Eghlima Jalaly - Clinical Research Development Unit, Velayat Hospital, Semnan University of Medical Sciences, Semnan, Iran.
Masumeh Ghazanfarpour - Reproductive Health, Family and Population Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Malihe Afiat Milad - Infertility Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Fatemeh Abdi - Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Saeed Soleimany - Regional Educational Blood Transfusion Center, Kerman, Iran.
Sara Saadat - Department of Pediatric, Division of Nephrology Mashhad University of Medical Sciences, Dr Sheikh hospital, Mashhad, Iran.

Background and Objectives: Gavage feeding is associated with adverse effects, such as irritations in the mouth, hyperactivity, problems in gag reflex, bradycardia, and the parents’ unacceptance. Accordingly, it is essential to undertake a comprehensive review of the effects of breast milk and other pleasant odors that may reduce the transition time from gavage to oral feeding in preterm infants. Methods: In this systematic review, online English databases, such as PubMed, Scopus, ISI Web of Science, and Cochrane Library were systematically searched without any time limitation up to February ۱۰, ۲۰۲۲. The modified Jadad scale was also used to assess the quality of the articles. The inclusion criteria comprised all clinical trials evaluating the effect of aromatherapy on odors on the transition from gavage to oral feeding in preterm infants. Results: ۸ studies were assessed with the effects of aroma inhalation on the transition from gavage to oral feeding. Meta-analysis of these studies showed that preterm infants transitioned from tube feeding (gavage (to oral feeding earlier in the groups stimulated by pleasant odors (standardized mean difference = -۰.۴۷, ۹۵% confidence interval: -۰.۶۴ to -۰.۳۱, heterogeneity, P = ۰.۳۲; I۲= ۱۳%, ۸ trials) and odor of breast milk (standardized mean difference = -۰.۶۱, ۹۵% confidence interval: -۰.۶۴ to -۰.۳۱, heterogeneity, P = ۰.۸۵, I۲= ۰%, ۶ trials) in comparison to the control group.  Conclusion: Our meta-analysis supports using breast milk and other pleasant odors as a safe and noninvasive way of reducing the transition time from gavage to oral feeding in preterm infants. Health providers should use effective and family-friendly interventions to care for their premature infants.

Premature, Aromatherapy, Odor, Gavage, Breastfeeding, Breast milk