# Oral Feeding Competences of Healthy Preterm Infants: A Review

Authors: N. Bertoncelli; G. Cuomo; S. Cattani; C. Mazzi; M. Pugliese; E. Coccolini; P. Zagni; B. Mordini; F. Ferrari
Journal: International Journal of Pediatrics
 (2012)

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## Abstract

Background. With increasing sophistication and technology, survival rates hugely improved among preterm infants admitted to the neonatal intensive care unit. Nutrition and feeding remain a challenge and preterm infants are at high risk of encountering oral feeding difficulties. Objective. To determine what facts may impact on oral feeding readiness and competence and which kind of interventions should enhance oral feeding performance in preterm infants. Search Strategy. MEDILINE database was explored and articles relevant to this topic were collected starting
from 2009 up to 2011. Main Results. Increasingly robust alertness prior to and during feeding does positively impact the infant’s feeding Skills. The review found that oral and non-oral sensorimotor interventions, provided singly or in combination, shortened the transition time to independent oral feeding in preterm infants and that preterm infants who received a combined oral and sensorimotor intervention demonstrated more advanced nutritive sucking, suck-swallow and swallow-respiration coordination than those who received an oral or sensorimotor intervention singly.


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## Body

## Conclusions

Inadequate feeding capabilities in preterm infants often lead to poor nutritional and growth failure. Although the prevalence of feeding difficulties in preterm infants is well recognized, the nature of feeding milestones including the timeline of the acquisition of the coordination of sucking, swallowing and respiration still needs more research.This paper found that increasingly robust alertness prior to and during feeding does positively impact the infant’s feeding skills especially in their ability to generate numbers of sucks and numbers of sucks per burst. There is a significant difference in the coordination of swallowing and breathing between <34 and >34 weeks’ PMA; in preterm infants the maturation in respiration during feeding is not established fully yet at 36 weeks’ PMA. This paper also found that oral and nonoral sensorimotor interventions provided singly or in combination shortened the transition time to independent oral feeding in preterm infants. These findings demonstrated that sensorimotor interventions have beneficial effects beyond their specific site of input. This paper underlined that preterm infants who received a combined oral and sensorimotor intervention demonstrated more advanced nutritive sucking, suck-swallow, and swallow-respiration coordination than those who received an oral or sensorimotor intervention singly. The use of oral feeding skills levels can offer a more objective indicator of infants’ ability to feed by mouth than gestational age or other tools currently available. Finally, there were no studies that identified a particular bottle nipple that enhanced bottle feeding in healthy VLBW infants.



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*Source: 896257-2012-05-17.xml*