It’s Not About Tolerating, It’s About Enjoyment

“Tolerated.”

It’s a word that shows up everywhere in our documentation.
“Infant tolerated…”
“Tolerated handling…”
“Tolerated oral stimulation…”

And while it may signal stability, it does not reflect the full picture of learning.

Because tolerating something is not the same as enjoying it.

This distinction is not new. It is exactly what the Prefeeding Pathways™ framework has been built on.

From the beginning, this work has emphasized that early experiences are not just exposures—they are meaning-making events. They shape how an infant interprets sensory input, how they engage with it, and whether they will return to it.

A recent article published in Neonatal Network Enjoyment in Preterm Infants: Exploring Clinical and Research Perspectives in the Neonatal Intensive by Kristy Fuller and Barbara O’Rourke highlights the importance of infant enjoyment in early experiences, bringing well-deserved attention to this concept. It’s encouraging to see this perspective gaining visibility in the literature—because it reflects what many of us have been observing and emphasizing in clinical practice.

If you haven’t read it yet, I highly recommend taking time to read it!

In the Foundation Pathway, we talk about creating positive sensory-motor associations.

But positive does not simply mean the absence of stress. It means the presence of something more:

Engagement.
Regulation.
Curiosity.
Connection.

Enjoyment!

An infant who is tolerating will remain present.
An infant who is enjoying will begin to organize around the experience.

They lean in.
They stay longer.
They engage more readily the next time.

They demonstrate the sustained intentionality that is required for learning!

This is why early prefeeding experiences matter so deeply.

Not because they immediately build feeding skill,
but because they establish the foundation for how feeding will be experienced in the future.

In the early stages of development, infants are not just learning how to feed. They are learning:

Is this safe?
Is this predictable?
Is this something I want to engage in again?

The growing conversation around infant enjoyment is an important one. And it aligns directly with what this framework has always aimed to teach:

That experiences are not neutral.
They are either reinforcing engagement or discouraging it.

So the question for clinicians is not simply:

Did the infant tolerate this?

But rather:

What did this experience teach the infant?

And just as importantly:

Would this infant come back to this experience again?

Because prefeeding is not just preparation for feeding. It is the beginning of the infant’s relationship with feeding.

And that relationship is not built through tolerance.

It is built through experience.

Rachel Selman OTR/L, CNT, NTMTC