This study describes feeding readiness behavior during 50 prefeeding sessions of 26 preterm infants who were 32-33 weeks gestation at the time of the study. A continuous observation, non-intervention method was utilized. Continuous observations of specific indices through 2 successive prefeeding sessions were made via videorecording. Specific indices or cues that were observed were behavioral or state/activity changes, orally directed behaviors, and clinical indices. Continuous and simultaneous physiologic and biologic indices were also recorded. The videotapes were analyzed with the Anderson Behavioral State Scale and the Cagan Videotape Coding System for Orally Directed Behaviors and Clinical Indices.

Although physiologic and biologic indices reflected expected changes in state/activity, physiologic and biologic indices did not appear to have any relationship to feeding-readiness in preterm infants. In contrast, out of the 50 prefeeding sessions, 46 or 92%, displayed a cluster pattern of cues prior to feeding that might be interpreted as readiness-to-feed.

None of the 50 prefeeding sessions reflected infants who completely slept with no state/activity changes or cues from one feeding to the next. In four (80%) prefeeding sessions infants did show sporadic state/activity changes and cues, but they did not reflect any cluster pattern of cues. Thirty-five (70%) of the prefeeding sessions did display a cluster pattern of cues that suggested that the infant was ready to eat but at a time other than the infant's scheduled feeding time. Eleven (22%) of the prefeeding sessions did display a cluster pattern of cues that suggested that the infant was ready to eat at the infant's scheduled feeding time. This cluster included fussiness associated with hand-to-mouth activity, and/or rooting, and/or hiccoughs.

A model for feeding the preterm infant is described and a definition of feeding-readiness for preterm infants is proposed. It appears that preterm infants are able to provide cues that would assist caregivers in planning individualized feeding schedules.