Comparison of sucking patterns at introduction of oral feeding and at term in Israeli and American preterm infants

Background: It has been hypothesized that early initiation of oral feeding in premature infants may enhance the maturation of sucking patterns. Aim: To compare preterm infant sucking characteristics in urban level III neonatal care units in the USA and Israel. The two hospitals have different practices regarding the introduction of oral feeding. Methods: Infants were assessed at 34-35 wk postconceptional age (PCA) and at term. Sucking parameters were assessed with the Kron's Nutritive Sucking Apparatus. Results: 70 infants (38 Americans and 32 Israelis) participated in the study. Oral feedings were initiated earlier (32.6 ± 4.3 vs 34.5 ± 1.8 wk PCA, p < 0.01) and full oral feedings were reached earlier (35.4 ± 2.8 vs 36.5 ± 2.5 wk PCA, p < 0.05) in the USA infants. American preterm infants produced significantly more sucks (p < 0.001), had a higher suck rate (p < 0.001), more sucks per burst (p < 0.05), and a shorter interburst width (p < 0.01) at 34 wk PCA than Israeli infants. At term, American infants produced significant more sucks (p < 0.001), higher suck rate (p < 0.001), shorter intersuck width (p < 0.001), and a shorter interburst width (p < 0.05) than the Israeli infants of the same PCA. Conclusion: Different practices in the care of preterm infants, such as postconceptional age at introduction of oral feeding, may play a role in the development of feeding and feeding organization at term.