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Acta Paediatr. 2013 Apr;102(4):e147-52. doi: 10.1111/apa.12148. Epub 2013 Jan 30.

Feeding behaviour and performance of preterm neonates on Paladai feeding.

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Division of Neonatology, Department of Pediatrics, WHO Collaborating Centre for Newborn Care and Research, All India Institute of Medical Sciences, New Delhi, India.



To evaluate the feeding behaviour and performance of preterm neonates receiving feeds by paladai (a small beaked receptacle).


We enrolled stable neonates - 10 each in 28-30 weeks [group I] and 31-32 weeks gestation [group II], and offered them paladai feeds. We recorded the feeding sessions on alternate days until they were on full enteral feeds. The outcome variables were (1) feeding behaviour, as assessed by changes in states of wakefulness, oromotor functions and coordination between breathing and swallowing; (2) feeding performance, as assessed by proficiency and efficiency.


A total of 47 and 27 sessions were studied in groups I and II, respectively. The median postconceptional age (PCA) at start of paladai feeding was 30 (range, 29-32) and 32 (31-32) weeks in the two groups. The infants accepted paladai feedings in all behavioural states. Incoordination between feeding and breathing was observed in about 25% of the sessions in both the groups. We observed a rapid improvement in feeding performance with experience - the median proficiency improved from 5.5 to 10.1 mL/min and 6.2-11.5 mL/min in groups I and II, respectively. The proficiency of group I infants at a median PCA of 30.9 weeks was higher than that of group II infants at median PCA 31.7 weeks.


Stable preterm neonates can be fed with paladai from 30 weeks PCA. The oropharyngeal ability is possibly influenced more by the postnatal experience than by maturity at birth.


Feeding behaviour; feeding performance; paladai feeding; preterm

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