Incoordinated sucking pattern is associated with longer transition time to full oral feeding in premature infants

Abstract

Several treatments have been proposed in order to shorten the time to the attainment of full oral feeding (FOF) for pre-term infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the neonatal oral-motor assessment scale (NOMAS) could estimate the time to FOF in preterm infants with sucking difficulty. Video recordings of at least 2 minutes of oral feeding were analyzed by two assessors, and the premature infants observed to exhibit disorganized sucking patterns ( n = 109) were divided into three clusters (clusters 2, 3, and 4), and further divided into incoordination positive (cluster 4) and incoordination negative groups (clusters 2, 3). Premature infants in the incoordination positive group showed a median transition time of 22 days (range: 4–121 days) which was longer than that in the incoordination negative group (arrhythmic and/or unable to sustain sucking pattern, median 6 days; range: 1–25 days). Univariate analysis revealed that the presence of incoordination among disorganized sucking patterns (NOMAS cluster 4 vs. clusters 2, 3), birth weight, TPN duration, NIPPV duration, the presence of moderate to severe BPD, pulmonary hypertension, sepsis, SGA, and NEC, are associated with the transition time to FOF. When selecting premature infants to be treated with swallowing therapy, it is reasonable to perform treatment with the incoordination positive group described in the NOMAS, that is, premature infants with stress signals to shorten the time to attain full oral feeding.