Question
What feeding skills and behaviors should a speech-language pathologist expect to observe in premature infants across different postmenstrual ages in the NICU?
Answer
Before ever going bedside, the chart review is where we gather all available information about a patient and begin forming our clinical hypothesis. We want to understand why we are being consulted as speech-language pathologists, identify factors that may currently be impacting feeding performance, and determine what materials and supplies to bring bedside. A thorough chart review allows us to anticipate what we will see before we even meet the baby, the nurse, and the caregivers.
The suck-swallow-breathe pattern begins to coordinate between 32 and 34 weeks, which is why most NICUs begin initiating oral feeding during that window. However, it is critical to understand that the coordination of suck, swallow, and breathe continues to develop through term and even through the baby's due date. Premature babies who begin oral feeding at 32 to 34 weeks will continue to need support from the feeding team, nursing, and parents through 37 weeks or longer.
At 33 to 34 weeks post menstrual age (PMA), a baby likely will not wake with each set of cares. If the baby does stay awake and shows hunger cues, the suck pattern will be immature, meaning approximately 3 to 5 sucks per burst. The suck-swallow-breathe pattern is just beginning to emerge.
This Ask the Expert is an edited excerpt from the course, Navigating the NICU Chart Review, presented by Nicole Scafura, M.S., CCC-SLP, CNT.
