A key developmental step for preterm babies: achievement of full oral feeding

Aims: To investigate timing of oral feeding (OF) introduction and full oral feeding (FOF) achievement in preterm infants and to explore factors associated with feeding progression. Methods: Retrospective review of 100 medical records of preterms ≤32 weeks of gestation (GA) without major complications. Outcome measures were timing of OF introduction, transition time from nasogastric tube to FOF and FOF achievement. Variables such as sex, twins, GA, birthweight, respiratory supports used and duration of tube feeding, were also considered. Results: Post menstrual age (PMA) for OF introduction was 33.6 ± 1.1 weeks. FOF was achieved at 35.1 ± 1.5 weeks. PMA at OF introduction and PMA at FOF correlated with: birthweight (p =.0001, p =.001); duration of respiratory supports (p = 0.01, p =.0001); PMA at which respiratory supports were stopped (p =.0001, p =.0001); age of introduction of gavage (p =.0001, p =.003) and time of utilization of tube feeding (p =.02, p =.0001). Transition time was 1.5 ± 8.5 days. PMA at OF introduction significantly influenced PMA at FOF (p =.0001, r =.61). OF introduction, transition time and FOF were correlated with duration of hospitalization (p =.004, p =.0001, p =.008). Conclusions: The achievement of feeding skills is confirmed to affect length of hospitalization, but the earlier you introduce OF, the earlier you reach FOF, so introduction should be anticipated. There is a clear trend to favor higher birthweight classes in FOF achievement. Feeding tube placement and need for respiratory supports may represent a nociceptive experience delaying feeding skills' achievement. This highlights the importance of prospective studies investigating the role of preventative interventions.