Preterm infants spend much of their time in the neonatal intensive care unit (NICU) learning to orally feed. Attempts to support the preterm infant in acquiring oral skills have evolved greatly over the past decades, including the increasing involvement of speech, physical, and occupational therapists. Interventions have included modified positioning, specialized nipples, external pacing, sensorimotor exercises, oral motor skills programs, and cue-based feeding programs. While many infants seem to have benefited from these methods, a subset of babies continues to require supplemental feeding methods via nasogastric or gastrostomy tube. In particular, infants with aerodigestive complications are at high risk for needing supplemental feeding methods. Additionally, the neurodevelopmental implications of having significant feeding difficulties early on is not fully known. Studies have brought about concerns that children with early oral feeding difficulties may be at risk for the presence of neurodevelopmental delays and continued feeding issues later in childhood. Further research is needed to better understand which infants will struggle with oral feeding, as well as identify appropriate therapeutic options and optimal time periods of implementation.
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