Objective Assessment of Oral Feeding Development in Preterm Infants Using the Neoneur Feeding System

Achoimre

Abstract To evaluate feeding and respiratory skills in preterm infants using the neoneur feeding system (NFS) clinical biomarkers and track maturation until discharge in infants achieving full oral feeds. This prospective, observational, nonrandomized, longitudinal study enrolled infants born ≤ 34 weeks' gestation from the level III neonatal intensive care unit at Thomas Jefferson University Hospital. The NFS was used to record feeding, with each infant contributing a minimum of six feeds recorded over 3 weeks. Six NFS biomarkers were analyzed: intersuck width, swallow rate, swallow burst rate, maximum pressure/burst, suck width, and rests between bursts. Biomarker trajectories were assessed using linear mixed-effects models with an infant-specific random intercept and corrected gestational age as the longitudinal predictor. The analysis included 42 infants with mean gestational age of 29.9 weeks (standard deviation [SD]: 2.73), mean birth weight of 1,377 g (SD: 485 g), and mean birth weight z-score of − 0.27 (SD: 0.92). A total of 241 feeds from all 42 infants were assessed in the primary mixed-effects analysis. Five of six biomarkers showed a statistically significant weekly increase with corrected gestational age; the rest between bursts did not. A phase-shifted trend line was observed on two of the biomarkers when compared with normative data, reflecting instrumentation differences. NFS-derived biomarkers can potentially offer an objective method to track feeding skill development in preterm infants. Our findings suggest these measures may complement clinical observation and provide new insights into feeding maturation.