Neonatology: feeding a preterm with immature suck-swallow: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: feeding a preterm with immature suck-swallow

Sample item

A stable 31-week preterm baby cannot coordinate sucking, swallowing and breathing. What is the best method of feeding?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Orogastric tube feeds of expressed breast milk

Coordination of suck, swallow and breathing matures at about 32 to 34 weeks. Until then, expressed mother's milk is given by orogastric tube, with non-nutritive sucking and skin-to-skin contact, and oral feeding is started as readiness signs appear.

Option by option

  • A. Direct breastfeeding on demand

    Oral feeding risks aspiration and apnoea when the reflexes are not coordinated.

  • B. Bottle feeding with formula

    Bottle feeding carries the same aspiration risk and gives up the benefit of mother's milk.

  • C. Exclusive parenteral nutrition

    Enteral feeding is preferred in a stable baby, and parenteral nutrition alone risks sepsis and gut atrophy.

  • D. Orogastric tube feeds of expressed breast milk (correct)

    Correct. Tube feeding with the mother's expressed milk is safe and provides nutrition and protection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Orogastric tube feeds of expressed breast milk. Coordination of suck, swallow and breathing matures at about 32 to 34 weeks.

Why is "Direct breastfeeding on demand" not the answer?

Oral feeding risks aspiration and apnoea when the reflexes are not coordinated.

Why is "Bottle feeding with formula" not the answer?

Bottle feeding carries the same aspiration risk and gives up the benefit of mother's milk.

Why is "Exclusive parenteral nutrition" not the answer?

Enteral feeding is preferred in a stable baby, and parenteral nutrition alone risks sepsis and gut atrophy.

What concept does this question test?

It tests Neonatology: feeding a preterm with immature suck-swallow in Pediatrics. Until then, expressed mother's milk is given by orogastric tube, with non-nutritive sucking and skin-to-skin contact, and oral feeding is started as readiness signs appear.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: feeding a preterm with immature suck-swallow?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.