Maturation of Infant Oral Feeding Skills

With the increased survival of infants born prematurely comes the awareness that many of them struggle to safely and competently feed by mouth. This is not unexpected as these infants’ functional physiological systems programmed for an in utero environment are not yet appropriate for their ex utero world. As these infants’ responses to any feeding difficulty most often fall into a nonspecific category of behaviors, e.g., feeding refusal, disorganization, or adverse events, e.g., oxygen desaturation and apnea/bradycardia, it is difficult for caregivers to identify the origins of these symptoms in order to arrive at a differential diagnosis and develop a management plan. As research on the development of infant oral feeding skills has advanced over the last two decades, this chapter is a review of our latest understanding of the maturation of infant oral feeding skills and the work that still lies ahead. Although we have gained some understanding of the maturation process of the individual functions implicated in the transport of a bolus from the oral cavity to the stomach, namely, sucking, swallowing, respiration, and esophageal function, there is a lack of understanding as to how the coordination of these functions needs to occur in order to ensure safety and efficiency for these infants during feeding.