• Lower scores mean better outcomes for the all scales except the prosocial scale

• A comprehensive and widely used measure of behavioral and skill-based feeding problems
• It consists of 35 questions: 25 related to child eating, and 10 related to parent feeding behaviors.
• Parents answer each question on a five-point Likert scale, then indicate whether they perceive that behavior to be problematic or not.
• Child an parent frequency scores : from the Likert scales (score range : min 35 ~ max 175)
• Child and parent problem scores : from the yes/no questions

One session of DST and the other of sham intervention/day, five days a week

Direct swallowing training (DST): The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Sham intervention: The sham intervention consisted of the therapists placing his/her hands into the incubator or bassinet for 15 minutes without touching the infants. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

One session of DST and the other of OSMS/day, five days a week

Direct swallowing training (DST): The DST consists of placing a bolus of 0.05-0.2 mL of formula milk (if the parents refuse, distilled water) via a 1-mL syringe directly on the medial-posterior part of the tongue approximately at the level of the hard and soft palate junction. The volume is started with 0.05 mL, and increased in increments of 0.05 mL to a maximum of 0.2 mL until the swallowing reflex is observed. Once the minimal volume necessary to initiate the swallow reflex is identified, it is used for the duration of the training. The bolus is provided every 30 sec over the 15-minute program or as tolerated. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.

Oral sensorimotor stimulation (OSMS): The OSMS consists of a 15-minute stimulation program, whereby the first 12 minutes involve stroking the cheeks, lips, gums, and tongue, and the final 3 minutes consist of sucking on a pacifier. It is continued until infants are able to complete independent oral feeding, 2 days in a row with no adverse events that do not self-resolve.