Oral Feeding Assessment Predicts Length of Hospital Stay in Late Preterm Infants

When compared with term infants, late preterm (LP) infants have greater morbidity and mortality, longer hospital stay, and greater rate of hospital readmission. Oral feeding difficulty is one of the prominent reasons for delayed discharge in LP infants.

To identify the maturity levels of LP infants' oral feeding skills (OFS) at the time of their first oral feeding and to determine the relationship between OFS maturity levels and length of hospital stay.

OFS was assessed in 48 LP infants born between 34^0/7 and 35^6/7 weeks gestational age at the time of their first oral feeding within 24 h of birth. The intake at 5 minutes, at completion of the feeding, and the duration of feeding a 15 mL prescribed volume of milk were tabulated. Proficiency expressed as percent mL consumed in the first 5 min/15 mL prescribed and rate of milk transfer over the entire feeding (mL/min) were recorded. OFS were assessed using a novel 4-level scale defined by the combined proficiency and rate of milk transfer.

When compared with their 35-week counterparts, infants born at 34 weeks gestation had poorer OFS profiles (p = 0.035) and longer hospital stay (p < 0.001). Additionally, further analyses demonstrated that, independently, LOS was associated negatively with both GA and OFS.

Assessment of OFS levels in LP infants at their first oral feeding can help identify infants at risk of oral feeding issues that may delay hospital discharge. For those infants, we speculate that provision of evidence-based efficacious interventions that improve OFS may shorten hospital stay and decrease hospital re-admissions.