Reliability of an instrument to assess the readiness of preterm infants for oral feeding

BACKGROND: the transition from gastric to oral feeding of preterm infants is one of the greatest concerns of health professionals and therefore needs an objective criterion to support the beginning of this process. AIM: to test the reliability of an instrument that assesses the readiness of preterm infants for the transition from gastric to oral feeding. METHOD: the instrument is composed by the following items: corrected gestational age; behavioral state; global posture and tonus; lips and tongue posture; rooting, suck, bite and gag reflexes; tongue and jaw movements; tongue cupping; sucking strain; sucking and pause; maintenance sucking/pause; maintenance alert state and stress signs. The study was conducted at the Intermediate Care Unit of the Hospital de Clinicas da Faculdade de Medicina de Ribeirao Preto - University of Sao Paulo. The research sample consisted of 30 preterm infants who attended the following inclusion criteria: corrected gestational age <36 weeks and 6 days; clinically stable; absence of facial deformities; respiratory, cardiovascular, gastrointestinal and neurological disorders or syndromes that prevent or make oral feeding difficult; and not having received oral feeding of milk. The Kappa Test was used to verify interjudge reliability. RESULTS: the items that presented high reliability levels were: behavioral state, global posture and tonus, lips and tongue posture, gag reflex and maintenance of alert state. The items that presented satisfactory reliability levels were: rooting reflex, sucking and biting and jaw movement, sucking strain and sucking and pause. Only the items of tongue cupping, maintenance of sucking/pause and stress signs presented unsatisfactory reliability levels. CONCLUSION: in general, the items investigated by the assessment instrument presented adequate interjudge reliability.