Development of Oral Feeding Skills in the Preterm Infant

  • Chantal Lau


This chapter reviews the current understanding of the development of oral feeding skills in preterm infants. Preterm infants frequently have difficulty transitioning from tube to independent oral feeding due to the immaturity of their feeding skills. Consequently, they should not be expected to feed by mouth as efficiently as term infants. Their inability to attain independent oral feeding prolongs their hospital discharge thereby delaying mother–infant reunion and increasing maternal stress and medical cost. Immature feeding skills put these infants at risk for oxygen desaturation, apnea, bradycardia, and aspiration with the potential development of oral feeding aversion. It is now recognized that mature sucking alone is not predictive of readiness to oral feed. For a safe and successful feeding, not only should sucking, swallowing, and respiration be appropriate but, very importantly, also their activities must be coordinated. Research has begun to shed light on the temporal and sequential maturation of these individual functions. In the clinical practice, healthcare professionals have also realized that to optimize these infants’ oral feeding performance and experience, attention must be placed not only on their feeding skills but also on their behavioral state, organization, the environment of the neonatal intensive care unit, and the caregivers’ approach to oral feeding. Interventions to enhance feeding performance are practiced, but their efficacy is often questioned due to lack of evidence-based support.


Preterm Infant Neonatal Intensive Care Unit Oral Feeding Mature Sucking Bottle Feeding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Central pattern generator


Lower esophageal sphincter


Neonatal intensive care unit


Neonatal Individualized Developmental Care and Assessment Program


Postmenstrual age


Swallow-induced lower esophageal sphincter relaxation


Transient lower esophageal sphincter relaxation


Upper esophageal sphincter



This work is supported by funding from the National Institute of Child Health and Human Development (R01-HD044469) to the author. The contents of this publication are solely the responsibility of the author and do not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Pediatrics/NeonatologyBaylor College of MedicineHoustonUSA

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