ORAL-FEEDING IN LOW-BIRTH-WEIGHT INFANTS

To gain a better understanding of the development of sucking behavior in low birth weight infants, the aims of this study were as follows: ( 1) to assess these infants' oral feeding performance when milk deliver y was unrestricted, as routinely administered in nurseries, versus res tricted when milk flow occurred only when the infant was sucking; (2) to determine whether the term sucking pattern of suction/expression wa s necessary for feeding success; and (3) to identify clinical indicato rs of successful oral feeding. Infants (26 to 29 weeks of gestation) w ere evaluated at their first oral feeding and on achieving independent oral feeding. Bottle nipples were adapted to monitor suction and expr ession. To assess performance during a feeding, proficiency (percent v olume transferred during the first 5 minutes of a feeding/total volume ordered), efficiency (volume transferred per unit time), and overall transfer (percent volume transferred) were calculated. Restricted milk flow enhanced all three parameters. Successful oral feeding did not r equire the term sucking pattern. Infants who demonstrated both a profi ciency greater than or equal to 30% and efficiency greater than or equ al to 1.5 ml/min at their first oral feeding were successful with that feeding and attained independent oral feeding at a significantly earl ier postmenstrual age than their counterparts with lower proficiency, efficiency, or both. Thus a restricted milk flow facilitates oral feed ing in infants younger than 30 weeks of gestation, the term sucking pa ttern is not necessary for successful oral feeding, and proficiency an d efficiency together may be used as reliable indicators of early atta inment of independent oral feeding in low birth weight infants.