The studies reported on in this thesis addressed the development of suckingpatterns in preterm newborns. Preterm infants often have problems learningto suckle at the breast or to drink from a bottle. It is unclear whether this isdue to their preterm birth or whether it is the consequence of neurologicaldamage. From the literature, as well as from daily practice, we know thatthere is much variation in the time and in the way children start suckingnormally. Factors such as birth weight and gestational age may indeed berisk factors but they do not explain the differences in development. A smallspot-check proved that most hospitals in the Netherlands start infants onoral feeding by 34 weeks’ post-menstrual age (pma). By and large the policyis aimed at getting the infant to rely on oral feeding entirely as soon aspossible. The underlying rationale is to reduce the stay in hospital, and theidea that prolonged tube-feeding delays or even hampers the development ofsucking.
This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
A key element in social development is interaction with others, and preterm infants have an increased risk for problems in this aspect. We aimed to gain additional insight into parents’ perception about their preterm child’s social interaction upon reaching school age. Parents informed us about their child being a little fighter, having issues of coping with their disabilities in social contexts, and how their child withdraws from situations that are overlystimulating. They also expressed their concerns about the future, how they encourage their child, and how they experience the transition to primary school. Parents’ experiences concerning the social interaction of their preterm child can be categorized into eight themes of processes in social interaction: child factors, self-regulation, real-time social interaction, long-term social interaction, parental factors, parenting, social environment, and social experiences. Our proposed model of social interaction in preterm infants visualizes theinterrelatedness between these themes in social interaction
