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Sleep-Wake States and Feeding Progression in Preterm Infants

Jinhee Park1, Susan G Silva, Suzanne M Thoyre

  • 1Jinhee Park, PhD, RN, is Assistant Professor, School of Nursing, Boston College, Chestnut Hill, Massachusetts. Susan G. Silva, PhD, is Associate Professor, School of Nursing, Duke University, Durham, North Carolina. Suzanne M. Thoyre, PhD, RN, FANN, is Professor, School of Nursing, University of North Carolina at Chapel Hill. Debra H. Brandon, PhD, RN, CNS, FAAN, is Associate Professor, School of Nursing, Duke University, Durham, North Carolina.

Nursing Research
|December 14, 2019
PubMed

Insights

Delays in preterm infants' sleep-wake state development may impact feeding progression. Supporting sleep development could improve feeding skills during hospitalization.

Area of Science:

  • Neonatal Development
  • Infant Sleep Studies
  • Clinical Nutrition

Background:

  • Short-term links between infant sleep-wake states and feeding exist, indicating neurobehavioral readiness.
  • Longitudinal evaluation of sleep-wake states and feeding skills during hospitalization is lacking.

Purpose of the Study:

  • To examine developmental trajectories of sleep-wake states in preterm infants.
  • To investigate associations between these sleep-wake trajectories and feeding progression during hospitalization.

Main Methods:

  • Secondary analysis of a longitudinal randomized controlled trial involving extremely preterm infants (≤28 weeks gestational age).
  • Sleep-wake states (active sleep, quiet sleep, waking) assessed during interfeeding periods from 30 weeks postmenstrual age until discharge.
  • Feeding progression tracked through five key milestones (e.g., first enteral feeding, full oral feeding).
  • Trajectory analyses used to model developmental changes and associations.

Main Results:

  • Active sleep decreased, while quiet sleep and waking increased during hospitalization.
  • Two feeding groups emerged: typical and delayed progression.
  • Delayed feeding progression was linked to slower daytime active and quiet sleep development.
  • Infants with delayed feeding were more frequently awake at night.

Conclusions:

  • Delayed sleep-wake state development may correlate with delayed feeding progression in hospitalized preterm infants.
  • Environmental modifications to support sleep may benefit infants with delayed feeding skills.
Abstract

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