Abstract :
Keywords Infant feeding; Extremely premature; Developmental coordination disorder; Motor skills disorder; Neurodevelopment Highlights * Infant feeding difficulties are associated with major neurodevelopmental disorders. * Infant feeding problems may be an early marker for DCD in childhood. * Infants with poor feeding should be routinely screened for DCD and other disorders. Abstract Background Infants born extremely preterm are at high risk for early feeding difficulties, as well as poor neurodevelopmental outcomes in childhood. Feeding, a complex motor skill, may be predictive of later neuromotor outcomes. Aims To determine the relationship between feeding behaviours of extremely preterm-born infants ( Study design Retrospective cohort design with prospectively collected data. Subjects Infants born extremely preterm from September 1999 -- October 2013 [n = 412, mean gestational age 25.4 (1.3) weeks; mean birth weight 771 (168) grams]. Oral feeding was assessed at 4-months CA by an experienced occupational therapist; infants were classified as either having poor suck-swallow ('feeding difficulties') or no feeding difficulties. Outcome measures Motor outcomes were assessed at 4--5 years using the Movement Assessment Battery for Children (MABC). Children were categorized as: (1) typical motor development (TMD; n = 214); (2) Developmental Coordination Disorder (DCD; n = 116); or (3) major neurodevelopmental disorder (MND; n = 82). Results Feeding behaviour at 4-months CA predicted DCD (OR = 2.95, CI 1.13--7.68) and MND (OR = 3.67, CI 1.35--9.96) after controlling for confounders. Infants with feeding difficulties were more likely to be diagnosed with DCD (40 % of poor feeders) or MND (36 %) at 4--5 years, compared to infants without feeding issues. Conclusions Early feeding behaviours significantly predicted motor outcomes at 4--5 years. Infants born extremely preterm with early feeding difficulties should be identified as at high risk for poor motor outcomes later in childhood and screened for early diagnosis and intervention. Abbreviations CA, corrected age; DCD, Developmental Coordination Disorder; MND, Major Neurodevelopmental Disorders; MABC, Movement Assessment Battery for Children; NFUP, Neonatal Follow-up Program; TMD, typical motor development Author Affiliation: (a) Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada (b) Neonatal Follow-Up Program, BC Women's Hospital, Vancouver, Canada (c) Department of Pediatrics, University of British Columbia, Vancouver, Canada (d) Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada (e) Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada (f) Healthy Starts Theme, BC Children's Hospital Research Institute, Vancouver, Canada * Corresponding author at: BC Children's Hospital Research Institute, K3-180 4480 Oak Street, Vancouver V6H 3V4, Canada. Article History: Received 3 April 2022; Revised 31 July 2022; Accepted 3 August 2022 Byline: Shie Rinat (a), Margot Mackay (b), Anne Synnes (b,c,d), Liisa Holsti (e,c,f), Jill G. Zwicker [jill.zwicker@ubc.ca] (e,c,d,*)