Oral feeding in infants.

he proper growth of the infant is primarily a function of adequate nutritional intake, which depends on whether the infant can feed safely and successfully. Extensive studies have focused on the benefits of mother's milk and on the appropriate nutrients and growth-promoting factors that are needed in formula for optimal infant growth. 1-3 Less attention has been placed on understanding how infants feed and, more important, how feeding can be carried out safely and successfully. The oral feeding of infants is a rising concern. It is probably due to the growing population of infants who are born prematurely, as well as those who survive embryopathy or genetic pathologic disorders. The survival rate of premature infants has increased drastically during the last decade. 4 For instance, the number of infants born between 23 and 25 weeks' gestational age is increasing. Similarly, advances in the clinical management of infants with disorders such as bronchopulmonary dysplasia, cerebral palsy, and other neurologic impairments have increased the survival of these patients. Feeding difficulties develop in many of these infants. Assessment of infant readiness to feed is not well developed. The proper coordination of sucking, swallowing and breathing is required for safe feeding. Impairment of any one of these functions can put the infant at risk for aspiration, pneumonia, oxygen desaturation, apnea, and bradycardia. Such an impairment is rarely an issue for healthy term infants who, because of their developmental level, begin oral feeding within hours of birth. For premature infants, oral feeding generally is not offered before 33 to 34 weeks' postmenstrual age (pma), a time when their sucking pattern begins to resemble that of term infants. 5 However, no