Abstract:
Feeding during infancy is a complicated, multidimensional task involving dynamic coordination between sucking, swallowing, and breathing (Wolf & Glass, 1992). The synactive theory of infant development discusses the influence of the autonomic, motor, and state systems on the resulting stability and homeostasis of newborns (Als, 1982). The synactive theory proposes that the core of stability for all developing infants is the autonomic nervous system, especially the respiratory, circulatory, and digestive systems. The motor system supports the development of the state system – levels of arousal that range from deep sleep to a vigorous cry. The ability to attend and to actively process incoming stimuli is supported by the ability to maintain stability in the autonomic and motor systems and remain alert (Ross, 2012). By the synactive theory, feeding can be conceptualized as a developmental skill that emerges when the coordination for sucking/swallowing/breathing is present at approximately 35 weeks post gestational age along with maturation of the state system (Ross, 2012). Previous research has established that many common newborn morbidities, such as those that impact the cardiac and respiratory systems, can delay the post gestational age at which infants born prematurely achieve full oral feeding competency. The purpose of this project is to establish the impact of common newborn morbidities, as measured by the Morbidity Assessment Index for Newborns, on the resulting transition time and post conceptual age at which a modern cohort of preterm infants attain the skills and coordination necessary to support nutritional intake by exclusive oral means.
