Prefeeding Pathways™ Framework

The Prefeeding Pathways framework is the first comprehensive, developmentally grounded model designed to support clinical reasoning in neonatal prefeeding habilitation.This framework introduces a structured, goal-directed approach to treatment planning that helps clinicians create meaningful learning opportunities for medically complex infants as they prepare for oral feeding. 

Clinicians approach prefeeding therapy through three overarching objectives and select evidence-based interventions that align with each infant’s developmental readiness, clinical presentation, and placement within the continuum of prefeeding habilitation.

The Foundation Pathway promotes positive associations with oral sensory and motor experiences, serving as a critical foundational phase in prefeeding treatment planning and laying the groundwork for curiosity and engagement needed for future feeding behaviors.

The Guided Progression Pathway builds occupational competence by breaking oral feeding into smaller, more manageable steps. Clinicians gradually increase the complexity of the simulated feeding experiences by enhancing the challenge of milk exposures or by advancing the method of milk delivery. 

The Performance Pathway targets specific skill deficits—such as strength, rhythmicity, control, and endurance—that impact prefeeding efficiency. Therapists employ targeted strategies to address and remediate these traits, thereby supporting optimal performance. 

Prefeeding Pathways equips neonatal therapists to make informed treatment decisions that enhance developmentally meaningful experiences and broaden the lens through which feeding readiness is assessed. It provides a shared language that strengthens the clinical rationale for the therapeutic role in neonatal care and promotes caregiver involvement by reinforcing their role as valued partners in their infant’s development at every stage.

Prefeeding Pathways: A Clinical Framework for Goal-Directed Prefeeding Habilitation