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"Latar belakang: Kelahiran hidup bayi prematur di Indonesia mencapai 675.700 kasus (15.5%) tiap tahun. Peningkatan insidens gangguan minum dan menelan pada bayi ditemukan terbanyak pada kelompok bayi prematur. Dampaknya akan meningkatkan komplikasi pasien berupa infeksi saluran napas, gangguan nutrisi, dan tumbuh kembang. Keadaan tersebut berisiko memperpanjang konversi pemberian makan per oral, perawatan, serta pembiayaan perawatan. Penelitian terdahulu belum melaporkan prevalensi dan karakteristik gangguan menelan serta gangguan koordinasi siklus isap-telan-napas (ITN) sebagai salah satu bentuk gangguan minum pada bayi prematur. Tujuan: Menilai prevalensi ganguan minum dan menelan pada bayi prematur, serta menilai karakteristik dan faktor risiko yang berpengaruh terhadap kemampuan minum dan menelan pada bayi prematur.Metode: Penelitian ini merupakan studi potong lintang pada bayi prematur dengan riwayat perawatan di NICU yang dilakukan Flexible Endoscopic Evaluation of Swallowing (FEES) di Klinik Disfagia Terpadu  Departemen THT-KL RSCM periode Oktober 2020-Oktober 2022. Parameter yang dinilai adalah faktor karakteristik kelahiran, karakteristik paska lahir, karakteristik oromotor dan tonus postural, serta karakteristik pemeriksaan FEES.Hasil: Prevalensi gangguan menelan sebesar 25% dengan karakteristik temuan disfagia fase oral mekanik, disfagia fase faring neurogenik, dan disfagia fase orofaring neurogenik. Prevalensi gangguan koordinasi siklus ITN sebesar 62,5%. Faktor risiko penyakit refluks gastro esofagus (PRGE) berhubungan dengan gangguan menelan pada bayi prematur (p=0,015) dengan menggunakan uji chi-square. Parameter lain seperti kelompok PMA, high arched palate, standing secretion, nutritive sucking, penetrasi dan aspirasi memiliki hubungan terhadap gangguan menelan pada bayi prematur (p<0,05).Kesimpulan: Karakteristik gangguan minum dan menelan pada bayi prematur ditemukan prevalensi gangguan koordinasi siklus ITN lebih banyak dibandingkan gangguan fungsi menelan (disfagia). Kelompok PMA, PRGE, high arched palate, standing secretion ditemukan sebagai faktor risiko yang berhubungan dengan gangguan menelan pada bayi prematur. Nutritive sucking, penetrasi, dan aspirasi  ditemukan sebagai faktor menentu diagnosis disfagia pada bayi prematur.

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Background: Preterm birth in Indonesia reaches 675,700 cases (15.5%) each year. This condition is the etiologic feeding difficulty and swallowing disorders in preterm babies. The impact will increase patient complications, such as respiratory tract infections, nutritional disorders, and growth and development. It precedes the risk of prolonging the conversion of oral feeding, and treatment, as well as a financial burden related to hospitalization. Previous studies have not reported the prevalence and characteristics of swallowing disorder or dysphagia and suck-swallow-breath (SSB) coordination disorder as a form of feeding difficulty in premature infants.

Objective: To assess the prevalence of feeding difficulty and swallowing disorders in premature babies and analyzed characteristics and risk factors that affect the ability to feed and swallow in premature babies.

Method: A cross-sectional study in preterm babies with a history of treatment in the NICU using a flexible endoscopic evaluation of swallowing (FEES) for swallowing evaluation at the Dysphagia outpatient clinics Department of ORL-HNS RSCM for the period October 2020-October 2022. The parameters assessed were birth characteristics, postnatal characteristics, oro-motor characteristics, and postural tone, as well as FEES examination characteristics.

Results: The prevalence of swallowing disorders was 25% with characteristics of mechanical oral phase dysphagia, neurogenic pharyngeal phase dysphagia, and neurogenic oropharyngeal phase dysphagia. The prevalence of SSB cycle coordination disorders was 62.5%. The risk factor associated with dysphagia in preterm babies was gastroesophageal reflux disease (GERD) with a p-value = 0.015. Other parameters such as post-menstrual age (PMA) group, high arched palate, standing secretion, nutritive sucking, penetration, and aspiration have an association with swallowing disorders in premature infants (p<0.05).

Conclusion: Characteristics of feeding difficulties and swallowing disorders in preterm babies were found to have more prevalence of SSB cycle coordination disorders than impaired swallowing function (dysphagia). The PMA, GERD, high-arched palate, and standing secretion group were found to be risk factors associated with swallowing disorders in premature infants. Nutritive sucking, penetration, and aspiration were found to be the erratic factors of dysphagia diagnosis in premature babies."

"Neonatus dengan kelahiran prematur cenderung mengalami beberapa masalah kesehatan, salah satunya adalah gangguan menelan. Gangguan menelan pada bayi prematur terjadi karena perkembangan refleks mengisap dan menelan bayi belum matang sehingga terjadi ketidaksempurnaan koordinasi antara mengisap-menelan-bernapas pada bayi. Bayi prematur dengan gangguan menelan tidak dapat diberikan nutrisi melalui oral secara penuh sehingga bergantung kepada pemberian nutrisi melalui selang makan selama masa awal perawatan. Intervensi stimulasi oral dapat dilakukan untuk meningkatkan perkembangan refleks mengisap dan menelan serta mengurangi lama waktu transisi dari pemberian makan melalui selang makan ke pemberian makan langsung melalui oral pada bayi prematur. Studi kasus ini akan menggambarkan penerapan stimulasi oral pada bayi prematur dan pengaruhnya dalam meningkatkan refleks mengisap dan menelan bayi selama 5 hari perawatan. Intervensi dilakukan pada salah satu bayi prematur di ruang perinatologi dengan kelahiran usia gestasi 34 minggu. Intervensi ini dilakukan setiap hari dengan durasi 15-20 menit sebelum makan. Hasil evaluasi menunjukkan bahwa terdapat peningkatan pada kemampuan mengisap dan menelan bayi serta koordinasi antara mengisap-menelan-bernapas bayi. Kesimpulan: Stimulasi oral dapat meningkatkan kemampuan mengisap dan menelan pada bayi prematur dengan gangguan menelan.

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Neonates with premature birth tend to experience some health problems, including swallowing difficulty. Swallowing difficulty in preterm infants occur because the immature development of sucking and swallowing reflexes, resulting in imperfect coordination between sucking-swallowing-breathing in infants. Premature infants with swallowing difficulty cannot be given full oral nutrition and thus they have to rely on feeding tube to meet their nutritional needs during the initial treatment. Oral stimulation intervention can be carried out to improve the development of sucking and swallowing reflexes and reduce the transition time from using tube feeding to direct oral feeding in preterm infants. This case report will describe the application of oral stimulation on preterm infants and its effect on improving sucking and swallowing reflexes of infants during 5 days of treatment. The intervention was carried out to one of the preterm infants with 34 weeks gestational age in the perinatology room. The intervention was carried out every day with a duration of 15-20 minutes before eating. The results of the evaluation showed that there was an improvement in the infant’s sucking and swallowing abilities and the infant sucking-swallowing-breathing coordination. Conclusion: Oral stimulation can improve sucking and swallowing abilities in preterm infants with swallowing difficulties. "