title: Multiple factors related to bottle-feeding performance in preterm infants.
abstract: BACKGROUND
  A great deal of attention has focused on understanding preterm infant feeding behaviors and on strategies to support the preterm infant during this period; however, comprehensive descriptions of the feeding behavior of preterm infants that incorporate an examination of multiple subsystem levels are lacking.
  
  
  OBJECTIVE
  To examine various physical indicators related to preterm infants' bottle-feeding performance.
  
  
  METHODS
  This was a retrospective, descriptive, exploratory study using a convenience sample. Medical records of 116 preterm infants were reviewed from the initiation of bottle-feeding until discharge from the neonatal intensive care unit. This study examined bottle-feeding performance (volume intake in milliliters per minute) as well as postmenstrual age, weight at each observed feed, oral motor skills, signs of distress, feeding techniques, feeding experience, gender, and Apgar scores at 5 minutes. Oral motor skills were measured by the Neonatal Oral Motor Assessment Scale.
  
  
  RESULTS
  Linear mixed-effects models were used to examine the relationship between bottle-feeding performance and the remaining variables. Postmenstrual age, weight at each observed feed, oral motor skills, feeding experience, and feeding techniques were found to be significant predictors of feeding performance at the .05 level.
  
  
  CONCLUSIONS
  Multiple factors, both intrinsic and extrinsic, play a role in determining an infant's bottle-feeding performance. In addition to age and weight, the presently employed conventional criteria, oral motor skills, feeding practice, and feeding techniques also contribute to infants' feeding performance. Arbitrary age (34 weeks gestational age) and weight criteria (1,500 g) should not be the only indicators for oral feeding.
authors.affiliation: Department of Occupational Therapy, New York University, New York, USA.
authors.forename: Tsu-Hsin
authors.initials: TH
authors.lastname: Howe
authors.forename: Ching-Fan
authors.initials: CF
authors.lastname: Sheu
authors.forename: Jim
authors.initials: J
authors.lastname: Hinojosa
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.forename: Ian R
authors.initials: IR
authors.lastname: Holzman
mesh_terms: D001724:Birth Weight; D001903:Bottle Feeding / Q000379:methods / Q000451:nursing*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D017283:Neonatal Nursing; D009730:Nursing Assessment / Q000379:methods; D015404:Nursing Methodology Research; D012189:Retrospective Studies; D013391:Sucking Behavior / Q000502:physiology*