Development of oral function in pre-term infants

Establishment of functional oral feeding is an important aspect of care of infants born pre-term. The developmental patterns of intra- and extra-oral responses provide some uesful guidelines.A study of six such responses (gag, cough, non-nutritive suck, rooting, suck-swallow and nutritive sucking) in 110 very low birth weight infants (mean gestational age 29; s.d. 2.5 weeks, mean birthweight 1136; s.d. 212.3 gms) during the period of perinatal hospitalisation (mean 68.35; s.d. 26.1 days) revealed that these responses could be stimulated several weeks before reaching a consistently functional level of maturity. The gag reflex, elicitable at 29 weeks in 90% of infants, was not consistently functional until 33 weeks. No other responses were consistently mature until 37 weeks. Development of responses was not significantly altered by age at birth, birthweight, mechanical ventilation or sex. The presence of cerebro-ventricular haemorrhage and ventricular dilatation as determined by cranial ultrasound significantly affected the function of rooting, non-nutritive suck and suck-swallow responses (p< 0.05).