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Exploring Factors Related to Oral Feeding Progression in Premature Infants

White-Traut, Rosemary PhD, RN, FAAN; Pham, Thao BSN, RN; Rankin, Kristin PhD; Norr, Kathleen PhD; Shapiro, Nicole MS, RN; Yoder, Joe MS

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0b013e31829d8c5a
Original Research

PURPOSE: To identify infant and maternal characteristics associated with the pace of progression from the first oral feeding to complete oral feeding.

SUBJECTS: One hundred forty-two stable premature infants who were fully or partially gavage feeding immediately after birth (29 to 34 weeks gestational age at birth).

DESIGN: Exploratory secondary analysis.

METHODS: Data are from an ongoing randomized clinical trial of a developmental maternally administered intervention (Hospital to Home Transition–Optimizing Premature Infant's Environment) for mother-infant dyads at high social-environmental risk.

MAIN OUTCOME MEASURES: Oral feeding progression (transition time from the first attempt to complete oral feeding).

SAMPLE CHARACTERISTICS: The convenience sample of preterm infants consisted of 48.6% male infants; the mean gestational age at birth was 32.4 weeks and mean birth weight 1787 g; and African American mothers (47.9%; n = 80) and Latina mothers (52.1%; n = 83).

PRINCIPLE RESULTS: Multivariable linear regression results showed that, on average, the number of days for infants of Latina mothers to achieve complete oral feeding was 2.43 days more than for infants of African American mothers. In addition, lower birth weight and lower postmenstrual age at first oral feeding were associated with longer feeding progression. Higher infant morbidity was correlated with longer feeding progression.

CONCLUSION: Infants with Latina mothers, lower birth weight, lower postmenstrual age at first oral feeding, and higher morbidity scores had a longer transition from first to complete oral feeding. Identification of infants at risk for delayed transition from first to complete oral feeding may allow for the development and testing of appropriate interventions that support the transition from gavage to complete oral feeding.

Department of Women, Children and Family Health Science, College of Nursing (Drs White-Traut and Norr, Mss Pham and Shapiro, and Mr Yoder), and Department of Epidemiology, School of Public Health (Dr Rankin), University of Illinois at Chicago.

Correspondence: Rosemary White-Traut, PhD, RN, FAAN, 845 S Damen Ave (MC 802), Chicago, IL 60612 (

The research occurred at University of Illinois at Chicago.

The authors thank the mothers and infants who participated in the study. The authors received financial assistance from the National Institute of Child Health and Development, the National Institute of Nursing Research grant 1 R01 HD050738-01A2, and the Irving B. Harris Foundation.

The authors declare no conflict of interest.

© 2013 by The National Association of Neonatal Nurses