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Updated: Aug 14, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Identification of neonates at risk of developing feeding problems in infancy
J M Hawdon1, N Beauregard, J Slattery
1Obstetric Hospital, University College London Hospitals, UK. j.hawdon@academic.uclh.nthames.nhs.uk
Insights
Many preterm infants experience feeding difficulties, impacting long-term development. Early identification and intervention in neonatal intensive care units are crucial for optimizing infant outcomes.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Developmental Pediatrics
Background:
- Increased survival rates in sick and preterm neonates highlight the need to address associated long-term health issues.
- Immature feeding patterns in neonates can lead to significant challenges post-discharge.
Purpose of the Study:
- To investigate the incidence and impact of abnormal feeding patterns in neonates.
- To identify risk factors associated with feeding difficulties in infants born preterm.
- To explore the long-term consequences of neonatal feeding issues on infant development.
Main Methods:
- Prospective study of 35 neonates admitted to a neonatal intensive care unit.
- Assessment of feeding patterns at 36-40 weeks postmenstrual age.
- Follow-up assessments at 6 and 12 months of age to evaluate feeding milestones and tolerance.
Main Results:
- A high incidence (14/35) of immature or abnormal feeding patterns was observed at 36-40 weeks postmenstrual age.
- Neonates requiring prolonged respiratory support and delayed feeding were more susceptible to feeding issues.
- Infants with disorganized feeding were significantly more likely to experience vomiting and coughing at 6 months, and had difficulties with lumpy food and mealtime enjoyment at 12 months.
Conclusions:
- Immature and abnormal neonatal feeding patterns are prevalent and linked to adverse feeding outcomes later in infancy.
- Prolonged respiratory support and delayed enteral/oral feeding are risk factors for developing feeding dysfunction.
- Addressing neonatal feeding problems may mitigate risks of failure to thrive and psychosocial distress post-discharge.
Abstract:
The increased survival of sick and preterm neonates may be associated with long-term problems which must be recognised and managed if outcome is to be optimised. In a prospective study of 35 neonates (median gestational age at birth 34 weeks) admitted to a neonatal intensive care unit over a 3-month period, we have documented a high incidence (14 of 35) of immature or abnormal feeding patterns when infants were assessed at 36 to 40 weeks postmenstrual age. Neonates with prolonged respiratory support and delayed enteral and oral feeding were most affected. Compared with neonates who have normal initial feeding assessments, neonates with disorganised or dysfunctional feeding were six times more likely to vomit and three times more likely to cough when offered solid food at 6 months of age. At 12 months of age significant differences were also found in tolerating lumpy food and enjoying mealtimes. We hypothesise that these feeding problems contribute to failure to thrive and psychosocial distress after discharge from the neonatal unit and propose potential neonatal measures to reduce their incidence.
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