Characterization of the developmental stages of sucking in preterm infantsduring bottle feeding

It is acknowledged that the difficulty many preterm infants have in feeding orally results from their immature sucking skills. However, little is know n regarding the development of sucking in these infants. The aim of this st udy was to demonstrate that the bottle-feeding performance of preterm infan ts is positively correlated with the developmental stage of their sucking. Infants' oral-motor skills were followed longitudinally using a special nip ple/bottle system which monitored the suction and expression/compression co mponent of sucking. The maturational process was rated into five primary st ages based on the presence/absence of suction and the rhythmicity of the tw o components of sucking, suction and expression/compression. This five-poin t scale was used to characterize the developmental stage of sucking of each infant. Outcomes of feeding performance consisted of overall transfer (per cent total volume transfered/volume to be taken) and rate of transfer (ml/m in). Assessments were conducted when infants were taking 1-2, 3-5 and 6-8 o ral feedings per day. Significant positive correlations were observed betwe en the five stages of sucking and postmenstrual age, the defined feeding ou tcomes, and the number of daily oral feedings. Overall transfer and rate of transfer were enhanced when infants reached the more mature stages of suck ing. We have demonstrated that oral feeding performance improves as infants' suc king skills mature. In addition, we propose that the present five-point suc king scale may be used to assess the developmental stages of sucking of pre term infants. Such knowledge would facilitate the management of oral feedin g in these infants.