Oral Feeding in the Preterm Infant

Abstract

After completing this article, readers should be able to: 1. Describe the sequential development of sucking, swallowing, and respiration. 2. Delineate the limitation of an infant’s oral feeding skills at specific times of development to provide realistic expectations for oral feeding performance. 3. Define oral feeding success in preterm infants. 4. Use the current knowledge of preterm infants’ oral motor skills to facilitate and enhance their performance. 5. Enumerate the potential short- and long-term consequences of an infant’s oral feeding aversion for the patient, family, and health professional. Oral feeding issues in preterm infants are a growing concern for neonatologists because attainment of independent oral feeding is one of the prerequisites for hospital discharge. With the increase in survival of infants born continuously more preterm, understanding such issues has a certain urgency. Concerns do not pertain only to difficulties encountered by neonatologists during the birthstay hospitalization, but also by pediatricians and pediatric gastroenterologists who attend to long-term feeding difficulties/disorders, such as oral feeding aversion. Indeed, greater than 40% of patients followed in feeding disorder clinics are former preterm infants. Research over the last decade has begun to shed light on the development of oral feeding skills in these infants as they mature, which has increased understanding of their limited skills at varying postmenstrual ages. Such knowledge is crucial in clinical practice insofar as expectations of these infants’ oral feeding performance must take into account the ever-changing level of maturity of their skills. This article focuses on the development of sucking, swallowing, and respiration (as it pertains to oral feeding) and the coordination of these three functions. Additional factors, separate from infant feeding skills, also are discussed because they can affect oral feeding performance. This review examines information gathered from bottle feeding because more extensive research has been conducted on bottle feeding than on breastfeeding. However, …