Feeding problems are frequently encountered in the neonatal intensive care unit as a result of the survival of greater numbers of preterm, medically fragile, and chronically ill infants. Such feeding problems have not, however, been well described. In an attempt to categorize the oral-motor patterns that underlie poor feeding in the neonatal period, a clinical assessment tool was devised that describes jaw and tongue function during nutritive sucking. The Neonatal Oral-Motor Assessment Scale separates 13 characteristics of jaw movement and 13 characteristics of tongue movement into categories of normal, disorganized, and dysfunctional. This scale was administered to 40 infants to establish interrater reliability, revise the scale as necessary based on the reliability, and attempt to further qualify and describe patterns of disorganized and dysfunctional sucking in the neonatal period.