Identification of a Pivotal Period in the Oral Feeding Progression of Preterm Infants.

OBJECTIVE:  Preterm infants are at risk of encountering oral feeding difficulties which impede on the transition to independent oral feeds. The objective of this study was to identify a pivotal period where regressions are most likely to occur during their oral feeding progression.

STUDY DESIGN:  This is a retrospective study on 101 infants born <35 weeks' gestation. The sample was separated into two groups, infants who experienced a regression during their oral feeding progression and those who did not. A pivotal period was defined as a time frame where setbacks (a decrease in oral feed attempts by one) are most likely to occur at the start (1-2 oral feed attempts per day), middle (3-5 oral feed attempts per day), or end (6-8 oral feed attempts per day) of the oral feeding progression.

RESULT:  Eight-two percent of infants experienced setbacks; 45% of all setbacks occurred at the middle time frame ( p  = 0.03). Infants' degree of maturity and enteral tube feeding intolerances were associated with increased occurrence of setbacks ( p  = 0.04).

CONCLUSION:  The midpoint in the oral feeding progression is a pivotal period where setbacks are most likely to occur. This time frame can be used by clinicians to evaluate oral-motor skills for earlier provision of interventions to reduce the occurrence of oral feeding difficulties in this high-risk population.