Behind the Framework
As an Occupational Therapist with over 20 years of experience—and more than a decade dedicated to neonatal care—I’ve devoted my work to understanding how early experiences shape feeding, regulation, and connection in our most vulnerable infants.
Over time, it became clear that our field needed more than evidence—it needed direction. Despite the abundance of research, there was no unified voice guiding how to apply prefeeding practices in a developmentally meaningful way. Clinicians were left without the structure to integrate sensory, motor, and affective strategies into a cohesive plan that supports each infant’s readiness journey.
The Prefeeding Pathways™ framework was created to fill that gap. It brings together the science of development with the art of responsive, purposeful care—offering clinicians a roadmap to design intentional treatment plans that build readiness step by step across the full continuum of care.
I teamed up with Aleksandra Popkowska-Gutierrez, MS, CCC-SLP, CNT, IBCLC, and Kristin M Laurino, PT, DPT, CPST, CNT, NTMTC, when creating the Prefeeding Pathway™ to ensure a well-rounded clinical perspective and highlight the benefits of multidisciplinary collaboration.
At its heart, Prefeeding Pathways™ is about creating purposeful experiences that nurture readiness—empowering therapists, nurses, and families to help every infant move toward safe, confident, and joyful feeding.
“I have followed Rachel Selman’s evolving work on prefeeding habilitation since 2020 when she trained in PIOMI. Her study of using safe scaffolding of the sensorimotor development of feeding in preterm infants is innovative and empirically driven. Selman was the first to integrate milk drops for smell and taste awareness as a gentle "waking" approach to starting the PIOMI sequence on the road to feeding, and this is now an important part of the PIOMI protocol that I include in all of my training.”
Dr. Brenda Knoll, PhD, RN, FAAN
Founder of Premature Infant Oral Motor Intervention (PIOMI)
- Rachel Selman, M.S. OTR/L, CNT, NTMTC
DISCLAIMER
By accessing and using this website, you agree to indemnify and hold harmless Prefeeding Pathways and its creator(s) from any claims, damages, losses, or liabilities arising from your use of this site or reliance on its content.
Prefeeding Pathways reserves the right to modify, update, or remove content on this website at any time without prior notice.
The information provided on this website is intended for educational and informational purposes only and is designed primarily for healthcare professionals working in neonatal and infant care settings. It is not intended to serve as medical advice, clinical directives, or a substitute for individualized patient assessment and clinical judgment.
The Prefeeding Pathways framework is a clinical model designed to support decision-making, not to replace established medical protocols, institutional policies, or interdisciplinary collaboration. Application of this framework should always be guided by the clinician’s professional judgment, the infant’s medical status, and the policies of the treating institution.
Any techniques, examples, case discussions, or third-party content shared on this site have not been independently validated in all clinical contexts. Prefeeding Pathways does not guarantee specific outcomes and does not assume responsibility for the results of any interventions or clinical decisions made based on the information presented.
While every effort has been made to ensure the accuracy, clarity, and timeliness of the information provided, errors or omissions may occur. Prefeeding Pathways disclaims any liability for such inaccuracies or for any actions taken based on this content.
This website and its content are governed by the laws of the State of New York.
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