The Development of Sucking Patterns in Preterm, Small-for-Gestational Age Infants

Objective To determine whether the development of sucking patterns in small-for-gestational age (SGA) preterm infants differs from appropriate-for-gestational age (AGA) preterm infants. Study design We assessed sucking patterns in 15 SGA and 34 AGA preterms (gestational age <= 36 weeks) longitudinally from 34 to 50 weeks postmenstrual age (PMA) using the Neonatal Oral-Motor Assessment Scale (NOMAS). At each measurement, we scored sucking as normal, dysfunctional, or disorganized. We examined the development of their sucking patterns in relation to clinical characteristics. Results SGA preterms developed a normal sucking pattern later than did AGA preterms (median, 50 versus 44 weeks PMA, P = .002). At term-equivalent age, none of the SGA and 38% of the AGA preterms showed normal sucking (P < .05); at 48 to 50 weeks PMA this was 54% and 81%, respectively (P = .064). Abnormal sucking including "incoordination'' and dysfunctional sucking were more prevalent in SGA preterms than in AGA preterms (median, 11% versus 0% per infant, P < .05). A higher gestational age and z-score for birth weight were predictive of normal sucking at 50 weeks PMA. Conclusions SGA preterms developed a normal sucking pattern later than AGA preterms. Many AGA preterms also developed a normal mature sucking pattern only after they had reached term age. (J Pediatr 2010; 157:603-9).