A comprehensive assessment of feeding performance of infants in the neonatal intensive care unit (NICU) includes not only the traditional approaches of evaluating oral motor control and sensory responses but also evaluation of other factors. Infant feeding is a highly complex and integrated process involving numerous body systems. A global assessment would determine the infant's feeding function in the key areas of state and behavior, tactile responses, motoric control, oral motor function, physiologic control, and coordination of sucking, swallowing, and breathing. Information is obtained through skilled clinical observation as well as from technological monitors or medical tests and procedures. This article provides an overview of a comprehensive assessment that occupational therapists may use when providing service to infants in the NICU.

No abstract

This case report describes an infant who presented with coughing and choking during breastfeeding. Comprehensive clinical evaluation of these difficulties included assessment of sucking, swallowing, and breathing. Stridor and difficulty interspersing breaths during sucking bursts were observed, although sucking mechanics were normal. Further evaluation of airway structure revealed asymmetric laryngomalacia. This structural problem, exacerbated by the breastfeeding position, impeded respiration and resulted in poor coordination of sucking, swallowing, and breathing. This case underscores the need to include respiratory function and coordination in the evaluation of breastfeeding difficulties.