The neurodevelopmental (ND) profile of preterm infants with dysphagia remains unclear. The purpose of this study was to characterize the ND features of PT infants with dysphagia. A prospective case series design was used to identify all preterm infants <31 weeks gestational age (N=249) who were admitted to one regional NICU between 1989-1990. A standardized oral feeding including a standard nipple and positioning was performed on 163/217 (75%) survivors at a mean post menstrual age of 35.4 ± 1.6 wks. A standardized ND examination including assessments of visual and auditory attention, posture, passive muscle tone, righting reactions, motility, primitive reflexes, state regulation, and cranial nerves were performed within 48 hours of the feeding. Infants (N=21) consuming a volume (<11 mL) of formula/breast milk greater than 1 SD below the mean (23 mL ± 11 mL) in the first five minutes were classified as inefficient (IN) feeders. Analyses were performed to assess the association between IN oral feeding and select ND characteristics. Statistical significance (P ≤ 0.05) was assessed with Chi Square Statistics or Fisher's Exact Test.

Abnormalities of head and truncal righting (P=0.003), paucity of extremity movements (P=0.016) and extensor posturing of trunk (P=0.02) were associated with IN feeding. Only abnormal righting reactions were significantly associated with IN feeding (1.21-9.6 95% CI; P=0.02) on logistic regression analysis. Inefficient feeders require both careful health and neurodevelopmental surveillance. (Supported by the Children's Guild of Buffalo)