title: Factors associated with feeding difficulties in the very preterm infant.
abstract: OBJECTIVE
  To investigate early medical and family factors associated with later feeding risk in preterm infants.
  
  
  METHODS
  For this longitudinal study, 136 infants born ≤30 weeks gestation were enrolled. Medical and social background factors were assessed at term equivalent age. Infants underwent magnetic resonance imaging, neurobehavioral evaluation and feeding assessment. Parent involvement in the neonatal intensive care unit was tracked, and maternal mental health was assessed at neonatal intensive care unit discharge. At age 2 years, feeding outcome was assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment (n = 80). Associations between feeding problems at age 2 years and (i) early medical factors, (ii) neurobehavioral functioning and feeding at term equivalent age, (iii) cerebral structure and (iv) maternal mental health were investigated using regression.
  
  
  RESULTS
  Eighteen (23%) children had feeding problems at age 2 years. Feeding problems were associated with early hypotonia (p = 0.03; β = 0.29) and lower socio-economic status (p = 0.046; β = -0.22). No associations were observed between early medical factors, early feeding performance, cerebral structure alterations or maternal well-being and feeding outcome.
  
  
  CONCLUSIONS
  Early hypotonia may disrupt the development of oral-motor skills. Hypotonia and poor feeding also may share a common aetiology. Associations with lower socio-economic status highlight the potential influence of family background factors in feeding problems in the preterm infant.
authors: Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
authors: T L
authors: TL
authors: Crapnell
authors: C E
authors: CE
authors: Rogers
authors: J J
authors: JJ
authors: Neil
authors: T E
authors: TE
authors: Inder
authors: L J
authors: LJ
authors: Woodward
authors: R G
authors: RG
authors: Pineda
mesh_terms: D001007:Anxiety; D054022:Cerebrum / Q000033:anatomy & histology; D002675:Child, Preschool; D004750:Enteral Nutrition; D005247:Feeding Behavior; D019959:Feeding and Eating Disorders of Childhood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007440:Intubation; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008429:Maternal Welfare; D008923:Missouri / Q000453:epidemiology; D009123:Muscle Hypotonia / Q000150:complications; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications
keywords: Feeding; Neonatal intensive care unit; Outcome; Socio-economic status; hypotonia; preterm
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