Association between feeding difficulties and language delay in preterm infants using Bayley Scales of Infant Development-Third Edition

J Pediatr. 2013 Sep;163(3):680-5.e1-3. doi: 10.1016/j.jpeds.2013.03.006. Epub 2013 Apr 10.


Objective: To evaluate the relationship between abnormal feeding patterns and language performance on the Bayley Scales of Infant Development-Third Edition at 18-22 months adjusted age among a cohort of extremely premature infants.

Study design: This is a descriptive analysis of 1477 preterm infants born ≤ 26 weeks gestation or enrolled in a clinical trial between January 1, 2006 and March 18, 2008 at a National Institute of Child Health and Human Development Neonatal Research Network center who completed the 18-month neurodevelopmental follow-up assessment. At 18-22 months adjusted age, a comprehensive neurodevelopmental evaluation was performed by certified examiners including the Receptive and Expressive Language Subscales of the Bayley Scales of Infant Development-Third Edition and a standardized adjusted age feeding behaviors and nutritional intake. Data were analyzed using bivariate and multilevel linear and logistic regression modeling.

Results: Abnormal feeding behaviors were reported in 193 (13%) of these infants at 18-22 months adjusted age. Abnormal feeding patterns, days of mechanical ventilation, hearing impairment, and Gross Motor Functional Classification System level ≥ 2 each independently predicted lower composite language scores.

Conclusions: At 18 months adjusted age, premature infants with a history of feeding difficulties are more likely to have language delay. Neuromotor impairment and days of mechanical ventilation are both important risk factors associated with these outcomes.

Keywords: BSID-III; Bayley Scales of Infant Development-Third Edition; ELBW; Extremely low birth weight; GMFCS; Gross Motor Functional Classification System; IVH; Intraventricular hemorrhage; MRI; Magnetic resonance imaging; ND; NEC; NICHD; NRN; National Institute of Child Health and Human Development; Necrotizing enterocolitis; Neonatal Research Network; Neurodevelopmental; PVL; Periventricular leukomalacia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Feeding and Eating Disorders of Childhood / diagnosis*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Extremely Premature / psychology*
  • Infant, Newborn
  • Infant, Premature, Diseases / diagnosis*
  • Language Development Disorders / diagnosis
  • Language Development Disorders / etiology*
  • Language Tests
  • Linear Models
  • Logistic Models
  • Male
  • Prospective Studies
  • Psychological Tests*
  • Risk Factors

Grant support