Transition to competent oral feeding in preterm infants: Analyzing timing and determinants

The achievement of oral feeding competence (OFC) is a challenge in preterm infants and can be affected by several factors.

The aim of our study was to determine the time elapsed to development of OFC in very low birth weight (VLBW, weight <1500g) preterm infants and to identify factors associated with greater difficulty in achieving this skill.

Observational, longitudinal and prospective study in VLBW infants over a period of 7 years (2016-2022). We collected data on perinatal variables, feeding practices and complications associated with prematurity. We analyzed the number of days needed to achieve OFC and which variables predicted greater delay in achieving OFC.

We included 145 VLBW infants with a median gestational age (GA) of 29 weeks with a weight of 1247g. Oral feeding was initiated at 33.6 weeks (SD, 1.2) and full oral feeding was achieved at 35.9 weeks (SD, 1.9). The median time to achievement of OFC was 15 days (8-22.5). The variables associated with longer delay of OFC were severe combined morbidity (24 vs 14 days; P<.001) and moderate/severe bronchopulmonary dysplasia (23 vs 14 days; P<.001). In infants without severe combined morbidity, we found no differences in the days elapsed to achievement of OFC between those born before or after 28 weeks of GA (P=.131).

Our findings highlight the importance of structuring the transition to oral feeding and identifying the most at-risk group, which in our study were infants with severe morbidity associated with prematurity, for the purpose of targeting potential interventions.