Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


College of Health Professions

First Advisor

Bonnie Martin-Harris

Second Advisor

David R. White

Third Advisor

Elizabeth Hill

Fourth Advisor

Charles Ellis


Background: Dysphagia of prematurity is a highly prevalent condition that carries negative developmental, social, and financial implications. Although the modification of bottle nipple properties is a widely used treatment for dysphagia of prematurity, there have been a paucity of investigations examining the effect of this intervention on refined measures of feeding performance. Methods: Healthy preterm infants were evaluated for measures of milk ingestion and respiratory performance during oral intake on a laser-cut slow-flow and standard-flow nipple. Time to achieve hospital discharge milestones was recorded. Results: Few differences were observed in feeding performance between slow-flow and standard-flow nipples. Characteristics of respiration during oral intake and at rest were correlated with time to hospital discharge. Conclusions: Slow-flow nipples may reduce the need for skilled feeders that are able to adapt feeding method based on infant feeding performance; when broadly applied to all infants by skilled feeders the clinical benefits are in question.


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