A Novel Approach to Assess Oral Feeding Skills of Preterm Infants

BACKGROUND: There is no well-defined means to identify the level of oral feeding skills (OFS) in preterm infants. OBJECTIVE: To determine whether OFS as reflected by the combination of proficiency (PRO, %ml taken during the first 5 min/ml prescribed) and rate of milk transfer (RT, ml/min) correlates with gestational age (GA), oral feeding performance (OT, %ml taken during a feeding/ml prescribed) and days from start to independent oral feeding (SOF-IOF). Our working premises are that PRO is reflective of infants' actual feeding skills when fatigue is minimal and RT, monitored over an entire feeding session, reflects their overall skills when fatigue comes into play. METHODS: Infants (26-36 weeks GA) with prematurity as their principal diagnosis were recruited and monitored at their first oral feeding. GA was divided into 3 strata, 26-29, 30-33, and 34-36 weeks GA. OFS was divided into 4 levels delineated by PRO (≥ or <30%) and RT (≥ or <1.5 ml/min). ANOVA with post-hoc Bonferroni and multiple regression analyses were used. RESULTS: OFS levels were correlated with GA. OT, PRO, and days from SOF-IOF were associated with OFS and GA, whereas RT was only correlated with OFS levels. CONCLUSIONS: OFS is a novel objective indicator of infants' feeding ability that takes into account infants' skills and endurance. As a clinical tool, it can help caretakers monitor infants' skills as they transition to oral feeding and identify oral feeding issues arising from immature skills and/or poor endurance.