The development of preterm infants' breastfeeding behavior

Extensive scientific data are available on the development of sucking in te rm infants, but corresponding knowledge about preterm infants has been lack ing. The aim was to describe the development of preterm infants' behavior a t the breast, according to postmenstrual and postnatal age. Mothers co-oper ated as data collectors using the Preterm Infant Breastfeeding Behavior Sca le for observations. Seventy-one singletons (born after 26.7-35.9 gestation al weeks) were studied prospectively. Mothers received regular advice about breastfeeding and guidance about interaction and appropriate stimulation. Breastfeeding was initiated at a postmenstrual age (PMA) of 27.9-35.9 weeks . Mothers provided 4321 records of infants' behavior, 70% of the total brea stfeeding sessions during the infants' hospital stay. Irrespective of PMA, the infants responded by rooting and sucking on the first contact with the breast. Efficient rooting, areolar grasp and latching on were observed at 2 8 weeks, and repeated bursts of greater than or equal to 10 sucks and maxim um bursts of greater than or equal to 30 sucks at 32 weeks. Nutritive sucki ng appeared from 30.6 weeks. Sixty-seven infants were breastfed at discharg e. Fifty-seven of them established full breastfeeding at a mean PMA of 36.0 weeks (33.4-40.0 weeks). Their early sucking behavior is interpreted as th e result of learning, enhanced by contingent stimuli. We therefore suggest that guidelines for initiation of breastfeeding in preterm infants should b e based on cardiorespiratory stability, irrespective of current maturity, a ge or weight. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.