When Preterm Infants Struggle to Feed

March 31, 2021

By Erin Sundseth Ross, PhD, CCC-SLP

Working in the NICU, I have observed a wide range of challenges affecting late preterm infants. But perhaps the most concerning is difficulty eating. 

Late preterm babies, born between 34 and 37 weeks’ gestation, may look as healthy as term babies. Yet they lack the physical maturity and developmental skills needed for their small bodies to function properly. They may have underdeveloped lungs, low muscle tone, difficulty regulating their body temperature – and feeding issues.

Late preterm babies may experience similar challenges as early preterm babies. They may look bigger or healthier than fragile preemies born earlier, but these late-preterm infants are struggling too. And these feeding problems may continue after the baby goes home. Preterm babies often are not interested in eating and may avoid eating foods that are higher in nutrition, such as vegetables.

Feeding is a learned ability, not a function of the body such as breathing. And for late preterm infants, learning the skill of feeding is critical. Only with proper feeding skills can a preterm infant continue maturing and developing. Lack of optimal nutrition, on the other hand, can lead to a downward health spiral. 

Perhaps that’s why feeding challenges are particularly stressful for the parents of late preterm babies. They agonize – and understandably so – about their little one’s struggle. Mounting stress and concern can cause a hyper-focus on intake and food. This may lead to force feeding, which can have adverse effects on the baby. 

NICU staff are committed to helping infants and families facing feeding challenges. The necessary tools, however, are not always available. Educational information, questionnaires, specialists and early intervention services can make a significant difference. But these solutions are not always readily accessible or affordable. 

Developmental delays are hard to identify. Many insurance providers refuse to cover the cost of feeding therapy, arguing that not enough “research” exists to justify coverage for the intervention. That is why recognizing infant feeding challenges as a critical developmental delay is so important. 

Through increased awareness, research and education, and improved health plan coverage, we can bring about changes that help preterm infants master the most fundamental of skills – feeding. 

Erin Sundseth Ross, PhD, CCC-SLP, is the founder of Feeding Fundamentals, LLC.

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