{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:20:14Z","timestamp":1790799614247,"version":"4.1.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>\n                    <jats:bold>Importance:<\/jats:bold>\n                    Feeding difficulties are common among preterm infants during neonatal intensive care unit (NICU) hospitalization. Although most preterm infants achieve full oral feeding by term-equivalent age, whether feeding difficulties persist despite the infant taking full volume and whether these difficulties may relate to other neurobehavioral challenges remain unclear.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To identify the prevalence of feeding problems among preterm infants and the relationships between infant feeding behaviors and neurobehavior at term-equivalent age.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Cohort study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Level 4 NICU with 85 beds.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants:<\/jats:bold>\n                    Thirty-nine very preterm infants born \u226432 wk gestation (range = 22\u201332 wk). Exclusion criteria were congenital anomalies, &gt;32 wk gestation at birth, and lack of feeding or neurobehavioral assessment at term-equivalent age.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Outcomes and Measures:<\/jats:bold>\n                    Standardized feeding assessments using the Neonatal Eating Outcome Assessment and standardized neurobehavioral evaluation using the NICU Network Neurobehavioral Scale.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Thirty-nine infants (21 female) were included in the final analysis. The mean Neonatal Eating Outcome Assessment score was 66.6 (\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    = 13.3). At term-equivalent age, 10 infants (26%) demonstrated feeding challenges, 21 (54%) demonstrated questionable feeding issues, and 8 (21%) demonstrated normal feeding performance. Lower Neonatal Eating Outcome Assessment scores (poorer feeding performance) at term-equivalent age were associated with more suboptimal reflexes (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = .04) and hypotonia (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .01).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions and Relevance:<\/jats:bold>\n                    Feeding challenges and questionable feeding performance were prevalent among preterm infants at term-equivalent age and appeared in conjunction with suboptimal reflexes and hypotonia. Understanding this finding enables therapists to take a holistic approach to addressing feeding difficulties.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>What This Article Adds:<\/jats:bold>\n                    Elucidating the relationships between feeding performance and neurobehavior during the neonatal period allows for a better understanding of potential contributors to early feeding challenges and identifies targets for intervention.\n                  <\/jats:p>","DOI":"10.5014\/ajot.2023.050123","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T14:21:51Z","timestamp":1685456511000},"page":"554-562","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of Early Feeding Alterations Among Preterm Infants and Their Relationship to Early Neurobehavior"],"prefix":"10.1177","volume":"77","author":[{"given":"Molly","family":"Grabill","sequence":"first","affiliation":[{"name":"Molly Grabill, OTD, OTR\/L, is Occupational Therapist, Department of Therapy Services, St. Louis Children\u2019s Hospital, St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Smith","sequence":"additional","affiliation":[{"name":"Joan Smith, PhD, RN, NNP-BC, FAAN, is Director, Department of Quality Safety, and Practice Excellence, St. Louis Children\u2019s Hospital, St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Carolyn Ibrahim, MS, OTR\/L, CLC, is PhD Candidate, College of Health Sciences, Rush University, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Pineda","sequence":"additional","affiliation":[{"name":"Roberta Pineda, PhD, OTR\/L, CNT, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14832"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00548.x"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2174"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2013.11.001"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-017-1718-6"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2008001000012"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.164186"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1640"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0880"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2011.08.004"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12393"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2021.118488"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2011.100"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.06.047"},{"key":"e_1_3_2_16_1","first-page":"488","article-title":"The cost of prematurity: Quantification by gestational age and birth weight","volume":"102","author":"Gilbert W. 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