Oral Feeding in Preterm Infants: A Conceptual Model for Health Care Practitioners

Oral feeding competence is a critical milestone needed for proper growth and development in preterm infants. Commonly, the oral feeding process is conceptualized as an infant's ability to coordinate suck-swallow-breathe. However, oral feeding is a highly complex multisystem process. In this article, an oral feeding model is presented that takes into consideration the intrinsic and extrinsic factors that influence oral feeding performances. The intrinsic neurophysiologic factors include the musculoskeletal, gastrointestinal, respiratory, cardiovascular, behavioral, and neurologic systems. The extrinsic environmental factors include the physical surroundings, NICU policies, parental attributes, health care practitioners, and feeding equipment. The objectives of this article are to (1) describe the intrinsic and extrinsic factors affecting oral feeding performance of preterm infants in the NICU, (2) introduce a conceptual model of oral feeding that displays the relationship between these factors, and (3) provide a reference guide for health care practitioners to refer to when evaluating an infant's oral feeding performance.