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Behavioral indicators, Feeding readiness



  1. White-Traut, Rosemary C. DNSc, RN
  2. Berbaum, Michael L. PhD
  3. Lessen, Brenda MS, RN
  4. McFarlin, Barbara MS, CNM, RN
  5. Cardenas, Leticia BSN, RN


Purpose: The purpose of this secondary analysis was to assess whether alert behavioral states were associated with an increased number of feeding readiness behaviors (FRBs) and whether the number of FRBs were associated with subsequent feeding efficiency in healthy premature infants born between 29 to 35 weeks gestation.


Study Design and Methods: The data were collected as part of a larger study designed to compare the frequency of FRBs and feeding efficiency between control and experimental groups. Data from 21 stable premature infants were included in this secondary analysis. Infants were videotaped immediately prior to each of the first three oral feedings, from which infant behavioral state (IBS) and FRBs were assessed. Feeding efficiency was determined by calculating the ratio of feeding intake to feeding duration.


Results: IBS was not a significant predictor of the number of FRBs. The number of FRBs was predictive of feeding efficiency (p <.05). Group assignment was a marginally significant predictor of feeding efficiency (p <.10). Infant sex (p <.05), birthweight (p <.01), gestational age at birth (p <.01), and gestational age at entry (p <.05) were identified as significant predictors of the number of FRBs. Group assignment was marginally significant (p <.10).


Clinical Implications: Feeding efficiency may be predicted by the increased number of FRBs immediately prior to feeding. An infant's attributes (sex, birth-weight, and gestational age) may relate to feeding efficiency and should be assessed when instituting oral feeding. Assessment of FRBs can be easily incorporated into routine clinical practice.