A Framework for Occupational Therapists Managing Oral Feeding in Preterm Infants

Oral feeding is a complex multidimensional process that preterm infants often face challenges achieving due to their immaturity, medical complexity, and environmental influences in the neonatal intensive care unit. The objective of this study is to describe a framework and clinical guide of the oral feeding process. Evidence from current literature on preterm infant oral feeding was synthesized and integrated. The proposed framework identifies core skills (sucking, swallowing, breathing, and aerodigestion), which are influenced by intrinsic factors (musculoskeletal, respiratory, cardiovascular, gastrointestinal, sensory, and neurological) and extrinsic factors (physical surroundings, policies, parent attributes, health care provider, and feeding equipment). The framework and clinical guide offer an evidence-based approach for understanding oral feeding in preterm infant. Recognizing oral feeding as a multidimensional occupation enables occupational therapists to address the range of factors influencing infants' oral feeding performance.