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Characterization of the developmental stages of sucking in preterm infants during bottle feeding
C Lau1, R Alagugurusamy, R J Schanler
1Baylor College of Medicine, Department of Pediatrics, Feeding Disorders Center, Houston, TX 77030, USA. clau@bcm.tmc.edu
Insights
Preterm infants
Area of Science:
- Neonatal development
- Pediatric nutrition
- Oral motor function
Background:
- Preterm infants often struggle with oral feeding due to immature sucking skills.
- The developmental trajectory of sucking in preterm infants remains poorly understood.
- Effective oral feeding is crucial for the growth and development of preterm infants.
Purpose of the Study:
- To investigate the correlation between sucking skill development and bottle-feeding performance in preterm infants.
- To establish a developmental scale for assessing sucking maturation in preterm infants.
- To provide insights for managing oral feeding challenges in this population.
Main Methods:
- Longitudinal assessment of oral-motor skills using a specialized nipple/bottle system.
- Monitoring of suction and expression/compression components of sucking.
- Development and application of a five-stage sucking maturation scale.
Main Results:
- Positive correlations were found between sucking stage, postmenstrual age, feeding outcomes (overall and rate of transfer), and daily oral feeding volume.
- Improved overall transfer and rate of transfer were associated with more mature sucking stages.
- The five-stage sucking scale effectively characterized infant sucking development.
Conclusions:
- Oral feeding performance in preterm infants significantly improves with the maturation of sucking skills.
- The proposed five-point sucking scale can serve as a valuable tool for assessing sucking development in preterm infants.
- Understanding sucking maturation facilitates optimized management of oral feeding for preterm infants.
Abstract:
It is acknowledged that the difficulty many preterm infants have in feeding orally results from their immature sucking skills. However, little is known regarding the development of sucking in these infants. The aim of this study was to demonstrate that the bottle-feeding performance of preterm infants is positively correlated with the developmental stage of their sucking. Infants' oral-motor skills were followed longitudinally using a special nipple/bottle system which monitored the suction and expression/compression component of sucking. The maturational process was rated into five primary stages based on the presence/absence of suction and the rhythmicity of the two components of sucking, suction and expression/compression. This five-point scale was used to characterize the developmental stage of sucking of each infant. Outcomes of feeding performance consisted of overall transfer (percent total volume transferred/volume to be taken) and rate of transfer (ml/min). Assessments were conducted when infants were taking 1-2, 3-5 and 6-8 oral feedings per day. Significant positive correlations were observed between the five stages of sucking and postmenstrual age, the defined feeding outcomes, and the number of daily oral feedings. Overall transfer and rate of transfer were enhanced when infants reached the more mature stages of sucking. We have demonstrated that oral feeding performance improves as infants' sucking skills mature. In addition, we propose that the present five-point sucking scale may be used to assess the developmental stages of sucking of preterm infants. Such knowledge would facilitate the management of oral feeding in these infants.