The Complexity of Transitioning to Oral Feeds in Preterm Infants

Abstract

Abstract Transitioning to oral feeds is one of the final tasks that preterm infants need to accomplish before discharge from the neonatal intensive care unit. There are many types of pacifiers and nipples used to accelerate and encourage the development of feeding skills; however, little is known about the impact of the mechanical properties of these nipples on feeding among preterm infants, who often must endure prolonged periods of sensory deprivation, maladaptive inputs, and motor restriction. Many feeding specialists alternate between different nipple types on a trial-and-error basis in an attempt to find the most appropriate nipple type for the infant. Given the complexity of feeding, a more comprehensive understanding of the multiple neural interactions among suck, swallow, airway protection, pharyngoespophageal motility, and digestive mechanisms is needed. Delay or disruption of these processes during a critical phase in late gestation may prevent infants from transitioning successfully to oral feeds and may lead to poor neurodevelopmental outcomes.