Developmental feeding milestones in the transition from non-oral feeding to oral feeding in premature infants: a scoping review

ABSTRACT Purpose At birth, premature infants often present with feeding disorders due to immaturity and/or the presence of comorbidities, which may necessitate a period of non-oral feeding until they can achieve full oral feeding safely to allow for hospital discharge. The typical progression from non-oral to oral feeding is ambiguous due to the lack of guidelines, and the heterogeneity of practice in the assessment procedure. Method In light of this ambiguity, a scoping review was conducted to obtain a comprehensive overview of research within this area. The primary aim was to identify a consensus within the available literature regarding the achievement and description of developmental feeding milestones that premature infants typically experience in their transition from non-oral feeding to complete oral feeding. Results The search strategy yielded 6583 articles. Following the screening procedures, a total of 13 articles were included in the final synthesis. All relevant numerical data and nominal information about the achievement of milestones were extracted. The results suggested that swallowing development in premature infants is described in a variety of ways across current research. While 17 different milestones were identified, consensus was highest regarding beginning enteral feeding, progression to full enteral feeding, day of first feed, and progression to complete oral feeding. It is suggested that these milestones are most typically assessed using unstandardized observation and reported according to chronological or postmenstrual age. Conclusions Further research prospectively investigating the assessment procedure using valid and reliable tools would be beneficial to delineate the feeding development in premature infants.