Relationship of Neonatal Oral Motor Assessment Scale to feeding performance of premature infants

ObjectiveSome premature infants require prolonged tube-feeding, beyond term equivalent gestational age. Tools that could prospectively identify such infants from among otherwise healthy patients are needed. We examined how well the Neonatal Oral Motor Assessment Scale (NOMAS) predicts premature infants’ transition from tube to oral feeding.DesignData from a prospective study of sucking behavior as a predictor of feeding skills were used to examine the relationship of NOMAS and other nominal predictors to pre-defined feeding milestones.SettingNeonatal intensive Care Unit.Patients51 tube-fed, premature infants.MethodsNOMAS was administered soon (<72 h) after oral feeding was initiated, and weekly thereafter, until infants reached full oral feeding. A timed measure of feeding efficiency was also done as oral feeding was initiated. A standardized, permissive protocol for feeding advance was used. Nonparametric rank sum tests and ANOVA were used to relate NOMAS, feeding efficiency, and other baseline variables to feeding milestones.ResultsGestational age at birth, birth weight, and initial feeding efficiency predicted shorter transition and earlier acquisition to full oral feeding; NOMAS scores did not predict feeding outcomes.ConclusionsNOMAS was a poor predictor, while feeding efficiency and other baseline traits were better predictors of feeding skills in premature infants.

▸ The NOMAS is a 2 min assessment that has been purported to indicate developmental readiness of tube-fed premature infants for oral feeding advance. ▸ These findings indicate that a simple feeding efficiency measure has greater utility than the NOMAS in predicting oral motor skills of premature infants.