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A Framework for Occupational Therapists Managing Oral Feeding in Preterm Infants
1Queen's University, Kingston, Ontario, Canada.
Insights
Preterm infants struggle with oral feeding due to immaturity and NICU environments. This study presents a framework to understand and guide the complex oral feeding process for these vulnerable infants.
Area of Science:
- Neonatal care
- Occupational therapy
- Pediatric feeding
Background:
- Preterm infants often experience difficulties with oral feeding.
- Challenges stem from immaturity, medical complexity, and the neonatal intensive care unit (NICU) environment.
Purpose of the Study:
- To present a framework and clinical guide for the oral feeding process in preterm infants.
- To synthesize current literature on preterm infant oral feeding.
Main Methods:
- Literature synthesis and integration.
- Development of a framework identifying core oral feeding skills.
- Identification of intrinsic and extrinsic factors influencing oral feeding.
Main Results:
- The proposed framework details core skills: sucking, swallowing, breathing, and aerodigestion.
- Identified intrinsic factors include musculoskeletal, respiratory, cardiovascular, gastrointestinal, sensory, and neurological systems.
- Extrinsic factors encompass physical surroundings, policies, parental attributes, healthcare providers, and feeding equipment.
Conclusions:
- The framework provides an evidence-based approach to understanding preterm infant oral feeding.
- Recognizing oral feeding as a multidimensional occupation aids occupational therapists.
- This approach helps address factors impacting infant oral feeding performance.
Abstract:
Oral feeding is a complex multidimensional process that preterm infants often face challenges achieving due to their immaturity, medical complexity, and environmental influences in the neonatal intensive care unit. The objective of this study is to describe a framework and clinical guide of the oral feeding process. Evidence from current literature on preterm infant oral feeding was synthesized and integrated. The proposed framework identifies core skills (sucking, swallowing, breathing, and aerodigestion), which are influenced by intrinsic factors (musculoskeletal, respiratory, cardiovascular, gastrointestinal, sensory, and neurological) and extrinsic factors (physical surroundings, policies, parent attributes, health care provider, and feeding equipment). The framework and clinical guide offer an evidence-based approach for understanding oral feeding in preterm infant. Recognizing oral feeding as a multidimensional occupation enables occupational therapists to address the range of factors influencing infants' oral feeding performance.
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