ARS | Publication request: ORAL FEEDING IN PREMATURE INFANTS

Submitted to: Pediatric Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: September 27, 1996
Publication Date: N/A

Interpretive Summary: In order to be discharged from the hospital, premature infants have to be able to successfully drink milk from a bottle. Sometimes babies born early have trouble coordinating the sucking, breathing and drinking involved. Standards have not been established for figuring out when it is an appropriate time to introduce babies to oral feeding. We wanted to find out thow well premature babies could drink from a bottle with unrestricted flow as milk is routinely given in nurseries, compared to restricted flow, meaning the baby must actively suck at the nipple to produce flow. Second, we wanted to see whether the rhythmic sucking pattern used by full-term babies is necessary for successful oral feeding. Third, we wanted to come up with yardsticks that doctors could use to figure out when premature babies were successful in oral feeding. After studying several groups of babies, we found out: first, restricted milk flow is helpful to infants under 30 weeks old; second, the full-term sucking pattern is not necessary for successful oral feeding; and third, that proficiency and efficiency of milk-drinking are both useful signs for figuring out how well a premature baby has mastered drinking milk from a bottle.

Technical Abstract: The objectives of this study were to assess oral feeding performance in preterm infants when milk delivery was unrestricted, as routinely administered in nurseries, versus restricted when milk flow occurred only when the infant was sucking; to determine whether the fullterm sucking pattern of suction/expression was necessary for feeding success; and to identify clinical indicators of successful oral feeding in premature infants. Infants (29-33 wk gestation) were evaluated at their first oral feeding and upon achieving independent oral feeding. Bottle nipples were adapted to monitor the suction and expression components of sucking. To assess feeding performance proficiency (% volume transferred during the first 5 min of a feeding/the total volume ordered), efficiency (volume transferred per unit time) and overall transfer (percent volume transferred) were calculated. Feeding performance of 26-30 wk, but not 31-33 wk infants, was enhanced with a restricted milk flow. When infants demonstrated a proficiency greater than 30% and efficiency greater than 1.5 ml/min, 86% of infants will have satisfactory oral feeding performance. Thus, a restricted milk flow facilitates oral feeding in infants less than or equal to 30 wk, the appearance of the fullterm sucking pattern is not necessary for successful oral feeding, and proficiency and efficiency may be used as reliable indicators of such success.